When it comes to entertainment for kids, there are few boxes that video games do not check. Real-life simulation, competitive play with friends, colorful graphics, constant feedback and rewards, and easy accessibility—a good video game has it all to keep kids (especially those with ADHD or Attention Deficit Hyperactivity Disorder) coming back for more, and more, and …you get the idea.
Many parents admit that video games are lifesavers in a pinch, providing sustained distraction during dinners out, long car and plane rides, and when adults need a “time out” themselves.
Sounds like a win-win for both parents and kids. But what’s the catch?
A 2021 article published in Frontiers in Pediatrics reported that 91 percent of children aged two through 17 engage at some level with video gaming. Once only available through a console or computer, video games are now more accessible and mobile than ever through tablets and smart phones. Kids are also exposed to them at increasingly earlier ages; 30% of children have used a tablet before the age of two and often for playing video games.
Yes, there are some benefits to video gaming!
Research shows the benefits of video games can go beyond recreation and cheap entertainment.
- Many schools increasingly utilize video games in the classroom to practice math facts, spelling, foreign languages, etc. in a more engaging way.
- For the first time, The U.S Food and Drug Organization approved a video game in 2017, EndeavorRX, as an effective non-drug alternative to treat ADHD symptoms.
- During the COVID-19 pandemic, video games provided essential social interaction for kids and teens when in-person events were put on hold.
- Pre and post pandemic, kids who struggle to make friends or lack interest or skill in team sports are more likely to seek out video gaming as an emotionally safe environment, no audience to witness their mistakes and socializing can be done under the mask of a username.
But video gaming is not all fun and games.
Recent research reveals a darker side of video games, especially for youth diagnosed with ADHD which is characterized by symptoms impacting several areas of executive functioning including organizational skills, impulse control, managing emotions, memory, and focus.
According to the CDC, between 2020-2022, just over 11 percent of U.S. children ages five through 17 had been diagnosed with ADHD, making it one of the top mental health conditions diagnosed in children. While ADHD symptoms make video gaming almost irresistible, play itself exacerbates them. Playing video games continually reinforces the need for instant gratification and therefore can quickly lead to excess time screen time and cross the line into addiction for some.
A 2018 study found that ADHD is a risk factor for addiction in general, and it is the most frequent psychopathology in video game addiction. In 2018, the World Health Organization (WHO) introduced the diagnosis of gaming disorder (GD) to the International Classification of Disease-11 (ICD-11) , consisting of three symptoms: “impaired control over gaming, increasing priority given to gaming and continuation or escalation of gaming despite the occurrence of negative consequences” such as impairment to an individual’s social, family or professional life over an extended period of time.
Parents are befuddled how their child who with ADHD struggles to stay engaged in imaginative play or a board game for five minutes, yet easily can spend hours on end in front of a video game often in a trance-like state, forgoing bathroom and meal breaks. The spell breaks and the fall-out happens as soon as the console or tablet is turned off.
Dr. Clifford Sussman, MD, a psychiatrist specializing in video game addiction, shared that a process called “downregulation”, which begins after gaming, causes a drop in the number of dopamine receptors in the reward processing area of the brain that becomes more severe the more time one spends gaming. This is not unlike what the brain experiences during withdraw from addictive substances. Turn off the game; cue the meltdown.
Finding the right balance.
Luckily, it is possible for most families to allow their kids video game time without going overboard, only if structured tools and expectations are in place.
Get a lay of the land and set limits
According to the Academy of Pediatrics, children six years and over are recommended to spend no more than 1 hour on video games per school day and no more than two hours on a non-school day. 30 minutes of video game time is the max amount recommended for children under six-years old.
With this information in mind, parents should determine a time limit along with a time-of-day video games will be accessible, and stick with it!
- Will homework or chores need to be completed first?
- Will video games only be allowed on weekends?
- Will video games be a privilege that can be both earned and lost?
Video game types (gaming system vs. online) and ratings/content allowed should be determined as well by parents. Caregivers should not assume that just because a game looks like it is marketed towards kids, does not mean it is age appropriate. Playing the game yourself will allow you to make the best decision about appropriateness. Consider locking up remotes when not in use to remove any temptation to access without supervision.
Set the tone
In many areas of life, we prep kids for a new challenge by talking about what to expect, what issues they may run into, and how to work through them as well as remind them we are there to help. While parents may not be as video game savvy as their child, they can engage in conversations with them about the feelings they experience when playing video games and when it is time to turn them off.
A conversation could go something like, “Honey, I know how much you love playing video games, and you are so good at them! And I also know when it is time to stop and eat dinner you feel upset and want to yell or use your body in an unsafe way. Let’s find a way we can help you know what to do when this happens, and remember–you will be able to play again tomorrow.”
We want to communicate to kids that we are on their team, we want them to enjoy doing what they like! But as the adults, our kids look to us to help set limits when they are not able to.
Visual countdown
Once a time limit is set, let your child know exactly how many minutes they will have before each session. Also providing a visual reminder for kids, like a kitchen timer, let’s them know exactly how much time they have left, taking away the surprise element that can set off tears. Parents (or smart speakers) can also provide an auditory reminder when 10, five, and one minutes are left.
Positive reinforcement
If your child continues to struggle even after clear limits and expectations are set, incentivizing expected behavior around video games can increase compliance. Involve your child in identifying small rewards they may want to work towards (the best rewards are non-materialistic and can include special time/activity with parents, a special privilege, etc.). You may even find it effective to offer kids a couple extra minutes of game time the next time they play if they are able to switch off video games when expected without a fuss.
Even if kids won’t hand over the remote when an incentive is presented, parents should avoid chasing them down and wrestling the remote from their hands, cutting the internet, or unplugging the game system. This will only escalate anger. Instead of doubling down on negative attention, calmly telling your child that each minute they continue to play past the time limit will be subtracted from the next time they play. When they do earn their privilege back ask if they are willing to try again to follow the rules.
What happens after “game over”?
After you have successfully powered down the video games, make sure you have an activity on hand to transition your child to. You may consider making a list of screen-free activities that they can pick from depending on the time of day. Talk to your child and help them identify their strengths and the activities they enjoy. If team sports are too intimidating, consider individualized sports such as martial arts or swimming. Noncompetitive activities such as art clubs or class, robotics, drama or outdoor exploration also offer a social outlet.
Modeling
While not all parents are engaged in their own video gaming, they can spend hours on their scrolling their social media, answering emails, online shopping, etc. This is screen time, too! If parents are setting the expectation for their kids that screens should be used in moderation, their own technology habits should reflect that.
A great way to create accountability for all family members is implementing a “tech-free time” in the home—a chance for everyone to engage in an intentional activity that promotes connection. This could be a board game, project or just a time to discuss the day and check in with one another.
Through content monitoring, clear expectations and moderation, families can harness the benefits of video games while mitigating the potential risks for children, ultimately promoting a healthy gaming experience.
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