A video game under development as a medical device boosts attention in some children with sensory processing dysfunction, or SPD, a condition that can make the sound of a vacuum, or contact with a clothing tag intolerable for young sufferers.
In a study published April 5, 2017, in PLOS ONE, researchers at UC San Francisco measured the impact of a “digital intervention” on attention among 38 children with the disorder and compared them with 25 typically developing counterparts, matched by age and gender.
The researchers found that 20 of the children with sensory processing dysfunction also met criteria for attention deficit hyperactivity disorder (ADHD), using parent reports. These children exhibited reduced midline frontal theta activity, a neural measure of attention revealed through the examination of brain wave patterns.
After playing the video game for four weeks, this group of children showed improvements in attention. Seven of the 20 (one third) showed such marked improvements that they no longer met research criteria for ADHD. Significantly, parent-reported improvements were noted nine months after the intervention.
After four weeks of playing a video game, seven of the 20 children with sensory processing dysfunction who also met criteria for attention deficit hyperactivity disorder showed a marked improvement in attention. [Photo courtesy Akili Interactive Labs]
‘First step in personalizing care’
“To varying degrees, all children with sensory processing dysfunction struggle to properly modulate sensory information,” said senior author Elysa Marco, MD, director of the UCSF Sensory Neurodevelopment and Autism Program, and associate professor in the UCSF departments of neurology, psychiatry and pediatrics.
“A subset of children with sensory processing dysfunction show challenges involving cognitive control, which includes sustained attention, selective attention and goal management. These challenges act as an additional impediment in their daily lives and suggest an important avenue for treatment,” she said. “This is our first step in personalizing care for these children and we’re excited to be approaching it with cognitive training.”
Sensory processing dysfunction affects 5 percent of all children, according to the American Occupational Therapy Association, and is considerably more prevalent among those with autism and ADHD. The condition can cause extreme sensitivity to some stimuli, such as loud noise or bright lighting, and poor sensitivity to others, leading to inappropriate behavior like “crashing into walls” or overly aggressive hugging. Occupational therapy is sometimes recommended to help children regulate sensory input and make them more comfortable and focused.
Game design engages young players
The study participants, whose ages ranged from 8 to 11, were instructed to play the video game that uses a digital platform called Project: EVO™. The platform is designed to feel like a consumer product with a high-level interface and engaging visual and auditory feedback. The core technology is based on patent-pending neuroscience designed to strengthen the brain’s ability to process and prioritize thoughts and external stimuli. It was originally discovered in the lab of Adam Gazzaley, MD, PhD, of UCSF.
The platform uses proprietary algorithms to automatically assess a child’s ability level, adjusting the difficulty of the tasks as they become more proficient. Users navigate a character through winding paths, avoiding walls and obstacles, while responding selectively to colored targets.
The researchers found that after playing the video game for 25 minutes, five days a week for four weeks, children with sensory processing dysfunction and inattention showed improvements in attention, according to both parent reports and an increase in midline frontal theta activity. While previous research has shown how the brain of children with sensory processing dysfunction is structurally different from their typically developing counterparts, the new study shows that some children have measurable functional differences that can be improved with this intervention.
“These findings are also important to consider from the perspective that one size doesn’t fit all, as there were selective benefits of this intervention for some of these children compared to their counterparts without attentional deficiencies,” said lead author Joaquin A. Anguera, PhD, director of the clinical program in the Neuroscape center and assistant professor in the UCSF departments of neurology and psychiatry.
“Moreover, this study highlights the importance of conducting individual assessments from multiple perspectives – parental reports, attention testing and neuroimaging – to have a robust understanding of why this approach was beneficial in the first place.”
Alternative to medication
Marco said that the intervention may prove to be an appealing alternative to medication for the subset of children with sensory processing dysfunction and inattention.
“We believe that all children with sensory processing dysfunction should be assessed for attention challenges. We expect that about 40 percent will have deficits in this important neurodevelopment domain and could benefit from cognitive training,” she said.
If the technology is approved as a medical device by the Food and Drug Administration, it may be available through a child’s medical provider and eventually covered by health insurance companies, said Anguera.
The technology is also being studied in an ongoing large-scale clinical trial for children with ADHD. It follows the results of a study last year that found it could be used effectively to identify children with attention disorders, as well as a more recent study using the same platform to treat older adults with depression.
The technology was developed by Akili Interactive Labs in Boston and San Francisco. Authors of the current study report that they have no financial interests in Akili.
The study’s co-authors are Anne Brandes-Aitken, Ashley Antovich, Camarin Rolle and Shivani Desai, all of the UCSF Department of Neurology.
The UCSF Department of Psychiatry and the Langley Porter Psychiatric Institute are among the nation's foremost resources in the fields of child, adolescent, adult, and geriatric mental health. Together they constitute one of the largest departments in the UCSF School of Medicine and the UCSF Weill Institute for Neurosciences, with a mission focused on research (basic, translational, clinical), teaching, patient care and public service.
UCSF Psychiatry conducts its clinical, educational and research efforts at a variety of locations in Northern California, including UCSF campuses at Parnassus Heights, Mission Bay and Laurel Heights, UCSF Medical Center, UCSF Benioff Children's Hospitals, Zuckerberg San Francisco General Hospital and Trauma Center, the San Francisco VA Health Care System and UCSF Fresno.
About the UCSF Weill Institute for Neurosciences
The UCSF Weill Institute for Neurosciences, established by the extraordinary generosity of Joan and Sanford I. "Sandy" Weill, brings together world-class researchers with top-ranked physicians to solve some of the most complex challenges in the human brain.
The UCSF Weill Institute leverages UCSF’s unrivaled bench-to-bedside excellence in the neurosciences. It unites three UCSF departments—Neurology, Psychiatry, and Neurological Surgery—that are highly esteemed for both patient care and research, as well as the Neuroscience Graduate Program, a cross-disciplinary alliance of nearly 100 UCSF faculty members from 15 basic-science departments, as well as the UCSF Institute for Neurodegenerative Diseases, a multidisciplinary research center focused on finding effective treatments for Alzheimer’s disease, frontotemporal dementia, Parkinson’s disease, and other neurodegenerative disorders.
About UCSF
UC San Francisco (UCSF) is a leading university dedicated to promoting health worldwide through advanced biomedical research, graduate-level education in the life sciences and health professions, and excellence in patient care. It includes top-ranked graduate schools of dentistry, medicine, nursing and pharmacy; a graduate division with nationally renowned programs in basic, biomedical, translational and population sciences; and a preeminent biomedical research enterprise. It also includes UCSF Health, which comprises top-ranked hospitals – UCSF Medical Center and UCSF Benioff Children’s Hospitals in San Francisco and Oakland – and other partner and affiliated hospitals and healthcare providers throughout the Bay Area.
