What are the risks associated with video game use in pediatric patients with Attention Deficit Hyperactivity Disorder (ADHD)?

From the Guidelines

Children with ADHD should limit their video game use to less than 2 hours per day, as excessive gaming can worsen attention problems, disrupt sleep patterns, and increase the risk of developing problematic gaming habits or gaming disorder. The American Academy of Pediatrics recommends that individuals limit “screen time” spent watching television and/or using computers and handheld devices to less than 2 hours per day unless the use is related to work or homework 1. Excessive gaming can displace other important activities like physical exercise, social interaction, and academic work, which are crucial for the overall development and well-being of children with ADHD.

Risks Associated with Video Game Use in Children with ADHD

• Excessive gaming can worsen attention problems, as the high stimulation and rapid rewards of video games may make it harder for children with ADHD to focus on less stimulating but important tasks like schoolwork.
• Gaming can disrupt sleep patterns through both screen time exposure and heightened arousal before bedtime, potentially exacerbating ADHD symptoms the following day.
• There's also a risk of developing problematic gaming habits or gaming disorder, as children with ADHD may be more vulnerable to the dopamine-triggering reward systems in games.
• Some games with violent content might increase aggressive behaviors in susceptible children.

Recommendations for Parents and Healthcare Providers

• Implement clear time limits (typically no more than 1-2 hours daily) for video game use.
• Ensure gaming doesn't interfere with sleep (stopping at least one hour before bedtime).
• Choose age-appropriate content and monitor for signs of problematic use such as irritability when unable to play.
• Work with healthcare providers to adjust medication timing, which can sometimes help manage gaming-related behaviors in children with ADHD 1.

Importance of a Comprehensive Approach

A comprehensive approach to managing ADHD in children should include a combination of behavioral therapy, medication, and lifestyle changes, including limiting screen time and encouraging physical activity 1. By working together, parents, healthcare providers, and children with ADHD can develop a plan to minimize the risks associated with video game use and promote overall health and well-being.

From the FDA Drug Label

The FDA drug label does not answer the question.

From the Research

Risks of Video Game Use in Pediatrics with ADHD

• Video game playing is a popular leisure activity among children, including those with Attention-Deficit/Hyperactivity Disorder (ADHD) 2, 3.
• Children with ADHD are at a higher risk for compulsive video game use and game addiction compared to healthy controls 2.
• Studies have shown that children with ADHD exhibit more addictive behaviors with respect to video games, including prolonged periods of use 3.
• There is a correlation between the severity of ADHD symptoms and excessive use of video games, with children having severe ADHD showing significantly higher addiction scores 3.
• The pattern of leisure activities, including video game use, should be assessed during health supervision visits to identify those at risk for game addiction and provide appropriate intervention 2.

Comparison of Video Game Use in ADHD and Non-ADHD Children

• Video game use is prevalent in both ADHD and non-ADHD children, but those with ADHD have a higher rate of problematic video game use 2, 3.
• ADHD children exhibit more addictive behaviors with respect to video games, including higher addiction scores and prolonged periods of use 3.
• The use of video games by ADHD children is associated with a higher risk of game addiction, highlighting the need for early identification and intervention 2, 3.

Treatment and Management of ADHD

• While the provided studies do not directly address the treatment of video game addiction in ADHD children, they do discuss the efficacy of methylphenidate and atomoxetine in improving social adjustment and reducing emotional and behavioral problems in youths with ADHD 4, 5.
• These studies suggest that both methylphenidate and atomoxetine are effective in improving social adjustment, including school functions and peer relationships, in youths with ADHD 4.
• However, the management of video game addiction in ADHD children requires a comprehensive approach that includes assessment, intervention, and ongoing monitoring 2, 3.