The First Video Game Treatment for ADHD Approved by the FDA

By Dr. Mary Rooney, Ph.D.

The U.S. Food and Drug Administration (FDA), which evaluates the safety and effectiveness of medications and other treatments, recently approved EndeavorRxTM as the first video game prescription treatment for ADHD. Yes, you read that correctly. A video game has been approved as a treatment for ADHD!

EndeavorRxTM is designed to improve attention in children between the ages of 8-12 years old with primarily inattentive or combined-type ADHD, who have a demonstrated attention issue. It functions like most video games, requiring kids to move their character through different worlds and unlock new objects and challenges. The developers incorporated specialized algorithms into the video game design to increase or decrease difficulty depending on the child’s performance, with the goal of keeping children with ADHD challenged but not overloaded. The game also attempts to stimulate specific areas of the brain related to attentional control.

The FDA’s decision to approve EndeavorRxTM as an ADHD treatment was based on five studies involving more than 600 children. In the largest trial, 348 children with ADHD between the ages of 8-12 were randomly assigned to either play EndeavorRxTM or an unrelated word puzzle video game (the control condition) for 25 minutes per day, five days per week, for four weeks. At the end of the treatment period, researchers measured the children’s attention through rating scales (completed by the children and their parents) and computer-based measures, including the Test of Variables of Attention (T.O.V.A.).

Results showed that children in both the EndeavorRxTM group and the control group improved on measures of attention, but the children in the EndeavorRxTM group showed about 15% greater improvement on their T.O.V.A sustained attention scores than the control group. The EndeavorRxTM group also had more parents, about 12% more, who rated their children as focusing better at the end of treatment than parents in the control group. However, EndeavorRxTM did not outperform the control condition on behavioral outcomes, including ADHD symptoms related to hyperactivity and impulsivity.

The findings from these studies are definitely promising, but there are reasons to be cautious about the level of improvement you may see in your child. First, all of the studies to date have been funded by the treatment (video game) developers. This isn’t unusual for treatments newly approved by the FDA – in fact, it’s the norm for medications that receive FDA approval. However, additional independent studies would help increase confidence in the intervention’s effects. In addition, it’s unclear whether EndeavorRxTM primarily improves focus during video game- or computer-based activities, or if these improvements translate into real-world situations, like better focus at school or during homework time.

The intervention developers emphasize that “EndeavorRxTM should be considered for use as part of a therapeutic program that may include clinician-directed therapy, medication, and/or educational programs, which further address symptoms of the disorder.” In other words, EndeavorRxTM is not intended to be a stand-alone treatment for ADHD and should only be used in conjunction with other treatments. The good news is that this landmark approval by the FDA will likely accelerate interest in the development of computer-based treatments for ADHD, and we may see more exciting treatment options in the future.



Mary Rooney, Ph.D., is a licensed clinical psychologist in the Department of Psychiatry at the University of California San Francisco. Dr Rooney is a researcher and clinician specializing in the evaluation and treatment of ADHD and co-occurring behavioral, anxiety, and mood disorders. A strong advocate for those with attention and behavior problems, Dr. Rooney is committed to developing and providing comprehensive, cutting edge treatments tailored to meet the unique needs of each child and adolescent. Dr. Rooney's clinical interventions and research avenues emphasize working closely with parents and teachers to create supportive, structured home and school environments that enable children and adolescents to reach their full potential. In addition, Dr. Rooney serves as a consultant and ADHD expert to Huntington Learning Centers.


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