# Efficacy and Compliance of a Working Memory Multitasking Task Mobile Intervention for Children With Attention-Deficit/Hyperactivity Disorder: Single-Arm, Pre-Post Pilot Study

## TL;DR

A mobile game-based treatment improved attention and hyperactivity in children with ADHD, regardless of whether they were on medication.

## Contribution

A gamified working memory task delivered via mobile improved ADHD symptoms and was well accepted by children and caregivers.

## Key findings

- Significant reductions in ADHD symptoms and improved neurocognitive performance after 4 weeks of use.
- High satisfaction ratings from both children and caregivers.
- Treatment effects were consistent regardless of medication status.

## Abstract

Attention-deficit/hyperactivity disorder (ADHD) is a prevalent neurodevelopmental disorder affecting 3%-7% of children globally. Alternative treatments are needed to address the limitations of traditional pharmacotherapy and nonpharmacotherapy, such as drug side effects and substantial time and financial costs. In this light, digital therapeutics for childhood ADHD are emerging as an effective alternative, with the benefits of potentially being free from serious side effects associated with software-based treatments and facilitating easy home use without constraints on time or space.

This study aims to evaluate whether a 4-week digital treatment program can improve symptoms, problem behaviors, and neurocognitive functions in children with ADHD, independent of medication status, while also gauging participant satisfaction with the program.

We recruited 22 Korean children aged 6-12 years with a diagnosis of ADHD. During the preintervention visit, we collected data on ADHD symptoms, relevant behavior scales, and neurocognitive assessments. Participants then used the program 5 times per day, 5 days a week for 4 weeks at home. At the postintervention visit, we collected the same data as during the preintervention visit and gathered additional feedback on their experience over the 4 weeks.

A total of 19 participants were included in the statistical analysis, showing significant decreases in scores across various categories. These included the Korean ADHD Rating Scale (Total: P=.004; Inattentive: P=.004; and Hyperactive-impulsive: P=.01) and Korean Conners’ Parent Rating Scale (Total: P<.001; Impulsive-hyperactive: P=.001; and Conduct Problem I: P=.04). Significant improvements were also noted in the Stroop word (P=.004), color (P<.001), and color-word (P<.001) scores. No significant differences in treatment effects were found between medicated and unmedicated participants. Caregiver and child satisfaction surveys yielded mean ratings of 4.3 and 4.1 out of 5, respectively.

A 4-week gamified intervention improves attention and hyperactivity-impulsivity in children with ADHD, irrespective of medication status, demonstrating its potential effectiveness and acceptability as a treatment option. As this is a small pilot study and underpowered, larger studies with appropriate control groups are needed in future research.