The First FDA (De Novo) Approved

ADHD Video Game

EndeavorRx

Akili Interactive is a company that specializes in digital medicine. Founded in 2011 in Boston, Massachusetts, Akili is best known for its game — EndeavorRx.

EndeavorRx is the first video game to receive an FDA De Novo approval. Also known as Project: Evo and AKL-T01 in the beginning stages, the software is aimed at children diagnosed with ADHD.

While the concept of a medical treatment distributed digitally may seem novel, it is not. Aside from the negative connotations assigned by various media outlets, video games have therapeutic effects. And Akili’s efforts with the EndeavorRx video game prove it.

So what is this software about, and how is it effective in the treatment of ADHD symptoms? Let us find out!

Can Video Games Help in ADHD Treatment?

To give you a better understanding of how EndeavorRx works, we are going to focus on ADHD for a moment.

Attention deficit hyperactivity disorder is a neurodevelopmental disorder caused by a deficiency in neurotransmitters. With ADHD in particular, the neurotransmitter in question is norepinephrine.

Norepinephrine works hand-in-hand with dopamine. Similarly, dopamine affects the brain’s reward and pleasure centers. With that said, a person diagnosed with ADHD is unable to receive enough stimuli in parts of the brain that are responsible for activating these centers.

Ultimately, the lack of norepinephrine results in the impairment of four functional regions of the brain. For this reason, patients diagnosed with ADHD display varying degrees of inattention, hyperactivity, and impulsivity.

Be that as it may, you are probably wondering how this is connected to video games. In video game design, the main focus is on creating an engaging and rewarding user experience. That is to say, video game psychology is the key to providing the audiences with a gameplay that will elicit dopamine effects.

To that end, a well-structured and intuitive game design can successfully address the symptoms of certain mental conditions — ADHD included.

How EndeavorRx Works

In essence, EndeavorRx is a prescription-based ADHD treatment. Before gaining access to the software, parents need to consult with the child’s healthcare professional. Afterward, they can send the prescription to Akili’s pharmacy partner, Phil. This will allow their child to begin the three-month therapeutic video game treatment.

Since no rules of thumb apply to the treatment of ADHD symptoms, an individual approach is prevalent. However, EndeavorRx takes this a step further by offering a different take on progressive medicine. Moreover, the software does what video games do best — stimulate multiple sensory receptors at the same time.

Although this may sound cut and dried in theory, let us see how EndeavorRx works in practice.

1.   Engagement

EndeavorRx engages children by promoting autonomy and personalization. That is to say, they can select a preferred avatar before starting the game.

When it comes to cognitive reactions and agreeability levels, freedom of choice plays an important role. Even though the software is a treatment for ADHD symptoms, the children are more likely to engage with the video game due to the heightened sense of being in control.

2.   Progression

EndeavorRx successfully tackles progression. Children can unlock different worlds and reap the fruits of their efforts gradually.

In video games, the sense of progression is intricately tied to the rewards system. It triggers dopamine effects and stimulates the brain centers that process it. For this reason, EndeavorRx presents an effective treatment for inattentive or combined-type ADHD.

3.   Guidance

Since the software is aimed at audiences aged 8 to 12, EndeavorRx’s in-game AI (artificial intelligence) guidance works wonders.

As the children navigate the course with their avatar while responding to on-screen prompts, the game adapts to their playstyle. In other words, the software tracks their movements and uses this information to tailor itself to their behavior. Altogether, it optimizes the challenging aspects while proactively helping the children overcome obstacles throughout the course.

4.   Competence

Endeavor Rx’s meaningful interactions motivate the children to explore what comes next. To that end, the software features a list of short-term and long-term goals.

By and large, these two types of goals promote competence. They allow the children to strategize, use different game elements, and discover new methods that help them advance. Furthermore, competence strengthens their focus and prevents it from decreasing.

5.   Consistency

Akili encourages consistency with EndeavorRx. Gameplay elements aside, the software treats ADHD symptoms because of the way it is administered.

The children are advised to play the game five times a week for twenty-five to thirty minutes. The initial treatment extends over four weeks. For this reason, a consistent prescription plan makes EndeavorRx succeed where other ADHD treatments fall short.

What Does the Research Say?

Endeavor Rx’s study results are impressive. In a clinically controlled and randomized trial, the software has shown a 73% increase in the children’s overall attention span. Similarly, 68% of parents reported a visible improvement in their child’s ADHD symptoms after a two-month treatment.

On the other hand, approximately 9.3% of participants experienced adverse effects. These included frustration, headache, dizziness, emotional reaction, nausea, and aggression. In the long run, only 3 out of 538 participants had to discontinue the prescribed treatment.

Dawn of Digital Medicine — Plausible or Not?

All things considered, technology has come a long way. What was once viewed as impossible or improbable has now become our daily routine. As we move toward complete digitalization, unique treatments such as EndeavorRx no longer verge on science fiction. However, they beg the question — what is next?

For Akili, EndeavorRx’s success is a stepping stone. In fact, the company’s goals are to revolutionize and reinvent medicine. After all, Akili has been researching mental conditions beyond ADHD for a while.

To that end, the company conducted a study in 2019 on patients suffering from major depressive disorder. The research has shown that Akili’s video game treatments contributed to the reduction of participants’ cognitive impairments. Moreover, the company’s next step is to test the EndeavorRx’s beneficial effects on cognitive impairments in COVID-19 survivors.

All in all, the dawn of digital medicine is upon us. In a way, it will challenge our belief system and understanding of different mental conditions. That being the case, the best way to move forward is to keep an open mind. In the long run, humanity can only benefit from digital prescriptions such as EndeavorRx.