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Many kids and teens love to play videos games. But families often worry about the effects of gaming. How long should kids play for? Which games should they play? And are there benefits or risks to playing video games for kids who learn differently? 

In this episode, hosts Amanda Morin and Gretchen Vierstra get answers from digital play expert and child psychologist Dr. Randy Kulman. Listen in to hear Randy’s tips on how families can help kids maximize learning from popular video games — and transfer that learning to the real world. Plus, hear Randy’s thoughts on EndeavorRX, a prescription video game for kids with ADHD.

Related resources

And check out Randy’s book: The Gaming Overload Workbook: A Teen's Guide to Balancing Screen Time, Video Games, and Real Life

Episode transcript

 

Amanda: Hi, I'm Amanda Morin. I'm the director of thought leadership for Understood.org. And I'm also a parent of kids who learn differently. 

Gretchen: I'm Gretchen Vierstra, a former classroom teacher and an editor here at Understood. And this is "In It."

Amanda: "In It" is a podcast from the Understood Podcast Network. On the show, we talk to parents, caregivers, teachers, experts, and sometimes even kids. We offer perspective, stories, and advice for, from, and by people who have challenges with reading, math, focus, and other types of learning differences. 

Gretchen: Today we're talking about gaming — as in video gaming — and whether or not it can help our kids with some of those learning differences Amanda just mentioned.

Amanda: And we're going to get into some exciting developments in the world of digital games that are specifically designed to help with ADHD.

Gretchen: Joining us to talk about this is Dr. Randy Kulman. Randy is a child psychologist who's worked with children, teens, and families for over 30 years and is an expert on the use of digital technologies for improving thinking skills in kids.

Amanda: Randy is also a writer. He's a speaker, and he's the founder and president of LearningWorks for Kids, which offers training, video game reviews, and learning resources to make digital games good for kids. 

Gretchen: He's based in Rhode Island — yay, my home state! And we're delighted to have him on the podcast today. Randy, welcome to "In It."

Randy: Thank you for having me. I'm really excited about being here. 

Gretchen: So before we get into the good, the bad, and the ugly when it comes to gaming, I wonder if you could tell us a bit about your work. Who comes to see you in your practice and how does that tie into your work on digital tech and video games?

Randy: So if I can, let me even give you a bit of history from before I started working with kids directly. I was an undergraduate at the University of Rochester.

Amanda: My alma mater.

Randy: Oh, I didn't know that. Well, I also had a chance to spend time with Dr. David Elkind, who is one of the leading developmental psychologists in the world. He was an incredible mentor. And his expertise is in children's play. And I've always been super interested in children's play. And back in the 1990s when I started my clinical practice, kids would come into my office, all these kids with ADHD and learning disabilities and to some degree spectrum disorders, but particularly the first two. And the parents would be talking about all the troubles that the kids have, all the difficulties they would have.

And then, I started to notice, and then — back in the '90s is when some of the original console games were out. The Nintendo, the Atari was around, and the kids loved those games and technology. And I began hearing, even at that point: "My kid couldn't have ADHD. You should see how much they play with a video game. They can focus and concentrate on that fpr hours. In fact, I can't get them off of it." 

It really got me thinking about how can we use that — gaming — because one of the things I learned from Dr. Elkind was "Play is learning." This is how kids learn. How could we use that to help these kids? 

Fast-forwarding, I worked in my clinical practice. We started doing some stuff in the practice. We began using a game called RollerCoaster Tycoon in the early 2000s as a game to teach kids problem-solving. Basically we're doing group therapy, playing RollerCoaster Tycoon. I'm not sure how successful we were. I do remember one thing, that l=kids love to build roller coasters that would end in the middle of the year and people would die falling from the roller coaster. And they were good at it.

And by the way, that uses a lot of planning. You have to use some planning skills. You have to be a little bit flexible in terms of how you design it. You have to do a bunch of things. So they were using the skills. And that's sort of where we got going. At some point, shortly thereafter, we developed our LearningWorksforKids.com website that was designed to essentially help parents understand how gaming might help their kids — to find games that practice some of these executive functioning skills and what they could do about it. 

Gretchen: I'm wondering, before we move on from your history, Randy, do you play games?

Randy: So, whenever I'm giving talks, one of the first things I say is: Here's my disclaimer. I am not a gamer. I'm really interested in children's play. And that's really kind of my focus is. And what I'm really interested in is how do we make children's play into real learning? Because if you think about this, many of these kids that we see with learning disabilities and ADHD who play a lot of video games — and perhaps they're almost drawn to those games because it's something that they're good at. It's something that makes them feel good when they're paying attention. It feels good to pay attention, to be really focused, to be in the flow. 

But if gaming was so good for those kids, why are they coming to my office? Why aren't they learning all these skills? Why is that not happening from playing those games? And I think that that's kind of an important question to take a look at and to determine: can we leverage or use those games to help these kids.

Amanda: There's been sort of a lot of buzz in the, well, in the circles that we inhabit, right? About this game called EndeavorRX. And it's that FDA-approved treatment for ADHD. Can you tell us about EndeavorRX, what you know about it, and who's supposed to use it, who can prescribe it and how it works?

Randy: So, Endeavor is really designed to improve focusing skills and control of focus. And it's essentially a game that uses sensory and motor feedback to help the kids improve their attention — that challenges them to use those skills. I would say that we're still in the infancy with Endeavor. Another game that I think is really good is called Mightier. Now, if I could say one thing that I think is super important about this stuff, is Endeavor and Mightier, and there are other ones out there as well, but those two games in particular start off from the premise of "Let's make this fun." Because if you don't make it fun, the kids aren't going to do what they need to do. I mean, you learn because you pay attention and you focus. If you don't pay attention, you can't learn. You can't remember. 

And both of these companies started off with game developers and they said, how do we make fun, engaging games? Because that's what they're competing against to keep kids' attention. You got to make this fun because otherwise it's not gonna matter.

Gretchen: Right. Kids will feel like it's meant to teach something rather than "I'm going to play" — and learn at the same time — if it's not fun. 

Randy: Yeah. Well, I think that's part of it. Although maybe I have a little bit more faith in kids in the sense of, we can say to them, this is fun and you're going to learn, OK? What we're trying to do at LearningWorks for Kids is we try to make games digitally nutritious. You can make healthy things into something good. And I think you can tell kids that. In fact, I actually believe that that's probably one of the things that we don't do well enough is that part of helping kids to improve these skills — is to work on the metacognitive component. To think about what they're doing in a game, then think about how that might help them in the real world, too. 

That's kind of the premise of what I do with all of our LearningWorks materials. We basically use one simple ditty. We say you need to be able to detect, reflect, connect. So you have to identify a skill, think about that skill, and then connect it to the real world. And so I think we can tell kids, when it comes to, for example, Mightier or Endeavor, the kids know, you know, Endeavor is being prescribed. "My pediatrician or a psychiatrist is prescribing it for me," but this is good medicine. This is the kind of medicine you want to take, if you will.

Amanda: I'm wondering a little bit about non-prescription video games. So like, thinking about popular ones like Minecraft and Fortnite and Roblox, and that's about where I can land, because I don't know any of the names of the other ones. Are there any that stand out to you as being really good for that metacognitive, that thinking about thinking for kids who learn differently?

Randy: Absolutely. It's funny that you mentioned that. So Minecraft, Roblox, another one that's pretty popular now is called Animal Crossing. Those are three of the main games where we kind of use that to teach kids these skills while we're playing the games. One of the concerns that I have about video gaming and kids is that the kids don't play the game and immediately generalize what they've learned in the game to the real world. And that's the key for learning any place. I mean, if you go to a classroom and the teacher teaches you some math facts, but you can't go and measure something when you leave the classroom or you can't apply it in some ways, it's not that helpful.

It's it's, this is really all about generalization. It's, you know, how do you learn something in one setting and apply it to another setting? It's really the key to it. And the way that oftentimes happens is that people work to teach kids. What goes on when it comes to video games — and Amanda, I'm going to pick on you for a minute, OK?

Amanda: Absolutely. 

Randy: You sure? I don't know if you'll talk to me after this, OK? How old are your kids? Can I ask that on a podcast? 

Amanda: Oh yeah — 25, 19, and 11.

Randy: OK. So first of all, you're too young for a 25-year-old. OK. 

Amanda: I'm going to talk to you again for sure.

Randy: So let's put that out on the table, OK? But the 11-year-old, OK? I would say to you that it's important for you to play some of those games with your 11-year-old or sit with — is it a boy or a girl?

Amanda: He's a boy. He has ADHD. I do sit with him and he tells me all about what he's doing.

Randy: Excellent. Then I'm wrong, because by getting him to tell you what he's doing is really also an opportunity for you to help with that metacognitive process — to kind of think about that stuff.

And I think that what's happened with video games in particular, is that, you know, a certain generation of parents, maybe the next generation that's coming out will do this, but an older generation didn't play the games cause they didn't know the games. The kids were the experts in the games. They kind of stayed away from that.

I mean, when my kids were growing up, I coached him in baseball. I talked to them about baseball. We would do that kind of stuff. If you played board games, you would do that kind of stuff. That's traditional parenting is sort of teaching kids. If they get frustrated after losing a game, you talk to them about that.

But I think when it comes to video games that parents have been far less involved. Now some of that is because of the nature of video games and sitting, staring at a screen. But I think that that's become one of the reasons that kids don't learn so much though, because we don't have parents engaged and involved.

Amanda: Well, I will say though, that it took me a while to realize that what he wanted me to do was to listen to him, talk it through, right? And I know a lot of parents will say to me, like, I don't understand why they're telling me everything that's going on in the game as they're doing it. It took me a while to read, realize he wants feedback. He's looking to figure out, like, what do I think of this? What, you know, what — he's into, like a lot of the LEGO city games where he builds the things and then he, you know, navigates them and he'll say, you know, do you think this will work? Or do you think this won't work? And, you know, I realized he wasn't just saying it to talk out loud. But I think that's such an important thing is to realize that you don't have to play it to be engaged with them. 

Gretchen: Yeah. Randy, you know, since Understood supports people who learn and think differently, we want to ask some questions about specific learning challenges and how games might help — or might make them worse. So I think Amanda is cuing up the first question.

Amanda: You know, I think I may have already asked, but I'm going to ask it a different way. Those games like Minecraft and Roblox and Animal Crossing, do they have a way of supporting visual-spatial planning, that ability to look at things, understand where they fit in space, and that kind of thing? Cause I know that that's something that parents worry about when they talk to us. Is this helping or not helping?

Randy: I'm not a hundred percent convinced that there's any great research out there to say that. However, I also have no doubt whatsoever that that's what's going on. Because I mean, you know, some people have referred to Minecraft as LEGOs on steroids, if you will.

And I can tell you from thousands of interviews, when I see kids who have visual-spatial strengths at least, if I say to the parents, you know, after I'm going over a testing evaluation kind of information with them, and I say, oh, your child's got really strong visual-spatial skills. I'll say, does he or she like playing with LEGOs?

And the answer is yes, yes, yes, almost always. And the kids who struggle with that don't do as well, OK? Now what happens is, again, like anything else, you avoid things that you're not as good at, but I think that because some of these things are a little bit more engaging, it does offer that opportunity for kids to practice some of those skills that they might struggle with otherwise.

And certainly Minecraft is designed like that and there's lots and lots of other building games. One of the games that a lot of the kids that we see and we've actually done some classes on it, was called Terraria. They like that game as well. So there's a lot of those games where they're, they're building work things in the world and developing that and they have to think it out.

Gretchen: So what about kids who get stuck or perseverate? Are there games that can be either helpful or harmful for that?

Randy: Both. So, I mean, the most common thing that I hear from parents when they're complaining about their kids' video games is that they get stuck and they won't get off the game. Now it's interesting. Some of the research on kids with ADHD going back into the mid 2000, 2005, 2010, those years, suggested that kids who don't have attention problems are far more likely to give up playing and get done when their parents tell them to, whereas compared to about 90% of kids with ADHD struggle with that. So they are far more likely to get stuck in terms of the transitions. However, it's an incredible opportunity to teach flexibility, because almost by nature, any of the good video games require that you sort of die or you lose a life, or you kind of have to go back to the beginning and you have to then use a different strategy to be successful.

That's how the games teach you — the good games teach you how to play the game not by giving you a set of instructions. Like you can't go get a set of instructions and say, OK, how do you play this video game? You just play it. And you say, oh, that didn't work. I got to do something differently. 

Now do the kids take that and do they internalize that? Some do. Many don't. Could we help some of those who aren't doing it to internalize that? That's our belief at LearningWorks. You know, we really think that that's one of the things that parents should be doing is they should be saying, well, what'd you do then? I know you got frustrated last week with something. Did you get past that? Yeah. Well, what did you do? And it's really an opportunity to teach kids. And then by the way, then the real thing we have to do is say, "And how can you do that in the real world? See if you can kind of connect that to something in the real world." So, I don't know if I answered your question.

Gretchen: You did. And the fact that you're saying perhaps these games can help with things like confidence and perseverance, but you have to be talking about it and think of a way to pull it out of the game, right? 

Amanda: Well, and the sentence starters matter too, right? Like what you're giving us, Randy, as some of those questions that parents can ask that they may not think about asking. And I think that makes a big difference too. One of the things that I know a lot of teenagers — my older son, who is a teenager, he's very much into these MMOGs, right? The massively multiplayer online games. I worry that it makes him more socially isolated, but I'm wondering if I'm wrong and it's actually supporting his social skills.

Randy: Oh man. I'm so glad you asked because I know all the answers — not. So here's my take on that, is that it's an opportunity to socialize in a different way. And keep in mind, look how we're socializing right now in some ways, OK? And in the future, that's going to be part of socialization. I love to encourage kids who are doing that kind of stuff to do it with kids that are local — to be playing those games with kids who are in their high schools, kids who they're going to see in some other setting, even if it's just a couple of them.

I think that that makes a world of difference because now they have someone they could sit with at lunch and they can talk about the same thing they were talking about when they were online. So to the degree that you can make that happen. There are also a lot of skills that kids learn in terms of leadership skills. Harvard Business Review did an incredible study on people who were World of Warcraft players and found that the people who were Guild leaders there were actually better trained to become business leaders than people who went and got their MBAs. So I do think that's the case, but it also never then helps the kids sort of overcome that face-to-face sort of anxiety issues and things like that. 

And I would say to you that probably when it comes to gaming in general, the most important part of thinking about this stuff is to think about it from the perspective of balance. The thing that I am proudest of in terms of all the stuff I've written about and developed is this concept of what I call a play diet. What's a healthy play diet in today's world, OK? And a healthy play diet in today's world includes certainly a lot of physical play, being outside, exercising, social play, doing stuff with other people, opportunities for unstructured or creative play.

But also, you need to have digital play in there. If you don't, it's actually problematic. There's been a series of studies by a guy by the name of Andrew Przybylski and a few other people that basically says playing an hour of video games a day is probably pretty healthy for you. Playing three hours or more is probably pretty unhealthy for you. But maybe even more fascinating is not playing at all is pretty unhealthy for you as well, because it's how kids connect. So, if that's all your child does, that's probably not healthy because it's just not balanced. 

Gretchen: So, during the pandemic, I know a lot of kids turned to video games. And my 11-year-old daughter did, and it was a way for her to socialize because she'd be chatting with her friends, sometimes separately on like a hangout thread while they're playing or sometimes in the game.

But she was anxious about the world, right? Lots of kids were at that time. And the game started making her more anxious because she couldn't stop thinking about, well, are my friends on, am I missing it? Oh, are they earning more points? Oh, how can I get this token? Oh, wait Mom, I need money. I want to buy this thing. So, what do you say about kids with anxiety and games? How do those two go together?

Randy: Yeah, the fear of missing out is huge. And actually I would connect that less to gaming and more to the social media component of it as well. That, that social part, where that's really a remarkable area if you think about it. I see more 8-, 9-, 10-year-old girls who are in the kinds of things that we used to see with teenagers in terms of their peers and the social kinds of stresses and the clicks and feeling removed from that. So, yeah. And you're absolutely right too. When you look at the data on anxiety, in terms of what we've seen during COVID compared to pre-COVID, it's crazy. I think I saw something recently, the data was something like 41% of teens reported some signs of anxiety during COVID compared to typically about 11%. And I think part of that is also how do we help kids with anxiety in general? 

And part of that is, again, I'll go back to the healthy play diet. Kids with anxiety need to be exercising. They need to be doing other things. Cause I just think sometimes, think about treating anxiety solely as putting somebody in therapy and maybe give them medication. That's not the long view approach to that. Yeah.

Gretchen: Maybe games that make you get up and move.

Amanda: Dance Dance Revolution.

Randy: Well, yeah, there aren't as many of those as they used to be, but there are those, and I think we're going to see more and more of that with virtual reality. Cause that's kind of the next phase of what's going to go on with gaming. And with virtual reality, I mean, you could really be boxing and you can do all kinds of movement. I'm waiting for a really good tennis game so I can start playing. Cause then I'll be a gamer. I keep looking all the time for a new game that is realistic tennis so I can go in my basement — instead of getting on my exercise bike and just peddling, I'm actually kind of moving and doing things.

Amanda: Randy, I'm going to ask you another question — knowing this is a question I'm sure you get a lot and that the answer is nuanced. Are there games out there that you think we should really limit kids' exposure to?

Randy: Well, I do not like violent video games and that's part of me personally, but I also think that if we can assume that you can learn something from playing video games that's positive, might we assume that she could learn some negative things. Now the data does not say that you play violent video games and you'll become violent. But I do think it can desensitize kids. And I do think that that can have a negative impact upon relationships. Maybe some of why some of the meanness that's in society nowadays could be related to it. I don't know. That's a stretch. So, I don't know if I want to be quoted on that one. 

But the bigger piece to that, though, is a lot of younger kids. I can't tell you how many 5- and 6-year-olds I have who are playing Fortnite. And normally I don't tell parents what to do, OK? I try very hard to kind of work with them. But I very clearly will say to them, "I really don't think that your 6-year-olds should be playing Fortnite. It's a very violent game." And probably this is my being a non-gamer is there are probably games that if I really knew about in more detail, I would kind of like really be saying to you, no, no, no to these. But, but I'm guessing that those games are fitting into violence or racism, sexism, those kinds of things.

I'm not as familiar with those kinds of games. I know they're out there. So like the Call of Duty games, for example. They're really exciting for the kids. They love playing them. And I think if a teenager wants to play them with their friend after school, that's probably fine. They're old enough also to know the difference between fantasy and reality. And the kids who don't, they're going to have problems wherever they're at.

Gretchen: So let's look ahead a little. Let's look into your crystal ball, Randy. You know, what do you see in the future in terms of how we're going to think about the role of digital games in our kids' development and how we design them? 

Randy: Well, let me veer off for a second, OK, if I can. I think that in many ways, a smartphone could be a person with ADHD's best friend. If it's used properly. One of the things that I'm very, very interested in is kids who struggle with writing. I am such a big believer that we are doing a horrible job of teaching kids how to use dictation skills. They're talking all the time, whether they're online talking to their friends or whether they're talking to Siri, everything's going to be like that. They need to learn how to use dictation for example. 

So part of the future, I think, is going to be that we start to accept this as just kind of what it is. We do a lot of stuff at LearningWorks about finding apps that support weak executive functioning skills. And I think that all these technologies can do that and in a much easier fashion than some of the video games. Cause I think the video game piece is a little bit more indirect. I look at it like, well, you can walk to school and it's three miles away. It takes you an hour. You can ride your bike to school and it's three miles away and it takes you 15 minutes. Why do we not use technologies to help these kids? 

Especially — I have another particular interest with kids with slow processing speed. I'm actually working on a book on that because there's a lot of video games out there that actually can help a little bit with that. But there's a lot of technologies that can help a lot with that. So those are some of the things I think we're going to be moving towards in the future.

Amanda: Well, I mean, this has just been such a fascinating conversation. Thank you so much for joining us today, Randy. I really appreciate it. 

Gretchen: Really interesting. I've learned a lot, you know, just for my own knowledge at home, but also for the world and for our kids. So thank you so much.

Randy: Well, you're quite welcome. This is really fun for me. This is kind of what I really enjoy doing.

Gretchen: Dr. Randy Coleman is the author of a bunch of books, including most recently "The Gaming Overload Workbook: A Teen's Guide to Balancing Screen Time, Video Games, and Real Life." To find out more about Randy's work on maximizing children's learning from popular video games and interactive digital media go to LearningWorksforKids.com.

Amanda: You've been listening to "In It," part of the Understood Podcast Network.

Gretchen: You can listen and subscribe to "In It" wherever you get your podcasts.

Amanda: And if you like what you heard today, please tell somebody about it. 

Gretchen: Share it with the parents you know

Amanda: Share with somebody else who might have a child who learns differently.

Gretchen: Or just send a link to your child's teacher.

Amanda: "In It" is for you. So we want to make sure that you're getting what you need.

Gretchen: Go to u.org/init to find resources from every episode.

Amanda: That's the letter U, as in Understood, dot O R G slash in it. And please share your thoughts. Email us at init@understood.org. We'd love to hear from you.

Gretchen: As a nonprofit and social impact organization, Understood relies on the help of listeners like you to create podcasts like this one to reach and support more people in more places. We have an ambitious mission to shape the world for difference. And we welcome you to join us in achieving our goals. Learn more at understood.org/mission.

Amanda: "In It" is produced by Julie Subrin. Justin Wright mixes the show. Mike Errico wrote our theme music. Laura Key is our editorial director at Understood. Scott Cocchiere is our creative director, and Seth Melnick and Briana Berry are production directors. Thanks for listening, everyone. And thanks for always being in it with us.

Hosts

  • Gretchen Vierstra, MA

    is the managing editor at Understood and co-host of the “In It” podcast. She’s a former educator with experience teaching and designing programs in schools, organizations, and online learning spaces.

    • Rachel Bozek

      is co-host of the “In It” podcast and the parent of two kids with ADHD. She has a background in writing and editing content for kids and parents. 

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