ADHD, Executive Functions, & AI: A New Era in Treatment
What Research Shows About How Technology and AI Can Help Neurodivergent Kids
ADHD is often identified as a disorder of executive functioning, brain-based, self-management skills such as working memory, flexibility, time management, organization, and self-control. Viewing ADHD as an executive functioning disorder rather than as simply hyperactivity or inattention allows clinicians to treat it as a set of treatable skills. This approach has led to many behavioral interventions and, increasingly, the use of AI and other technologies to support and improve skills such as time management, organization, working memory, and emotional regulation.
Over the past year, artificial intelligence (AI) tools have been considered in assessing and treating ADHD and helping kids with learning disabilities. In addition, recent interventions using AI as tutors, as written about by Salman Khan, the founder of the Khan Academy and author of Brave New Words: How AI Will Revolutionize Education (and Why That’s a Good Thing), view AI as a tool that can provide low-cost one-on-one tutoring to students who could never otherwise afford to have this service.
Treating ADHD with Video Game-Based Technology
Treating problems with executive functions and ADHD with video games and other digital tools is not a new phenomenon. Initial research (from 2011) utilized a computer training program called AIXTENT to enhance four components of attention: alertness, vigilance, selective attention, and divided attention. Findings indicated a generalized improvement in attention skills, including vigilance, divided attention, and cognitive flexibility. Another study used various video games to show that brain-training games can improve executive functioning skills, such as working memory and processing speed, in young adults. Puzzle games (in this case, Tetris) were observed to enhance attention and visuospatial ability compared to playing the brain-training game.
There is now substantial evidence that video-game-like technologies can improve working memory skills, which are frequently identified as the most critical executive functioning deficit observed in children with ADHD. Research from the Karolinska Institute in Sweden suggests that this type of training leads to structural changes in the brain that directly improve the symptoms of Attention Deficit/Hyperactivity Disorder. Another study from the Karolinska Institute, conducted in 2009, found that video game-based working memory training improved working memory and concentration, as well as a variety of academic skills, including reading and math. This study also suggested that working memory training could improve self-awareness and strategic thinking, both of which are considered executive skills.
More recently, EndeavorRx, an adaptive, algorithm-driven prescription video game designed to improve attention in children with ADHD, received FDA clearance. A study published in The Lancet Digital Health demonstrated that EndeavorRx improved objective measures of attention in children with ADHD compared to an active control. This marks a significant step forward in the recognition and use of video games as a legitimate therapeutic tool for ADHD.
Several studies by Shawn Green and colleagues have explored the connection between video game skills and enhanced attention. Their work has shown that action video game players exhibit improved attentional control, working memory, and cognitive flexibility compared to non-gamers. These findings suggest that the dynamic and engaging nature of certain video games can train and strengthen the cognitive skills underlying attention and executive function.
Technology Tools as a Treatment for Executive Functioning Skills
In addition to these developments, other products and digital therapeutics have emerged that utilize video game technology to address executive function challenges. These include various apps and online platforms offering cognitive training exercises and games designed to target specific skills, such as working memory, planning, and impulse control.
While research on the use of AI and video games to improve executive functions and ADHD symptoms is ongoing and evolving, there are some common themes across current studies. First, working memory training via video game play holds great promise. Secondly, video game play needs to be adaptive, with the level of challenge increasing over time to support cognitive growth. This type of real-time adjustment is one of the strengths of AI-based tools. Third, making the games engaging, fun, and motivating helps develop executive functioning skills. And finally, creating opportunities to generalize game-based skills to real-world activities increases the likelihood of long-term effects.
The Future of AI, VR, and Wearables as Treatment for ADHD
Many researchers and companies are developing technologies to enhance executive function skills in children, particularly those with ADHD. Artificial intelligence (AI) offers intriguing possibilities. AI-based interventions for executive function in ADHD could include educational apps that can adapt in real time to a child’s academic level and attention patterns. AI tutoring apps already use personalized encouragement to sustain attention and effort. AI could be used to analyze a child’s gameplay to assess specific executive function weaknesses and suggest activities to practice these skills.
Virtual Reality (VR) is already being used to help kids with ADHD and may offer unique, real-world-like opportunities to practice executive function skills. VR environments can be designed to simulate real-world situations that require strong executive function skills, such as navigating a busy classroom, managing a schedule, or handling social interactions. Future VR games could require players to manage their time to complete daily tasks in a simulated school environment and to use executive functioning skills such as planning, sustained attention, and time management.
Wearable technology also holds potential. Smartwatches or other devices could monitor physiological indicators of attention, such as heart rate variability or brainwave activity. Wearables also offer private but effective alerts to inform a child to do their homework, pay attention, or assist with weak working memory skills.
While old school and emerging technologies are not a cure for ADHD, they can support and improve many executive functioning skills. However, they should not be considered a replacement for other evidence-based treatments for ADHD, such as medication and behavioral therapy. Rather, they can be used as a complementary or adjunctive intervention to enhance and support these traditional approaches in the treatment of ADHD.
References
Doulou, A., Pergantis, P., Drigas, A., & Skianis, C. (2025). Managing ADHD Symptoms in Children Through the Use of Various Technology-Driven Serious Games: A Systematic Review. Multimodal Technologies and Interaction, 9(1), 8. https://doi.org/10.3390/mti9010008
Goh, C., Ma, Y., & Rizzo, A. (2024). Normative Performance Data on Visual Attention in Neurotypical Children: Virtual Reality Assessment of Cognitive and Psychomotor Development. Frontiers in Virtual Reality, 5. https://doi.org/10.3389/frvir.2024.1309176
Green, C. S., & Bavelier, D. (2012). Learning, Attentional Control, and Action Video Games. Current Biology, 22(6). https://doi.org/10.1016/j.cub.2012.02.012
Holmes, J., Gathercole, S. E., & Dunning, D. L. (2009). Adaptive Training Leads to Sustained Enhancement of Poor Working Memory in Children. Developmental Science, 12(4). https://doi.org/10.1111/j.1467-7687.2009.00848.x
Khan, S. (2024). Brave New Words: How AI will revolutionize education (and why that’s a good thing). Viking, an imprint of Penguin Random House LLC.
Klingberg, T. (2010). Training and Plasticity of Working Memory. Trends in Cognitive Sciences, 14(7), 317–324. https://doi.org/10.1016/j.tics.2010.05.002
Kollins, S. H., DeLoss, D. J., Cañadas, E., Lutz, J., Findling, R. L., Keefe, R. S., Epstein, J. N., Cutler, A. J., & Faraone, S. V. (2020). A novel digital intervention for actively reducing severity of paediatric ADHD (stars-ADHD): A randomised controlled trial. The Lancet Digital Health, 2(4). https://doi.org/10.1016/s2589-7500(20)30017-0
Nguyen, L., Murphy, K., & Andrews, G. (2021). A Game a Day Keeps Cognitive Decline Away? A Systematic Review and Meta-Analysis of Commercially-Available Brain Training Programs in Healthy and Cognitively Impaired Older Adults. Neuropsychology Review, 32(3), 601–630. https://doi.org/10.1007/s11065-021-09515-2
Tucha, O., Tucha, L., Kaumann, G., König, S., Lange, K. M., Stasik, D., Streather, Z., Engelschalk, T., & Lange, K. W. (2011). Training of Attention Functions in Children with Attention Deficit Hyperactivity Disorder. ADHD Attention Deficit and Hyperactivity Disorders, 3(3), 271–283. https://doi.org/10.1007/s12402-011-0059-x
