[umbra07]

I've been on this for about a month and a half now.

The game itself isn't engaging at all. It was a struggle to get myself to actually play the game regularly, for the allotted time (30 minutes, 5 days a week). It feels like a pretty big flaw with the game - after all, one of the challenges that people with ADHD face is forcing themselves to do things they don't want to do. This game is a complete bore, and I can't imagine anyone over, idk, 10 feeling differently.

It's also an incredibly frustrating game, and for the first couple of weeks I was fairly irritated after each 30 minute session.

I haven't noticed any improvement yet.

[routerl]

Thanks for your perspective. I've known and lived with several people who have ADHD, and you've expressed exactly the perspective I expected to hear from them.

"Games as treatment" are a new frontier of "selling bullshit". This happened before in education, and it's now making its way into health care.

The problem, here, is that the users aren't any part of how these games are designed. Everything about them is just directed at making presentations to investors and licensing bodies.

In the real games industry, user testing is the apex of success: you know your users will enjoy and benefit from your design choices because your users have already enjoyed and benefited from your design choices. When this relationship doesn't hold, the game gets changed. Play testing is king.

This kind of thing is cynical, thoughtless, and testless. It shouldn't exist, and it's nothing more than the effort of some founders to gather funding from clueless agencies.

[loopdoend]

And let’s be honest they’re just torturing people with no positive outcome. The net effect is you have a poorer, more frustrated patient, who has this stupid game burned into their memories.

[cowsaymoo]

Here is their safety and warnings section disclosing that. It's really interesting because of how they're presumably required by law to make a CVS-receipt-length FDA medicine warning but all the dangers are for playing a video game. I think it's pretty cool to see how effective the FDA's procedures are at capturing your concerns, through forcing them to be transparent

# Indications: > EndeavorRx is a digital therapeutic indicated to improve attention function as measured by computer-based testing in children ages 8-17 years old with primarily inattentive or combined-type ADHD, who have a demonstrated attention issue. Patients who engage with EndeavorRx demonstrate improvements in a digitally assessed measure, Test of Variables of Attention (TOVA®), of sustained and selective attention and may not display benefits in typical behavioral symptoms, such as hyperactivity. EndeavorRx 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.

# Safety: > No serious adverse events were reported. Of 342 participants who received AKL-T01 in the two clinical trials supporting EndeavorRx authorization for age ranges 8-17, 17 participants (4.97%) experienced treatment-related adverse events (TE-ADE) (possible, probable, likely). TE-ADEs reported at greater than 1% across the studies include: frustration tolerance decreased (2.34%) and headache (1.17%). Other adverse events occurred less than 1% and included dizziness, emotional disorder, nausea, and aggression. All adverse events were transient and no events led to device discontinuation. Across other studies in children and adolescents with ADHD, rates of adverse events were similarly low (<10%) and no Serious Adverse Events have been reported. All reported adverse events across all clinical trials resolved at the end of treatment. Users should consider the totality of evidence presented along with their health care provider when considering incorporating AKL-T01 into their treatment plan.

# Cautions: > Rx only: Federal law restricts this device to sale by or on the order of a licensed health care provider. EndeavorRx should only be used by the patient for whom the prescription was written. For medical questions, please contact your child’s healthcare provider. If you are experiencing a medical emergency, please dial 911. EndeavorRx is not intended to be used as a stand-alone therapeutic and is not a substitution for your child’s medication.

> If your child experiences frustration, emotional reaction, dizziness, nausea, headache, eye-strain, or joint pain while playing EndeavorRx pause the treatment. If the problem persists contact your child’s healthcare provider. If your child experiences a seizure stop the treatment and contact your child’s healthcare provider.

> EndeavorRx may not be appropriate for patients with photo-sensitive epilepsy, color blindness, or physical limitations that restrict use of a mobile device; parents should consult with their child’s healthcare provider.

> Please follow all of your mobile device manufacturer’s instructions for the safe operation of your mobile device. For example, this may include appropriate volume settings, proper battery charging, not operating the device if damaged, and proper device disposal. Contact your mobile device manufacturer for any questions or concerns that pertain to your device.

[codr7]

I wish these texts were written with the intent to inform rather than cover their asses legally, it's barely readable to me.

[ThrowawayTestr]

I feel like playing a video game for 30 minutes a day is pretty far from torture.

[Spivak]

ADHD is a weird disorder that's hard to explain to people who don't suffer from it. Understimulation is a physically painful experience, one that pain killers don't really work with. Before I got on a regimen that works well-enough for me I had to regularly leave social events and check out of work to lie down and sleep it off. And it's not really a boredom thing, I can be actively enjoying the thing I'm doing — hell I can want to be doing the thing and it still happens.

Forcing yourself through 30 minutes of a video game likely isn't much compared to their day-to-day painful experiences at work or school but given the high likelihood that it doesn't actually work it's unnecessary additional suffering likely imposed on them by a frustrated parent who wants them to "get better" for their own sake instead of the kid's.

[Zambyte]

> This game is a complete bore, and I can't imagine anyone over, idk, 10 feeling differently.

FWIW, from their FAQ (and several other places on the site):

> EndeavorRx is indicated only for children ages 8-12 years old with primarily inattentive or combined-type ADHD who have a demonstrated attention issue.

[kevinh]

The FAQ does indeed say that it's for children ages 8-12 years old, but the main page says the following:

> EndeavorRx improves attention function in children 8‑17 with ADHD.

I went back to look at older versions of the site, and some of the references have changed from 12 to 17, but not others. I assume that they ran another study with a higher upper limit later, but didn't update their site everywhere.

[umbra07]

so there's endeavorRX, which is aimed at kids, and then there's also endeavorOTC, which is 18+. my understanding is that both games are more or less the same, really the big difference is just that the child version requires a prescription.

[umbra07]

there's an adult version, endeavorOTC. it's what I use - but it's really the same thing as the kids version. the gameplay is more or less identical.

[latentsea]

I can barely get myself to play games I'm actually interested in, since there's always something slightly more interesting than that. I can imagine this would be not only a complete non-starter but also... how is this specific video game supposed to help?

[tossandthrow]

My guess is that this is indeed what gaming would practic: prolonged focus on a single activity.

For me it seems like other games would also do, as long as they don't promote "scatterbrain".

[TeMPOraL]

Prolonged focus on a single activity isn't what people with ADHD have problems with. Rather, it's being able to control when they're focusing, and on what, and keeping that focus for any activity, not just the engaging ones.

Playing video games is thus usually a problem, not treatment - games are just more interesting in the moment than anything else you can or should be doing, so it's hard to stop playing. Ripping out everything that makes the game interesting and stimulating doesn't turn it into a therapeutic tool, it turns it into a bullshit chore that's done on a computer. In comparison, doing your taxes may seem more appealing, because while it's mind-dumbingly boring, it's at least not a make-believe time waster. Which I suppose could be of therapeutic value, if not for the fact that other videogames still exist.

(And so do books, TV shows, parties, substances, whatnot.)

[FrustratedMonky]

Could it be that the boring part is part of the treatment?

If a game was exciting and engaging, wouldn't someone with ADHD be drawn in and be focused naturally, like that isn't different from any game. But the problem with ADHD is paying attention to things in life that are boring, so forcing someone to focus on a game for some 30min/day is training them to focus on boring?

IF it was a good game, then it would just be a game. So just go play other games. But the point is to focus on something boring?

[codr7]

Thanks for sharing.

Reading your comment though, did I understand correctly that the irritation faded over time? Wouldn't that be an improvement?

Not that I think that inability to focus on boring BS is something that needs to be fixed, but it still might be doing something positive.

[lloeki]

> The game itself isn't engaging at all

> It's also an incredibly frustrating game

I'm curious, is that intentional? As in, progressively learn to deal with those two aspects that are instant triggers for an ADHD mind to run away?

I mean, otherwise literally any other actually engaging and satisfying game would do.

[TeMPOraL]

> As in, progressively learn to deal with those two aspects that are instant triggers for an ADHD mind to run away?

Regular life will do that to you anyway; not sure how a game is going to help.

If anything, particularly when aimed at kids, it's main effect is likely exhausting the video game time budget parents allotted to the kid, possibly souring the whole class of entertainment to them. Which I guess may look like a win to outsiders if the kid happens to use videogames to cope with ADHD. Not sure if it's a win for the kid.

[lloeki]

Let's say you have an allergy to nuts, or shrimps, or some phobia. Life does throw a lot of this at you but it doesn't really help. What helps is following a protocol with controlled doses of exposure to make the body/mind unlearn "DANGER!!!1!11!!" and instead "oh actually this is safe".

Same difference as life making you lug objects/yourself around daily vs a workout plan. You start small and progressively build up to go from here to there. Also you don't stop all physical activity when following a workout plan, it's just that you have a framework to build up.

There may be a thousand ways to do these brain workouts, probably kids would not be too enticed to do meditation or read books so a videogame is more appealing on the surface.

Also I'm not saying this particular game is any good or not in that regard, I'm just saying maybe there's something to it, asking naive questions such as "was this actually intentional design?", and conducting some thought experiment.

Tangentially I'll be the old man yelling at clouds, but I've noticed that games these days are very much not frustrating, probably to cater for the widest audience: compare today's infinite respawn at magic checkpoints with automated difficulty adjustment and no mistake possible change-your-build-tree-anytime and deus-ex-machina health/ammo drops so that you never quite fall short to the likes of Megaman, Mario, Sonic, Gradius, Doom, Ikaruga, Baldur's Gate, Diablo... To be successful these days it seems like games must be pleasing with all frustrations removed, plowing like a demigod through hordes of prop opponents or gigantic bosses made of cheese. By endgame you can even max out all skill trees and be a warrior/wizard/necromancer/sharpshooter/thief all at once.

You can't make a mistake, you can't paint yourself in a corner, you can't lose, you never have to roll back to a savegame 10 hours back or live with your erroneous choice for the next 40+ hours, or, god forbid, start over.

[gjsman-1000]

My initial reaction is that it looks like a Super Mario Galaxy ripoff.

[jncfhnb]

That looks like an extremely generous take

[butlike]

I was going to comment that the asinine gameplay and frustrating design elements may be "by design" and part of the treatment, but then I decided to comment about how this would be a perfect way to ask for the most money, develop it for the least, and handwave away all the bugs as "by design."

My gut-check says Zelda (especially the newer ones where you build things and have creative, problem-solving leeway) may be a better choice.

[readthenotes1]

Heh Maybe reading a good physical book for the same time would work as well??

[acchow]

If you do find a book which manages to totally captivate you, then you’d just rather read that instead of returning to normal life. Not sure if this really counts as helping ADHD

[bitwize]

The key is to find a hard, less captivating book and just power your way through it. Crime and Punishment may be this for some. You could also try learning X11 programming with the famous wall-o'-manuals that entails.

[RoyalHenOil]

>The key is to find a hard, less captivating book and just power your way through it...

This is a lot like saying that the way to treat a broken leg is to just start running on it and not have it be broken anymore.

[yjftsjthsd-h]

Unironically yes. Neuroplasticity means that that is exactly a way to improve brain function. Not perfect, not universal, not the only way, but absolutely a working approach.

(Obvious disclaimer: Not a doctor, not your doctor, this is not medical advice.)

[RoyalHenOil]

The brain is plastic, but it does not respond well to being hit with a brick wall. It needs reinforcement in the direction you want it to go.

For example, you treat a phobia through gradual exposure to the source of fear, not through undergoing a sudden overwhelming experience. That usually creates a traumatic response that actually makes the phobia worse.

Likewise, if you want to learn how to read a long book, start with shorter books and work your way up. If you can't sit through a novella and so you try to force yourself to read Crime and Punishment, you will fail — and you risk actually making it harder to read books in the future by strengthening the neural association between reading and feeling bored/frustrated.

[lazyasciiart]

Unironically wrong. That’s like saying the key to a kid being good at calculus is skipping the silly arithmetic and geometry topics and taking a calculus course.

[PhasmaFelis]

As a middle-aged adult with ADD, "try harder, just do it" is absolutely not an effective overall treatment for ADD at any age.

[helboi4]

Dunno why you're being downvoted. Practising reading is probably one of the best things I've done for my attention recently. I've gone from being so unable to sit still in a one hour reading session that I read only 4 pages, to mostly being able to sit still and read around 30 pages. And yeah I started with a book I was hyper-engaged in, then joined a book club and read what's assigned to me, and I'm working up to reading harder things. This is a much cheaper way to train your attention than an overpriced shitty videogame. Though playing super hard video games like Dark Souls type and forcing myself to persevere also can be a good excercise for me.

[01HNNWZ0MV43FF]

My productive habit is that every morning I wake up, eat a healthy breakfast, and pop a couple Atomoxetine