Design and evaluation of a game-based digital therapeutic intervention to improve self-regulation and impulse control...

This pilot study evaluated how the content design of a nonpharmacological digital therapeutic intervention influenced therapeutic targets (self-regulation and impulse control) in children with ADHD. Examining the link between content-design features and target constructs clarifies the importance of design choices in digital intervention content. Typically, digital therapeutic intervention content is structured in a question-and-answer format that incorporates multiple therapeutic objectives. Evaluation involves tracking changes in the user's accuracy rate, which is then used to link target elements to the intended therapeutic goals. This makes it challenging to present elements that precisely align with specific therapeutic goals.

Self-regulation and impulse control were the therapeutic objectives, with 30 children divided into experimental and control groups. The former performed content designed to target self-regulation and impulse control; the latter content focused on general cognitive elements. Both groups were evaluated using K-CBCL and FAIR.

For K-CBCL, statistically significant differences were observed between the two groups in the rate of change in internalizing (t = 2.34, p = 0.031) and externalizing (t = 2.39, p = 0.026) behaviors. For FAIR, significant differences were observed in the P-percentile (t = 2.40, p = 0.024), Q-percentile (t = 2.52, p = 0.022), and C-percentile (F = 4.42, p = 0.045).

These findings preliminarily indicate that ADHD digital intervention content aligned with assessment instrument targets may be associated with improvements in the intended therapeutic domains. Confirmatory evaluation in larger, longer, multisite studies, including teacher ratings and academic and social functioning outcomes, is warranted.