The effect of context on the performance of children with ADHD on a series of computerised tasks and games

Shaw, Rebecca M. (2004). The effect of context on the performance of children with ADHD on a series of computerised tasks and games. PhD thesis The Open University.



This thesis examines context effects in relation to the performance of children with ADHD in test and 'real world' situations. There is a wealth of empirical research that illustrates poor performance of these children on a range of cognitive measures, particularly tasks that claim to measure executive function and inhibitory control. However, anecdotal reports have suggested that while playing computer games these children display abilities that contrast sharply with empirical findings. This contrast was the basis for a series of studies using computer games and computerised tasks to investigate the performance of children with ADHD across contexts.

The first investigation (Study 1), a questionnaire study, lent support to the anecdotal reports. Parents of children with ADHD confirmed that their children were able to sit still, concentrate, pay attention and achieve higher levels of success when playing computer games. In Study 2 parents of children with ADHD were asked to discuss the features of computer games they felt were most influential in contributing to their child's interest and performance. Observations made in the Study 3 provided further confirmation that performance improves when children with ADHD play computer games; performance in terms of error making and and on-task activity on a standardised test of inhibition and attention, the Conners' Continuous Performance Test II (CPT II), was significantly poorer than performance on a more 'game' like Pokemon version of the task and significantly different to the performance of typically developing children. Features of computer games that may have contributed to the observed improvements for children with ADHD were examined in four subsequent studies. These features included the addition of narrative, the addition of a points scoring system, the addition of character, auditory reinforcement and differing levels of response cost. Inhibitory performance on two commercially available games was also investigated (Study 8), and the performance of participants with ADHD was not significantly different to that of typically developing participants. The results raise questions about current understanding of the disorder and models of ADHD, stress the need for examining contextual sensitivity of children with apparently constitutional disorders such as ADHD, and have implications for methodological design and the contexts in which cognitive abilities are investigated.

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