Areas › Focus, starting, and ADHD › Treatment and medication
Brain training and therapeutic games raise one question above all others. Does the improvement show up anywhere except inside the game, and does it last once you stop playing?
People do get better at what they practise, and the scores go up, which makes for a persuasive chart on a website. The harder question is whether that reaches the morning school run or an unopened pile of post. Approval by a regulator is also not the answer to this: it means a product cleared the route it had to clear, which is a different thing from showing it changes ordinary life.
This explains how treatments work. Never start, stop or change a medication because of something you read here.
Qur’an and Sunnah
God does not change the condition of a people unless they change what is in themselves (Quran 13:11). Real change is described as reaching the condition itself, not just the score on the surface of it.
لَهُۥ مُعَقِّبَٰتࣱ مِّنۢ بَيۡنِ يَدَيۡهِ وَمِنۡ خَلۡفِهِۦ يَحۡفَظُونَهُۥ مِنۡ أَمۡرِ ٱللَّهِۗ إِنَّ ٱللَّهَ لَا يُغَيِّرُ مَا بِقَوۡمٍ حَتَّىٰ يُغَيِّرُواْ مَا بِأَنفُسِهِمۡۗ وَإِذَآ أَرَادَ ٱللَّهُ بِقَوۡمࣲ سُوٓءࣰ ا فَلَا مَرَدَّ لَهُۥۚ وَمَا لَهُم مِّن دُونِهِۦ مِن وَالٍ
each person has guardian angels before him and behind, watching over him by God’s command. God does not change the condition of a people [for the worse] unless they change what is in themselves, but if He wills harm on a people, no one can ward it off–– apart from Him, they have no protector
Qur’an 13:11read it in the library
Translation: M.A.S. Abdel Haleem, The Qur'an, Oxford University Press, 2004.
What the research says
A meta analysis of randomised trials of cognitive training in ADHD found gains on some neuropsychological measures, while the effects on symptoms largely disappeared once raters who did not know the group assignment were used. That difference between unblinded and blinded ratings is the whole story in miniature. Something did improve, and much of what looked like symptom change was in the eye of people hoping to see it.
Cortese S, Ferrin M, Brandeis D, Buitelaar J, Daley D, Dittmann RW, Holtmann M, Santosh P, Stevenson J, Stringaris A, Zuddas A, Sonuga-Barke EJ, European ADHD Guidelines Group (EAGG). (2015). Cognitive training for attention-deficit/hyperactivity disorder: meta-analysis of clinical and neuropsychological outcomes from randomized controlled trials.. Journal of the American Academy of Child and Adolescent Psychiatry doi
Strength of evidence: one line of research. A single study, or a theoretical account.
Why it works
Improving at a task you have drilled is easy to demonstrate, and carrying that improvement into daily life is the part that keeps failing.
This one is still a draft. It is waiting on a scholar and a clinician to read it before it is published.
Near this one
One social approach does have a real evidence base behind it, and what makes it different is who delivers it. Parents do the coaching, in the middle of actual play with actual friends.
People who are sleeping properly, eating properly and moving a bit tend to want each other more. The unglamorous parts of life management run closer to the bedroom than either of you might expect.
Untreated ADHD is not free. It turns up in appointments, in repeat trips to A and E, in school reports and in lost work, and the bill lands on the family either way.