The Tampa Clinic’s Cure for ADHD? Play this video game 5 days a week.

How’s this for medicine?

Freah Lewis sits on the couch at her home in Port Richey, a tablet in her tiny hands. On screen, her avatar rides a small hovercraft across rivers and valleys. She determines the direction of the craft by tilting the tablet left or right. Every few seconds, the 10-year-old earns points by smacking sliding targets on the screen with her thumbs.

After about 25 minutes, the craft runs out of fuel, signaling ‘game over’.

That’s her therapy for today. A spoonful of sugar is not necessary.

Freah has struggled with attention deficit hyperactivity disorder, or ADHD, since she was four, said her mother, Amanda Lewis. In kindergarten, she did not sit in the circle and hid under tables to escape the crowds in the classroom. She found it hard to concentrate on activities and was kicked out of two kindergartens where staff said they didn’t know how to help her.

Her formal diagnosis at the age of 6 was the beginning of a search for the right medication and dosage. Some worked for a while until she outgrew them. Others helped, but would usually wear out by late afternoon, her mother said.

A breakthrough came in December when Freah was prescribed a video game instead of another pill.

Known as EndeavorRx, it was approved by the Food and Drug Administration in 2020 to be marketed as ADHD therapy for children ages 8 to 12. Freah uses the game in combination with medication.

Her daughter’s improvement wasn’t immediate, Lewis said, but after two weeks, they found Freah sitting alone working on her homeschool lessons. Previously, she needed constant supervision and encouragement.

“I didn’t know if it would be effective,” Lewis said. “That’s when it really started to become noticeable.”

ADHD is a common neurodevelopmental disorder that usually begins in childhood and affects more than 6 million American children. Symptoms include difficulty staying focused and controlling behavior and very high levels of activity.

It is often treated with stimulant medications such as Adderall.

Freah’s video game was prescribed by Katharine Quinn, a nurse practitioner at Pediatric Epilepsy and Neurology Specialists in Tampa.

Quinn first heard about the game after patients started asking for it. She reviewed data from several clinical trials that showed significant improvements in children’s attention.

According to the 2020 STARS-ADHD study, nearly half of children who played the game five days a week over two four-week treatment periods showed improved attention. Nearly 70% of parents reported improvements in their child’s ADHD when they used play along with medication, another study found. Game manufacturer Akili Interactive funded both studies.

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The game helps stimulate a child’s prefrontal cortex, Quinn said. The player must maintain concentration to control the craft while dealing with the “interruption” of flying objects that must be assessed quickly to see if they can be converted into points.

The code that powers the game contains an algorithm that constantly monitors the child’s reaction levels in real time. As their performance improves, the difficulty increases to keep pushing them.

Quinn typically recommends that children use the game five days a week over a two-month period. She uses the therapy in addition to medication, but she knows of cases where it has helped children who couldn’t take medication or whose parents didn’t want to take drugs.

“It’s a great option for patients who have struggled with drug side effects or who want to reduce dependence on prescription drugs,” she said.

The game is only available to patients with a prescription and is available from specialist pharmacies, who provide a copy that can be downloaded onto a smartphone, tablet or computer. It can be a struggle to get insurance to pay for therapy, Quinn said. The game’s manufacturer offers a $99 discounted rate for out-of-pocket parents. The full cost is $450 per month.

All four of Lewis’ children have been diagnosed with ADHD, which scientists believe is linked to genetics, but not a single gene.

Her oldest son is prescribed Adderall but has been unable to get his medication due to a national shortage of the drug.

Lewis hopes that play therapy will soon be available to her older children. Akili announced in January that it will file for a label extension from the U.S. Food and Drug Administration for use in teens ages 13 to 17 based on new studies showing the game produced higher attentional improvements than those seen in younger children.

“It’s important to find solutions other than medication,” Lewis said. “You want your kids to live their dream and function in the real world. Medicines don’t work all day.”