The effect of a digital interactive game in distractibility, hyperactivity and impulsivity in individuals with attention deficit hyperactivity disorder and intellectual disability

IntroductionAttention Deficit Disorder with Hyperactivity (ADHD) is one of the most known neurobiological disorders (Ballard & Bolan, 1997) of childhood and adolescence (Watemberg et al. 2007). According to the American Psychiatric Association (1994) ADHD is a psychiatric dysfunction, which may be described as a chronic disorder of behavior (Lakoff, 2000) with neurobiological basis characterized by not developmentally appropriate level of attention, impulsivity and / or hyperactivity, that affects social, academic and professional activity (American Psychiatric Association, 2000). The onset of ADHD is placed in early childhood and often occurs in adolescence and adulthood (Faigel, 1995; Fargason & Ford, 1994). As for intellectual disability (ID) and in accordance with the definition given in 1959 by the American Association for mental disorder (American Association on Mental Retardation, 2006), ID is referred as a significantly below average general intellectual functioning accompanied by shortages in adaptive behavior and manifested during the developmental period. However, researchers (Luckasson et al. 1992) revised this definition, giving special emphasis on the potential of the individual, the environment in which he lives and works, and finally, the operating level achieved within these environments. This reformulation led to the effective integration and adaptation of people with ID in environments like schools (Freeman, 2000).In the last decade there have been several successful efforts to reduce the symptoms of ADHD through exercise, since physical education improves fine motor skills, increases playing time, reduces stress and depression and improves self-esteem of people with ADHD. Numerous studies reinforce the important role of exercise on physical, mental and social condition of people with ID (Pate & Hohn, 1994), producing many benefits related to parameters such as self-knowledge, flexibility, endurance, joint mobility, muscle strength, synergy and eye - hand coordination.Studies have shown that participation in exercise contributes to except endorphins, and catecholamine secretion which in turn help to increase attention span and blood flow to the brain leading to the release of its growth factor (Brain Derived Neurotrophic Factor) and the creation of new nerve cells (Aggelopoulou-Sakadami, 2004). The acute effects of exercise have been associated with improved behavioral and cognitive functions in children with ADHD (Tomporowski, 2003). According to researchers (Gapin et al. 2011), several studies indicated the positive effect of exercise on the behavior of individuals with ADHD in promoting self-awareness, self-esteem, behavioral and perceptual capacity, while at the same time decreasing behavioral problems such as attention deficit, hyperactivity, aggression and negativism (Aggelopoulou-Sakadami, 2004). Clearly, games play an important role in the socialization of people with ID (Winnick, 1995). However, reviewing the literature it seems that a lack of studies is noted concerning the effect of exercise in the form of a digital interactive game on individuals with ADHD and concurrent ID. Therefore, the purpose of this study was to investigate the effect of an interactive digital game on distractibility, hyperactivity, impulsiveness and other symptoms of individuals with ADHD and ID, in order to broaden the knowledge about the behavior of these individuals in exercise conditions, but also to examine the potential impact of a different way of exercise in reducing symptoms that affect the behavior of this population.Material &methodsParticipantsThis study involved 20 adults aged 20-25 years diagnosed with ADHD according Instrumente zur Diagnose der Adulten ADHS (IDAA) (Rosler et al. 2004) and Adult ADHD Self-ReportScale-V1.1 (ASRS-VI. 1) (World Health Organization, 2003), and with moderate ID (IQ: 35-50) according to Wisk-III test (Georgas et al. 1997). …