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OPINION Video game play, attention, and learning: how to
shape the development of attention and influence
learning?
Pedro Cardoso-Leite a and Daphne Bavelier a,b
Purpose of review
The notion that play may facilitate learning has long been touted. Here, we review how video game play
may be leveraged for enhancing attentional control, allowing greater cognitive flexibility and learning and
in turn new routes to better address developmental disorders.
Recent findings
Video games, initially developed for entertainment, appear to enhance the behavior in domains as varied
as perception, attention, task switching, or mental rotation. This surprisingly wide transfer may be mediated
by enhanced attentional control, allowing increased signal-to-noise ratio and thus more informed decisions.
Summary
The possibility of enhancing attentional control through targeted interventions, be it computerized training
or self-regulation techniques, is now well established. Embedding such training in video game play is
appealing, given the astounding amount of time spent by children and adults worldwide with this media. It
holds the promise of increasing compliance in patients and motivation in school children, and of enhancing
the use of positive impact games. Yet for all the promises, existing research indicates that not all games are
created equal: a better understanding of the game play elements that foster attention and learning as well
as of the strategies developed by the players is needed. Computational models from machine learning or
developmental robotics provide a rich theoretical framework to develop this work further and address its
impact on developmental disorders.
Keywords
attention, child development, computerized training, learning, learning disabilities, play, video games
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Developmental disorders
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Video game play, attention and learning Cardoso-Leite and Bavelier
children are to take a pose and hold it for as long as highlight the need to go beyond intuitive analyses
possible. Although laughter and chatting initially of the impact of technology use on the brain and call
dominate the classroom, over time children get into for more controlled laboratory studies distinguish-
the game, trying their best to outperform their peers! ing among the many technology uses. Only by
The use of such games, Binet [16] surmises, was key doing so can we achieve the needed level of gran-
in allowing students who had failed the school ularity to understand how various technology uses
system to catch up two academic years in one! More affect brain and behavior.
recently, in another surprising twist, playing com- In adults, many of the studies have gone
mercially fast paced, action packed such as first or beyond contrasting groups based on their reported
third shooter video games has been shown to action video game play experience (>5 h/week for
improve attentional control across many of its at least 6 weeks vs. <1 h per week). In training
manifestations [17] and has led to investigating studies, nonvideo game players asked to play
whether action video game play may positively action video games for about 0.5–1 h per day,
affect attention in the developing brain [10,18,19]. 5 days a week for 2–10 weeks, show improved
Dye and Bavelier [10] tested top-down atten- attentional abilities above and beyond a control
tional skills of 7–22 year olds focusing on top-down group asked to play other genres of commercial
attention in space (Visual Search), in time (atten- video games [26–33], establishing a direct link
tional blink paradigm), or over objects as in the between action game play and attention enhance-
multiple object tracking (MOT) paradigm, in which ment. In children, because of the typical violence
participants are presented a set of identical objects in action video games, training studies would
moving in space and asked to keep track of a subset be unethical, calling for the development of age-
of them. For all of these tasks, children who reported appropriate action video games.
playing action video games systematically outper- This work should not be taken as an excuse
formed those who did not. This group difference to binge on video games. Short daily sessions over
emerged between 7 and 10 years of age, and kept multiple weeks suffice to induce long-lasting
increasing thereafter. Notably, action video gaming positive changes, in line with the importance of
children reached adult nonplayer levels of perform- distributed practice in learning. In some studies,
ance for attention in time (attentional blink) by ages the effects of action video game training were still
7–10 and for attention to objects (MOT) by ages 11– visible months to years after the end of training. It
13 years (see also [19]). Clearly, the developmental should be recognized that video game play affects
time-course of attention is being modified by the the brain at multiple time-scales. Some effects occur
technology use. Here, we see it accelerated by a after small amounts of training, whereas others
certain type of video game play, but technology require extensive practice. The potential of video
use has certainly been associated with worse, rather game play to induce neuroplastic changes is high-
than better, attentional control, with many report- lighted by reports of changes in both gray [34] and
ing an increase in ADD and ADHD and other well- white matter [35] after only 2 h of playing an action-
being issues among pediatric populations [20,21]. video car-racing game. Interestingly, these changes
The source of this rise remains an active topic were observed only when participants raced the
of studies. same track repeatedly, and thus could learn its
Although video game play is often blamed, the spatial layout, but not when the track changed
Test of Variables of Attention (TOVA) which focuses continuously, implying that in addition to the time
on impulsivity and sustained attention – functions on task, the specific way in which a game is played
typically hindered in ADD and ADHD – shows that critically determines its effects on the brain.
action video game play is not the culprit. When The existing training studies in children have all
tested on the TOVA, action video game players were used specially designed computer software (e.g.,
faster, but not less accurate, than nonaction game [36–39]). For example, Rueda et al. [38] assigned 4
players, suggesting a notable ability at making more and 6 year olds to five sessions of either an attention
correct decisions per unit of time ([22], see Fig. 1). training game – originally designed by the National
Finally, it is important to note that various Aeronautics and Space Administration (NASA) to
components of attention are not all equally affected prepare monkeys for space travel – or of video
by action video game play. Whereas attentional watching. Both groups were pretested and post-
control is seen to improve, exogenous attention tested on an attention task while recording ERPs.
or the automatic pull on attention created by abrupt In the game but not the movie-watch group, the
onsets is unchanged by action video games [18,23– brain markers of attention after training resembled
25]. This is the case despite the profusion of abrupt those observed in the adult brain. Interestingly, no
onsets that these video games contain. Such results effect was observed at the behavioral level (see also
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Developmental disorders
350 5
Accuracy (d')
Respond 325
respond respond respond respond
300 4
(b)
Impulsivity–Target frequent
Time 275
250 3
225
Don’t
Respond Respond Respond Respond
respond
200 2
Sustained Impulsivity Sustained Impulsivity
attention attention
FIGURE 1. The Test of Variables of Attention (TOVA) assesses impulsivity and sustained attention. In this test, participants are
seated in front of a computer screen and required to press a key as fast as possible in response to a target (black square in
upper position) and to withhold responding to nontarget stimuli (black square presented in lower position). (a) In one
condition, the targets are rare and the nontargets appear frequently. The extent to which participants are able to stay on task
and respond quickly to rare targets is a measure of sustained attention. (b) In a different set of trials, targets appeared
frequently, whereas nontargets were rare. The extent to which participants are able to withhold responding to nontargets is a
measure of impulsivity. Dye et al. [22] used the TOVA to assess differences in impulsivity and sustained attention between
young adults who were either nonvideo game players (NVGPs) or habitual action video game players (VGPs). (c) Their results
show that VGPs were overall faster than NVGPs and that held true in both the sustained attention and the impulsivity
condition. (d) This increased speed did not come at the expense of accuracy as both groups did not differ on this measure,
indicating overall enhanced attentional control in VGPs. Error bars are standard errors of the mean. Of note is the fact that the
TOVA software automatically considers response times shorter than 200 ms as anticipatory responses and classifies them as
incorrect. Because VGPs have many response times below 200 ms, VGPs would have been found to have worse attention than
NVGPs despite being correct on these trials. The plotted data did not use the 200-ms cutoff for anticipation. An important
lesson is the importance of revising clinical tests and their criteria for use as new generations may not match previous norms.
In this case, ample research documents faster response times in the users of technology. Reproduced with permission [22].
[39]). This observation fits well with the notion of as mindfulness meditation [44] or compassion
‘preparation for future learning’, which states that meditation [45,46] also improves the abilities to
games produce latent effects that facilitate future regulate one’s behavior, be it through enhanced
&&
learning [40 ]. Computerized games have also been attentional control or better emotional regulation
&
developed to train executive functions of preschool [47 ]. Yet, applications of these approaches on
children [41,42]. Although not directly targeting children and adolescents remain limited, calling
attention, some of these studies reported transfer for further studies [48].
effects from working memory training to atten- Physical exercise, especially in sedentary individ-
tional control tasks [43]. uals, results in both physical and cognitive improve-
Top-down attention appears, therefore, highly ments. After exercising regularly for several weeks,
plastic, especially during development, making it older adults display not only improved physical
both vulnerable and also a powerful target for inter- health, but also enhanced cognitive functions,
vention. including faster reaction times, enhanced attentional
control, and executive processes, and spatial cogni-
tion [49]. Although exercise training studies on chil-
OTHER APPROACHES TO RETRAINING dren are rare, the sharp rise in obesity and the all-too
ATTENTIONAL CONTROL common attention problems that affect this age
Other interventions exist in addition to computer group, combined with the fact that exercise can easily
and video games. Contemplative training such be gamified (as illustrated by the recent surge in
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Video game play, attention and learning Cardoso-Leite and Bavelier
exergames [50]), suggest that such interventions different proposition than doing so in individuals
might be especially promising [51,52]. in whom these systems are dysfunctional. Finally, to
The possibility of re-introducing within the appeal to a wide audience, video games allow for
school system some of the best practices suggested many types of game play and thus strategies. This
by the studies of attention and its underlying brain means that the same game can be played not only
systems has recently caught some traction. An proactively – with the player seeking to predict next
example is ‘Tools of the Mind’ – a program based moves and events – but also reactively, with the
on Vygotsky’s insights on the factors that promote player jumping in the middle of the action and
learning, including use of aids and strategies to indiscriminately pushing the buttons. These two
facilitate focus, use of private speech to regulate types of game play are unlikely to have the same
one’s thoughts as well as acting of short scenarios. effect on attention, and may explain the apparent
All these activities require self-regulation and con- discrepancy between action video game playing
centration; in turn, such interventions markedly enhancing performance in TOVA (see Fig. 1),
improve executive functions and attentional con- whereas being a risk factor for ADD and ADHD.
trol in school-age populations [53]. In the ADD and ADHD population, a series of
Finally, an often-forgotten catalyzer of cognitive mini-games targeting both attentional control and
development is children’s home environment. In a executive functions have shown some promising
&&
recent thought-provoking study, Neville et al. [54 ] results [58]. Yet, at present, neurofeedback whereby
contrasted two forms of intervention: one focusing the patient is trained to control his or her brain
mainly on child classroom training with reduced states appears one of the most promising techno-
parent-directed training, and the other both on logy-based interventions for attention disorders
&
children’s attention and parent-directed training. [59,60 ,61]. Of course, neurofeedback could be
Increase in attentional control was assessed both naturally integrated into video game play, facilitat-
behaviorally and through ERP markers of selective ing treatment compliance [62].
attention, demonstrating an enhancement of brain Surprisingly, some commercial video games have
responses to attended stimuli in the group who been found to positively impact health. Low vision
received most parent training. This study is all patients, such as amblyopic patients, can enhance
the more important in that it focused on children their visual acuity by playing the Sims, Tetris, or
from low socio-economic background, in which the Unreal Tournament. This was shown in adult ambly-
neural underpinnings of selective attention are opes typically thought to be past the ‘critical period’
compromised. The key role of family members in for visual plasticity and thus untreatable [63,64].
fostering positive conduct in children is receiving Children with language impairment often
more and more attention and has led to the develop- exhibit attentional problems and seem to benefit
ment of family video games, specially designed for from retraining attentional control. In one study,
children to play with adults [55]. Although this Italian dyslexic children played either action mini-
game genre is developing fast, controlled studies games or nonaction mini-games for 12 h over 9 days.
are needed to quantify their impact on cognition, The action mini-game trainees exhibited increased
social, and affective skills. attentional skills and faster reading speed than
the nonaction trainees [65]. Of note, both forms of
IMPLICATIONS FOR CLINICAL mini-games were part of the same commercial video
POPULATIONS game ‘Rayman’s Raving Rabbids’. Action mini-games
The possibility of retraining attentional control and emphasized visuo-motor control, precise aiming, and
stimulating learning makes this work particularly proper timing of action, as well as divided attention
relevant to children with learning disabilities and and planning, whereas the control mini-games
attention disorders (ADD and ADHD). Yet not all emphasized very fast motor execution with little
interventions that boost attention in normal chil- need for control on behalf of the player. That differ-
dren may apply to clinical populations. This point is ent parts within a game can have such different
probably best illustrated by asking whether ADD impact tellingly illustrates the key role of processing
and ADHD individuals, who suffer from low atten- demands inherent to the game play in shaping the
tional and executive control, should be advised game impact, and call for further cognitive task
to play action video games. Probably not! First, a analyses of game play. And indeed, not all games
number of studies point to the time spent playing seem to equally foster performance improvement
video games as a risk factor for ADD and ADHD and and transfer, as shown by a large-scale study of ‘brain
pathological gaming, calling for caution [56,57]. games’ in adults which reported gains on the trained
Second, enhancing attentional control in indivi- mini-games, with little transfer to different assess-
duals with intact regulatory brain systems is a ments testing the same cognitive functions [66].
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Developmental disorders
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Video game play, attention and learning Cardoso-Leite and Bavelier
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