UCSF study shows Akili's Project EVO game improves cognitive control in children with sensory processing disorder

By Heather Mack
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There’s plenty of debate about the impact of consumer-level computer or video games on children’s brains. But a new study from the University of California, San Francisco published in PLOS One shows that, in a clinical setting, games that have been developed to function as a medical device may be beneficial to children with certain cognitive impairments.

UCSF and Akili Interactive Labs, which is developing several app-based games for neurocognitive assessment and therapies, ran a pilot to evaluate the use of Akili’s Project Evo game for children with Sensory Processing Disorder and ADHD. Children with the condition receive incoming information in atypical, distracting ways, meaning they have trouble learning and can withdraw or become aggressive.

Project Evo, which was originally developed as NeuroRacer, is comprised of three tasks: perceptual discrimination, visuomotor tracking and multitasking ability. Each task is performed simultaneously during the game, and Project Evo uses adaptive algorithms to assess differences in cognitive ability. They enrolled enrolled 57 children with SPD (half of which also had ADHD symptoms) who received at-home treatment with Project Evo over a four-week period and subsequently underwent post-treatment cognitive, behavioral and neurological assessments. All children improved with Project Evo, and those with SPD and inattention showed statistically significant improvements in real-world function using the gold-standard parent-rated scale.

“These findings are quite exciting given that they both reproduce critical elements of the study of this technology in older adults and suggest that this treatment approach can have powerful effects across thelifespan and in distinct populations with specific cognitive deficits,” Dr. Joaquin A. Anguera, lead author of the study and assistant professor in the departments of neurology and psychiatry at UCSF.

Initially, the trial assessed cognitive, behavioral and neurological measurements of 62 children to quantify their capacity for attention as well as the neurological reasons for their abilities. They found those with SPD and ADHD symptoms started  worse off and improved more than children with just SPD.

“We’re encouraged to see not only the magnitude and duration of what appears to be a meaningful treatment effect, but also continued validation of the targeted neurological mechanism of our technology,” Akili’s CEO Eddie Martucci said in a statement.  “We are currently in the midst of a large-scale, randomized, controlled trial in ADHD, and we are excited to continue our clinical research to validate our digital treatments in populations where we can have a meaningful impact.”

Akili’s platform is currently involved in multiple clinical trials. The company started a study last year to evaluate Project Evo’s impact on ADHD, and they are also exploring similar studies with autism spectrum disorder, depression, Alzheimer’s disease and traumatic brain injury. In December, the company announced results of a study with Pfizer that showed use of Akili’s technology (albeit a different screening platform called AD Screen) could detect biomarkers of Alzheimer’s disease, and the company is working towards completing clinical trials necessary to receive FDA clearance by the end of the year.

While Project EVO is improving cognitive control in children with SPD and ADHD, it is also revealing more insight about the neurological mechanism that makes them respond to treatment. Additionally, it opens up the door for expanded screening and potentially supportive services for children with the condition. Differences in sensory processing can translate to lifelong learning and social abilities, but because the children may not meet the clinical cutoff for Autism Spectrum disorder or ADHD, they may not properly be treated.

“Although there is symptom overlap, children with SPD often fail to receive services despite having similar impairments,” the researchers write. “This disparity of treatment in this population highlights the benefits of using quantitative assessments to determine one’s specific needs as well as the most beneficial type of intervention, versus the use of behavior-based labels to guide treatment.”

That’s what gets researchers excited about Project EVO.

“Once again, we are reminded by this study that it is critical to assess specific domains of function in our children with neurodevelopmental differences, in this case attention/cognitive control,” Dr. Elysa Marco, associate professor in the Departments of Neurology, Psychiatry, and Pediatrics at UCSF and an author on the study, said in a statement. “Once an area of challenge is identified, specifically targeting that skill or challenge can make a difference not only in brain activity but also in the classroom.”