A small feasibility study conducted by the Children’s Hospital of Philadelphia suggests that Project: Evo, the digital medicine developed by Akili Interactive Labs that is delivered via a video game, continually engaged children with autism spectrum disorder (ASD) and reduced their ADHD symptoms, although more objective measures of cognitive control were mixed.
Nineteen children aged nine to 13 years, all of whom were diagnosed with ASD and demonstrated symptoms of ADHD, completed the Akili-funded trial. Of that group, researchers reported a 95 percent rate of adherence among those assigned a multi-tasking version of the treatment (n = 11), and a 98 percent rate among those given an educational treatment (n = 8). When asked, the majority of children and parents said that they believed these treatments improved their attention, with the former saying that they would play their assigned game for fun.
Changes in the children’s cognitive performance following treatment were a bit more split. Those assigned the multi-tasking treatment demonstrated a non-significant attention performance index (API) gain, as determined with the validated Test of Variables of Attention (TOVA), while those in the multitasking group showed no significant gains or losses, but an overall API reduction. Parents in both groups reported reduced ADHD symptoms, although these were only significant among the multi-tasking group.
How it was done
Researchers picked the final 19 study participants from an initial group of 42 children, all of whom had previously received an ASD diagnosis and high scores on ADHD symptom scales. Participating children were provided an iPad mini for four weeks with their treatment, and asked to complete a 20-minute session at least five times per week.
The multi-tasking intervention assigned to the majority of the children required them to rapidly switch between memory and driving tasks, while the educational intervention required players to generate words from a selection of letters.
The researchers monitored adherence remotely, and sent a reminder email to the family if no gameplay was observed over a 72-hour period. All of the included participants completed an quantitative screen before and after the intervention period, and were asked alongside their parents to complete a brief feedback questionnaire.
What’s the history
Over the past few years, Akili has been among those driving the burgeoning field of digital therapeutics. The company has been actively pursuing FDA clearance of Project: Evo for roughly a year now, and has a fair body of clinical evidence backing its case. In addition, 2018 saw the the company bring in $68 million in new funding, which brought its total backing to just over $140 million.
On the record
"This study had a small sample and was the first 'digital medicine' we offered so there could be a number of reasons for the high treatment adherence," Benjamin Yerys, a child psychologist in the Center for Autism Research at the Children’s Hospital of Philadelphia, and the study's lead author, told MobiHealthNews in an email. "Families who are most willing to participate may be the most motivated to receive treatment, or the high adherence could be related to the novelty of this type of treatment approach, or most interestingly the treatment may be particularly engaging for autistic children compared to traditional behavioral therapy treatments that have higher social demands. Future work is needed to understand the feasibility of this treatment to the broader autism community, and also to rigorously test its ability to improve cognitive function and reduce ADHD symptoms."