Vol. 20 No.3, 2002 Education and Health 47

What is clear from the empirical literature is that the negative consequences of playing almost always involve people who were excessive users of videogames.

Dr Mark Griffiths is Professor Mark Griffiths of Gambling Studies in the Psychology Division, Nottingham Trent University. The educational benefits of videogames Videogames have great positive potential in addition to their entertainment value and there has been considerable success when games are designed to address a specific problem or to teach a certain skill.

ost reported effects of videogames - Some evidence suggests that important skills Mparticularly in the popular press - appear may be built or reinforced by videogames. For to centre upon the alleged negative example, spatial visualization ability (i.e., men- consequences. These have included my own tally, rotating and manipulating two- and research into video game addiction,1,2 increased three-dimensional objects) improve with video aggressiveness,3 and the various medical and game playing.9 Videogames were also more psychosocial effects.4 However, there are many effective for children who started out with rela- references to the positive benefits of tively poor skills. It has also been suggested that videogames in the literature.5,6 Research dating videogames may be useful in equalizing indi- Research has right back to the early 1980s has consistently vidual differences in spatial skill performance. consistently shown that playing computer games For over 20 years researchers have been using shown that (irrespective of genre) produces reductions in videogames as a means of researching individ- playing computer reaction times, improved hand-eye uals. Many of these reasons also provide an games produces co-ordination and raises players’ self-esteem. insight as to why they may be useful education- What’s more, curiosity, fun and the nature of ally. For instance : reductions in the challenge also appear to add to a game’s reaction times, educational potential.7 This paper briefly > Videogames can be used as research and/or mea- improved overviews some of the educational benefits of surement tools. Furthermore, as research tools they hand-eye videogame playing. have great diversity > Videogames attract participation by individuals co-ordination Videogames as educational and raises across many demographic boundaries (e.g., age, research tools gender, ethnicity, educational status) players’ Videogames can clearly consume the atten- > Videogames can assist children in setting goals, self-esteem. tion of children and adolescents.8 However, it is ensuring goal rehearsal, providing feedback, rein- important to assess the extent that videogame forcement, and maintaining records of behavioural technology had an impact on childhood educa- change tion. Since videogames have the capacity to > Videogames can be useful because they allow the engage children in learning experiences, this researcher to measure performance on a very wide has led to the rise of “edu-tainment” media. Just variety of tasks, and can be easily changed, stan- by watching children it becomes very clear that dardized and understood they prefer this type of approach to learning. > Videogames can be used when examining individual However, it appears that very few games on the characteristics such as self-esteem, self-concept, commercial market have educational value. goal-setting and individual differences > Videogames are fun and stimulating for participants. 48 Education and Health Vol. 20 No.3, 2002

Consequently, it is easier to achieve and maintain a patterns, speed and storyline that help chil- person’s undivided attention for long periods of dren’s basic skills development. Some of the time.10 Because of the fun and excitement, they may therapeutic benefits Demarest outlined were also provide an innovative way of learning language skills, mathematics and reading skills, > Videogames can provide elements of interactivity that and social skills. may stimulate learning > Videogames also allow participants to experience Language skills novelty, curiosity and challenge. This may stimulate These included videogame play being able learning to facilitate (i) discussing and sharing, (ii) fol- > Videogames equip children with state-of-the art tech- lowing directions (understanding prepositions nology. This may help overcome technophobia (a etc.), (iii) giving directions, (iv) answering ques- condition well-known among many adults). Over time tions, and (v) having a discussion topic with it may also help eliminate gender imbalance in IT use visual aides to share with others. (as males tend to be more avid IT users) > Videogames may help in the development of trans- Basic maths skills ferable IT skills These included videogame playing pro- > Videogames can act as simulations. These allow par- moting basic maths skills as children learn to ticipants to engage in extraordinary activities and to interact with the score counters on videogames. destroy or even die without real consequences > Videogames may help adolescents regress to child- Basic reading skills hood play (because of the ability to suspend reality in These included videogames’ character dia- videogame playing) logue which are printed on the screen (‘Play’, ‘Quit’, ‘Go’, ‘Stop’, Load’ etc.). There of course some disadvantages to Social skills researching videogames in an educational con- text. For instance : Videogames provided an interest that was popular with other children makes talking and > Videogames cause participants to become excited playing together so much easier. At school there and therefore produce a whole host of confounding are always other children who share a passion variables such as motivation and individual skill11 for videogame play. > Videogame technology has rapidly changed across time. Therefore, videogames are constantly being Horn15 used videogames to train three chil- upgraded which makes it hard to evaluate educa- dren with multiple handicaps (e.g., severely tional impact across studies limited vocal speech acquisition) to make scan > Videogame experience and practice may enhance a and selection responses. These skills were later participant’s performance on particular games, which transferred to a communication device. Other may skew results researchers have used videogames to help learning disabled children in their development Despite the disadvantages, it would appear of spatial abilities,16 problem-solving exer- Despite the that videogames (in the right context) may be a cises17 and mathematical ability.18 Other facilitatory educational aid. researchers have offered comments on how best disadvantages, it to use computer technology for improved would appear Videogames and the achievement and enhanced motivation among that videogames development of skills among the learning disabled.19,20 (in the right special need groups There are now a few studies that have examined whether videogames might be able to context) may be a Videogames have been used in comprehen- help in the treatment of another special needs sive programmes to help develop social skills in facilitatory group - children with impulsive and attentional children and adolescents who are severely educational aid. difficulties. Kappes21 tried to reduce retarded or who have severe developmental impulsivity in incarcerated juveniles (ages 15 to problems like autism.12,13 Case studies such as 18 years) by providing either biofeedback or those by Demarest14 are persuasive. Demarest’s experience with a videogame. Impulsivity account of her own autistic 7-year old son scores improved for both conditions. Improve- reported that although he had serious deficien- ment was also noted in negative cies in language and understanding, and social self-attributions and in internal locus of control. and emotional difficulties, videogame playing The authors concluded that most likely expla- was one activity he was able to excel. This was nation for the improvement in both ego-boosting for him and also had a self-calm- experimental conditions was the immediate ing effect. Videogames provided the visual feedback. Clarke22 also used videogames to Vol. 20 No.3, 2002 Education and Health 49

help adolescents learn impulse control. A compliance in children and adolescents with videogame was used for four weeks with four diabetes. Players assume the role of characters subjects (11 to 17 years) diagnosed with impulse who demonstrate good diabetes care practices Players assume the control problems. After the experimental trial, while working to save a summer camp for chil- role of characters the participants became more enthusiastic and dren with diabetes from rats and mice who have who demonstrate co-operative about treatment. stolen the supplies. ‘Packy and Marlon’ is now available through ‘Click Health’ good diabetes care Brain-wave biofeedback (www.clickhealth.com), along with two addi- practices while New (as yet unpublished) research23 sug- tional health-related software products, working to save a gests videogames linked to brain-wave ‘Bronkie the Bronchiasaurus’ (for asthma summer camp for biofeedback may help children with attention self-management) and ‘Rex Ronan’ (for smok- children with deficit disorders. Biofeedback teaches patients ing prevention). to control normally involuntary body functions In a controlled study using ‘Packy and diabetes from rats such as heart rate by providing real-time moni- Marlon’,26 8- to 16-year olds were assigned to and mice who tors of those responses. With the aid of a either a treatment or control group. All partici- have stolen the computer display, attention-deficit patients can pants were given a ‘Super Nintendo’ game supplies. learn to modulate brain waves associated with system. The treatment group was given ‘Packy focusing. With enough training, changes and Marlon’ software, while the control sub- become automatic and lead to improvements in jects received an entertainment videogame. In grades, sociability, and organizational skills. addition to more communication with parents Following on from research involving pilot and improved self-care, the treatment group attentiveness during long flights, a similar prin- demonstrated a significant decrease in urgent ciple has been developed to help medical visits. attention-deficit children stay focused by rewarding an attentive state of mind. This has Rehabilitation been done by linking biofeedback to commer- There are also several case reports describ- cial videogames. ing the use of videogames for rehabilitation. In In their trial, Pope24 selected half a dozen one application, an electronic game was used to ‘Sony PlayStation’ games and tested 22 girls improve arm control in a 13 year old boy with and boys between the ages of 9 and 13 who had Erb’s palsy.27 The authors concluded that the attention deficit disorder. Half the group got game format capitalized on the child’s motiva- traditional biofeedback training, the other half tion to succeed in the game and focused played the modified video games. After 40 attention away from potential discomfort. one-hour sessions, both groups showed sub- Electronic games have also been used to stantial improvements in everyday brain-wave enhance adolescents’ perceived self-efficacy in patterns as well as in tests of attention span, HIV/AIDS prevention programs.28 Using a impulsiveness, and hyperactivity. time travel adventure game format, informa- Parents in both groups also reported that tion and opportunities for practice discussing their children were doing better in school. The prevention practices were provided to difference between the two groups was motiva- high-risk adolescents. Game-playing resulted tion. The video-game group showed fewer in significant gains in factual information about no-shows and no dropouts. The researchers do safe sex practices, and in the participants’ per- warn that the ‘wrong kinds of videogame’ may ceptions of their ability to successfully negotiate be detrimental to children with attention disor- and implement such practices with a potential It is vital that we ders. For instance, ‘shoot ‘em up’ games may partner. have a negative effect on children who already continue to have a tendency toward short attention and Concluding remarks develop the impulsivity. They also state that the technique is It is vital that we continue to develop the positive potential an adjunct to drug therapy and not a replace- positive potential of videogames while remain- of videogames ment for it. ing aware of possible unintended negative while remaining effects when game content is not prosocial. At Videogames and health care the present time, the most popular games are aware of possible Videogames have also been used to usually violent. Given current findings, it is rea- unintended improve children’s health care. Several games sonable to be concerned about the impact of negative effects have been developed specifically for children violent games on some children and adoles- when game with chronic medical conditions. One of the cents. Game developers need support and content is not best-studied is an educational game called encouragement to put in the additional effort ‘Packy and Marlon’.25 This game was designed necessary to develop interesting games which prosocial. to improve self-care skills and medical do not rely heavily on violent actions. 50 Education and Health Vol. 20 No.3, 2002

Relationships between playing violent elec- It is assumed that the greater the influence of chance tronic games and negative behaviors and in the working of the game, the less educational and emotions may never be proven to be causal by therapeutic in nature. However, some players prefer the strictest standard of “beyond a reasonable games of chance over games of strategy doubt,” but many believe that we have already > Difficulty. Some games allow the player to choose reached the still-compelling level of “clear and the difficulty level. Others adjust difficulty level based convincing evidence.” on the progression of the player. This approach Finally, most parents would probably sup- allows the game to become progressively more inter- port the use of videogames if they were sure esting as it becomes more challenging they helped their children learn about school > Competition. Many games build in competition. subjects. There are several elements which the Some players are attracted by competition. Teachers teacher, parent, or facilitator should evaluate may wish to examine if the competition is presented when choosing a health promoting/educa- in such a way that all can win and that one does not tional or helping videogame (adapted from win at the expense of all others Funk29). > Duration. Some games have very short duration, while others may go on at length. Making of user > Educational or therapeutic objective. The objec- rewards, personal challenges, or changes in color or tive of the game should be clear. Professional graphical surroundings to maintain interest some helpers and developers should have a known goal in games can hold player interest for long periods of mind for the players of the game. The outcomes they time are seeking should be clear to the teacher and to the > Participant age and characteristics. Computerized player games have been developed for a range of ages. It > Type of game. There are many types of activity con- assumes that the participant can understand the tent : games, puzzles, mazes, play, rules of the game and has the skill level to accom- fantasy/adventure, simulations, and simulation plish the motor aspects of playing the game. Some games. Some games require physical skill and strat- games allow for modification of text to meet the egy, while others are games of chance. Some needs of poorly sighted players videogames are board or adventure game, while oth- > Number of players. Some videogames are solitary ers involve simulation involving real events or in nature. Others pit players against each other or the fantasy. No evidence supports a greater therapeutic computer. Solitary games may meet the needs of or educational effect in either situation those who find group work difficult > Required level and nature of involvement. The > Facilitator’s role. In some videogames, the teacher evaluator should assess whether the videogame or facilitator merely observes. In others, the facilitator player is passive or active. In some games, the com- may be an important part of the game format puter plays the game while the participant watches > Setting. Fully prepare staff to integrate these games the results. In computer-moderated games, the com- into the curriculum. Without proper acceptance, the puter provides the environment for the game to occur games may be used primarily as a game or toy rather and presents decisions or questions to the player at than as a therapeutic or educational tool key points during the game. The computer then Videogame reveals the consequences of the decisions made by Videogame technology brings new chal- the player lenges to the education arena. Videogames technology brings > Information and rules. Some games allow the represent one technique that may be available new challenges to player to have a range of knowledge and information to the classroom teacher. Care should be taken the education about past experiences with the game. Others pro- that enthusiastic use of this technique does not arena. vide minimal amounts of information to the player. displace other more effective techniques. Video Part of the strategy may involve the player’s and computer-based games may possess response to this lack of information. Rules and player advantages not present in other learning strate- participation in setting rules may vary among games gies. For example, the ability to choose different > The role of luck. Some games are driven by chance. solutions to a difficult problem and then see the Education and Health

In the next issue: Young People in 2001 Young people tell us what they do at home, at school and with their friends Vol. 20 No.3, 2002 Education and Health 51

effect those decisions have on a fictional game Applied Behaviour Analysis, 17, 229. allows students to experiment with prob- 13 Sedlak, R. A., Doyle, M. and Schloss, P. (1982) “Video lem-solving in a relative safe environment. Games - a Training and Generalization Demonstration with Severely Retarded Adolescents”, Education and Training in Videogames have great positive potential Mental Retardation and Developmental Disabilities, 17 (4), in addition to their entertainment value. There pp.332-336. has been considerable success when games are 14 Demarest. K. (2000). Video games – What are they good specifically designed to address a specific prob- for? Located at:http://www.lessontutor.com/kd3.html lem or to teach a certain skill. However, 15 Horn, E., Jones, H.A. & Hamlett, C. (1991). An investigation generalizability outside the game-playing situ- of the feasibility of a video game system for developing ation remains an important research question. scanning and selection skills. Journal for the Association for What is also clear from the empirical literature People With Severe Handicaps, 16, 108-115. is that the negative consequences of playing 16 Masendorf, F. (1993). Training of learning disabled children’s spatial abilities by computer games. Zeitschrift fur almost always involve people who were exces- Padagogische Psychologie, 7, 209-213. sive users of videogames. From prevalence 17 Hollingsworth, M. & Woodward, J. (1993). Integrated studies in this area, there is little evidence of learning : Explicit strategies and their role in problem serious acute adverse effects on health from solving instruction for students with learning disabilities. moderate play. Adverse effects are likely to be Exceptional Children, 59, 444-445. relatively minor, and temporary, resolving 18 Okolo, C. (1992a). 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