Our survey of 1,254 middle-schoolers included 78 students with mild learning disabilities who could fill out the survey with extra time or assistance from staff (while still keeping their answers private). As a group, these kids tended to play games for more hours per week than others. They were more likely than other children to play games to feel less lonely, to get their anger out, and because they liked “the guns and other weapons.”



They were also more likely to be victims of bullying, and to report being left out or excluded by their peers. Their overall top reasons for playing games reflect their needs to connect with friends and cope with feelings: playing because their friends did, to make new friends, or to teach others; or playing because they’re bored and games are exciting.

Child psychiatrists and psychologists have found that children with attention deficit disorder (ADD) are often particularly attracted to media, including television, video games, and computers. Surveys, including ours, support the idea that kids who have problems paying attention or sitting still spend more time with video and computer games. Some parents worry that video games are a cause of ADD symptoms, or make them worse. But it’s more likely that for kids who already have ADD, games have greater appeal.

Many of these children find school stressful, demanding, and—even with an individualized education plan—not very supportive of their self-esteem. One of the things they value about electronic games is that they offer interaction without criticism.

“That feels great for most of us,” says Michael Jellinek, M.D., professor of pediatrics and psychiatry at Harvard Medical School and chief of child and adolescent psychiatry at Massachusetts General Hospital, “but it’s especially important to kids who have learning disabilities. A lot of people don’t appreciate how much these kids get criticized, and how self-critical the kids themselves are. They don’t understand how liberating it is to be in control of something like a computer where they can pause and start over, where their work comes out neat and organized instead of messy. They don’t understand how much of a relief this is. The computer is unconditionally accepting, while most parents and teachers aren’t.”

Our middle-school survey gave other hints about how children with attention or hyperactivity problems use video games. We incorporated five questions from the Pediatric Symptom Checklist, a standardized survey used by pediatricians to screen for behavioral and other problems. Boys whose responses put them over the threshold level for ADD symptoms were more likely than others to use games to cope with angry feelings. Among girls with ADD symptoms, twice as many (almost one in four) played games to make new friends, compared to other girls. In moderation, these are probably healthy uses of video games.

Because skill with video games or computers can be an important source of self-esteem for a child with ADD, Jellinek encourages parents to support this. He notes that coming home from school and immediately starting on homework can be too much for these kids; some kind of afterschool activity, such as a sport, can help. Once children are home, video games can serve as a useful transition to or break from homework.

Like children diagnosed with ADD, developmentally delayed kids may use video games to pass the time, especially when they have few social relationships. Parents of children with developmental delays need to keep a closer eye on media use, however, because these children may have more trouble than their peers with distinguishing a fantasy game world from the real world. This could lead them to mimic language or behavior from a game in socially inappropriate ways, possibly getting themselves into trouble. When using age-based ESRB ratings to choose games, parents need to consider their child’s developmental age as well as their calendar age.