Can You Game Your Way to Better Focus? Digital Therapeutics & ADHD (2026)
Bandai Choi
MSSc, MAPS, MCCLP, AFHKPS | Clinical Psychologist
Breathe-n-Smile Psychology — Essendon & Footscray, Melbourne
- Digital therapeutics (SaMD) are prescription software applications that treat medical conditions through structured, evidence-based interaction.
- ENDEAVORRIDE (SDT-001), recently approved in Japan, uses a video game interface to force dual-tasking, directly training the prefrontal cortex.
- The pivotal STARS-ADHD randomised controlled trial found statistically significant improvements in objective attention after just 4 weeks of daily 25-minute use.[1]
- While not yet TGA-approved in Australia, the underlying neuroplasticity science applies to everyday strategies you can use right now.
The Rise of Prescription Gaming for ADHD
In June 2026, Japan approved ENDEAVORRIDE (SDT-001)—a “Software as a Medical Device” (SaMD) developed specifically for pediatric ADHD. It shares its core technology with EndeavorRx, which was FDA-authorised in the United States in 2020 after five clinical studies involving over 600 children. This approval signals a meaningful shift in how the medical community thinks about ADHD treatment: clinical interventions are successfully moving beyond traditional medication into highly structured digital therapeutics.
While these specific applications are not yet cleared by the Therapeutic Goods Administration (TGA) in Australia, the science driving them offers incredibly valuable insights into how we can rethink ADHD management and executive function training.
Can a Video Game Actually Change ADHD Symptoms?
Despite looking like a high-quality action video game, ENDEAVORRIDE operates on a clinical algorithm designed to create “sensory-motor interference.” The goal is not entertainment—it is to force the brain into a specific kind of cognitive work. Here is how the mechanics translate into clinical outcomes:
- Simultaneous Demand: Users must continuously steer an avatar (a continuous motor task) while simultaneously tapping specific targets and ignoring distractors (a perceptual task). The brain cannot do both on autopilot—it must actively manage the conflict.
- Targeting the Prefrontal Cortex: Managing two competing tasks at the same time highly activates the prefrontal cortex—the brain’s centre for sustained attention, impulse control, and cognitive flexibility. This is the same region that is under-activated in ADHD.[2]
- Adaptive Difficulty: The software adjusts in milliseconds, keeping the user consistently challenged without triggering total frustration or autonomic hyperarousal. This is the sweet spot for neuroplastic change.
- Proven Results: The pivotal STARS-ADHD randomised controlled trial (n=180, ages 8–12) showed statistically significant improvements in objective attentional functioning after 4 weeks of daily 25-minute use, with a very low risk of adverse effects.[1] A subsequent replication study across three independent trials confirmed these findings across children, adolescents, and adults.[3]
Harnessing Neuroplasticity in Daily Life
In my practice, I often see how standard behavioural tools can feel repetitive or under-stimulating for neurodivergent clients, failing to genuinely engage their executive functions. The most exciting takeaway from the rise of digital therapeutics is not the technology itself—it is the powerful validation of neuroplasticity as a treatment mechanism.
The prefrontal cortex is highly malleable. When the neural circuits responsible for attention and cognitive flexibility are consistently challenged—through a dual-tasking engine, a complex sport, or a demanding multi-step task—they physically adapt and become more efficient over time. Anguera and colleagues demonstrated this elegantly in a landmark Nature study, showing that multitasking video game training not only improved cognitive control but produced measurable changes in frontal EEG activity that persisted six months after training ended.[4]
This science shifts how we view executive functioning. Rather than seeing traits like working memory or task initiation as fixed limitations, they are capacities that respond to conditioning. Just as physical training builds muscular endurance, structured cognitive training expands attentional capacity. It is a core part of helping clients write their own user manual for their mind and body to thrive in life.
While prescription digital therapeutics are not yet available in Australia, the core mechanism—harnessing neuroplasticity through consistent, structured practice—is central to our neurodiversity-affirming approach at Breathe-n-Smile Psychology. Whether it is engaging in complex coordination sports like free diving or indoor climbing, or practising mindful attention-shifting during multi-step tasks, the brain learns through doing.
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Book Your Assessment Free 15-Min ChatFrequently Asked Questions
What is a digital therapeutic (SaMD)?
A Software as a Medical Device (SaMD) is a software application intended to be used for medical purposes—such as treating, diagnosing, or managing a disease—without being part of a physical medical hardware device. Unlike general wellness apps, they are subjected to rigorous clinical trials and regulatory approval processes before they can be prescribed.
Are ADHD video game treatments available in Australia?
Not yet. Prescription digital therapeutics for ADHD, including ENDEAVORRIDE and EndeavorRx, are not currently approved by the Therapeutic Goods Administration (TGA) and are therefore not legally available for clinical prescription in Australia. This may change as the regulatory landscape evolves.
Can cognitive training replace ADHD medication?
No. Developers and medical guidelines explicitly state that digital therapeutics are designed as adjunctive treatments. They are intended to be used alongside standard environmental adjustments, psychosocial therapies, and prescribed medications where appropriate—not as standalone replacements. If you are exploring your options, a comprehensive ADHD assessment is a good starting point.
How does neuroplasticity relate to ADHD treatment?
Neuroplasticity is the brain’s ability to reorganise itself by forming new neural connections in response to learning and experience. In ADHD, the prefrontal cortex—which governs attention, impulse control, and working memory—is under-activated. Structured, consistent cognitive challenges can strengthen these circuits over time, improving executive function. This is the mechanism behind both digital therapeutics and many evidence-based therapy approaches used at Breathe-n-Smile.
References
- Kollins SH, DeLoss DJ, Cañadas E, et al. A novel digital intervention for actively reducing severity of paediatric ADHD (STARS-ADHD): a randomised controlled trial. Lancet Digital Health. 2020;2(4):e168–e178. https://doi.org/10.1016/S2589-7500(20)30017-0
- Rubia K, Westwood S, Aggensteiner PM, Brandeis D. Neurotherapeutics for attention deficit/hyperactivity disorder (ADHD): a review. Cells. 2021;10(8):2156. https://doi.org/10.3390/cells10082156
- Stamatis CA, Farlow D, Mercaldi C, et al. In-game performance metrics derived from a digital therapeutic for inattention predict ADHD-related clinical outcomes: replication across three independent trials of AKL-T01. Translational Psychiatry. 2024;14:362. https://doi.org/10.1038/s41398-024-03045-0
- Anguera JA, Boccanfuso J, Rintoul JL, et al. Video game training enhances cognitive control in older adults. Nature. 2013;501(7465):97–101. https://doi.org/10.1038/nature12486