Developing and evaluating the feasibility of an active training game for smart-phones as a tool for promoting executive function in children
Gray, Stuart Iain
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Executive function (EF) comprises a series of interrelated cognitive and self-regulatory skills which are required in nearly every facet of everyday life, particularly in novel circumstances. EF skills begin developing from birth and continue to grow well into adulthood but are most crucial for children as they are associated with academic and life success as well as mental and physical health. There is now strong evidence that these skills can be trained through targeted intervention in a diverse range of approaches, such as computer games, physical activity, and social play settings. This thesis presents the process of the design and evaluation of an active EF-training game (BrainQuest) for smart-phones, in participation with end-users: a group of 11-12-year-old children from a local Primary School. The design process placed emphasis on creating an engaging user experience, a phenomenon which has eluded many serious games, by building upon motivational game design theory and satisfying end-user requirements. However, in the pursuit of promoting particular executive functions: working memory; inhibitory control; planning and strategizing, the design integrated aspects of a cognitive assessment while also utilizing a range of alternative approaches for training EF, including physical activity and social play. Following an iterative design process which included many single session prototype evaluations, a mixed methods evaluation was undertaken during a 5-week study with twenty-eight 11-12-year-old school children. The study gathered exploratory qualitative and quantitative evidence regarding the game’s potential benefits which was evaluated by triangulating a range of data sources: multi-observer observations notes, interviews with children and teachers, game performance data and logs, and cognitive assessment outcomes. The analysis describes the statistical relationships between game and executive function ability, before exploring user experiences and evidence of cognitive challenge during gameplay through a series of triangulated case studies and general whole-class observations. The analysis presents the game to be engaging and enjoyable throughout the study and, for most children, able to generate a sustainable challenge. Though there were initial difficulties in understanding the complex game rules and technology, the game became increasingly usable and learnable for the target user group and created opportunities for goal setting. It also encouraged feelings of pride and self-confidence as well as facilitating positive social interactions and requiring regulation of emotion, which are considered to be pathways to developing executive functions (Diamond, 2012). There was also promising initial evidence that the game’s variable difficulty level system was able to challenge executive functions: planning and strategizing, working memory, and inhibitory control. Most notably, the game appeared to support improvements in strategizing ability by demanding increasing strategic complexity in response to evolving and increasingly difficult task demands. Supporting BrainQuest’s cognitive challenge, several statistical relationships emerged between executive function ability and game performance measures. However, the game’s ability to significantly improve cognitive outcomes could not yet be concluded. Nevertheless, these findings have implications for both the future design and evaluation practices undertaken by cognitive training researchers. From a design perspective, less credence should be paid to simply gamifying cognitive assessments while greater emphasis should be placed on integration of formal game design and motivational theories. With regards to evaluation, researchers should understand the importance of establishing first whether CTGs can remain engaging over time as well as the feasibility of their challenge to cognitive functions.