This section will define the terms as used in this document. The term “computer games” in this paper is used very loosely. Sometimes called “video games” they are any game that can be played on a computer, game console, or handheld device. They may include on-line games, multi-player games or stand-alone games.
The focus and many of the examples included in this paper will be based on stand-alone computer games. This is not meant to negate any of the other types of games, which can be effective learning and rehabilitation tools, but is a reflection of my familiarity and knowledge base.
Computer Games come in many varieties: Total immersion games, action games, multiple player games, skill based games such as racing games, sports games, shoot-em-ups, strategy games, simulation games, serious games which are meant to train a skill set, problem solving games, story games, educational games, trivia type games, puzzle games, word games, card games and other casual games. The one characteristic that all these have in common is that they are “games”.
Games usually involve a system of competition either with yourself or others, a reward for accomplishments, problems to solve, and a challenge for you to overcome. This tends to engage the player in a way that a simple exercise or drill will not. This engagement in what the player is doing is the main reason for using games in learning and rehabilitation rather than less enticing media. However, if the games are not accessible to people with special needs, the learning and rehabilitation value is lost to this population.
Benefits of computer games
Over the past few years a number of studies have been conducted to evaluate the effectiveness of computer games in learning and rehabilitation. In 2002, a project conducted in the United Kingdom, Teachers Evaluating Educational Multimedia (Teem), found that simulation and adventure games developed children’s strategic thinking and planning skills.
In 2003, researchers from the University of Rochester found that people who played action-based video games scored high on vision tests, and were better able to spot details in complex scenes, cope with distractions better and process changing visual information more rapidly and efficiently.
In 2005, The Swedish National Institute of Public Health reported that a review of 30 studies from around the world indicated that computer games improved spatial thinking and reduced reaction times from a stimulus to an action. Also in 2005, the Serious Games Summit had several presenters who were involved with games for health. They indicated these games helped modify behavior among risk prone teens.
The Federation of American Scientists reported in 2006 that after a year studying the games and their effect on children, “a new vision of video games could redefine education and captivate students so they will spend hours learning on their own.”
In addition, several books have been written including a 2006 detailed study of video games by Peter Vorderer and Jennings Bryant called “Playing Video Games: Motives, Response, Consequences. The most recent is a 2007 book “How Computer Games Help Children Learn” by Williamson Shaffer.
A number of studies have been done reviewing the effectiveness of computer games in brain training as a tool to assist seniors in cognitive maintenance and slow the progress of Alzheimer’s and other dementias. The response to these studies has been the development of a number of products specifically designed for this purpose by major computer game companies such as Nintendo. We will deal in detail with this and other rehabilitative and maintenance benefits of computer games when we talk about specific problem domains.
Warnings about Computer Games
A number of psychologists and physicians have expressed concerns about the negative effects of computer games. The primary concern is that the violent content of many computer games will increase violent and antisocial behavior in the children who play them.
Other concerns include: addiction to gaming; increase in obesity from being sedentary – an accusation shared with excessive TV viewing; desensitization, a numbing or blunting of emotional reactions to events that would usually elicit a response; poorer academic performance – from playing during time that should be spent on homework; and reduction in the ability to distinguish reality from fiction.
In 2001, Anne D. Walling, MD reported in the Journal of Adolescent Health that, after a review of 29 studies on the topic of the negative effects of violent video games, little evidence supported the concerns and that more work was needed.
In 2004, the American Family Association Journal reported that research indicated there was increased aggression, and desensitization among adolescents who played violent video games.
In 2006, researchers at the University of Missouri found there was less brain reactivity when violent video game players viewed violent images than when non-players viewed the same images. Researchers at Indiana University School of Medicine identified an increase in emotional arousal as measured on brain scans of kids who played violent video games, and a decrease of activity in brain areas related to self-control, inhibition and attention.
In 2007, the AMA reviewed the status of research on the physical, behavioral and psychosocial effects of computer games on game players. The paper discussed efforts to control video game content including the ESRB (Entertainment Software Rating Board) rating system. They reviewed regulatory attempts both on the Federal and State levels, mostly aimed at ensuring that the rating system was accurate and age appropriate, and preventing younger children from accessing inappropriate material.
Mainstream game companies have produced very few games that are accessible to gamers with special needs; much less accessible educational games.
The Game Accessibility Special Interest Group of the International Game Developers Association has been working to change this. Also, there are a number of independent individuals and small game developers who are working on accessibility in games. But these resources are dispersed.
The 7-128 Software ALERT project is an effort to gather that information in one place. It addresses “how to use them”, “where to get them”, and “who to go to for help using them”.
This series of ALERT papers addresses “how” to use computer games in educational and rehabilitative settings.
The ALERT Game Book demonstrates “how” specific Accessibility Accommodations for specific Accessibility Modalities work in real games.
The ALERT tables of annotated Web site links for the various Accessibility Modalities tell “where” to get those types of games.
The ALERT Experts list presents an annotated set of links to knowledgeable people “who” are available to help you use those games in your efforts.
How to Use Computer Games for Learning
1) The first step in using computer games for learning is, as with any curricular tool, to identify the specific learning objectives you wish the student to master.
2) The next step is to determine how you can measure progress in mastery of those objectives.
3) The third step is to identify a game or games that will aid the student in mastery of the objective. It is important to note that the selected games need not be so-called educational games in order to do what you want.
4) The student must then learn how to play the game. This means the parent or teacher must have played the game and be able to assist the student. A too complicated game will not be an effective learning tool. For best results, the game MUST be perceived as fun by the student.
5) If the game is engaging, the student will play it a number of times. The effect of the game on mastery of the learning objective can then be measured.
If the learning objective is fairly straightforward, such as an objective to improve the short term memory, a pre-test can be used. Then after playing several memory games such as Kim’s game and Spotter for a period of time, a post-test can be administered to test for improvement. If the game has an ongoing measure of mastery such as levels, completion of higher levels may indicate mastery of the objective, as well as feeding student satisfaction.
If the learning objective is a complex one, a discussion process should be built into the use of the game. For example, in the original Sim City, a person playing the game will learn about the interaction between taxation levels and public satisfaction with government. This can provide a lively discussion about the role of government.
How to Use Computer Games for Rehabilitation and Maintenance
1) As with use of computer games for learning, the first step in use of games for rehabilitation is to determine the objective you wish to accomplish. For example, your objective is to improve hand-eye coordination.
2) The next step is to evaluate the level of hand-eye coordination the person has presently, and determine how to measure improvement.
3) Selection of the games to use would involve a number of factors. For example, is the target large enough for the person to succeed, at least sometimes? Can the speed be varied so that the level of difficulty can be increased? Is the game engaging enough that the person will willingly learn to play the game and play it often enough to improve?
4) After a period of time, measurement must be made to see if the game has been effective in improving hand-eye coordination.
Just as exercise is essential to keep the body fit, mind exercises are needed to maintain acuity. Maintenance could also mean slowing down of deterioration in mental and physical functions through specific activities – the “use it or lose it” philosophy. Computer games that improve memory function, assist in naming objects and generally exercise the mind can provide maintenance for early Alzheimer’s as well as the aging of normal brains. We will discuss this in detail later.
How to Select the Correct Game
1) The game must specifically act in the area of performance or learning objective you wish the person to master. To determine this, review of the documentation provided can cull the possible appropriate games down. However, first or good second hand knowledge of the game is the only way to be sure it will accomplish what you want.
2) Second, the game must have whatever accommodations are required for the person who is to play it. For a blind person, the game must self voice or work with whatever assistive technology the person has. For an elderly person, the print must be large enough for them to be comfortable with, or the game will be ineffective. For a deaf person, no important component of the game should be available only through auditory input.
3) The game selected must be age appropriate. It must not be so complex as to be defeating to the player. Game documentation and ratings will help to determine the age level it is appropriate for. But, first-hand knowledge is still the best determiner as to its’ appropriateness for your child, elderly parent or client.
4) The ESRB rating system does tell you a lot about the mainstream games from major game developers. However, there are not many mainstream developers that produce games with accommodations for handicapped players.
Getting a game rated is expensive. To my knowledge there is no difference between a casual, simple puzzle game and a more comprehensive, multiple level, complex adventure game as far as cost to become rated. This means that many games that you may wish to use will not be rated. This is another reason for you to become familiar with the games your child is using and especially with games you are recommending for students, elderly parents and clients.
There has been enough research validation of the negative effects of super violent and graphic games, especially with younger children, that I personally recommend that games be reviewed so that the least violent game that achieves the learning or performance objective is selected over more graphical or violent games. I prefer use of Family Friendly games where possible.
5) The game should engage the player. It should provide entertainment. If it is perceived as a chore, it will not be an effective learning or training tool.
6) Finally, cost is a consideration. Many “brain training” games cost many times what standard computer games cost. The economics behind this is that such games typically sell far fewer units than purely entertainment games. Still, there are bargains. Check out Academic sources. Inquire on forums.
If you can achieve the same performance or learning objective at a third of the cost, by all means do it. It costs the developer to produce games with slick graphics. While they may increase the appeal of the game for the player, they may not advance the performance or learning objective significantly compared to a game that has less sophisticated graphics and is less costly, but is on target at addressing the performance or learning objective.
During 2008, we intend to produce further papers that specifically address selection of games for each of the problem domains outlined in our Accessibility Ratings. These will address the needs of both children and adults.
They will include the specific accommodations required and some suggestions as to where games with these accommodations might be acquired.
We will also look at some specific performance or learning objectives and make recommendations as to how they may be accomplished.