Digital health interventions for youth with ADHD: A systematic review

Given the growing interest in digital health interventions (DHI) and increasing number of commercial products targeting youth with ADHD, we conducted a mapping review of the current evidence for DHI for children and adolescents with ADHD. To identify DHI designed to support or extend ADHD treatment. Electronic databases (PubMed, ACM Digital Library, and IEEE Xplore) were searched for studies published in English from January 1, 2004, through January 1, 2022. Search keywords included ADHD and terms for technology (e.g., digital, smartphone, computer) and treatment (e.g., treatment, intervention, cognitive training, neurofeedback). Two reviewers reviewed titles, abstracts, and articles. Prior reviews and meta-analyses for two clusters of DHI (cognitive training and neurofeedback) were identified and summarized. The remaining 1,246 records focused on other DHI, and 51 studies representing 16 countries met eligibility criteria. These DHI addressed functioning in domains commonly targeted in treatments for ADHD and were classified based on targeted domains, users, technological platforms, and intended settings. The 51 DHI studies described interventions delivered via serious games or e-learning, the web, mHealth, telehealth, and augmented or virtual reality. DHI targeted a range of domains relevant to ADHD treatment: cognition, social-emotional skills, behavior management, academic/organizational skills, medication adherence, vocational skills, motor behaviors, and clinical care. Twelve well-designed, adequately powered randomized clinical trials reported positive outcomes from interventions delivered using telehealth, the web, mHealth applications, exergaming, and clinician decision-making support tools. Keyword selection, terminology usage, and digital libraries in the DHI space were not consistent within or across disciplines, nor across countries, which limited study identification. Few studies had evidence from randomized, controlled trials which limited information on the efficacy of most tools. Research supports the use of several DHI and describes emerging DHI, not yet available for implementation in community settings. Our review provides a map of the current field, identifies gaps and potentials for future research, and highlights the need to increase translation from early designs to robust evidence-based products. • This review covers research addressing how to use computers to support individuals with ADHD using digital health interventions (DHI). • DHI described include serious games or e-learning, the web, mHealth, telehealth, and augmented or virtual reality. • DHI have been developed to improve multiple domains including cognition, emotion, behavior, and organizational skills. • While a handful of DHI have evidence supporting their use, far more work is needed to translate promising tools into evidence-based community practice. Research bridging the computing and clinical sciences illustrates the potential for DHI to improve and sustain positive outcomes for patients with ADHD and their families.