Can You Beat the Music? Validation of a Gamified Rhythmic Training in Children with ADHD

Neurodevelopmental disorders like ADHD can affect rhythm perception and production, impacting the performance in attention and sensorimotor tasks. Improving rhythmic abilities through targeted training might compensate for these cognitive functions. We introduce a novel protocol for training rhythmic skills via a tablet-based serious game called Rhythm Workers (RW). This proof-of-concept study tested the feasibility of using RW in children with ADHD. We administered an at-home longitudinal protocol across Canada. A total of 27 children (7-13 years) were randomly assigned to either a finger-tapping rhythmic game (RW) or a control game with comparable auditory-motor demands but without beat-synchronization (active control condition). Participants played the game for 300 minutes over two weeks. We collected data (self-reported and logged onto the device) on game compliance and acceptance. Further, we measured rhythmic abilities using the Battery for the Assessment of Auditory Sensorimotor and Timing Abilities (BAASTA). The current findings show that both games were equally played in duration, rated similarly for overall enjoyment, and relied on similar motor activity (finger taps). The children who played RW showed improved general rhythmic abilities compared to controls; these improvements were also positively related to the playing duration. We also present preliminary evidence that executive functioning improved in those who played RW but not controls. These findings indicate that both games are well-matched. RW demonstrates efficacy in enhancing sensorimotor skills in children with ADHD, potentially benefiting executive functioning. A future RCT with extended training and sample size could further validate these skill transfer effects. ### Competing Interest Statement SDB is on the board of the BeatHealth company dedicated to the design and commercialization of technological tools for assessing rhythm abilities such as BAASTA tablet and implementing rhythm-based interventions. Other authors have no competing interests to disclose. ### Funding Statement This work was supported by funding from grant 05453 from the Natural Sciences and Engineering Research Council of Canada (NSERC), grant 115050 from the Canadian Institute of Health Research (CIHR), and grant 0160 from NSERC Tier 1 Canada Research Chairs to Simone Dalla Bella, Canada Research Chair in Music Auditory-Motor Skill Learning and New Technologies. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Ethical approval for this research was granted by the ComitE d'Ethique de la Recherche en Education et Psychologie (CEREP) of the University of Montreal - CEREP-20-008-P. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors.