Attention and Memory Games for Children With ADHD

Say an eight-year-old child is playing a card game at the table after supper. They asked about the rules twice, but when their turn comes they remember which colour to play, they watch the opponent's card, and they don't leave the table for twenty minutes. The next day the same child gets lost at the second of a five-item homework list. The parent is surprised: "So they do have attention, why isn't it there for homework?"

The answer to this surprise shapes most of the article. Attention in a game and attention in homework are not the same thing. A game gives instant feedback, novelty and competition; homework does not. Because of this difference, the idea of "working on attention with games" always sounds more promising than it is. Below I have written which games are useful at which age, how many minutes to play, and how you can carry what is in the game over to daily life. First I need to say where the evidence ends, because the rest of the article should be read from there.

The limit of the evidence: what changes with play, what does not

Attention and working memory training is one of the most tried interventions in ADHD research. Most of it was done with computerised programmes: sequences of numbers, letters or positions are shown on the screen, the child holds them in mind and repeats them, and the tasks get harder as they go. The results come out quite similar to each other. The child improves markedly on the task in the training and on tasks very like it. Transfer to tasks that are not similar, that is, to reading, maths or daily attention, is weak or absent. A broad meta-analysis evaluating working memory training (Melby-Lervåg and Hulme, 2013) describes this pattern: near transfer exists, far transfer is not lasting.

The same line is seen in ADHD-specific reviews. In the 2013 meta-analysis by Sonuga-Barke and colleagues, cognitive training did not give a meaningful difference in measures where those assessing ADHD symptoms did not know what the training was. In parent reports the improvement was more marked. This does not mean what the parent sees is entirely wrong. But because the parent knows the child is receiving training, perception can change too. The 2015 meta-analysis by Cortese and colleagues drew a similar picture: there is some gain in neuropsychological measures, none in symptoms assessed blind.

These are mostly studies done with computerised programmes. There are very few studies in which card and board games were tried and measured separately in children with ADHD. So for none of the games I recommend in this article can I say "it reduces ADHD symptoms". I rely on two grounds: the general value of play in child development (Ginsburg's American Academy of Pediatrics report describes this) and general learning principles, that is, the idea that short, frequent practice with feedback is better than long, infrequent practice. These are not results tested in children with ADHD, they are reasonable inferences. In the rest of the article I will say so in the places where this applies.

Medication and behavioural approaches are on a quite different level of evidence. The consensus statement of the World Federation of ADHD counts them among the best supported options in managing symptoms (the parent training programmes article describes how this approach works). Play does not replace them. The decision about medication needs to be talked through with the doctor; I do not say anything in its place here.

What play works on: four separate jobs

When we say "attention game" we actually mean different things, and this distinction is useful when choosing games.

Sustained attention is staying on the same task for a few minutes. Waiting for your turn and not drifting away from the game while the opponent plays come under this (under sustained attention in the glossary it is written how it shows up in measurements). Selective attention is picking out what is needed from the crowd: finding a particular symbol in a pack of cards, following a sound in noise. Working memory is holding information in mind for a short time and doing something with it: what the card was two cards ago, what the three steps of an instruction were. Inhibition is stopping the first thing that comes to mind: not playing the wrong card, not carrying out a command that doesn't say "Simon says".

In ADHD all four can be affected but it differs from person to person. When choosing games it makes sense to look at what the child struggles with. If they blow up at waiting for a turn, inhibition and sustained attention come to the fore; if they miss instructions, working memory. For how working memory works in ADHD, you can look at the article on working memory and forgetfulness. I wrote it for adults there, but the mechanism is similar in a child.

Ages 4-6: short, visual, active

At this age the rules should be two or three sentences at most and the game should be understood in a minute. Games that do not require reading text and rely on visuals go well.

Memory matching cards. Start with six pairs, that is, twelve cards. Turn them face down, turn over two cards each in turn. When the child finds it easier, go up to eight pairs, then ten. Drawing the cards together or cutting them out of a magazine both turns the preparation into an activity and increases the child's sense of ownership. Time: 5-10 minutes.

Tray game ("what's missing?"). Put three or four familiar objects on a tray: a spoon, a ball, a candle, a comb. The child looks for twenty seconds, then closes their eyes, and you take one away. "Which one has gone?" When four objects are comfortable, go up to five, six. When the roles swap, the child tests your memory, and this gives most children great pleasure. 5 minutes is enough.

Freeze dance and rhythm imitation. Becoming a statue when the music stops works on inhibition. Repeating a three-beat rhythm is working memory by ear. I wrote about both in detail in the article on activities at home.

Three-step instruction game. "Go to the door, pick up a cushion, bring it to me." Start with one step, two a week later, then three. When they get it right, swap roles, so the child gives you instructions. When they get it wrong, instead of correcting, it is good to say "shall we try again, this time I'll repeat it." It looks like a game, but this is the game closest to a skill used in real life.

Simple dice and path games. Rolling a dice and moving forward, waiting for a turn, holding a rule in mind. Since losing is heavy at this age, games that finish quickly and have a shared goal in place of a race can be preferred.

Ages 7-10: rules, strategy, short rounds

At this age the child both understands the rule and can love it, and may be upset when they notice a peer not keeping to the rule. There is competition, and there is losing. Games are 10-20 minutes.

Uno and similar matching card games. Matching colour or number, watching the opponent's play, remembering to say "Uno": sustained attention, working memory and inhibition in one game. Special cards complicate the rules; in the first games you can take them out and play the plain version.

Dobble-style symbol spotting games. Finding the common symbol of two cards is selective attention practice. Because it is quick and has short rounds, it leaves little room for boredom. If the child is fast, you can add a rule to slow them down, such as "before you say what you found this round, point with your finger".

Dominoes and rummikub-style games. Matching and arranging tiles also involves planning. Dominoes is calm, rummikub needs a bit more thinking.

Pişti. A game known in Turkey, short, played with numbers. You need to watch the card in the middle, count the cards on the table, and hold in mind to some extent which cards have been played. In older children it uses working memory in a natural way.

Jenga and balance games. Careful movement, hand-eye coordination, waiting for a turn. For a child who acts too quickly in a move, the feedback comes at once when the tower falls; this is instructive.

Word chain and "I went to the market". Someone begins by saying "I went to the market, I bought an apple", and the next repeats this and adds to it. As the chain gets longer, working memory is strained. When played in pairs the success rate stays high. Start with three or four items, extend it when the child is comfortable. It works on car journeys too.

What changed game. Look at the room, change something (turn a book around, slide a cushion), and let the child find what changed. Selective attention and observation.

Ages 11-13: strategy and abstract thinking

At this age the child may reject what they see as a "baby game". The game must be a real game and the child must have a say in the choice. Duration 15-30 minutes.

Mastermind and code-breaking games. Guessing a colour or number code and holding in mind the information obtained from each guess. Working memory and planning. When the child is the one who sets the code, they work on a lot too.

Word and clue games. Word games played in teams, giving a clue with a single word, are rich socially and mentally. Thinking about what someone else means, controlling your own clue.

Chess and draughts. Planning, inhibition ("let me not play the first move I see"), anticipating consequences. I know of no solid evidence for the effect of chess on attention in children with ADHD. If the child likes it, great; if not, there is no point in forcing it. Playing with a teacher or at a club can be good socially too.

Pişti and card counting. At this age Pişti can be played more seriously: watching which cards have been played, making predictions from the remaining cards is a good working memory exercise. Without money or betting, only with points.

Colour-word game. Write the names of colours on paper in different coloured pens: the word "RED" in blue ink. The child says not the written word but the colour of the ink. Inhibition practice; trying to beat their own time instead of competing is more fun.

Homemade secret code. Set up a simple cipher system (letters correspond to numbers), and write messages to each other. Holding the code in mind and decoding it is a nice activity for working memory.

How much, how often

The figures in this section are my suggestion. I know of no study measuring play duration for children with ADHD. What I rely on is general learning research: short and frequent practice holds better than long and infrequent practice (the review by Cepeda and colleagues on spaced repetition shows this, but that is not a study of children with ADHD). I applied this principle to studying in the article on how to study. Adapted to play, it gives something like this.

Age	One game	Per week	Example games
4-6	5-10 minutes	4-5 short sessions	Matching cards, tray game, three-step instructions
7-10	10-20 minutes	3-4 times	Uno, Dobble-style, pişti, word chain
11-13	15-30 minutes	2-3 times	Mastermind, code games, chess, card counting

If the child wants to continue, don't cut it. Finishing without wearing them out makes starting the next game easier. If the child drops it in three minutes, I wrote the reasons in the article on activities at home in the same series: too hard, too easy, too long or an adult not beside them.

A sample week (for ages 7-10, entirely a suggestion):

• Monday: matching cards, 10 minutes, increase the number of cards by two from the previous week.
• Tuesday: a round of Uno after the meal, 15 minutes.
• Thursday: word chain in the car or on a walk, 10 minutes.
• Saturday: the what changed game and a board game, 25 minutes in total.

It is also possible to order play with movement. If I were you, with a high-energy child I would have them run around for ten minutes first and then sit at the table. How attention changes after short movement is in the article on outdoor activities, but that is not an order tested separately for play.

Losing, waiting for a turn, breaking rules

Where a child with ADHD struggles in play is often not attention itself but emotion. Blowing up on losing, fidgeting while waiting for a turn, bending the rule in their own favour. So sometimes the part of learning through play that works best is this: trying out losing at small risk.

A few things seem to work, but these are not a package tested in children with ADHD, they are ideas I have drawn from the principles of behavioural parenting. Cooperative games, that is, games where everyone is on the same side, are safe for a first step. Short rounds: if a game is longer than ten minutes, the tension of losing builds up. Practising beforehand the sentence to say on losing ("shall we play again?"). The adult sometimes truly losing and receiving it calmly models it for the child. And when the child wins, a calm "you played nicely" is enough, instead of exaggerated celebration.

For waiting for a turn, a turn object is a good trick: the person whose turn it is holds a stone or a pencil. The hands of the child who doesn't have the turn must not be empty and idle; give them a job, ask them to predict the opponent's move. This turns the moment of waiting into a moment of attention.

If the child reacts badly to losing in every game, this is not a game problem. It is an emotion regulation problem and needs separate attention. The article on calming activities is a better place for this. For the side of playing with friends, there is the article on friendships.

Carrying the skill in the game into daily life

The clearest thing the evidence says is this: transfer does not happen by itself. Then the transfer has to be done separately and deliberately. This is a principle from general learning psychology (using a skill in a context different from the one where you learned it needs separate practice). I know of no clear study testing this in children with ADHD, but I see no other option either.

It can be done like this in practice. Name the strategy used in the game. In the "I went to the market" game the child is most likely doing something: tying each word to a picture or holding the first letters in mind. Make them notice: "What did you do with the apple in your head?" Then try the same strategy in a real task. "You'll take three things to school: a notebook, watercolours, a snack. Make a picture in your head." Repeat this when preparing the bag in the morning.

The three-step instruction game is the most direct bridge. A child who can do "go to the door, take a cushion, bring it" in the game can start taking the instruction "put on your shoes, take your bag, wait at the door" during the day too. But even here, having the child repeat the instruction, or turning the instruction into a picture list, is far more reliable than expecting it from memory. Games can be a good ground, but what really makes daily life easier is the supports outside: a visible list, a fixed place, reminders. My own keys still go missing, and what solved that was not a memory game but, if anything, a hook hung beside the door. Moving memory outside instead of trying to strengthen working memory often works better; the methods in the homework follow-up article are in the same logic for homework.

One more thing: not mixing play with the reward system. The sentence "if you finish your homework we'll play" makes play a reward and weakens the quality of play as shared time. If a reward system is going to be set up, let it be set up in a separate frame.

Screen games and brain training programmes

Memory games played on a tablet or computer fall into two groups. The first are ordinary entertainment games. The second are usually paid programmes sold as "brain training" or "working memory training".

For ordinary games, what there is to say is short: being a memory game does not make it beneficial for ADHD, but it does not make it harmful either. Adjusting duration and timing is a separate subject and the article on screens and ADHD in children describes it.

For paid training programmes, the meta-analyses I wrote about above are important. The programmes have been tested in controlled studies. The improvement on near tasks is real. On blind-assessed ADHD symptoms and school achievement, the effect is either small or nonexistent. Most of these programmes require weeks of regular, long sessions and an adult's follow-up. That is a serious burden on a family's time and money. If I were you, I would first put that time and money on things whose evidence is more solid: parent training, school adjustments and, if needed, treatment talked through with the doctor. Play can be done in addition to these; let it not take their place.

If play doesn't work

If the child cannot stay in any game for more than three or five minutes, keeps breaking rules during the game or every time it ends in crying, it is hard to solve this with the choice of game. The first place to look here is the child's general state: sleep, anxiety, a learning difficulty or inadequate treatment of ADHD. These are things to talk about with the doctor or the school counsellor.

The reverse can happen too: the child is very good at games and terrible at homework. This does not disprove a diagnosis of ADHD. It fits the way Barkley describes ADHD: the problem lies less in knowing the information or skill than in being able to use it at the moment it is needed, so difficulty lessens in interesting tasks with instant feedback. Play shows this gap but does not close it.

What I make of it

I would recommend attention and memory games not as an intervention but as good time spent with the child. When the game is over the child's attention may not have increased, but that evening you have laughed together, shared a rule, tried losing and winning. Since the share of criticism and correction in the day of a child with ADHD is high, even a twenty-minute stretch in which nothing is corrected is valuable.

I would ask you not to expect a treatment effect from play. The evidence on this is clear: near improvement exists, far transfer is weak. When expectations are held high, one of two things happens: either the game turns into a disliked task, or when no improvement comes, parent and child experience disappointment. If expectations are low, the game gives its own value anyway.

I would look for what will work in real life outside the game: visible lists, fixed places, putting instructions into writing or pictures. I put the game beside these supports, not in their place. A child can be wonderful at memory cards and still forget their bag in the morning. That is not the child's failure, it is the skill not transferring. And the solution is not playing more cards but hanging a list beside the bag.