The Impacts of Video Games on Cognition (and How the

Policy Insights from the

Behavioral and Brain Sciences

2015, Vol. 2(1) 101 –110

DOI: 10.1177/2372732215601121

bbs.sagepub.com

Health

Playing some, but not all, video games can improve percep-

tion and cognition. Many issues remain, though, particularly

how to best translate research to produce public good.

Key Points

 Playing some types of video games, particularly

“action” video games, results in widespread enhance-

ments in cognitive function.

 There is evidence that other types of games can also

lead to similarly positive outcomes—for instance, cer-

tain custom designed “brain games.”

 Many questions remain as to how to best translate the

base science to produce public good.

 Many questions remain as to how to best regulate

the industry promoting games for cognitive en hance-

ment.

 Effective governmental regulations would provide an

incentive structure for better science to be conducted,

in particular, by recognizing that scientific evidence

for product efficacy is typically graded, rather than

all-or-none.

Introduction

Over the past half century, video game play has gone from

being a somewhat fringe activity to a ubiquitous part of mod-

ern culture. While the first dedicated video game console

(the Magnavox Odyssey, released in 1972) sold only about

300,000 units, the three major consoles released in the mid-

2000s (the Xbox 360, the PlayStation 3, and the Wii) sold

more than 84 million units each. More than 40% of Americans

report playing video games regularly (i.e., more than 3 hr a

week), and counter to impressions that video games are the

exclusive domain of male children and teenagers, video

game use cuts across nearly all American demographics,

with 27% of players being above 50 years of age and 44% of

players being female. This shift toward gaming has resulted

in a concomitant decrease in time spent watching television

or movies (Entertainment Software Association, 2015).

601121BBS

XXX10.1177/2372732215601121Policy Insights from the Behavioral and Brain SciencesGreen and Seitz

research-article2015

University of Wisconsin–Madison, USA

University of California, Riverside, USA

Corresponding Author:

C. Shawn Green, 1202 W. Johnson St., University of Wisconsin–Madison,

Madison, WI 53706, USA.

Email: [email protected]

The Impacts of Video Games on Cognition

(and How the Government Can Guide the

Industry)

C. Shawn Green

and Aaron R. Seitz

Abstract

Video game play has become a pervasive part of American culture. The dramatic increase in the popularity of video games

has resulted in significant interest in the effects that video gaming may have on the brain and behavior. The scientific research

to date indicates that some, but not all, commercial video games do indeed have the potential to cause large-scale changes

in a wide variety of aspects of human behavior, including the focus of this review—cognitive abilities. More recent years

have seen the rise of a separate form of video games, the so-called “brain games,” or games designed with the explicit goal

of enhancing cognitive abilities. Although research on such brain games is still in its infancy, and the results have definitely

not been uniformly positive, there is nonetheless reason for continued optimism that custom games can be developed that

make a lasting and positive impact on human cognitive skills. Here, we discuss the current state of the scientific literature

surrounding video games and human cognition with an emphasis on points critically related to public policy.

Keywords

video games, brain games, cognitive enhancement

102 Policy Insights from the Behavioral and Brain Sciences 2(1)

The rising popularity of video games has spurred signifi-

cant interest in how video games may alter the human brain

and human behavior. This is a concern not just for research

psychologists but also for politicians, parents, teachers, med-

ical doctors, and many others involved in setting and imple-

menting public policy. Numerous questions surrounding

the effects of video games—spanning many psychological

domains—have already made their way from the scientific

to the public sphere. For example, in the domain of social

psychology, a recent Supreme Court case (“Brown v.

Entertainment Merchants Association,” 2011) grappled with

the question of whether certain types of video games (spe-

cifically graphically violent video games) represent a suffi-

cient threat to the social-psychological development of

children to warrant state-mandated restrictions on their sale.

Here, we examine just one of these domains—the cogni-

tive effects of video game play. Research shows that playing

some types of video games produces significant and long-

lasting enhancements in a variety of cognitive functions. The

scope and scale of these beneficial effects has prompted

many research groups to test efficacy of video games in real-

world contexts such as in rehabilitative settings or in job-

related training (Green & Bavelier, 2012). However, research

of video games is fraught with controversy, and questions

remain regarding how to translate the science into public

policy. Below, we review the science on cognitive effects of

video games, including why video games might be capable

of altering cognitive function, what types of video games

affect cognitive function and which do not, what cognitive

effects of video gaming have been observed in adults and in

children, and how commercial video games relate to “brain

games” in terms of content and cognitive outcomes. We also

discuss the real-world and public policy implications of the

cognitive effects of video games.

Why Might Video Games Be Effective

in Altering Brain and Behavior?

Modern video games have evolved into sophisticated experi-

ences that instantiate many principles known by psycholo-

gists, neuroscientists, and educators to be fundamental to

altering behavior, producing learning, and promoting brain

plasticity (for reviews, see Bavelier, Green, Pouget, &

Schrater, 2012; Gentile & Gentile, 2008; Green & Bavelier,

2008). Video games, by their very nature, involve predomi-

nately active forms of learning (i.e., making responses and

receiving immediate informative feedback), which is typi-

cally more effective than passive learning (Michael, 2006).

In addition, this active learning usually occurs in a variety of

situations, thus promoting generalization of learning

(Schmidt & Bjork, 1992). Most video games also use a

dynamic degree of difficulty that increases along with player

skill, ensuring that players are continuously challenged.

Furthermore, many games use a combination of internal

reinforcement (e.g., positive social interactions and feelings

of competence; Przybylski, Rigby, & Ryan, 2010) and exter-

nal reinforcement (e.g., points, badges, etc.; King, Greaves,

Exeter, & Darzi, 2013). This reinforcement promotes signifi-

cant time spent on task, which is the best single predictor of

positive learning outcomes. In addition, this time is typically

distributed over many days, weeks, or even years—a practice

schedule that produces more effective learning than when

experience is amassed into only a few sessions (Baddeley &

Longman, 1978). Finally, video games are highly physiolog-

ically arousing and activate reward systems of the brain that

drive brain plasticity (Bao, Chan, & Merzenich, 2001;

Kilgard & Merzenich, 1998). Thus, there is a strong scien-

tific basis to suspect that video games, when properly

designed, have the potential to strongly alter the brain and

behavior.

Not All Video Games Are Equal When

It Comes to Altering Cognitive Function

Although every well-designed video game incorporates

some or all the principles of effective learning mentioned

above (as well as many others), and thus will have the poten-

tial to shape the brain and behavior, it is the specific content,

dynamics, and mechanics of each individual game that deter-

mines its eventual effects. Indeed, a common mistake that is

made when discussing video games is to lump all games

together into a single category. The term video games refers

to thousands of quite disparate types of experiences, any-

thing from simple computerized card games to richly detailed

and realistic fantasy worlds, from a purely solitary activity to

an activity including hundreds of others, from a strictly

antagonistic/competitive experience to a strictly friendly/

pro-social experience, from nothing more than a simple set

of rules to a full and highly immersive fiction (see Figure 1

for examples). A useful analogy is to the term food, which,

like the term video games, encompasses an incredibly wide

variety of sub-categories and individual exemplars. One

would never ask, “What is the effect of eating food on the

body?” Instead, it is understood that the effects of a given

type of food depend on the composition of the food—the

number of calories; the percentage of protein, fat, and carbo-

hydrates; the vitamin and mineral content; and so on. This

same fundamental principle is true of video games as well.

In the cognitive domain, perhaps not surprisingly, the

types of games that are of interest are those that have com-

plex 3D settings, that feature quickly moving targets that pop

in and out of view, that necessitate substantial visual process-

ing of the periphery, that include large amounts of clutter and

task-irrelevant objects, that require the player to consistently

switch between highly focused and highly distributed atten-

tion, and that require the player to make rapid, but accurate

decisions. Games that share these features are referred to as

“action video games” (Green & Bavelier, 2012; Spence &

Green and Seitz 103

Feng, 2010). Playing action video games has been linked

with myriad enhancements in cognitive function, from low-

level vision through high-level cognitive abilities, while

playing many other types of games fails to produce equiva-

lent impact on perception and cognition.

What Are the Cognitive Consequences

of Playing Action Video Games?

The consequences of playing action video games have been

addressed through numerous studies using several method-

ologies and examining a wide number of cognitive abilities.

Some studies provide more conclusive evidence than others.

For example, studies that train non-video gamers to play

video games (i.e., intervention studies) can provide causal

evidence, as opposed to studies that compare populations

that natively play or do not play certain games (i.e., cross-

sectional studies). Both types of studies provide useful infor-

mation, and as a whole, the literature supports the conclusion

that playing action video games provides broad-based and

consistent benefits on tests of cognitive skills.

Effects on Perceptual Skills

Both intervention and cross-sectional studies have shown

that action video game experience is associated with enhance-

ments in numerous basic perceptual tasks including those

involving contrast sensitivity (R. Li, Polat, Makous, &

Figure 1. “Video games” encompass a wide variety of experiences.

Note. Video games differ widely in their content, dynamics, and mechanics. As a result, games vary in their effects on cognitive skills. Action games, including

many “first-person shooters” (top-left: Wolfenstein: The New Order) and “third-person shooters” (top-middle: Grand Theft Auto V) have been shown to

enhance many cognitive functions. Others, including simple building/exploration games (top-right: Minecraft), social games (middle-left: The Sims 2), phone

games (middle-middle: Angry Birds; middle-right: Candy Crush), and card games (bottom-left: Hearthstone) lack features believed to be important to the

cognitive impact of action games. Even “brain games” have a wide variety—with some being gamified scholastic or lab tasks (bottom-middle: Balloons;

Owen et al., 2010), while others layer effective content into interesting game environments (bottom-right: NeuroRacer; Anguera et al., 2013).

104 Policy Insights from the Behavioral and Brain Sciences 2(1)

Bavelier, 2009), visual acuity and crowding (Green &

Bavelier, 2007), peripheral vision (Buckley, Codina,

Bhardwaj, & Pascalis, 2010), and temporal processing

(Donohue, Woldorff, & Mitroff, 2010). Collectively, these

are consistent with the fact that action games require respond-

ing quickly (temporal processing) to important stimuli that

are often similar to their backgrounds in their colorations

(contrast sensitivity) and features (visual acuity), and typi-

cally occur in somewhat cluttered environments (crowding).

Although there is increasing evidence that action video game

play improves performance on many basic perceptual tasks,

much remains to be established regarding the specific

mechanisms underlying these performance improvements.

Improvements in these tasks can be due to myriad factors

(Hung & Seitz, 2014) ranging from optimization of basic

visual processes, to improvements in strategies of how the

task is conducted, to more effectively attending to task-

relevant stimuli.

Effects on Attention Skills

Many studies demonstrate that action video game play

improves visual attentional skills, such as the ability to find a

particular target from within a large field of view when the

target is surrounded by task-irrelevant distracting items

(Feng, Spence, & Pratt, 2007; Green & Bavelier, 2003), or to

track a small subset of moving items from within a larger

field of visually identical moving items (Green & Bavelier,

2006). The fact that action gaming benefits performance in

this domain is of particular interest because better perfor-

mance on some of these same tasks is predictive of real-

world consequences, such as fewer driving accidents in

elderly populations (Myers, Ball, Kalina, Roth, & Goode,

2000). Thus, while there is still ambiguity regarding the

exact mechanisms by which action video game play leads to

improved task performance, as a whole, the literature sup-

ports the conclusion that action video games can give rise to

benefits on a wide array of tasks that rely on perceptual/

attentional abilities.

Effects on Higher Cognitive Functions

Action video game play can enhance a diverse set of higher

cognitive functions. Several studies show that individuals

can switch between competing tasks more efficiently after

action video game training (Colzato, van Leeuwen, van den

Wildenberg, & Hommel, 2010; Green, Sugarman, Medford,

Klobusicky, & Bavelier, 2012; Strobach, Frensch, & Schubert,

2012). Other aspects of cognitive function improved by

action video game training include the ability to multitask

(Strobach et al., 2012) and the ability to mentally rotate

objects (Feng et al., 2007). Cross-sectional work also sug-

gests that action video game players perform better on tasks

of working memory (Sungur & Boduroglu, 2012) and fluid

intelligence (Unsworth et al., 2015). However, the latter

study failed to find a linear relation between amount of game

play and fluid intelligence, and some studies have failed to

reproduce effects of gaming on cognition (Boot, Kramer,

Simons, Fabiani, & Gratton, 2008; van Ravenzwaaij, Boekel,

Forstmann, Ratcliff, & Wagenmakers, 2014), suggesting that

more research is required in this domain.

Cognitive Effects in Children

The vast majority of research on the effects of action video

games on cognitive function has utilized healthy young

adults as research participants. This is at least partially

because many action games contain content (e.g., violence)

that is not appropriate for children. When researchers have

found age-appropriate action video games, however, the sim-

ilar benefits to perception and cognition have been observed

as a result of training in children (Franceschini, Gori, Ruffino,

Viola, Molteni, & Facoetti, 2013). Furthermore, cross-

sectional studies reveal the same strong associations between

avid action gaming and enhancements in cognitive skills in

children as have been observed in adult populations (Dye &

Bavelier, 2010; Dye, Green, & Bavelier, 2009a; Trick,

Jaspers-Fayer, & Sethi, 2005).

What About Other Types of

Commercial Video Games?

Most cognitive research on commercial video games has

examined action video games. However, other game genres

may also benefit certain aspects of cognitive function. For

example, training on a difficult version of the strategy game

StarCraft resulted in improvements in cognitive flexibility,

but not measures of attention, or short-term memory (Glass,

Maddox, & Love, 2013). Training on Portal 2, a popular 3D

puzzle game, elicited improvements in problem solving and

spatial reasoning skills (Schute, Ventura, & Ke, 2015). And

training older adults on the real-time strategy game Rise of

Nations resulted in significantly greater improvements as

compared with controls on measures of working memory,

task-switching, visual short-term memory, and mental rota-

tion (Basak, Boot, Voss, & Kramer, 2008). Interestingly,

real-time strategy games do share some features with action

video games (e.g., the need to monitor multiple sources of

information simultaneously, to make decisions quickly and

accurately, etc.), which is consistent with the idea that the

cognitive effects of games are explicitly due their inherent

processing demands.

It is important to note that not all effects of gaming on

cognition have been positive. For instance, while some types

of games have been shown to enhance the process of “selec-

tive attention” (i.e., used when listening to a friend speak in

a loud/crowded restaurant and ignoring the other speakers),

the effects on “sustained attention” (i.e., the ability to stay on

Green and Seitz 105

task for a prolonged period) are more mixed. In particular,

while action game playing has been associated with either

enhancements or no changes to sustained attention (e.g.,

Dye, Green, & Bavelier, 2009b), one study, which lumped all

video games together, found that total amount of video game

play predicted poorer attention in the classroom (Gentile,

Swing, Lim, & Khoo, 2012). This is a good example of the

fact that not all games are likely to affect the cognitive sys-

tem equally, nor are all the effects likely to be positive (and

also attests to the need to differentiate between games as this

study does not allow us to determine what types of games

specifically are linked with diminished sustained attention).

What About “Brain Games?”

The discussion thus far has focused exclusively on commer-

cial entertainment video games that happen to, as a by-prod-

uct of their content, dynamics, and mechanics, produce

enhancements in cognitive skills. However, commercial

video games are (understandably) optimized for entertain-

ment and not mental fitness, and do not intentionally take

advantage of neuroscience and psychology research regard-

ing mechanisms and plasticity of cognitive processes

(Deveau, Jaeggi, Zordan, Phung, & Seitz, 2015). This is in

contrast to the so-called “brain games” (Bavelier & Davidson,

2013), which are designed explicitly to improve cognitive

function and that, in the best cases, are closely aligned with

an understanding of neuroscience underlying the trained

functions (Mishra, de Villers-Sidani, Merzenich, & Gazzaley,

2014; Whitton, Hancock, & Polley, 2014).

The typical brain game “gamifies” existing laboratory

tests of cognition by adding interesting graphics and sounds,

points, and so on. Examples include games such as Nintendo’s

Brain Age (Lorant-Royer, Munch, Mescle, & Lieury, 2010)

or the games developed for the BBC program “Bang Goes the

Theory” (Owen et al., 2010), as well as games sold by a grow-

ing number of brain-training companies. While these games

can add entertainment value to what are otherwise somewhat

sterile psychology tasks, they typically embody few of the

qualities of the commercial video games linked with cogni-

tive improvement. This is critical because the cognitive ben-

efits that a video game can yield depend on good game design

(Rabin, 2005). Indeed, without proper design, gamification

can potentially even impair task performance and learning.

For example, Katz et al. (2014) found that motivational fea-

tures such as scores, prizes, and scene-changes, when added

to a working memory training task, led to impaired learning

compared with the non-gamified task. A likely reason for this

is that gamification involves producing training tasks with

“game features” that may be incongruent with, and/or distract

attention from, task-relevant features (Leclercq & Seitz,

2012a, 2012b), which then in turn interferes with desired

learning outcomes (Seitz et al., 2005). This may be why the

cognitive benefits of simple gamified cognitive tasks are

often limited (Lorant-Royer et al., 2010; Owen et al., 2010).

A separate broad approach in the brain-training domain

works to combine the elements of off-the-shelf video games

and standard cognitive approaches that can contribute to cogni-

tive improvement. This approach recognizes that commercial

video games are not random assemblages; instead, their levels,

challenges, and virtual environments are carefully designed to

maintain balance, minimize player frustration, and promote a

fun experience. An early example of this new class of brain-

training games is the custom designed video game NeuroRacer

(which looked like a car racing game rather than a psychologi-

cal test), which resulted in improvements in multitasking, sus-

tained attention, and working memory in a group of older

adults, with improvements persisting for at least 6 months after

the cessation of training (Anguera et al., 2013).

There are many reasons why the development of custom

designed cognitive training games would be preferable to

utilizing commercial entertainment games for the same pur-

poses. This includes the ability to target specific cognitive

processes (e.g., a deficit in visual processing, or one in short-

term memory). Also, the content of many commercial video

games (many of which contain violence) is not appropriate

for all ages and/or all individuals.

Video Games Used for Real-World

Problems

Given the scope and scale of the positive effects induced by

certain types of video games, many groups have explored the

potential to utilize video games to address practical, real-

world issues. For example, a variety of video games (ranging

from Tetris to action video games) have been shown to

improve vision in individuals with amblyopia (colloquially

known as “lazy eye”; J. Li et al., 2013; R. W. Li, Ngo, Nguyen,

& Levi, 2011). Likewise, custom brain-training games for

vision have also been shown to improve reading abilities

(Deveau & Seitz, 2014), and even on-field performance in

Collegiate Baseball (Deveau, Ozer, & Seitz, 2014). Recent

research also indicates that action video games may amelio-

rate developmental dyslexia (Franceschini et al., 2013).

Action video games have also been considered useful to

improve performance in jobs that require enhanced cognitive

skills. For instance, laparoscopic surgery requires extreme man-

ual dexterity, as well as the ability to use 2D television images to

make 3D movements in the real-world and to make decisions

quickly. Accordingly, action video game training improves per-

formance of novice surgeons on a laparoscopic simulator

(Schlickum, Hedman, Enochsson, Kjellin, & Fellander-Tsai,

2009), and cross-sectional research shows action video game

experience is a better predictor of positive surgical outcomes

than years of training or number of surgeries performed (Rosser

et al., 2007). Action video game play has also been associated

with enhanced piloting abilities (Chiappe, Conger, Liao,

106 Policy Insights from the Behavioral and Brain Sciences 2(1)

Caldwell, & Vu, 2013), particularly the ability to fly unmanned

drone aircraft (McKinley, McIntire, & Funke, 2011).

Methodological Limitations and Issues

Related to Inferring That a Given Video

Game Will Produce Cognitive Benefits

in an Individual

Some studies provide stronger evidence than others—The

types of conclusions that can be supported by a given study

depend on the methods used (for a more thorough review, see

Green, Strobach, & Schubert, 2014). For instance, “cross-

sectional” studies, which take advantage of the fact that some

individuals, as part of their daily life, choose to play video

games while other individuals do not, do not allow for con-

clusions of causation (i.e., they do not show that the act of

playing the game itself causes enhancements in cognitive

skills). Although cross-sectional studies are informative,

such evidence needs to be weighed carefully when determin-

ing policy. It is because of the various inherent limitations of

purely correlational work that cross-sectional studies are

often supported by carefully controlled intervention studies

(e.g., taking a representative cohort of non-gamers and test-

ing their cognitive abilities before and after an assignment to

play a video game). Unlike cross-sectional studies, interven-

tion studies can allow for causal inferences regarding the

effects of the games on cognition.

Another issue that affects both cross-sectional and inter-

vention studies are expectancy effects (sometime termed pla-

cebo effects). These refer to the possibility that participants

will try harder, and thus perform better, on assessments of

cognitive function because they believe that playing the

video games should have improved their performance.

Comparing performance with a control group trained on

tasks matched for features of the intervention (e.g., general

interest, arousal, motivation, etc.), but critically lacking

those features hypothesized to be essential for driving

changes in cognitive performance can help address expec-

tancy effects.

It is important to note that the evidentiary basis of a given

study depends on many details of the study design and the resul-

tant data, and that there is no one-size-fits-all method of doing

science. Not all cross-sectional studies provide less evidentiary

basis than all intervention studies (e.g., A well-designed cross-

sectional study may provide better evidence than a poorly

designed intervention study), and not all research questions

allow for intervention studies. For instance, it is inappropriate to

force young children to play hours of violent video games for

the purpose of measuring causal relationships between game-

violence and aggression. The same is true of potential links

between video game play and clinical psychological issues

(e.g., attention deficit/hyperactivity disorder [ADHD] or major

depression), or negative effects on academic performance.

Thus, it is necessarily the case that public policy must often be

guided by complex and incomplete data. It is therefore extremely

important that public policy decisions also rely on the advice of

domain experts who have detailed knowledge of the broader

literature.

The effect of a game depends on how it is interacted

with—A key difference from the action of a drug is that the

impact of a video game depends on how that individual inter-

acts with the game, with individual differences in motiva-

tion, personality, and nascent cognitive abilities leading to

completely different game experiences. At the extreme, it is

obvious that having a child with ADHD press random but-

tons on the game controller will provide an ineffective learn-

ing experience. Thus, the results of a given video game

intervention can vary widely across individuals. While we

have discussed data from many demographic groups (from

children to seniors; from those with mental health impair-

ments to athletes and surgeons), showing that video games

can positively influence many demographics, there are

numerous reasons why a game that helps one individual may

or may not have the same effects on another.

If Playing Action Video Games Leads

to Many Cognitive Benefits, Should We

Encourage More Action Video Game Play?

Most of the public discussion around the topic of regulating

game play has centered on the question of whether game

play, especially in developing children, should be explicitly

limited. For instance, the American Academy of Pediatrics

recommends that children and teens should engage with

entertainment media, such as video games, for no more than

2 hr per day in total. As far as we are aware, this recommen-

dation of the American Academy of Pediatrics is not based

on any actual scientific research showing that less than 2 hr

of exposure is acceptable, while more than 2 hr is harmful.

Furthermore, the recommendation does not differentiate

between types of entertainment media content (i.e., Are 2 hr

of watching reality television fully equivalent to 2 hr of play-

ing educational video games or 2 hr of interacting with peers

on social networks?). This being said, playing action video

games for more than 1 to 2 hr a day is unlikely to provide

substantially greater cognitive benefits than what is found in

intervention studies, which mostly relies on around an hour a

day of training. Almost all learning, utilizing video games or

otherwise, is subject to the effect of diminishing returns. This

means that doubling the amount of time spent gaming will

result in far less than twice as much improvement, and in fact

can impair overall gain (Censor, Sagi, & Cohen, 2012;

Dosher & Lu, 2007; Heathcote, Brown, & Mewhort, 2000;

Stafford & Dewar, 2014). It is also the case that any time

spent gaming is time that is not spent doing other activities

that society may value to a greater degree (e.g., More time

spent gaming may result in less time doing school work, and

Green and Seitz 107

it is unlikely that the cognitive advantages will make up for

the reduced academic achievement; Weis & Cerankosky,

2010). The best policy supported by the science thus far is

one in which video gaming is monitored and adjusted as

needed. Any explicit guidelines should be reformulated

based on empirical scientific evidence. The guidelines should

also engage with the fact that terms such as entertainment

media, screen time, and video gaming are exceptionally

broad and that different activities within these categories

have differential impacts on child development.

How Should Games That Claim to

Improve Cognitive Function Be Regulated?

It is difficult to surf the Internet today without seeing adver-

tisements for products that claim to improve brain health and

general cognitive function. Many such products claim to be

built on the “science of neuroplasticity” or that they are

“inspired by work in the neurosciences.” In practice, how-

ever, the scientific basis for such claims varies widely, with

some claims relying on multiple efficacy studies done

directly on that product, others that are based on a resem-

blance to procedures found to be effective in the scientific

literature, and others that have virtually no true link to sci-

ence. At the moment, there is no standard of scientific valid-

ity for efficacy claims for such products, and in consequence,

it is very difficult for consumers to distinguish which prod-

ucts are more or less likely to be effective.

A first question is what agency is best positioned to regu-

late the use of video games and the claims made by game

companies. In regard to health claims, a natural fit would be

the Food and Drug Administration (FDA). Currently, though,

the FDA has determined that brain-training games pose no

risk to patient safety and thus do not fall under the purview

of the FDA. A reasonable analogy in this case might be that

of dietary supplements (also not regulated by the FDA)

where “a firm is responsible for determining that the dietary

supplements it manufactures or distributes are safe and that

any representations or claims made about them are substanti-

ated by adequate evidence to show that they are not false or

misleading.” One glaring issue with this is that there is no

provision under the law or FDA regulation that requires a

firm to disclose to the FDA or to consumers the information

that they have about the safety or purported benefits of their

dietary supplement products. It therefore seems unlikely that

the FDA is best positioned to regulate the gaming industry.

Another regulatory agency is the Federal Trade Commission

(FTC). The FTC has long regulated the advertising of dietary

supplements and has begun investigating claims of cognitive

benefits from brain-training games. Interestingly, the FTC

recently suggested that a company perform double-blind test-

ing to support its claims of efficacy (see “Analysis of the

Proposed Consent Order to Aid Public Comment In the

Matter of Focus Education, LLC, Michael Apstein, and John

Able, File No. 122 3153 [https://www.ftc.gov/enforcement/

cases-proceedings/122-3153/focus-education-llc-matter]”;

note that the FTC is requesting a similar standard of Aaron

Seitz, an author of this paper, and his company Carrot

Neurotechnology that marketed a vision training program

based upon research studies conducted by Seitz [see COI

information below]). Such procedures are the “gold-standard”

in drug trials, but in the case of cognitive training interven-

tions, there is no true way to perform a double-blind, placebo-

controlled study to demonstrate the efficacy of the cognitive

intervention. This is because participants will always be

aware of what they do during behavioral training (i.e., are not

“blind” to their condition). This leaves the possibility that

expectation effects can still influence study outcomes.

If cognitive training cannot utilize the same standards as

drug trials, what then might be the best practices that any

demonstration of scientific efficacy should observe in this

domain? A more thorough discussion of these issues can be

found in Green et al. (2014), but there is general agreement in

the field that proper intervention studies will include random

assignment to either an experimental group or a control group.

However, the nature of the appropriate control group depends

on many different factors and can be very different between

cases in which one is trying to determine mechanisms, and

those simply concerned with efficacy. In the case of determin-

ing mechanisms, controls should be matched to be as similar

as possible to the experimental group, while leaving out the

hypothesized active characteristics of the intervention so that

it can be determined whether those attributes lead to a differ-

ence between the treatment and the control. In the case of an

efficacy study, however, the most appropriate control is far

less clear. In the case of drug studies, there are two rather

obvious control treatments: (a) a truly neutral treatment (e.g.,

a sugar pill) and (b) the existing standard of care (e.g., com-

paring a new heart medicine to the current standard heart

medicine). No such alternatives exist in the case of cognitive

training platforms. In fact, it is unclear what the cognitive

equivalent of a sugar pill would be (e.g., a crossword puzzle,

another video game, an actual sugar pill?). Also, there exist

no accepted/standard interventions to address basic cognitive

problems (perception, attention, memory, executive function,

etc.), and thus the typical standard of care is to do nothing.

Given these deep questions about how the research should be

conducted, the current literature does not provide simple answers

to serve as a foundation of public policy. Instead, there is real

need for regulatory agencies to engage scientists and industry

groups to create standards and policies by which to better inform

the public of the complex impacts of video games on cognition.

What Is The Best Role For

Government?

A clear potential role for government is to create a regulatory

structure that incentivizes evidence-based practices in

108 Policy Insights from the Behavioral and Brain Sciences 2(1)

cognitive enhancement products. An incentive system, such

as a label indicating a certification level of efficacy (analo-

gous to what is currently done for organic foods and energy

efficient products), could provide a market advantage for

good science. Rather than directly applying models from

drug studies, evidentiary standards need to be developed that

respect the fact that video games are within consumers’ nor-

mal use patterns for entertainment, are safe, and that there is

necessarily a continuum of degrees of established efficacy

that inevitably involves some ambiguity. The government

can play a key role in creating standards to label the various

degrees of efficacy by bringing together scientists, industry

leaders, and consumer groups to create a system that respects

the constraints of the field described above, while consider-

ing the potential benefits that these products may have for

the public. Such a structure would permit innovation and

would allow for well-informed consumers to try out unproven

products that may have interesting attributes, while being

able to differentiate which products have achieved a stronger

evidentiary standard. This would facilitate a market wherein

investing in research to design cognitive training paradigms

that are more effective will actually result in greater profits

(as it is almost certainly the case that the public will gravitate

toward games that have been certified as having stronger evi-

dence behind their claims). At the moment, given a lack of

clear regulations, it is unclear whether there is any relation-

ship whatsoever between market share and efficacy.

Another obvious role for government is to provide mech-

anisms through which neuroscientists, psychologists, and

educators can collaborate with leaders in the gaming indus-

try. One common criticism of many games designed for posi-

tive impact is that such games have historically been designed

and implemented by academics rather than game designers

(with predictably poor game play resulting). While market

forces may be sufficient to drive collaborations around the

topic of general cognitive enhancement, there are other

domains where additional incentives may be needed. For

instance, there are many medical conditions that could poten-

tially benefit from well-designed video game cognitive inter-

ventions, but the conditions are rare enough that it would not

be a profitable domain for a major gaming company to work

in. Government could also incentivize gaming companies to

share data with research groups. Game companies collect

enormous amounts of data on their players, which would be

an incredibly rich source of information through which to

better understand human behavior. At the moment, there is

no incentive for such data sharing (if anything, it is deincen-

tivized as the data could be used by a competing company to

improve their own market share). Thus, overall, we suggest

that the best role for the government is to facilitate interac-

tions between stakeholders, encourage good behavior, pro-

mote good science, and reward innovation. This will help

realize the positive contribution that the games of the future

will provide to society.

Conclusion

Video gaming is likely to remain a pervasive part of American

culture for the foreseeable future. Given that well-designed

video games utilize principles known to effectively drive

changes in the brain, there is a real reason for video games to

remain the subject of close scientific study. In the cognitive

domain, the evidence to date suggests that some, but not all,

games are indeed capable of altering basic cognitive skills,

and that these changes are of a scope and scale that permit

practical applications (e.g., in rehabilitative or job-training

settings). Of particular interest for future work will be to

determine what game characteristics are most responsible for

such benefits, and then to utilize this information to continue

to refine custom designed games for cognitive impact (i.e.,

“brain games”). As the brain-training industry develops,

there is likely to be an increasing need for some type of regu-

latory structure to maintain consumer confidence in the effi-

cacy of these products as well as to incentivize better science.

The development of this regulatory structure will require

buy-in from many stakeholders, including basic research sci-

entists, game industry leaders, and governmental officials.

Declaration of Conflicting Interests

The author(s) declared the following potential conflicts of interest

with respect to the research, authorship, and/or publication of this

article: A. R. Seitz is a founder and stakeholder in Carrot

Neurotechnology, a company that sells a vision brain game called

ULTIMEYES. Carrot, and Seitz as an individual, are involved in a

case with the FTC regarding advertising claims that Carrot made

based upon Seitz’s University based research. Seitz’s conflict of

interest has been reported in all related research studies and is man-

aged by a University of California, Riverside Conflict of Interest

Management Plan. C. S. Green is on the scientific advisory board of

Headtrainer, Inc.

Funding

The author(s) received no financial support for the research, author-

ship, and/or publication of this article.

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