High User Control in Game Design Elements Increases Compliance and In-game Performance in a Memory Training Game

Abstract

Computer games are increasingly being used for training cognitive functions like working memory and attention among the growing population of older adults. While cognitive training games often include elements like difficulty adaptation, rewards, and visual themes to make the games more enjoyable and effective, the effect of different degrees of afforded user control in manipulating these elements has not been systematically studied. To address this issue, two distinct implementations of the three aforementioned game elements were tested among healthy older adults (N = 21, 69.9 ± 6.4 years old) playing a game-like version of the n-back task on a tablet at home for 3 weeks. Two modes were considered, differentiated by the afforded degree of user control of the three elements: user control of difficulty vs. automatic difficulty adaptation, difficulty-dependent rewards vs. automatic feedback messages, and user choice of visual theme vs. no choice. The two modes (“USER-CONTROL” and “AUTO”) were compared for frequency of play, duration of play, and in-game performance. Participants were free to play the game whenever and for however long they wished. Participants in USER-CONTROL exhibited significantly higher frequency of playing, total play duration, and in-game performance than participants in AUTO. The results of the present study demonstrate the efficacy of providing user control in the three game elements, while validating a home-based study design in which participants were not bound by any training regimen, and could play the game whenever they wished. The results have implications for designing cognitive training games that elicit higher compliance and better in-game performance, with an emphasis on home-based training.

Development and Co-design of NeuroOrb: A Novel “Serious Gaming” System Targeting Cognitive Impairment in Parkinson’s Disease

“…Due to the nature of gameplay, several of the games encompass training in multiple domains. This gamification of the CT paradigm introduces elements of high-user control, self-directed challenge, exploration and free-play, which have previously been shown to improve outcomes in home-based CT compared to more automated task delivery ( Nagle et al, 2015 ).…”

“…One strategy that may improve engagement is the addition of game-like features (gamification) into CT programs ( Lumsden et al, 2016 ; Van De Weijer et al, 2019 ). This can be attributed to the incorporation of features such as high-score and reward incentives, narrative, personalization, self-directed challenge, exploration, free-play, competition and graphics into the training platform ( Nagle et al, 2015 ). Gamification may also have benefits beyond improvement of engagement alone, with a systematic review of the literature of gamification in CT highlighting seven reasons researchers opted to gamify CT programs, including increased usability/intuitiveness for target age groups, increased ecological validity, increased suitability for the target disorder, and increased brain stimulation ( Lumsden et al, 2016 ).…”

Optimizing Cognitive Training for the Treatment of Cognitive Dysfunction in Parkinson’s Disease: Current Limitations and Future Directions

“…Whilst several computer-based CT programs incorporate elements of gameplay, such as real-time feedback, they do not necessarily include key features often attributed to traditional video games. Potential benefits of gamification include high-score and reward incentives, personalization, self-directed challenge, exploration and free-play ( Nagle et al, 2015 ). These are particularly important for the PD population, where patients have a decreased reward sensitivity in an off-dopaminergic medication state, as well as increased apathy ( Muhammed et al, 2016 ).…”

A Comparison of the Effects of Augmented Reality N-Back Training and Traditional Two-Dimensional N-Back Training on Working Memory

“…As technology rapidly advances, many researchers around the world are continuously exploring, trying to find new interventions that are more effective than traditional methods (Au et al, 2015;Katz et al, 2014). Some studies modified the features or forms of the traditional n-back task to make it more like a game and to investigate the effects on working memory (Katz et al, 2014;Nagle et al, 2015). These studies also proposed that future research might investigate whether AR technology can provide a more efficient way of cognitive training.…”