A gaze-controlled video game trains children with ADHD to strengthen the eye movements that underpin reading, writing, and paying attention in class. ADHD affects roughly 5% of school-age children worldwide, and its core symptoms—particularly inattention—directly undermine academic progress. Existing computerised cognitive training programmes show only small effects on attention, with no evidence they improve schoolwork. RECOGNeyes targets the oculomotor network, the brain system that controls eye movements and is typically impaired in ADHD. Pilot studies suggest the programme can improve the “academic enabling” skills—reading, writing, arithmetic, and sustained focus—that are critical for learning. If the feasibility trial succeeds, RECOGNeyes could be delivered by school staff early in the referral pathway, potentially reducing or replacing the need for medication and cutting NHS service use. The project will also produce an implementation manual, a commercialisation strategy, and a health economics case, creating a clear route for schools to adopt the programme.
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Research Questions RECOGNeyes is a novel gaze-controlled computerised cognitive training (CCT) programme designed to help children with Attention Deficit/Hyperactivity Disorder (ADHD) by targeting impaired oculomotor control. In this project we will: Optimise RECOGNeyes for schools-based implementation Establish a meaningful target effect size for full Clinical Efficacy Trial Develop a strategy to maximise impact Background ADHD affects about 5% school-age children world-wide. The core cognitive symptoms particularly impact schooling, with potential life-long impacts on employment prospects, mental wellbeing, and physical health. Although medication can help, its brain effects are largely transient; in contrast, CCTs can produce lasting neuroplastic changes to the brain. However, meta-analyses of existing CCTs indicate only small effects on attention, with no evidence of transfer to academic performance. RECOGNeyes targets the brain s oculomotor network function, the backbone of the neurocognitive systems typically impaired in ADHD. Pilot studies indicate promising impacts of RECOGNeyes on oculomotor control, key to many of the "academic enabling" skills – reading, writing, arithmetic, focusing on the task-in-hand – that are critical to academic progress. Aims and objectives Aim 1: to ensure that users remain central to the future of RECOGNeyes Objectives: to involve stakeholders throughout the design, evaluation, dissemination, and implementation of RECOGNeyes. Aim 2: To develop a robust, extendable, version of RECOGNeyes optimised for use in schools. Objectives: revise/recode RECOGNeyes in collaboration with stakeholders; co-produce an implementation manual. Aim 3: to conduct a feasibility RCT Objectives: evaluate the feasibility of RECOGNeyes as a school-based intervention; estimate outcome variance to inform target effect size. Aim4: to develop a viable pathway to implementation Objectives: an Intellectual Property (IP) protection and commercialisation strategy; an outline Health Economics value proposition; a viable adoption and dissemination strategy; regulatory compliance. Methods Development of RECOGNeyes III Software developers will recode and revise RECOGNeyes through iterative collaboration with a Participatory Research PPI team. Workshop versions of each revision will allow the team to try out alternative design parameters and propose improvements. Feasibility study This will be a school-based randomised controlled trial (RCT), involving 64 (32 per arm) school-children from years 5 to 8 (ages 9-13 years) who score above 95th percentile on an ADHD symptom rating scale. RECOGNeyes will be compared with CogMed, a CCT with small but real effect on inattention. Training will be implemented by school SEND department staff. Primary outcome measures: ADHD symptom ratings by independent assessors; standardised academic achievement scores. Timelines for delivery November 2025: RECOGNeyes III ready for Feasibility RCT September 2027: RECOGNeyes III ready for full Clinical Efficacy trial Anticipated impact and dissemination Impact: Implementable early in the referral pathway, RECOGNeyes could reduce or obviate the need for medication and reduce the risk of academic failure, reducing NHS service use and improving long-term adult outcomes. Dissemination: Dissemination plans will be developed in collaboration with PPIE groups. Findings will be disseminated to researchers through open-access publications and conference presentations; to study participants via dissemination events; to other stakeholders (teachers, parents, schools, education providers, potential commercial partners, policy makers) via traditional and social media.
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