Ask the Experts: Gaming Disorder and special needs

A boy gaming

Gaming is an important way for some children with special educational needs to express themselves and communicate. But when does a hobby turn into Gaming Disorder?

According to a report by the Children’s Commissioner for England (October 2019), 93% of children in the UK play video games. The average time spent playing those games for children aged between 12 and 15 being 11.6 hours per week (Statista). That’s pretty much two school days! This figure is likely to have increased during lockdown, and when considered together with other leisure activities children engage in (such as sport or just mucking around with friends after school), that time spent gaming means that other pursuits might have to give way.

There is little information or advice regarding how much screen time is too much. Emphasis is more likely to be placed on what children are doing online and the content they are viewing. Within the context of the home environment and the child’s support network, we could also take a more holistic approach.

The upsides to gaming

I could have been accused of being a video game naysayer in the past, but my experience as a school teacher has altered my view. Although the buzz in the classroom was electrifying when a new game was released, I also had to manage the fallout. However, before examining the downsides of gaming, it is important to reflect on the positives gaming can bring. Social interaction, turn-taking and learning to share, creativity and critical thinking are just a few. For the SEN student, gaming might be the one area where they can truly succeed. I’ve worked with children who found many aspects of the school curriculum difficult to access and friendships hard to establish. Those individuals who tend to be pushed to the outside can often find new friends online and establish themselves as ‘experts’ of the game, becoming the go-to person when their classmates are stuck.


In Growing Up in a Connected World, the report suggest that the aim ‘should not be to restrict the quantity of screen-time or the activities children engage in, but rather to improve the quality of children’s online experiences’. However, there has been a rapid increase of digital platforms availabl. Young people now access media content on laptops, tablets and phones, instead of just on television. It has become challenging to stay on top of what our children are engaging with online.

Gaming disorder was added to the 11th Revision of the International Classification of Diseases by the WHO in 2018. It was defined as a ‘pattern’ of behaviour in which the individual would find it difficult to control the amount of time spent gaming and find that it took priority over other activities and interests. Couple this with increased engagement with gaming (despite the negative impacts), and it can have devasting and lasting consequences in its extreme form.

Signs of gaming disorder

Some of the outward signs of gaming disorder might be thought of as part of being a teenager. However, it is important to be aware that the grumpy 14-year-old might be covering up something more troubling. Some of the outward signs might be:

  • Change of behaviour or mood swings
  • Isolation – withdrawing from friends and family
  • Extreme fatigue
  • Change in diet – binge eating, drinking a lot of energy drinks, skipping meals
  • Loss of interest in other leisure activities and hobbies
  • Complaints about muscle strain – aching back and shoulders, carpal tunnel syndrome
  • An inability to focus on anything else – obsession with the game
  • Asking for money for in-game purchases

For many children, especially those with autism and those with an overly active mind, such as ADHD, gaming can be a huge draw and quickly become an obsession. The constantly moving images, light, colour and sounds in games easily attract the child’s attention. Douglas Gentile from Iowa State University describes games as ‘crutches for attention’.

Because of these ‘attention crutches’, the virtual world may be the only place a child can focus for any length of time. Combine that with the potential to provide solace and a sense of self-esteem, and gaming can be highly seductive. Managing behaviour around gaming can be extremely challenging and have a huge impact on the entire family.

Loot boxes

It’s worth talking about loot boxes at this point. These are in-game purchases of a virtual treasure box, which when opened contains random virtual items which may help the player progress through the game. They may also reward them with customised items such as weapons to personalise their avatar. In July this year, the House of Lords Gambling Committee said that loot boxes should be regulated under gambling law. Loot boxes require no player skill and the outcome or prizes are completely random. Dr David Zendle from the University of York told the House of Lords Committee that the link between loot boxes and gambling is ‘extraordinarily robust’. As a result, the lines between gaming and gambling have become blurred and children may wander into gambling inadvertently.

The feel-good aspect of opening loot boxes and associated sense of reward can be difficult to manage for some. The effect of dopamine is like a quick burst of happiness, which children understandably seek to repeat. There are endless videos available online which show children (and adults) opening one loot box after another.

Treating Gaming Disorders

In the vast majority of cases families can work together and support their child. There are a range of organisations that can offer information on how to help children develop a more balanced and healthy lifestyle. Like many conditions, realising that outside professional help is needed can take time and be very painful. However, there is a wide range of support available. A good starting point is the GP, who will be able to direct families to local services. The NHS launched a gaming disorder clinic in London in December 2019. In a recent interview with Dr Henrietta Bowden Jones, Director for the Centre for Internet and Gaming Disorders, she pointed out that gaming disorder is a behavioural issue that can be ‘treated very well in the right context.’

Education around the potential harms of gaming and the importance of maintaining a balanced lifestyle supports young people to make informed decisions and set boundaries. For many years, schools have had a well developed PSHE curriculum providing a platform to teach about potentially risky behaviour involving alcohol and drugs. Recent changes to the curriculum allow space to discuss digital resilience, and appropriate behaviours online.  Organisations like ours have stepped into the space to provide educational settings with free information and resources. This way, we can support teachers to have purposeful conversations with students about the potential harms of gaming.

Some children with SEN will find a sense of achievement in games that they are unlikely to find elsewhere. The challenges of school work can be demotivating. The fact that children can maintain their self esteem through gaming is very important. Children with SEN may have to invest more time in a game than their peers to get to their desired level of competency. However, balanced with information about keeping safe, setting boundaries and pursuing other leisure activities, gaming can also bring positives and fun into young people’s lives.

Have you, your child, or someone you know experienced the positives or negatives of gaming with SEN? Feel free to contact our editor and share your story via For more articles about being online with SEND click here and here.

Rebecca Mark
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Rebecca Mark works with YGAM, a national charity that provides tools, information and research to build digital resilience and safeguard young people against the potential harms of gaming and gambling. As the Head of Delivery (South) for the Education Team, Rebecca delivers the YGAM City and Guilds Assured programme to teachers and youth workers providing them with free training, resources and activities for the young people they work with. Prior to joining YGAM Rebecca taught in primary schools in London.



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