Staples dons a virtual reality headset, selects a favorite piece of music to accompany his virtual undersea voyage, and holds the consoles that allow him to manipulate the patterns of fish as they swim through the water, around a sunken ship, or even into an octopus garden.
Afterward, he flashes a smile that could light up the Salt Lake City skyline. “It feels very cool being in control [of how the game plays out],” he says. “Whenever I play it, I feel better. It calms me down.” Staples’ mother, Meg, will never forget the first time he played Choreografish. “When he took the goggles off, his face was pure and complete joy,” she says. “I’d never seen that before. As a parent, that memory still chokes me up.”
“It’s great for people who have special needs,” he adds. “If I had the game, I’d probably play it every day.”
Johnny Staples played Choreografish several times during its development, and after each round, GApp Lab engineers, designers, and students solicited his feedback. His suggestions were often incorporated into the game. And Staples now has another idea: “In the octopus garden, I’d like to see them add a yellow submarine and some Beatles songs.”
Roger Altizer MS’06 PhD’13, director of The GApp Lab, and director of digital medicine in the Center for Medical Innovation, loves the idea. “That would be awesome!” he says with a chuckle.
Quick! Someone call Paul McCartney!
Altizer founded The GApp Lab in 2013 after University of Utah Health approached him about developing digital programs to help train health care workers. Altizer, a forward thinker fascinated with the interplay of technology and health care, knows that the future of medical diagnostics includes video game technology.
A 2012 American Journal of Preventive Medicine study found that using video games improved 69% of psychological therapy outcomes, 59% of physical therapy outcomes, 50% of physical activity outcomes, 42% of pain distraction outcomes, and 37% of disease self-management outcomes. That same year saw the launch of Games for Health Journal, a peer-reviewed publication highlighting game research and technology in the health care industry.
In June 2020, the FDA approved the first game-based digital therapeutic, EndeavorRx. Developed by Boston-based Akili Interactive Labs, the video game helps treat children with attention deficit hyperactivity disorder. FDA support is important because it allows physicians to prescribe the game—just as doctors prescribe approved medications—and makes it possible for insurance companies to cover the cost of games for patients.
EndeavorRx’s success gives hope to Altizer and others in The GApp Lab that the government has begun taking seriously the idea that video games can be used as treatment for some medical conditions.
Briefly, The GApp Lab is a collaboration supported by the U's Spencer S. Eccles Health Sciences Library, Center for Medical Innovation (CMI), Population Health Sciences department, and the College of Engineering's Entertainment Arts and Engineering program (EAE). The EAE program teaches students not only how to design video games, but how to cooperate with others to produce those products. In addition, students learn the business side of game and app production. And the idea for Choreografish grew out of the CMI, which is focused on developing and advancing medical digital technology.
Eric Handman MFA’03, associate professor of modern dance, envisioned a video game played on a tablet that would help people on the autism spectrum develop an appreciation for dance. His idea: players would use music to create movement patterns among flocks of birds.
“I was intrigued with the idea of how pattern thinking was important both in dance and in those with autism,” he says. “Dance is a social art form, and I wondered how people on the spectrum could access choreography on their own, without the social stress of being in an audience with other people.”
He took his idea to Altizer; Cheryl Wright, professor of family and consumer studies; and Greg Bayles MA’16, a GApp Lab project manager. Altizer proposed changing the graphics to schools of fish, as research showed water was more calming to people with autism. In addition, the game went from being screened on a tablet to played with a virtual reality headset so users could tune out the outside world and create their own peaceful inner sanctum.
Bayles says feedback from players like Johnny Staples helped improve Choreografish. “What the users were most struck by was their ability to control the scene,” Bayles says. “They wanted to stay longer and explore the environments we created. They liked being right in the middle of the fish as they virtually swam around the player.”
When Scott Gutting was diagnosed with mild cognitive impairment, he became depressed, fearful that he was on a slow slide toward more serious cognitive decline.
“After the diagnosis, the doctor basically sent me home saying there was nothing he could do to help me,” Gutting remembers. “Well, no one was going to tell me that at my age I couldn’t do anything to help myself. I decided to find some type of cognitive remediation.”
His daughter, a professor at Columbia University, told him about studies of remediation in older adults—using specially created video games—conducted at the U by Sarah Shizuko Morimoto, an associate professor of population health sciences. For more than a decade, Morimoto has designed video games that rejuvenate damaged circuits in the frontal lobe that seem to block the effectiveness of antidepressant medication. The brain games appear to improve cognitive functions while decreasing players’ disability.
With The GApp Lab, Morimoto created Neurogrow, which involves planting and tending a virtual flower garden with actions like watering, fertilizing, and eliminating pesky bugs. Players get points for cultivating bouquets, which they can then award to friends, and move on to more complicated levels and garden plots.
“Neurogrow has a deeper, double meaning,” Morimoto says. “Tending a garden is like tending to your aging brain. To stay healthy, your brain needs attention and care.”'
In their first clinical trial, Morimoto's team found that four weeks of Neurogrow provided relief for 60%-70% of patients who hadn’t previously responded to antidepressant medication. In a subsequent clinical trial testing Neurogrow against another mentally stimulating computer program, 60%-70% of patients reported a 50% reduction in depressive symptoms.
“The game creates hope in patients, which is incredibly important for them to improve their mental abilities in the face of cognitive decline,” she says. “We’ve optimized the game for seniors because aging brains react differently to medication than younger brains. Plus, using the game is a way to treat vulnerable people at home cost-effectively with evidence-based medicine.”
Like Empower Stars, Neurogrow is undergoing clinical trials to prove its efficacy.
Gutting finds Neurogrow fun yet challenging. “Sometimes I get mad at the machine,” he says with a chuckle. “The game really works my brain, but I do see a definite improvement. In fact, I find that when I take a week or two off, I miss it and my memory functions aren’t as sharp.”
Though Gutting’s wife, Lesley Jones, isn’t dealing with cognitive impairment issues, she plays the game, too. “Why wouldn’t I do this?” she asks. “I want my brain to stay young.”
Keeping people mentally and physically fit is what The GApp Lab is all about, says Altizer, who takes pride in the people around him and the games they produce. “I work with so many talented people: artists, doctors, engineers, programmers, patients, and clinicians. And when I see how the games are helping people—that’s an awesome, wonderful feeling.”
About the author: Benjamin Gleisser is a Toronto-based freelancer.
I host a video podcast, The Wide World Of ESports on the ThinkTech Hawai’i live-streaming network. If anyone at the U who’s working on application of games would like to be a guest on my show, please email me.
Fallout 4 and Skyrim SE are excellent for Senior Citizens.