In the past, I’ve applauded when the AMA called for more research on the issue before formally deciding to declare video game addiction diagnosable. I’ve been delighted with researchers’ efforts to distinguish between the “addictive” elements surrounding online gambling and traditional role playing games. Finally, my position piece on the issue, Video Game Addiction: Fact or Fiction, remains popular and is currently first to show up on Google searches for “video game addiction fiction,” and fourth on “video game addiction fact.”

So now, the time approaches for the DSM to be modified. One major development in the issue of video game addiction has been to roll it into a broader category of Internet addiction. Since most games these days are online, this sort of makes sense. Overuse of all types of screen time, though, might challenge the definition a bit. If a child spends too much time playing a game that is not connected to the Internet, could he be diagnosed as addicted to the Internet? You can see the difficulties.

Fortunately, the committee in charge of revisions sees the difficulties, too. News this week indicates that gambling will be included in DSM-V as a behavioral disorder, but Internet addiction will not. It will be relegated to an appendix in order to encourage more research, and possible future inclusion in DSM-VI. Of course with so many years between revisions, the relationships we’ve developed with Internet technology may substantially change by that time. Social networking hardly existed just a few years ago, after all.

So, this is a good thing. I’m glad this blog played a part, however small, in the discussion on video game addictions and the struggle over defining it. The public can comment on the proposed revisions to the DSM here, through April. DSM-V is scheduled to be published in 2012-2013, after field trials have been conducted on new and revised diagnoses.

References:
Gever, J. (2010, February 10). DSM-V draft promises big changes in some psychiatric diagnoses. [Online.] Available: http://www.medpagetoday.com/Psychiatry/GeneralPsychiatry/18399

More than 10 million of the country’s 100 million teenage web surfers are internet addicts, a survey by the China Youth Internet Association found last year. China has more than 338 million internet users, more than the entire population of the United States. Zhang Zhao , a Beijing-based mental health specialist with 15 years’ experience, told the South China Morning Post: “I can tie my patients to the chair in front of me, but I cannot unlock their hearts. Nobody can cure addicts without their co-operation.”

Recently the Health Ministry in China banned the use of electro-shock therapy in videogame and Internet “addiction” treatment. This article illustrates an extreme example of a misplaced emphasis on “addiction” to Internet and gaming. A far better term is “overuse.”

Certainly, beating to the point of death, or shocking someone, or otherwise torturing them to give up video games or Internet browsing is uncalled for in “treatment” of “addicts.” Read more on my thoughts on the matter here.

Parents are often concerned their children are playing addicting games. A new study offers clues to help determine if video games can be truly “addictive,” or are simply a preferred entertainment venue that crowds out other activities.

[For reprinting rights, contact John Rice.]

Another salvo has been fired in the war over video game addiction. In one camp are non-believers, who feel video games players may be impulsive but never truly addicted in the traditional sense. Their argument goes something like this: drug addicts are addicted because they have chemical dependencies. Video game players do not have a chemical dependency with the games, therefore they cannot be addicted in the sense most people define the word.

On the other side are true believers in video game addiction. They postulate an addiction can occur without drugs when the action involved harms the persons and/or those around them. Their strongest argument for video game addiction has revolved around linking video games with online gambling.

This is the strongest point the pro-video game addiction crowd has, that like gambling too much game play can be detrimental. But from there the argument loses steam. Someone addicted to gambling suffers clear detrimental consequences, mainly extreme loss of money. Gambling addicts have been known to lose their homes, jobs, spouses, and every dime that comes their way chasing the next opportunity to wager. Kids, or even adults, who like to while away their time on the latest video game rarely come close to that level of detrimental effect.

Nonetheless, many parents worry their kids are “addicted” to video games. Their children may get hold of a new title and disappear behind a monitor for hours on end. In some cases, grades and social opportunities may suffer due to intense game play, especially among adolescent boys.

But is this a true addiction? Does the overuse of video games lead to such negative life consequences that it should rank with gambling, nicotine, heroin and other drugs? Someone can overdose on heroin and die. Is it easy for someone to overdo a night of game play to the point it kills them? Should we be equating heavy video game playing with heroin addiction? Or is this simply a parental issue, something parents can simply pull the plug on if they feel their children play too much?

Ultimately, this is simply a war on terms. Using the proper term helps us to understand exactly what is being discussed. And to help nervous parents answer the above questions: no, a heavy video game player does not sink to the same level of addiction as a heroin addict.

The latest round in this ongoing discussion comes from a paper soon to be published in the journal Psychological Science by Douglas A. Gentile at Iowa State University. Dr. Gentile’s specialty is studying the effects of media. He has written or co-written several papers examining both the benefits and detrimental effects of videogames. Recently he co-authored a book, Violent Video Game Effects on Children and Adolescents: Theory, Research, and Public Policy, examining how violent video games may lead to proclivities in players for real life violence.

His latest study tackles a national survey of more than 1,100 youths by Harris Polls and looks at their self-reported video gaming habits. The survey used sets of questions, including one published in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) designed to measure pathological gambling that had been modified for video games. This set included 11 questions such as, “Have you tried to play video games less often or for shorter periods of time, but are unsuccessful?” and, “Do you sometimes skip household chores in order to spend more time playing video games?” and, “Have you ever needed friends or family to give you extra money because you spent too much money on video-game equipment, software, or game/Internet fees?” Respondents replied with “yes,” “no,” or, “sometimes.”

Of course, answering yes or sometimes to one or a few of these questions did not automatically shunt a respondent into the pathological column. The bar was set at six positive replies, with “sometimes” counting as a half “yes.” Using that measurement, Genitle found almost 12% of boys surveyed qualified as “pathological” video game players, and almost 3% of girls, for a grand total of 8.5% of all respondents. There also seemed to be a correlation with students who performed poorly in school being more likely to rate as pathological game players.

Gentile reasoned video game players with pathological playing tendencies may be “behaviorally addicted.” Ultimately, he noted there is strong debate as to whether or not video games can be truly considered a behavioral addiction or not, and readily admitted his study would not resolve the question. The survey’s strongest element was its national scope, he wrote, but both the survey and his study were far from resolving the question of video game “addiction.”

Reaction in the media was swift. In light of the fact a national survey apparently indicated 8.5% of American children are “addicted” to video games, headlines quickly trumpeted the news. A backlash also developed. Renowned video game research blogger Wai Yen Tang noted the Harris Polls product was a self-reported Internet survey. The “yes,” “no,” or “sometimes” response on the modified scale seemed to be simplistic as a diagnostic tool and suggested professional follow up would be needed before any individual could be properly diagnosed. Jerald Block at Oregon Health Science University was quoted by USA Today, cautioning that the respondents placed in the pathological category were placed there without physician interviews. Nancy Shute at US News and World Report wrote that if avoiding chores and homework were signs of video game addiction, then she was definitely addicted to reading.

Despite proponents’ comparisons, there is no accepted diagnosis for video game addiction as there is for pathological gambling. Therefore, as far as the American Psychiatric Association (APA) is concerned, it does not officially exist. This has not stopped members from debating the issue, though, as efforts on the newest revisions to the DSM continue. In the APA’s 2007 annual meeting, a subcommittee studying the research on video games recommended using the term “overuse,” rather than “addiction,” and called for much more research before including excess video game playing as a diagnosable disorder.

Clearly there is a difference between behavioral addictions and chemical dependencies, and here is where terms matter. If a person can be chemically addicted to heroin, and behaviorally addicted to gambling, we should differentiate. Thus, the term “addiction” should be reserved for chemical dependencies. Gambling problems should fall under the term “pathological.” Playing video games to excess should be termed “overuse.” The overuse of videogames may result in lost sleep and delayed homework, but will usually not result in mortgaging the house for the next round of bets (e.g., pathological gambling) or in accidental overdoses resulting in death (e.g., heroin addiction).

Understanding the differences between the terms and resolving to use them in discussions about these issues should go a long way toward eliminating misunderstandings about players and their occasional overuse of video games.

Update:
Safad0 at GameSpot has a good discussion based on this article here.

Update:
Take a look at this class assignment over at UC Santa Cruz. Students had to take sides on the video game addiction debate. This article is cited. Lots of Wikipedia references, but there are a few other good articles on both sides of the debate the students uncovered.

Update:
Good news on DSM-V.

The contrast sensitivity function (CSF) is routinely assessed in clinical evaluation of vision and is the primary limiting factor in how well one sees. CSF improvements are typically brought about by correction of the optics of the eye with eyeglasses, contact lenses or surgery. We found that the very act of action video game playing also enhanced contrast sensitivity, providing a complementary route to eyesight improvement.

Therefore, action videogames help to improve eyesight, complimenting glasses, contacts, or surgery. The paper offers further elaboration here:

Expert action video game players (VGPs) were compared to gender- and age-matched non–action game players (NVGPs) in a CSF procedure… Because we were interested in the effect of gaming on everyday eyesight, participants were tested binocularly with their current eye prescription. We were interested in whether vision, which should not be far from optimal under such conditions in young adults, may be further heightened by action video game practice. The VGP group showed enhanced contrast sensitivity as compared with the NVGP group, and this population difference interacted with spatial frequency, indicating a greater group difference at intermediate and higher spatial frequencies than at the lowest spatial frequency… We propose that the changes that we observed after action game playing also reflect cortical plasticity, but for the better in this case.

So, using appropriate video screen activities can apparently “exercise the eyes” as well as reflexes. This has caught the media’s imagination as Google News indicates over 230 articles have reported the study since its online release.

Not surprisingly, Daphne Bavelier over at U. Rochester had a hand in this research. Previous work by Dr. Bavelier in this field is blogged about here.

References:
Li, R., Polat, U., Makous, W., and Bavelier, D. (2009, March 29). Enhancing the contrast sensitivity function through action video game training. Nature Neuroscience. [Online.] Retrieved April 1, 2009 from http://www.nature.com/neuro/journal/vaop/ncurrent/full/nn.2296.html

A total of 375 subjects, ages 13-29, were recruited from 34 academic medical centers in North America and Australia in 2004-05. Subjects were screened by language (if they couldn’t communicate in one of the languages Re-Mission uses (English, French, & Spanish), they were screened out), ability to follow directions (if they ignored screeners’ directions, they were screened out), and, “history of seizures as a result of photosensitivity,” (if the flashing lights of the videogame bothered them, they were screened out).

Subjects played the game at least one hour per week for three months. The control group (n = 178 ) played, “A PC version of Indiana Jones and the Emperor’s Tomb … because the play structure and controller interface closely resembled that of Re-Mission.” All subjects were given a computer. Control group subjects received a computer with only the Indiana Jones game while the experimental group subjects’ computers had both the Indiana Jones game and Re-Mission.

Here is the conclusion:

The video-game intervention [Re-Mission] significantly improved treatment adherence and indicators of cancer-related self-efficacy and knowledge in adolescents and young adults who were undergoing cancer therapy. The findings support current efforts to develop effective video-game interventions for education and training in health care.

“Treatment adherence” means subjects took their medication. Therefore, the study shows an increased willingness to continue chemo or other treatments by young cancer patients when offered the videogame intervention.

The pilot study took place in San Antonio, so local coverage was heavy. Visit the San Antonio Business Journal and WOAI for more details.

A Randomized Controlled Study of the Effectiveness of Casual Video Games in Reducing Stress and Improving Mood
Carmen Russoniello, Eastern Carolina University

Should “Videogame Addiction” be in DSM-V?
Jack Kuo, Promises Treatment Centers

The World of Warcraft Blood Disease : Epidemiological Observations and Findings
Nina Fefferman, Tufts University

PDwii: Using Novel Interfaces to Promote Physical Rehabilitation & Achieve Quantifiable Results
Red Hill Studios

The one by Fefferman on the WoW disease will be intriguing because it will attempt to show how dynamic virtual environments can represent RL phenomena. I’ve covered Wii-hab, stress reduction, and the question of including videogame “addiction” in DSM-V here. (In a word, the answer to this question is, “No.”)

There are many more sessions, and all of them look inviting. The Games for Health conference is always chock full of good content, and this year will be no exception.

This is a good example to watch typical media treatment with easy to digest sound bites and oversimplification of complex issues, all crammed together in a tight time slot between advertisements. Here’s my summary of the segment, FWIW:

The segment opens with a tragic discussion of how Ms. Woolley’s son committed suicide after overuse of EverQuest, leading her to start OGA. Winterburn concedes gaming can become addictive in the sense that games can fill a hole in the lives of certain socially repressed people. Ouellette tries to get into an explanation of the research surrounding videogames, bringing up Loftus & Loftus (1983) regarding inherent reward schedules in games.

But, the journalists wanted to focus on the suicide related to EverQuest and ask Woolley if games like EQ should simply be banned. Ouellette gets back in to the conversation, and points out that comic books were blamed for youthful degeneracy in the 1950s, back-masking in rock lyrics were considered bad in the 1970s, and that basically each generation embraces a medium parents don’t understand. However, now parents have grown up with games and are more accepting. Woolley tries to ask that because Ouellette is a gamer and understands the medium, would he be more careful with his children playing, but this line of discussion is cut off due to lack of time. The journalist wraps up by belittling Ouellette’s last point, saying we’ve come a long way from the days of Pong and comic books with these videogames.

References:
Loftus, G. R. & Loftus, E. F. (1983). Mind at play: The psychology of video games. New York: Basic Books.

Overnight sleep tests along with pre and post visual and verbal memory tests indicated that boys playing the videogame took longer to fall asleep, and spent less time in deep sleep. Videogame players were more highly aroused than movie watchers, and seemed to show stronger emotional experiences with the games.

Movies were not blameless, either. In the movie group, boys slept less (the movies lasted longer than the hour allotted for games), and the movies did not seem to affect memory performance.

On the other hand, the game playing group experienced less “slow wave” sleep, and spent more time in “non-REM” sleep. Thus, their sleep was longer but less satisfactory as sleep patterns were disrupted. Verbal memory performance also suffered a hit in the game playing group.

The researchers concluded succinctly: “The results suggest that television and computer game exposure affect children’s sleep and deteriorate verbal cognitive performance, which supports the hypothesis of the negative influence of media consumption on children’s sleep, learning, and memory.”

Both television watching and videogame playing affected children’s sleep negatively, but videogames were portrayed as having an even more negative effect. Certainly, this seems like a “duh” statement. Who wouldn’t be jazzed after going through MC in WoW and perhaps suffer some sleep loss after a successful raid? Also, it should be noted the group size and study duration were small and short, respectively.

Nonetheless, this adds another drop in the bucket for educational game research. In particular, the researchers noted yet more evidence for a cognitive link with emotions and learning … a strongpoint for good educational games. Alas, from the paucity of information about the study online, I can’t tell how much the researchers fleshed out this idea.

The most negative way to portray the study’s findings in the media seem to center around sleep deficiencies caused by videogames. I think a more interesting angle is the level of emotional and intellectual stimulation caused by videogames versus passive movie watching. Of the two, videogames would seem to come out on top for educational purposes if the issue is framed that way.

References:
Dworak, M., DiplSportwiss, Schierl, T., Bruns, T., & Strüder, H. K. (2007, November). Impact of singular excessive computer game and television exposure on sleep patterns and memory performance of school-aged children. Pediatrics 120(5). 978-985.

Reuters. (2007, November 10). Video games disrupt teenagers’ sleep, researchers find. The Vancouver Sun. [Online]. Available: http://www.canada.com/vancouversun/news/story.html?
id=551773bb-66bd-4b10-9ad9-49b7ccc2282a

It’s this last generalization that has cropped up recently again, as we Americans seek to align commerce with our brethren across the pond. Previous commercial alignment has resulted in soda being sold in one and two liter bottles over here, where we stubbornly cling to the English measurement system whilst the rest of the world goes Metric. Another example is Microsoft’s recent agreement to abide by European anti-monopolist regulations.

Most recently, the Europeans have expressed their ire at American regulations on online gambling. First, US regulators let it be known that gambling sites were discouraged on American soil. The Caribbean, however, has several island nations a short plane ride away, with governments more amenable to profitable online sites. Next, the US passed a law stating that online gambling simply cannot take place at all on American soil. Gambling sites responded by continuing to take credit card payments on the sly, and the fun continued. Finally, the US cracked down on the card companies, arrested some site operators who happened to be passing through American airports, and generally put the kibosh on online gambling.

The EU and Caribbean nations such as Antigua have brought a complaint against the US law to the World Trade Commission, and continue to argue against what they see as overly restrictive US regulations. Namely, this coalition contends Americans should have the luxury of gambling online if the site is not based in the US. The US law essentially violates the rights of offshore gambling sites, they say.

There’s little doubt that gambling can lead some down the path of ruin. Europeans who’ve read Dostoevsky’s The Gambler surely know this. Ironically, legal gambling has become more accessible to Americans down through the years. When I was growing up, folks had to travel to Las Vegas or Atlantic City to legally gamble. Now with the proliferation of state lotteries and casinos on reservations, riverboats, and elsewhere, legal gambling in the real world is far more widespread than it ever was in the past.

The interesting thing about gambling from an academic perspective is that money influences things in ways nothing else can. It’s one thing to pretend to invest in the stock market, or place a virtual bet. It’s quite another to use your own money from your own account.

Gambling also fuels ongoing research into addiction, such as Fong’s work at UCLA. It’s true that people can get “addicted” to almost anything. I’ve long argued there is a difference between chemical addictions and behavioral addictions. Unfortunately, most news journalists make little difference between the two, and we’ve read stories equating videogame players with heroin addicts, etc.

There is something about interacting with a video screen that truly focuses people. I recall reading about the introduction of television at the 1939 World’s Fair. One writer remarked that folks did not have enough time to sit around and watch the contraption. Once World War II was over, and RCA could get about the business of transforming radio networks to television networks, people found plenty of time to sit down and watch television.

Combining true interaction, beyond yelling at the set, was advanced by Willy Higginbotham at the Brookhaven National Laboratory in 1958 when he hooked up a couple of paddle wheels to play virtual tennis on an oscilloscope. About the same time, Ralph Baer was thinking about interactive games for television, and he began developing schematics and a prototype in 1966.

Since then, this interactive element with the screen has caught fire in ways nobody foresaw. Now, people around the world can play online with one another in everything from simulated card games to mock battles with virtual monsters. Video poker and gambling ported to online environments combine the attention-grabbing aspects of videogames with the allure of gambling.

Online gambling creates a strong pool of research material because it combines two highly interactive elements to which players can become “addicted” (a better term is “overuse,” especially for online time or videogame play). I think we’ll see some interesting papers coming out of UCLA and elsewhere in the near future. In the meantime, folks wanting to gamble online in the comfort of their homes will have to wait, if they live in America. Or, they can hop a flight over to Europe and gamble online whilst on the beach. There, they can go topless as well. Maybe have a drink, if they’re underage.

Q: Why is it important to put video games in classrooms?
A: The question is still out as to whether or not video games are important for classroom use. Certain media hold advantages over other media, depending on the situation. For instance, books are good for preserving dense information. Lectures are good for transmitting brief information quickly. Videogames are good for simulated experiences that can be pedagogical in some way.

The best place for videogames may well be in after school or extracurricular programs where time is not as limited and there is less concern about traditional testing. This is backed up in Squire’s dissertation, and elsewhere.

Q: For how long have you been working on educational video games? Is it something new?
A: I’ve centered my doctoral work around educational videogames. In that regard, I’ve been in the field personally only a few years. I think Marc Prensky helped popularize the idea of instructional videogames with his book in 2001. I think James Paul Gee helped popularize the idea in the educational research establishment with his book in 2003.

Some might say that instruction through videogames has been occurring since videogames first appeared. They were introduced (although via tube technology and not true vector graphics that some folks define as video) at the Brookhaven Nuclear Laboratory in the 1950s.

Personally, I think the notion of instruction through gaming received its biggest boost when Microsoft introduced Windows Solitaire. This game “trained” computer users on a mouse. Up to that time, PC users mostly navigated without a mouse. Windows required a mouse for some activities. Folks who had never used a mouse before became quite proficient after a few rounds with Windows Solitaire.

Q: I read in one of your papers that it was “widely believed that much more learning can take place within active environments.” How widely? Numbers? Since when?
A: This is a key question for which we are awaiting more empirical data. As frustrating as that might be, one of the even more fundamental questions yet to be resolved is, What should we measure? If we are going to measure test scores, I suspect that videogames won’t show any more improvement than any other program or product. My personal theory on improved test scores is, it doesn’t matter what product is used. What matters are the teachers, and what they do to get students to learn. The product matters little, in my opinion, other than to help promote an initial burst of enthusiasm.

Now, the idea that active environments promote learning more than static ones falls back on constructivism, and that opens up another can of worms altogether. Constructivists will always come down on the side of active environments, with or without empirical data to back them up. There may well be some research on what students learn through active environments as opposed to static ones. I recall a survey of students who went through an interactive museum exhibit versus those going through static exhibits. If memory serves, the interactive group enjoyed their experiences more, although they came away with knowledge of fewer facts.

I believe the quote in question was a synthesis of arguments by Squire and Jenkins, from the Insight journal, around 2003. Since then, much more attention has been paid to the field, with multiple journal articles and research in both education and the medical field. One of the better summaries of papers detailing benefits of educational videogames down through the years can be found in Simon Egenfeldt-Nielsen’s article, “Third Generation Educational Uses of Computer Games,” in the latest issue of Journal of Educational Multimedia and Hypermedia. See Table 1 for his list.

Q: Video games are said to be more engaging. Where does that theory come from? Situated learning? Or something else? Role of the teachers and books?
A: I would argue videogame interaction is self evidently more interactive than sitting through a lecture. I have proposed a means of estimating the higher thinking potential of any game, in a paper published in January this year in the Journal of Technology and Teacher Education. This involves a melding of Bloom’s Taxonomy to videogame interaction. The article is entitled, “Assessing Higher Order Thinking in Video Games.”

As for the roles of teachers and books, some of the largest ongoing experiments have used both extensively with videogame environments. Indiana’s Quest Atlantis makes heavy use of hybrid learning, and the virtual world itself is quite text intense. In fact, I have discussed this with one of the lead developers, Dr. Scott Warren, now at UNT. My premise: Quest Atlantis is really a highly digitized, interactive text environment. If memory serves, Dr. Warren agreed, although he noted that much more than reading is involved with Quest Atlantis.

Nonetheless, text plays a key role in many of these games, which require reading and typing in order to engage in the environment. Books and teachers will never relinquish their key roles in the classroom. Videogames will increasingly offer supplemental educational vehicles, giving teachers additional resources to use in and out of the classroom.

Q: How do you measure the efficiency of video games in classrooms?
A: Again, efficiency of what? Efficiency of increasing knowledge? Higher test scores? Do videogames fall under the same media umbrella that other media do in Clark’s “delivery truck” argument, where he asserted media is immaterial in delivering the content? Or, do the interactions within games result in higher engagement and additional intrinsic motivation to discover new knowledge inside and outside the game, and school?

Q: Have scientists worked on the impact of learning through video games on the kids’ brains?
A: The major work in the hard sciences have centered around visual plasticity (Green & Bavelier) and glucose levels (Haier). Prensky is best known for postulating the digital natives / digital immigrants divide, but showed little in the way of experiments to back up the claim. Rosser showed that hand-eye coordination from videogame play has real world applications in modern surgery. Farrace-Di Zinno demonstrated that boys diagnosed with ADHD were more still and focused while engaged in videogames.

So, something is going on in the brain. Measuring the impact is somewhat difficult. Haier’s work with PET scans dates back to 1992, so at some point somebody will probably build on that work and give us a more detailed look at what is going on inside the brain during game play.

Here are the citations to the works above:
Farrace-Di Zinno, A.M., Douglas, G., Houghton, S. Lawrence, V., West, J. & Whiting, K. (2001, November). Body movements of boys with Attention Deficit Hyperactivity Disorder (ADHD) during computer video game play. British Journal of Educational Technology 32(5). 607-618.

Green, C.S., Bavelier. D. (2007). Action-video-game experience alters the spatial resolution of vision. Psychological Science 18(1), 88-94.

Haier, R. J. (2003). Positron emission tomography studies of intelligence: From psychometrics to neurobiology. In Nyborg, H. [Ed.]. The scientific study of general intelligence — Tribute to Arthur R. Jensen. 41-52. New York: Pergamon.

Prensky, M. (2001a, September/October). Digital natives, digital immigrants. On the Horizon, 9(5), 1-6.

Prensky, M. (2001b, November/December). Digital natives, digital immigrants, part 2: Do they really think differently? On the Horizon, 9(6), 1-6.

Rosser, J.C., Lynch, P.J, Cuddihy, L., Gentile, D.A., Klonsky, J., Merrell, R. (2007, February). The impact of video games on training surgeons in the 21st Century. Archives of Surgery, 142(2). 181-186.

Q: What perspectives do you see for the future? Do you see any evolution in the field?
A: A defining groundwork, where everybody agrees to the same set of definitions, will help. I think we’ll see much more empirical data come out of the medical literature, with applications for education. Finally, we need a really killer app for education that meets the needs I spelled out at AECT 2005: a product with an appropriate cognitive load for students, aligned to standards, with problem solving germane to the subject; probably built on a rich 3D environment, and easily customizable by the teacher. I think we see a lot of this already in teachers tweaking the Neverwinter Nights engine for their own classroom use, but it takes an inordinate amount of time programming that game. If something out there could be offered that was easier for teachers to use in the classroom, I think considerable interest among educators and researchers would follow.

-*-

Zadeh’s questions were good ones, and I enjoyed having to think about the topics she brought up, and justify some of my positions in the field. All told, it was a very thoughtful exercise, and I appreciated the opportunity to respond.