Gaming Disorder in Children

Gaming disorder is a pattern of behaviour related to digital or video gaming described in ICD-11. It can involve online or offline games. Frequent or enthusiastic gaming, even when intensive, does not by itself mean that a person has a disorder.

According to the World Health Organization, gaming disorder affects only a small proportion of people who play digital or video games. Diagnosis depends not simply on the number of hours spent gaming, but on a persistent pattern of behaviour and its effect on the life of a child or young person.

Core features in the WHO definition

The pattern of gaming behaviour includes:

• impaired control over gaming — difficulty regulating when gaming begins, how often or intensely it occurs, how long it lasts or when it stops;
• increasing priority given to gaming — gaming increasingly takes precedence over other interests and daily activities;
• continuation or escalation despite negative consequences — gaming continues even when it is already causing noticeable problems.

For a diagnosis, the pattern must be severe enough to result in significant impairment in personal, family, social, educational or another important area of functioning. It would normally have been evident for at least 12 months.

Enthusiastic gaming or a disorder

A child may play for long periods during a holiday, be deeply interested in a particular game or use games to socialise with friends while remaining in control, meeting everyday responsibilities and maintaining other interests. In this situation, a high number of gaming hours alone does not establish a disorder.

Reasons to look more closely include a persistent displacement of sleep, education, physical activity, face-to-face relationships or other important activities, repeated unsuccessful attempts to reduce gaming and continued play despite clear deterioration in daily life. Irritability, anxiety, mood changes, tiredness or concentration difficulties can occur in many conditions and are not diagnostic features of gaming disorder on their own.

Professional assessment

Gaming disorder is not diagnosed from a single questionnaire, computer test or a count of gaming hours. A mental health professional assesses the duration and pattern of gaming, the person's ability to control it, and its effects on education, relationships, sleep and everyday functioning.

Assessment of a child or young person includes their perspective and information from parents or legal guardians. When relevant, the clinician may consider information from school, developmental history, family circumstances and other physical or mental health conditions that could explain or intensify the difficulties. Questionnaires may support assessment but do not replace clinical diagnosis.

When to seek help

Professional advice may be useful when gaming behaviour has substantially affected education, family relationships, social life, sleep, self-care or other important areas over time, and attempts to restore balance have not helped.

Urgent help is needed if a child talks about self-harm or suicide, presents a danger to themselves or others, or develops severe agitation, confusion or another acute condition. In Ukraine, call 103 or 112.

Help and support

Support is planned individually according to age, the degree of disruption to daily life, family circumstances and coexisting conditions. It may include psychoeducation, agreed changes to daily routines, restoration of sleep, education and other activities, psychological or psychotherapeutic support, and help for parents.

The aim is not necessarily to ban all gaming, but to restore control and balance. Agreed boundaries, a predictable routine and consistent support are generally more constructive than shame, punishment or suddenly removing every device. If another physical or mental health condition is identified, its treatment is planned separately according to the person's needs.

What parents can do

• discuss not only gaming time but also its effect on sleep, education, relationships and wellbeing;
• agree realistic rules for device use with the child and review them when needed;
• support regular sleep, physical activity, shared activities and face-to-face relationships;
• avoid labelling a child as “addicted” solely because they enjoy games or using a diagnosis as criticism;
• seek professional advice if loss of control and negative consequences become persistent.