Do children with ADHD have greater situation awareness than other kids? Are they more likely to keep their wits about them in an ominous situation? Take the risks necessary to escape danger? Be alert and attuned to external threats? Exhibit an intuitive capacity for quickly protecting themselves in the face of uncertainty?

Some researchers hypothesize that the high incidence of ADHD — according to the Center for Disease Control and Prevention, in 2012 11% of individuals in the U.S. had been diagnosed with ADHD — can be best explained by evolutionary functionality. People with ADHD, the argument goes, are better at exploration, risk taking, and information sharing — all qualities in greater demand with each passing day. If that’s the case, kids with ADHD might be particularly well-suited to dominate the mega video game sensation Fortnite.

Fortnite is an incredibly popular co-op sandbox survival game from developer Epic Games (Gears of War). In its free-to-play player-versus-player Fortnite: Battle Royale, 100 players try to survive but only a single individual or squad is left standing by the end. It’s a bit like The Hunger Games, in that unpredictable new risks and dangers appear constantly, and fort construction is critical to survival.

Fortnite is very fast-paced. Though games typically last 20-25 minutes, kids tend to play for hours at a time. And though the chances of survival are scarce, navigating the game is a bit like playing a casino slot machine — getting close often encourages players to try again and again. The high level of risk, the need to remain alert for external distractors, and the opportunity to use hands-on skills for building make Fortnite and ADHD a natural match.

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This doesn’t mean that it’s a good idea for kids with ADHD to spend hours — or entire summer vacations — playing Fortnite. (I have to point out that, while the game’s violence is cartoonish in nature, it’s still a survival game that pits players against other players and therefore is not appropriate for preteens.) But it might explain why so many of the kids I see in my clinical neuropsychological practice love — and excel at — the game.

Some aspects of the game, such as the duos and the four-person squads, require teamwork and collaboration. Players can develop reputations for specific game skills such as finding weapons or building forts that require executive-functioning skills such as flexibility and planning. All players need to learn to escape danger, think on their feet, and be alert to external threats and changes. These game skills echo those that trip up many kids with ADHD in their daily lives, but which serve as assets in the world of Fortnite.

I asked a group of my patients with ADHD what they found so captivating about Fortnite, and here is what they said:

Stanley, a 15-year-old freshman, told me he plays Fortnite about two hours a day on weekends but not during the week, as his parents restrict him from gameplay on school nights. He most enjoys completing challenges, leveling up, surviving, and completing tasks in Fortnite. Typically he likes to play on teams. He describes himself as being very good at making “callouts,” a valuable communication skill. He can quickly identify enemies and resources for his teammates. Like his peers who enjoy Minecraft, Stanley appreciates the building aspect of the game, including construction of ramps, platforms, and stairs. Stanley and other interviewees describe liking the weekly updates and improvements made to Fortnite. He reported that he has played the game at least 200 times but had never become the final survivor; his best performance was second place at the time of our interview.

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Keenan, a 17-year-old senior, enjoys the randomness of Fortnite. He describes jumping into the map of the game and needing to make immediate decisions — and adjustments — based on where he lands and what challenges greet him. He describes Fortnite as “about as tame as you can get” when you’re shooting another person with guns. He notes that the game mimics fantastical sci-fi, so there is a clear layer of separation between reality and the game.

J. J., a 13-year-old middle school student, likes Fortnite because “it’s free, and it runs decently.” He enjoys the frequent game updates, which allow players to change the objects they can build. He also likes the quick editing options and learning about the patterns that aid in construction during the game. At the time of our interview, J. J. reported having 156 wins as the sole survivor and estimated playing more than 3,000 games (which I’d guess is actually an underestimate, much to the chagrin of his mother). In fact, one of the major reasons he was referred to me for a neuropsychological evaluation was because he was withdrawn and secluded from others. He had been spending most of his time playing video games.

Robbie, an 11-year-old sixth grader, reported that he likes playing Fortnite because he enjoys the building part of the game. He primarily plays “Save the World,” a version of Fortnite where players try to kill zombie-like Husks and can work individually or in teams to survive. He reported that he could play for 15 minutes or as much as 2 hours at a time. The building part is particularly interesting to him because it requires players to think quickly about where to build a fort — and whether to use walls, ramps, floor tiles, or roofing material. He described the importance of knowing the distinct types of building materials available in each part of the map.

It’s too early to say whether Fortnite will be a short-lived phenomena like Pokémon GO! — or sustain its audience like Minecraft. Undoubtedly, kids with ADHD will continue to flock to Fortnite and other similar action and sandbox games. As I often write in my articles on the LearningWorks for Kids website, it is critical to help children glean more from playing games like Fortnite by transforming game-based learning into real-world skills. You might find that talking to your child about gameplay nurtures your relationship and motivates him to reflect on the thinking skills he uses in gameplay. Expanding his interest beyond screen-based play is your ultimate goal.

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