Table 2 VR, AR, and MR Used for Children with ADHD
Reference | Number of Participants, Age, Sex, | Study Design | ADHD Diagnosis Methods | Clinical Target | Hardware technology, type of technology | Significant Findings |
|---|---|---|---|---|---|---|
Adams et al. 2009, USA [49]. | 35 (8–14) y/o, (35 M) | Case, Control Experimental (children with ADHD, n = 19 Comparison (Control: n = 16) | -licensed mental health professionals or pediatric physicians -parent confirmation | Diagnosis of ADHD | Elumens dome system, head-tracking sensor/VRC_CPT | VRC_CPT has an overall better ADHD classification rate than standard CPT (88% versus 69%). |
Areces et al., 2016, Spain [50]. | n = 117 (5–16) y/o (90 M,27F) | Case, Control Experimental (inattentive ADHD: n = 28 I/H ADHD: n = 29 ADHD combined: n = 32) Comparison (control: 28) | -DSM-5 | Diagnosis of ADHD | HMD equipped with motion sensors and headphones/ VRC_CPT | VRC_CPT classified 67% of control and 57% of ADHD combined participants correctly; standard CPT classified 60% of control and 50% of ADHD combined participants correctly. |
Areces et al., 2018, Spain [51]. | n = 88 (6–16) y/o (66 M,22 F) | Case, Control Experimental (children with ADHD: n = 50) Comparison (Control n = 38) | -DSM-5 | Diagnosis of ADHD | 3D virtual glasses/VRC_CPT | Omission errors on VCR-CPT had a classification rate of 66% for the control group and 89% for the ADHD group. |
Areces et al., 2020, Spain [52]. | n = 150 (5–16) y/o (114 M, 36 F) | Cross-sectional children with ADHD: n = 150 | -DSM-5 | Assessment of ADHD symptoms | (3D) glasses equipped with motion sensors and headphones/VR_CPT | EDAH ADHD observation inattention subscale predicts VR-CPT omission errors with 86% accuracy, commission errors with 80% accuracy, and response time with 74% accuracy. |
Arpaia et, al. 2020, Italy [45]. | n = 4 (6–8) y/o | Case Study Children with ADHD | Not identified | Concentration | AR/Glasses, Acquisition Unit, Processing Unit, Robot/AR, Robot | Controlling a robot in an AR environment enhanced attentional performance to 83% accuracy. |
Bioulac et al., 2012, France [53]. | n = 36 (7–10) y/o (36 M) | Case, Control Experimental (children with ADHD: n = 20) Comparison (Control: n = 16) | -DSM-IV -interviews with children and parents -The Conners’ Parent Rating Scale (CPRS) | Assessment of ADHD symptoms | HMD/ VRC_CPT | VRC_CPT is a reliable method to assess the ability to sustain attention over time. VRC-CPT variables correlate with standard CPT (CPT-III) measures. |
Bioulac et al. 2018, France [44]. | n = 51, (7–11) y/o (41 M, 10 F) RCT | Randomized Control Trial Experimental (children with ADHD: n = 16) Comparison (methylphenidate group: n = 16, psychotherapy group: n = 16) | -DSM-IV -interviews with children and parents | Concentration | HMD/ VRC_CPT | The VR cognitive remediation program reduces distractibility. |
Blume et al. 2018, Germany [54]. | n = 81, MA (11.27) y/o, (46 M,35 F) | Cross-sectional The sample covers a wide range from low to high intensity of ADHD symptoms. | -The Conners Rating Scale | Education | HMD/ VRC | The learning outcomes of students with ADHD are not better for those seated close to vs. distant from the teacher. |
Cho et al., 2002, China [55]. | n = 50 (14–18) y/o | Case, Control Experimental (children with ADHD1: n = 10, children with ADHD2: n = 10) Comparison (placebo groups1 = 10, placebo group2 = 10 Control: n = 10) | -Not identified | Concentration | HMD/ VRC_CPT | VR cognitive training improved the patients’ performance on the standard CPT. |
Clancy et al., 2016 New Zealand [56]. | n = 48(13–17) y/o | Case, Control Experimental (Children with ADHD: n = 24) Comparison (control: n = 24) | - DSM-IV-TR - Conners Scales, Parent and Teacher form | Assessment of ADHD symptoms | HMD/ VRC | Patients with ADHD had a lower margin of safety and twice as many collisions as the controls. |
Coleman et al., 2019, USA [57]. | n = 15(6–13) y/o (12 M, 3 F) | Quasi-Experimental ADHD Children | -DSM-5 -Conners Scales, Parent and Teacher form | Concentration | HMD/ VR_CPT | Working memory training using VR led to substantial improvements in sustained attention. |
DÃaz-Orueta et al., 2014, Spain [58]. | n = 57 (6B16)y/o (42 M, 15 F), ADHD children: n = 57 | Cross-sectional Children with ADHD | -DSM-IV-TR | Assessment of ADHD symptoms | HMD/ VRC_CPT | VR_CPT is better than standard CPT in differentiating children with and without pharmacological treatment. |
Eom et al. 2019, Korea [59]. | n = 38(6–17) y/o (33 M,5 F) | Case, Control Experimental (Children with ADHD: n = 20) Comparison (Control: n = 18) | -DSM-IV | Assessment of ADHD symptoms | HMD/ VRC_CPT | ADHD and control groups exhibit comparable performances on VRC_CPT in the presence of the teacher and social cues as distractors. |
Fang et al. 2019, China [60]. | n = 140 (6–18) y/o (106 M, 34 F) | Case, Control Experimental (ADHD children: n = 77) Comparison (Control: n = 63) | -DSM-5 | Assessment of ADHD symptoms | computer and a high-end VR headset/VR_CPT | VRC_CPT variables’ scores correlate with standard CPT, The Conners’ Parent Rating Scale, and Child Behavior Checklist variable scores |
Gutiérrez-Maldonado, et al. 2009. Spain [61]. | n = 20(6–11) y/o (13 M, 7 F) | Case, Control Experimental (Children with ADHD: n = 10) Comparison (Control: n = 10) | Diagnosed by clinical staff | Assessment of ADHD symptoms | VRC_CPT | Patients with ADHD make more omission errors than controls in distraction and no distraction conditions during VRC_CPT. |
Hong et al., 2021, Korea [62]. | n = 40 (9–17) y/o (31 M, 9 F) | Case, Control Experimental (Children with ADHD: n = 21) Comparison (Control: n = 19) | -DSM-5 | Concentration | HMD/ VRC | VR is an effective tool to improve the concentration of children with ADHD. |
Kim et al. 2020. Korea [46]. | n = 40(8–10) y/o (35 M, 5 F) | Case, Control Experimental (game group with ADHD: n = 20) Comparison (non-game group with ADHD: n = 20) | -DSM-5 | Concentration | (MR)HMD/ MR-Game | MR-Game practice reduced omission errors on the standard CPT. |
Mangalmurti et al., 2020, USA [63] | n = 85(6–12) y/o (62 M. 23 F) | Case, Control Experimental (Children with ADHD: n = 45)Comparison (Control: n = 40) | -DSM-5 | Focused attention | HMD/ VRC_CPT | VRC_CPT results indicate that shifts in the field of vision explain the link between hyperactive-impulsive symptoms and deficits in focused attention. |
Muhlberger et al., 2020, Germany [64]. | n = 128 (4–18) y/o (90 M, 38 F) | Case, Control Experimental (medicated Children with ADHD: n = 26, children with unmediated ADHD: n = 68) Comparison (Control: n = 34) | -DSM-IV | Assessment of ADHD symptoms | HMD/ VRC_CPT | VRC_CPT is sensitive for the detection of ADHD symptoms and medication effects. |
Negut et al., 2016, Romania [65]. | n = 75 (7–13)y/o (45 M,30 F) | Case, Control Experimental (Children with ADHD: n = 33) Comparison (Control: n = 42) | -DSM-IV-TR | Diagnosis of ADHD | HMD/ VRC_CPT | For children with ADHD, there was no significant difference between VRC_CPT and standard CPT on errors of commission, omission, and total correct responses. |
OU, et al. 2020, Taiwan [66]. | n = 3 (8–12) y/o (1 M, 2 F) | Case Study Children with ADHD | -Not identified | Concentration | VR headgear/ VR-game | Playing VR-Game improves concentration. |
Parsons et al., 2007, USA [67]. | n = 20(8–12) y/o (20 M) | Case, Control Experimental (Children with ADHD: n = 10) Comparison (Control: n = 10) | -SWAN Behavior Checklist - The Conners Rating Scale | Assessment of ADHD symptoms | HMD/ VRC_CPT | VRC_CPT measures correlate with standard CPT (Conners’ CPT) measures and parent behavior rating scale. |
Pollak et al. 2010. Israel [68]. | n = 27 (11–17) y/o (16 M, 11 F) | Case, Control Experimental (placebo children with ADHD: n = 19, placebo children with ADHD: n = 7) | -DSM-IV | Assessment of medication efficacy | HMD/ VRC_CPT | MPH reduced omission errors to a greater extent on the VR-CPT compared to the standard CPT (TOVA) |
Pollak et al.,2009, Israel [69]. | 37 (9–17) y/o (37 M) | Case, Control Experimental (Children with ADHD: n = 20 Comparison (Control: n = 17) | -DSM-IV | Assessment of ADHD symptoms | HMD/ VRC_CPT | VRC_CPT had better sensitivity (79% vs. 65%) and equal specificity (both 94%) compared to standard CPT (TOVA) in detecting attention deficits. |
RodrÃguez et al. 2018, Spain [70]. | n = 338(6–16) y/o (241 M,97 F) | Case, Control Experimental (Children with ADHD: n = 237 Comparison (Control: n = 101) | -DSM-5 | Diagnosis of ADHD | HMD/ VRC_CPT | VRC_CPT is slightly better than standard CPT (TOVA) in correctly classifying the control group (66% vs 60%.) and classifying the ADHD combined group (57% vs, 50%). |
Shema-Shiratzky et al., 2019, Israel [71]. | n = 14 (8–12) y/o (11 M, 3 F) | Quasi-Experimental Children with ADHD | -DSM-5 | Concentration | VR simulation is projected on a screen, treadmill/ VR training | VR-based training did not improve attention. |
Tabrizi et al. 2020, Iran [72]. | n = 48 (7–2) y/o (32 M, 16 F) | Case, Control Experimental (Children with ADHD: n = 16, medicated ADHD: n = 16 Comparison (Control: n = 16) | -diagnosis by psychiatrists | Memory Therapy | 360° Samsung VR camera to build it. The software was stored in the VR Box camera/ VR software. | Both VR therapy and medication improved memory function in students with ADHD compared to the control group. |
Tosto et al., 2020, Ireland [73]. | n = 117 (8–9) y/o (94 M, 23 F) pilot study | Case, Control Experimental (Children with ADHD in WWL-AR, children with ADHD in WWL-AR) Comparison (Control: without any access to WWL program) | -Not identified | Education | AR-webpage to handle the display/ web-based AR | Training using AR and no AR has similar results in improving the spelling and reading skills of children with ADHD. |
Yeh et al. 2020, China [74]. | n = 68 (6–12) y/o (42 M, 26 F) | Case, Control Experimental (Children with ADHD: n = 37Comparison (Control: n = 31) (simple comparison) | -DSM-5 | Diagnosis of ADHD | VR HMD, VR controller/ VRC_CPT | Machine learning models incorporating VRC_CPT and behavior rating scale data had a mean cross-validation l classification accuracy of 83%. |
Zulueta et al., 2018, Spain [75]. | n = 407 (6–16) y/o (272 M, 135 F) | Case, Control Experimental (Children with ADHD: n = 213 Comparison (control: n = 194) | -DSM-IV - The Conners Rating Scale parents’ form -interviews with children and their parents | Diagnosis of ADHD | VR/Movement sensor placed in the 3D glasses/ VRC_CPT | VRC_CPT is an effective tool to assess ADHD symptoms with a specificity of 75%, and sensitivity of 68% in diagnosing ADHD. |