Effectiveness of Virtual Reality-Based Interventions for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis

Abstract

This review aims to evaluate the effectiveness of virtual reality-based interventions (VR-based interventions) on cognitive deficits in children with attention deficit hyperactivity disorder (ADHD). A systematic review and meta-analysis were performed according to the PRISMA statement and the Cochrane Handbook guidelines for conducting meta-analyses. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) was used to assess the quality of the evidence. Clinical trials published up to 29 October 2020, were included. The meta-analysis included four studies, with a population of 125 participants with ADHD. The magnitude of the effect was large for omissions (SMD = −1.38; p = 0.009), correct hits (SMD = −1.50; p = 0.004), and perceptual sensitivity (SMD = −1.07; p = 0.01); and moderate for commissions (SMD = −0.62; p = 0.002) and reaction time (SMD = −0.67; p = 0.03). The use of VR-based interventions for cognitive rehabilitation in children with ADHD is limited. The results showed that VR-based interventions are more effective in improving sustained attention. Improvements were observed in attentional vigilance measures, increasing the number of correct responses and decreasing the number of errors of omission. No improvements were observed in impulsivity responses.

Effects of Neurofeedback in Children with Attention-Deficit/Hyperactivity Disorder: A Systematic Review

“…NF improved the symptomatology in children with ADHD, because of learning through video games, attending to their mistakes, and training functions nonconscious control-such as attention, achievement of objectives, self-control, and self-regulation of attention levels, and concentration-in addition to inhibiting distracting stimuli [35]. Also, it was found evidence of comparative effectiveness of NF and CogT for children with ADHD.…”

Exploratory study on the use of HMD virtual reality to investigate individual differences in visual processing styles

“…Researchers used VR and artificial Intelligence (AI) where participants are presented with multiple VR scenes in which visual, auditory and vestibular senses are stimulated and input to an AI model, which classifies these behaviours. A review by Romero-Ayuso et al. (2021) concluded that VR interventions in children and adolescents with ADHD show mixed results, where sustained attention and attentional vigilance are improved; however, impulsivity responses showed no changes.…”

“…Despite emerging promising work on VR use to understand ADHD (Hong et al. , 2021; Romero-Ayuso et al. , 2021; Son et al.…”

Future Challenges in Research in Children with Neurodevelopmental Disorders

“…Likewise, the study of Riquelme, Sabater-Gárriz and Montoya [ 11 ] delves into the impact on the family of chronic pain in children with cerebral palsy (CP) and its relationship to the quality of life of these children and their ability to communicate. This volume also addresses the effectiveness of two types of emerging therapies: hypnotherapy in children with CP [ 12 ] and the use of virtual reality in children with attention-deficit hyperactivity disorder (ADHD) [ 13 ]. Both studies allow us to advance the available evidence.…”

“…Thus, it is concluded that hypnotherapy, for 8–12 weeks, stimulates proprioceptive and balance reactions, reducing muscle spasticity, through rhythmic and symmetrical movement, leading to an improvement in the gross motor function in children with CP, such as lying down, roll, sitting and walking [ 12 ]. The meta-analysis of Virtual Reality-Based Interventions for Children and Adolescents with ADHD highlights the need to design randomized controlled trials with virtual reality and concludes that virtual reality may be effective in improving performance in sustained attention tasks in children with ADHD [ 13 ].…”