Quantifying ADHD Symptoms in Open-Ended Everyday Life Contexts With a New Virtual Reality Task

Abstract

Objective: To quantify goal-directed behavior and ADHD symptoms in naturalistic conditions, we developed a virtual reality task, EPELI (Executive Performance in Everyday LIving), and tested its predictive, discriminant and concurrent validity. Method: We collected EPELI data, conventional neuropsychological task data, and parent-ratings of executive problems and symptoms in 38 ADHD children and 38 typically developing controls. Results: EPELI showed predictive validity as the ADHD group exhibited higher percentage of irrelevant actions reflecting lower attentional-executive efficacy and more controller movements and total game actions, both indicative of hyperactivity-impulsivity. Further, the five combined EPELI measures showed excellent discriminant validity (area under curve 88 %), while the correlations of the EPELI efficacy measure with parent-rated executive problems (r = .57) and ADHD symptoms (r = .55) pointed to its concurrent validity. Conclusion: We provide a proof-of-concept validation for a new virtual reality tool for ecologically valid assessment of ADHD symptoms.

Eye movement behavior in a real-world virtual reality task reveals ADHD in children

“…We used a recently developed VR paradigm, EPELI, which simulates everyday life situations. In this study, we first successfully replicated the behavioral results obtained in our earlier study 12 . All five performance measures showed group differences.…”

“…Task performance measures: We first examined group differences in five measures reported by Seesjärvi and colleagues 12 (see Fig. 1 ).…”

“…EPELI is an open-ended VR task that was developed for the assessment of goal-directed behavior and related cognitive functions (e.g., attention, executive functions, and prospective memory) and validated in a previous study 12 . The game was implemented by Peili Vision Company ( http://www.peilivision.fi/ ).…”

“…We have recently developed the first VR task, named EPELI (Executive Performance in Everyday LIving), that allows quantification of attention and executive function deficits in more realistic open-ended conditions resembling situations where the ADHD symptoms are manifested 12 . In a previous study, we reported performance for five task measures that successfully discriminated ADHD children from typically developing children 12 . Despite its high potential, there is a lack of VR studies examining eye movements in ADHD individuals in naturalistic conditions 11 .…”

“…In this study, we collected eye movement data of the participants playing EPELI with the aim of further improving the detection of ADHD and clarifying the specific mechanisms of attention deficits. In a previous study 12 , we reported performance for five task measures reflecting key aspects in ADHD symptoms. Compared to controls, ADHD children showed a higher percentage of irrelevant actions out of all actions suggesting poor attentional and executive control, longer navigation paths indicating problems with planning, tendency to perform excessive number of actions possibly associated with impulsive behavior, lower number of correctly performed tasks reflecting difficulty in executing the tasks from memory, and higher amount of controller movement that was used to index motor activity level.…”