A Virtual Reality Game (The Secret Trail of Moon) for Treating Attention-Deficit/Hyperactivity Disorder: Development and Usability Study

Maria Rodrigo-Yanguas, Marina Martin-Moratinos, Angela Menendez-Garcia, Carlos Gonzalez-Tardon, Ana Royuela, Hilario Blasco-Fontecilla, Maria Rodrigo-Yanguas, Marina Martin-Moratinos, Angela Menendez-Garcia, Carlos Gonzalez-Tardon, Ana Royuela, Hilario Blasco-Fontecilla

Abstract

Background: Attention-deficit/hyperactivity disorder (ADHD) affects between 4% and 8% of children worldwide. The treatment of choice is multimodal treatment. Multimodal interventions for ADHD may be improved by incorporating new treatments, such as treatment via serious video games. The Secret Trail of Moon (TSTM) is a virtual reality serious video game that was designed for cognitive training related to core ADHD symptoms and executive dysfunction.

Objective: We aimed to describe the development and usability of TSTM.

Methods: The usability study included 37 children and adolescents who tested TSTM during the early usability stage (preinclusion) of a randomized controlled clinical trial for testing the effectiveness of TSTM. Chi-square tests were performed to compare patients with ADHD (ADHD combined subtype vs inattentive subtype) and to compare frequent and infrequent video game players in the second study. We used SPSS version 20 for Macintosh (IBM Corporation).

Results: A total of 31/37 (86%) and 30/37 (83%) of participants liked playing TSTM and wanted to continue playing TSTM, respectively. Further, 5/37 (14%) of participants reported that they experienced either perceived dizziness or virtual reality motion sickness. We found no statistically significant differences after comparing the ADHD combined subtype to the inattentive subtype and frequent video game players to infrequent video game players.

Conclusions: Serious video games, such as TSTM, may complement the current multimodal approach for treating ADHD.

Trial registration: ClinicalTrials.gov NCT04355065; https://ichgcp.net/clinical-trials-registry/NCT04355065.

Keywords: attention-deficit/hyperactivity disorder; chess; cognitive training; new technologies; psychotherapy; randomized controlled trial; serious video game; transfer; usability; virtual reality.

Conflict of interest statement

Conflicts of Interest: In the last 24 months, HBF received lecture fees from Shire. He is a member of the Advisory Board of ITA Mental Health [59]. The remaining authors do not have any conflicts of interest regarding the publication of this manuscript.

©Maria Rodrigo-Yanguas, Marina Martin-Moratinos, Angela Menendez-Garcia, Carlos Gonzalez-Tardon, Ana Royuela, Hilario Blasco-Fontecilla. Originally published in JMIR Serious Games (https://games.jmir.org), 01.09.2021.

Figures

Figure 1
Figure 1
Design and development stages of the user-centered design study.
Figure 2
Figure 2
Picture of the principal investigator (HBF) facing The Secret Trail of Moon.
Figure 3
Figure 3
Specific questions about each game’s mechanics (Smasher, Kuburi, Enigma, Teka Teki, and chess). The questions were as follows: (1) “Was the minigame fun” (factor: fun), (2) “Did you find it easy to understand the instructions” (factor: comprehensible), (3) “Did you find the minigame easy to play” (factor: easy to play), (4) “Did you find the controller easy to use” (factor: proper control), (5) “Do you understand the game better as the level increases” (factor: improvement after repeating), (6) “Did you think visual graphics were beautiful” (factor: enjoyable graphics), and (7) “Did you find it short” (factor: too short)?

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