The opportunities of virtual reality in the rehabilitation of children with attention deficit hyperactivity disorder: a literature review

Azadeh Bashiri, Marjan Ghazisaeedi, Leila Shahmoradi, Azadeh Bashiri, Marjan Ghazisaeedi, Leila Shahmoradi

Abstract

Attention deficit hyperactivity disorder (ADHD) is one of the most common psychiatric disorders in childhood. This disorder, in addition to its main symptoms, creates significant difficulties in education, social performance, and personal relationships. Given the importance of rehabilitation for these patients to combat the above issues, the use of virtual reality (VR) technology is helpful. The aim of this study was to highlight the opportunities for VR in the rehabilitation of children with ADHD. This narrative review was conducted by searching for articles in scientific databases and e-Journals, using keywords including VR, children, and ADHD. Various studies have shown that VR capabilities in the rehabilitation of children with ADHD include providing flexibility in accordance with the patients' requirements; removing distractions and creating an effective and safe environment away from real-life dangers; saving time and money; increasing patients' incentives based on their interests; providing suitable tools to perform different behavioral tests and increase ecological validity; facilitating better understanding of individuals' cognitive deficits and improving them; helping therapists with accurate diagnosis, assessment, and rehabilitation; and improving working memory, executive function, and cognitive processes such as attention in these children. Rehabilitation of children with ADHD is based on behavior and physical patterns and is thus suitable for VR interventions. This technology, by simulating and providing a virtual environment for diagnosis, training, monitoring, assessment and treatment, is effective in providing optimal rehabilitation of children with ADHD.

Keywords: Attention deficit hyperactivity disorder; Child; Rehabilitation; Virtual environment; Virtual reality.

Conflict of interest statement

Conflict of interest: No potential conflict of interest relevant to this article was reported.

References

    1. American Psychiatric Association. Diagnostic and statistical manual of mental disorders: DSM-5. Washington, DC: American Psychiatric Publishing; 2013.
    1. Lee JM, Cho BH, Ku JH, Kim JS, Lee JH, Kim IY, et al., editors. A study on the system for treatment of ADHD using virtual reality; Proceedings of the 23rd Annual International Conference of the IEEE; 2001 Oct 25-28; Istanbul, Turkey. Piscataway (NJ): IEEE Engineering in Medicine and Biology Society; 2001.
    1. Yeh SC, Tsai CF, Fan YC, Liu PC, Rizzo A, editors. An innovative ADHD assessment system using virtual reality; 2012 IEEE EMBS International Conference on Biomedical Engineering and Sciences; 2012 Dec 17-19; Langkawi, Malaysia.
    1. Strickland DC, McAllister D, Coles CD, Osborne S. An Evolution of Virtual Reality Training Designs for Children With Autism and Fetal Alcohol Spectrum Disorders. Top Lang Disord. 2007;27:226–241.
    1. Hurks PP, Hendriksen JG. Retrospective and prospective time deficits in childhood ADHD: the effects of task modality, duration, and symptom dimensions. Child Neuropsychol. 2011;17:34–50.
    1. Brown SJ, inventor. Health Hero Network, Inc, assignee. Method for diagnosis and treatment of psychological and emotional conditions using a microprocessor-based virtual reality simulator. US6186145 B1. United States patent. 1996 Jun 21;
    1. Kim J, Lee Y, Han D, Min K, Kim D, Lee C. The utility of quantitative electroencephalography and Integrated Visual and Auditory Continuous Performance Test as auxiliary tools for the Attention Deficit Hyperactivity Disorder diagnosis. Clin Neurophysiol. 2015;126:532–540.
    1. Cubillo A, Halari R, Ecker C, Giampietro V, Taylor E, Rubia K. Reduced activation and inter-regional functional connectivity of fronto-striatal networks in adults with childhood Attention-Deficit Hyperactivity Disorder (ADHD) and persisting symptoms during tasks of motor inhibition and cognitive switching. J Psychiatr Res. 2010;44:629–639.
    1. Heller MD, Roots K, Srivastava S, Schumann J, Srivastava J, Hale TS. A Machine Learning-Based Analysis of Game Data for Attention Deficit Hyperactivity Disorder Assessment. Games Health J. 2013;2:291–298.
    1. Goldstein S. Handbook of neurodevelopmental and genetic disorders in children. 2nd ed. New York: Guilford Publication; 2010.
    1. Kim JW, Sharma V, Ryan ND. Predicting methylphenidate response in ADHD using machine learning approaches. Int J Neuropsychopharmacol. 2015;18:pyv052.
    1. Schweitzer JB, Cummins TK, Kant CA. Attention-deficit/hyperactivity disorder. Med Clin North Am. 2001;85:757–777.
    1. Duda M, Ma R, Haber N, Wall DP. Use of machine learning for behavioral distinction of autism and ADHD. Transl Psychiatry. 2016;6:e732.
    1. Bioulac S, Lallemand S, Rizzo A, Philip P, Fabrigoule C, Bouvard MP. Impact of time on task on ADHD patient's performances in a virtual classroom. Eur J Paediatr Neurol. 2012;16:514–521.
    1. Gongsook P. Time simulator in virtual reality for children with attention deficit hyperactivity disorder. Berlin: Springer; 2012. pp. 490–493.
    1. Barkley RA, Koplowitz S, Anderson T, McMurray MB. Sense of time in children with ADHD: effects of duration, distraction, and stimulant medication. J Int Neuropsychol Soc. 1997;3:359–369.
    1. Schwebel DC, Gaines J, Severson J. Validation of virtual reality as a tool to understand and prevent child pedestrian injury. Accid Anal Prev. 2008;40:1394–1400.
    1. Reid D. Virtual reality and the person-environment experience. Cyberpsychol Behav. 2002;5:559–564.
    1. Nolin P, Stipanicic A, Henry M, Lachapelle Y, Lussier-Desrochers D, Rizzo AS, et al. ClinicaVR: Classroom-CPT: a virtual reality tool for assessing attention and inhibition in children and adolescents. Comput Human Behav. 2016;59:327–333.
    1. Satava RM. Medical virtual reality. The current status of the future. Stud Health Technol Inform. 1996;29:100–106.
    1. Johnson D, editor. Virtual environments in army aviation training; Proceedings of the 8th Annual Training Technology Technical Group Meeting; Mountain View (CA), USA. 1994.
    1. Parsons TD, Bowerly T, Buckwalter JG, Rizzo AA. A controlled clinical comparison of attention performance in children with ADHD in a virtual reality classroom compared to standard neuropsychological methods. Child Neuropsychol. 2007;13:363–381.
    1. Rizzo AA, Buckwalter JG. Virtual reality and cognitive assessment and rehabilitation: the state of the art. Stud Health Technol Inform. 1997;44:123–145.
    1. Rose FD, Attree EA, Brooks BM, Andrews TK. Learning and memory in virtual environments: A role in neurorehabilitation? Questions (and occasional answers) from the University of East London. Presence (Camb) 2001;10:345–358.
    1. Time simulator in virtual reality for children with attention deficit hyperactivity disorder. In: Gongsook P, editor; Herrlich M, Malaka R, Masuch M, editors. Entertainment Computing - ICEC 2012. ICEC 2012. Lecture Notes in Computer Science, vol 7522. Berlin: Springer; 2012.
    1. Barrett J. Side effects of virtual environments: a review of the literature. Edinburgh S (Australia): DSTO Information Sciences Laboratory; 2004.
    1. Schneider SM, Hood LE. Virtual reality: a distraction intervention for chemotherapy. Oncol Nurs Forum. 2007;34:39–46.
    1. Brooks JO, Goodenough RR, Crisler MC, Klein ND, Alley RL, Koon BL, et al. Simulator sickness during driving simulation studies. Accid Anal Prev. 2010;42:788–796.
    1. Lawson BD. Motion sickness symptomatology and origins. In: Hale KS, Stanney KM, editors. Handbook of virtual environments: design, implementation, and applications. 2nd ed. Boca Raton (FL): CRC Press; 2014. pp. 531–600.
    1. Stanney KM, Mourant RR, Kennedy RS. Human factors issues in virtual environments: a review of the literature. Presence (Camb) 1998;7:327–351.
    1. Hu S, Davis MS, Klose AH, Zabinsky EM, Meux SP, Jacobsen HA, et al. Effects of spatial frequency of a vertically striped rotating drum on vection-induced motion sickness. Aviat Space Environ Med. 1997;68:306–311.
    1. Rizzo AA, Buckwalter JG, Bowerly T, Van Der Zaag C, Humphrey L, Neumann U, et al. The virtual classroom: a virtual reality environment for the assessment and rehabilitation of attention deficits. Cyber Psychol Behav. 2000;3:483–499.
    1. Rose FD, Brooks BM, Rizzo AA. Virtual reality in brain damage rehabilitation: review. Cyberpsychol Behav. 2005;8:241–262.
    1. Pollak Y, Weiss PL, Rizzo AA, Weizer M, Shriki L, Shalev RS, et al. The utility of a continuous performance test embedded in virtual reality in measuring ADHD-related deficits. J Dev Behav Pediatr. 2009;30:2–6.
    1. Adams R, Finn P, Moes E, Flannery K, Rizzo AS. Distractibility in Attention/Deficit/Hyperactivity Disorder (ADHD): the virtual reality classroom. Child Neuropsychol. 2009;15:120–135.
    1. Díaz-Orueta U, Garcia-López C, Crespo-Eguílaz N, Sánchez-Carpintero R, Climent G, Narbona J. AULA virtual reality test as an attention measure: convergent validity with Conners' Continuous Performance Test. Child Neuropsychol. 2014;20:328–342.
    1. Kim IY, Cho BH, Jang DP, Lee JH, Lee JM, Kim JS, et al., editors. Attention enhancement system using virtual reality and EEG biofeedback; Proceedings of the IEEE Virtual Reality Conference 2002; 2002 Mar 24 – 28; Orlando (FL), USA.
    1. Gaitatzes A, Papaioannou G, Christopoulos D, editors. Virtual reality systems and applications; Proceedings of the ACM symposium on Virtual reality software and technology 2006; 2006 Nov 1–3; Limassol, Cyprus.
    1. Dehn MJ. Working memory and academic learning: Assessment and intervention. Hoboken (NJ): John Wiley & Sons; 2011.
    1. Self T, Scudder RR, Weheba G, Crumrine D. A virtual approach to teaching safety skills to children with autism spectrum disorder. Top Lang Disord. 2007;27:242–253.
    1. Riva G, Mantovani F, Gaggioli A. Presence and rehabilitation: toward second-generation virtual reality applications in neuropsychology. J Neuroeng Rehabil. 2004;1:9.
    1. Parsons TD, Rizzo AA. Neuropsychological assessment of attentional processing using virtual reality. Annual Rev CyberTher Telemed. 2008;6:23–28.
    1. Knight RG, Titov N. Use of virtual reality tasks to assess prospective memory: applicability and evidence. Brain impairment. 2009;10:3–13.
    1. Albani G, Raspelli S, Carelli L, Morganti F, Weiss PL, Kizony R, et al. Executive functions in a virtual world: a study in Parkinson's disease. Stud Health Technol Inform. 2010;154:92–96.
    1. Mühlberger A, Jekel K, Probst T, Schecklmann M, Conzelmann A, Andreatta M, et al. The influence of methylphenidate on hyperactivity and attention deficits in children with ADHD: a virtual classroom test. J Atten Disord. 2016 May 13; pii: 1087054716647480. [Epub]
    1. Rapport MD, Chung KM, Shore G, Denney CB, Isaacs P. Upgrading the science and technology of assessment and diagnosis: laboratory and clinic-based assessment of children with ADHD. J Clin Child Psychol. 2000;29:555–568.
    1. Fairley M. Fun and games: virtual reality turns the work of rehab into play. Northglenn (CO): Western Media LLC; 2010.
    1. Pollak Y, Shomaly HB, Weiss PL, Rizzo AA, Gross-Tsur V. Methylphenidate effect in children with ADHD can be measured by an ecologically valid continuous performance test embedded in virtual reality. CNS Spectr. 2010;15:125–130.
    1. Anton R, Opris D, Dobrean A, David D, Rizzo AS, editors. Virtual reality in rehabilitation of attention deficit/hyperactivity disorder The instrument construction principles; Virtual Rehabilitation International Conference; 2009 Jun 29 – Jul 2; Haifa, Israel. 2009.
    1. Areces D, Rodríguez C, García T, Cueli M, González-Castro P. Efficacy of a continuous performance test based on virtual reality in the diagnosis of ADHD and its clinical presentations. J Atten Disord. 2016 Feb 19; pii: 1087054716629711. [Epub]
    1. Ehlis A. A biofeedback training in schoolchildren with an attention-deficit/hyperactivity disorder (ADHD) Tuebingen (Germany): University Hospital Tuebingen; 2016.
    1. Neguţ A, Jurma AM, David D. Virtual-reality-based attention assessment of ADHD: ClinicaVR: Classroom-CPT versus a traditional continuous performance test. Child Neuropsychol. 2017;23:692–712.
    1. Wang M, Reid D. Virtual reality in pediatric neurorehabilitation: attention deficit hyperactivity disorder, autism and cerebral palsy. Neuroepidemiology. 2011;36:2–18.
    1. Gutiérrez-Maldonado J, Letosa-Porta A, Rus-Calafell M, Penaloza-Salazar C. The assessment of attention deficit hyperactivity disorder in children using continous performance tasks in virtual environments. Anu Psicol/UB J Psycho. 2009;40:211–222.
    1. Clancy TA, Rucklidge JJ, Owen D. Road-crossing safety in virtual reality: a comparison of adolescents with and without ADHD. J Clin Child Adolesc Psychol. 2006;35:203–215.
    1. Othmer S, Kaiser D. Implementation of virtual reality in EEG biofeedback. Cyberpsychol Behav. 2000;3:415–420.
    1. Cho BH, Ku J, Jang DP, Kim S, Lee YH, Kim IY, et al. The effect of virtual reality cognitive training for attention enhancement. Cyberpsychol Behav. 2002;5:129–137.
    1. McCloy R, Stone R. Science, medicine, and the future. Virtual reality in surgery. BMJ. 2001;323:912–915.
    1. Botella C, Baños RM, Villa H, Perpiñá C, García-Palacios A. Virtual reality in the treatment of claustrophobic fear: A controlled, multiple-baseline design. Behav Ther. 2000;31:583–595.
    1. Holden MK. Virtual environments for motor rehabilitation: review. Cyberpsychol Behav. 2005;8:187–211.
    1. Luiselli JK. Effective practices for children with autism: educational and behavior support interventions that work. Oxford: Oxford University Press; 2008.
    1. Slate SE, Meyer TL, Burns WJ, Montgomery DD. Computerized cognitive training for severely emotionally disturbed children with ADHD. Behav Modif. 1998;22:415–437.
    1. Pugnetti L, Mendozzi L, Motta A, Cattaneo A, Barbieri E, Brancotti A. Evaluation and retraining of adults' cognitive impairment: which role for virtual reality technology? Comput Biol Med. 1995;25:213–227.
    1. Hale KS, Stanney KM, Stone RJ, Hannigan FP. Applications of virtual environments: an overview. In: Hale KS, Stanney KM, editors. Handbook of virtual environments: design, implementation, and applications. 2nd ed. Boca Raton (FL): CRC Press; 2014. pp. 883–957.
    1. Iovannone R, Dunlap G, Huber H, Kincaid D. Effective educational practices for students with autism spectrum disorders. Focus Autism Other Dev Disabl. 2003;18:150–165.
    1. Anttila H, Autti-Rämö I, Suoranta J, Mäkelä M, Malmivaara A. Effectiveness of physical therapy interventions for children with cerebral palsy: a systematic review. BMC Pediatr. 2008;8:14.
    1. Moreau G, Guay M, Achim A, Rizzo A, Lageix P. The virtual classroom: An ecological version of the continuous performance test–A pilot study. Annual Rev Cyberther Telemed. 2006;4:59–66.
    1. Toplak ME, Dockstader C, Tannock R. Temporal information processing in ADHD: findings to date and new methods. J Neurosci Methods. 2006;151:15–29.

Source: PubMed

3
订阅