Currently submitted to: JMIR Serious Games
Date Submitted: Jun 3, 2026
Open Peer Review Period: Jun 8, 2026 - Aug 3, 2026
(currently open for review)
Warning: This is an author submission that is not peer-reviewed or edited. Preprints - unless they show as "accepted" - should not be relied on to guide clinical practice or health-related behavior and should not be reported in news media as established information.
The Effects of Digital Technology-Based Interventions on Executive Functions in Children with Attention Deficit Hyperactivity Disorder: A Systematic Review and Meta-Analysis
ABSTRACT
Background:
Executive function impairment is a common pathological characteristic among children with attention deficit hyperactivity disorder (ADHD). Digital technology-based interventions have provided a novel direction for improvement in this population.
Objective:
In this study, prior research on digital technology-based interventions was collated to identify effective intervention strategies.
Methods:
A systematic literature search of the PubMed, Web of Science, ProQuest, and EBSCOhost databases was conducted using predefined keywords and strict inclusion and exclusion criteria. The Risk of Bias 2.0 (RoB 2.0) tool and I2 statistic were used respectively to assess the risk of bias and heterogeneity among the included studies, and a random-effects model was used to pool weighted effect sizes.
Results:
The 27 included randomised controlled trials covered four types of digital technology approaches: computer-based technology, serious video games, virtual reality technology, and motion-sensing games. Digital technology-based interventions, particularly computer-based interventions, were found to significantly improve overall executive function in children with ADHD (standardised mean difference [SMD] = 0.35, 95% confidence interval [CI]: 0.14–0.56, p =0.001). Regarding executive function subcomponents, digital technology-based interventions significantly improved working memory (SMD = 0.48, 95% CI: 0.07–0.90, p =0.02) and cognitive flexibility (SMD = 0.19, 95% CI: 0.02–0.35, p =0.03), but not inhibitory control (SMD = −0.09, 95% CI: −0.46–0.29, p =0.65).
Conclusions:
In conclusion, such interventions can effectively improve executive function in children with ADHD. Future efforts to enhance intervention efficacy should involve standardised, large-sample, and long-term follow-up intervention trials and unified intervention dosage and assessment tools. Clinical Trial: PROSPERO CRD420261398808;https://www.crd.york.ac.uk/PROSPERO/view/CRD420261398808
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