JMIR Publications

ABSTRACT

Background:

ADHD is one of the most common neurodevelopmental disorders in childhood, featuring inattention, hyperactivity/impulsivity that is not commensurate with age and development level. Epidemiology shows that 5% of children worldwide suffer from ADHD, and the prevalence rate shows an upward trend. ADHD has become one of the important problems in the field of children's mental health. In addition, 45-70% of children with ADHD still have motor ability problems. They often show clumsiness and discordance in daily life, which affects their performance in learning and motor activities, and has adverse effects on their social ability, peer relationships and physical and mental health .

Objective:

This paper aims to systematically evaluate the effect of virtual reality (VR) technology on the attention and motor ability of children with attention deficit hyperactivity disorder (ADHD).

Methods:

The intervention method of the experimental group was VR technology, while the control group adopted non-VR technology. The population was children with ADHD. The outcome indicators were attention and motor abilities. The experimental design was randomized controlled trial (RCT). Two researchers independently searched PubMed, Cochrane Library, Web of Science (WOS), and EMBASE for randomized controlled trials related to VR technology on ADHD children's attention and motor ability. The retrieval date was from the establishment of each database to January 4, 2023. The PEDro scale was used to evaluate the quality of the included literature. Stata 17.0 was used for effect size combination, forest map-making, subgroup analyses, sensitivity analyses, and publication bias. GRADEpro was used to evaluate the level of evidence quality.

Results:

A total of 9 literature involving 370 children with ADHD were included. VR technology can improve ADHD children’s attention (Cohen’s d=-0.68, 95% CI (-1.12, -0.24), P=0.00) and motor ability (Cohen's d=0.48, 95% CI (0.16,0.80), P=0.00). The intervention method and diagnosis type of VR technology had a moderating effect on the intervention effect of children's attention (P<0.05). The improvement of children's attention by “immersive” VR technology was statistically significant (Cohen's d=-1.05, 95% CI (-1.76, -0.34), P=0.004). The improvement of children's attention by “non-immersive” VR technology was statistically significant (Cohen's d=-0.28, 95% CI (-0.55, -0.01), P=0.041). VR technology had improvement effects on both children with “informal diagnosis” (Cohen's d=-1.47, 95% CI (-2.35, -0.59), P=0.000) and on children with “formal diagnosis” (Cohen's d=-0.44, 95% CI (-0.85, -0.03), P=0.032).

Conclusions:

Virtual reality technology can improve ADHD children's attention and motor ability. The immersive virtual reality technology has the best attention improvement for the informal diagnosed children with ADHD. Clinical Trial: This research program has been registered on the international system evaluation platform Prospero （https://www.crd.york.ac.uk/PROSPERO/）Registration No. (crd42024499199).