. 2017 Nov 27;60(11):337–343. doi: 10.3345/kjp.2017.60.11.337

Table 1. Virtual reality experiences for the rehabilitation of children with ADHD.

Aim of study	ADHD patients' characteristics	VR technology types	Results	Sources
Study the efficacy of a near-infrared spectroscopy-based Neurofeedback training in VR classroom.	n=90 schoolchildren	VR classroom	Improve training programs and academic performance and decrease of ADHD symptoms.	University Hospital Tuebingen (2016)51)
	Range, 6–10 years	VR classroom		University Hospital Tuebingen (2016)51)
(1) Study the diagnostic validity of VC in comparison to a CPT test, (2) explore the task difficulty of VC, (3) address the effect of distractors on the performance of participants with ADHD.	n=33	Virtual classroom-CPT (VC)	Significant differences between performance in the virtual environment and the traditional computerized one, with longer reaction times in virtual reality.	Neguţ et al. (2016)52)
	Range, 7–13 years	Virtual classroom-CPT (VC)		Neguţ et al. (2016)52)
(1) Investigate validity and reliability of the ClinicaVR: Classroom-(CPT); (2) test the relationship between performance in the virtual test and the attendant sense of presence and cyber sickness experienced by participants (3) assess potential effects of gender and age on performance in the test.	n=102 (53 girls and 49 boys)	ClinicaVR: classroom-(CPT)	In this study, test did not cause much cyber sickness. Also ClinicaVR: classroom-CPT recommend as an assessment tool for selective and sustained attention, and response inhibition.	Nolin et al. (2016)19)
	Range, 7–16 years	ClinicaVR: classroom-(CPT)		Nolin et al. (2016)19)
The comparison of the performance in a CPT test in a VR classroom between medicated and unmedicated children with ADHD and healthy children	n=94 (26 medica ted children with ADHD and 68 medicated children with ADHD and 34 healthy children)	Virtual reality classroom (CPT-VRC)	Virtual reality technology has potential to evaluate ADHD symptoms in an ecologically valid environment.	Muhlberger et al. (2016)45)
	Range, 7–16 years	Virtual reality classroom (CPT-VRC)		Muhlberger et al. (2016)45)
Study time of performances in the VR classroom with measures of the CPT II.	n=36	VR classroom	Decrease performance time in individuals with ADHD.	Bioulac et al. (2012)14)
	Range, 7–10 years	VR classroom	Decrease performance time in individuals with ADHD.	Bioulac et al. (2012)14)
Study the efficacy of VR in manipulating and eventually training time perception	n=not mentioned	VR game	Training and improvement in time perception of children with ADHD	Gongsook (2012)15)
	Range, not mentioned	VR game		Gongsook (2012)15)
Develops a novel assessment based on performance of children with ADHD, behavior & reaction using VR	n=not mentioned	VR classroom	Improve attention and executive function.	Yeh et al. (2012)3)
	Range, 7–13 years	VR classroom	Improve attention and executive function.	Yeh et al. (2012)3)
Explore the efficacy of VR systems as treatment tools in primary impairments of ADHD, autism and cerebral palsy disorders.	n=not mentioned	Review past studies	Provide (1) feedback-focused interaction, (2) gesture-based interaction, and (3) haptic-based interaction.	Wang and Reid. (2011)53)
	Range, not mentioned	Review past studies		Wang and Reid. (2011)53)
(1) Compare the performance of children with ADHD on VR-CPT with TOVA. (2) Assess the how the VR environment is experienced.	n=37 (20 with ADHD and 17 without ADHD)	VR-CPT	The VR-CPT is an enjoyable and user-friendly assessment tool to help diagnosis of children with ADHD.	Pollak et al. (2009)34)
	Range, 9–17 years	VR-CPT		Pollak et al. (2009)34)
Investigate the ability of the VR classroom to compare between children with ADHD and the 16 same age control group and also evaluate the efficacy of ecologically valid distracters.	n=19	VR classroom	(1) Introduce lifelike distractions, (2) make test with more ecologically valid test and (3) offer a standardized environment to carry out research.	Adams et al. (2009)35)
	Range, 8–14 years	VR classroom		Adams et al. (2009)35)
Highlight the implementation of the psychotherapeutic principles for children with ADHD in VR classroom.	n=not mentioned	VR classroom	(1) Provide high accurate assessment, (2) reduce time (3) control the therapeutic process and (4) applying cognitive behavioral therapy techniques	Anton et al. (2009)49)
	Range, not mentioned	VR classroom		Anton et al. (2009)49)
The comparison of performance of children with ADHD in VR-CPT with NO VR-CPT and TOVA	n=20	VR-CPT	The VR-CPT is a sensitive and user-friendly assessment tool in children with ADHD.	Pollak et al. (2009)48)
	Range, 9–17 years	VR-CPT		Pollak et al. (2009)48)
Validation of VR technology for the assessment of children with ADHD	n=10	VR classroom	The efficacy of VR-CPT to identify attentional difficulties in children with ADHD	Gutiérrez-Maldonado et al. (2009)54)
	Range, 6–11 years	VR classroom		Gutiérrez-Maldonado et al. (2009)54)
A controlled clinical comparison of attention performance in children with ADHD in a VR classroom	n=10 boys	VR classroom	Virtual classroom had good potential for controlled performance assessment within an ecologically valid environment and due to the presence of distraction stimuli, appear significant effects.	Parsons et al. (2007)22)
	Range, 8–12 years	VR classroom		Parsons et al. (2007)22)
Highlight unsafe road-crossing behavior of children with ADHD in a hazardous environment.	n=24 (12 boys and 12 girls)	VR traffic gap-choice task	Virtual reality helps identify and educate those at higher risk of being involved in dangerous traffic situations.	Clancy et al. (2006)55)
	Range, 13–17 years	VR traffic gap-choice task		Clancy et al. (2006)55)
Investigate VR feedback to increase EEG signal	n=120 subjects with ADHD, epilepsy or mood disorders	VR games	Better outcomes with information-rich feedback in virtual reality environments	Othmer and Kaiser (2004)56)
Investigate VR feedback to increase EEG signal	Range, not mentioned	VR games		Othmer and Kaiser (2004)56)
Highlight the potential of VR for improving attention	n=26	VR classroom	The effectiveness of integrated VR with cognitive training in attention enhancement and focus on some tasks	Cho et al. (2002)57)
Highlight the potential of VR for improving attention	Range, not mentioned	VR classroom		Cho et al. (2002)57)
Developed the prototype of the Attention Enhancement System using VR and EEG biofeedback	n=50	VR Neurofeedback	(1) Improve assessment and treatment. (2) enhance attention	Cho et al. (2002)57)
	Range, 13–17 years	VR Neurofeedback	(1) Improve assessment and treatment. (2) enhance attention	Cho et al. (2002)57)
Develop the new treatment system for children with ADHD using VR.	n=10	VR classroom	(1) Decrease inattention or impulsivity (2) improve attention and treatment	Lee et al. (2001)2)
	Range, not mentioned	VR classroom		Lee et al. (2001)2)
Study VR applications in assessment and rehabilitation of cognitive/functional processes	n=15	VR classroom	Improve the reliability of neuropsychological assessments	Rizzo et al. (2000)32)
	Range, not mentioned	VR classroom	Improve the reliability of neuropsychological assessments	Rizzo et al. (2000)32)

ADHD, attention deficit hyperactivity disorder; VR, virtual reality; CPT, continuous performance test; VC, virtual classroom; TOVA, Test of Variables of Attention; EEG, electroencephalography.