How Virtual Reality and a Talking Dragon can Help to Diagnose Your Child

     Do you have a child, or someone close to you in their early childhood, that you think may possibly have attention deficit hyperactivity disorder (ADHD)? Have you ever thought about what goes into diagnosing ADHD in children? A parent might be surprised if, upon bringing their child in to be tested for ADHD, their child were handed a VR headset and then instructed, by a talking dragon, to complete sets of tasks around a virtual apartment. But in the not-so-distant future, this could become commonplace for testing children who display early symptoms of ADHD.

 

      ADHD, one of the most common neurodevelopmental disorders (about 5.9% of children worldwide), is associated with many difficulties, including but not limited to: impairments in quality of life, impairments in multiple cognitive domains, emotional and/or social impairments, and educational underachievement. The methods to measure these cognitive impairments, while many times effective, may fail to capture exactly how symptoms of ADHD manifest themselves in the unpredictable setting of day-to-day life. These methods are oftentimes highly structured, monotonous and lacking of external stimulus. Think about all of the distractions that you encounter every single day. I’m sure that if you tried to keep track of them, you would lose count within an hour of leaving your bedroom. Think of also the variety of goals, tasks or objectives which you set out to do every day. Even if you only have one goal, there is nobody telling you exactly how to reach that goal for the day. You have to create a series of sub-tasks to take steps toward that goal. These things cannot be accounted for in the highly structured nature of the standard methods used to identify symptoms, because they do not simulate everyday life. So what could be a solution? Who can help? Maybe a VR game named EPELI can.

     Neuroscience Meets … Videogames?

      Video games are loved by many, but also very much disliked by nearly as many. They have a bad reputation in some circles. Most who oppose video games view them as a waste of time or a distraction from the real world. This can be true, but video games have also shown that they can be educational and puzzling, can help young and old people alike learn new things and exercise their brain in an entertaining way. But can video games also be a tool? That’s what the developers of EPELI believe. EPELI, an acronym for Executive Performance in Everyday Living, is a VR video game for children and was developed by researchers in Helsinki. Its purpose is to assess the symptoms of children with ADHD as well as to distinguish behavior between ADHD children and typically developed children, meaning children without any neurodevelopmental disorders.

Virtual Reality has already been used before in assessing children with ADHD, most notably in the Continuous Performance Test (CPT). What makes EPELI different from the CPT, however, is the environment and the tasks given. The CPT is set in a virtual classroom (kinda boring) and tasks are usually something like watching and waiting for a certain character or image to show up on screen. EPELI places kids into a virtual apartment, with several rooms, interactable objects and interactable distractors (e.g a television that can be switched off). Then kids are basically asked to do chores (also kinda boring).

      So how do I play the game?

      So you decide that you’d like to give EPELI a try. If you’re worried about learning the controls, don’t be. Once you put on your Oculus Go headset and enter your new apartment, you will be greeted by a friendly little dragon. This little dragon will walk you through a practice session, in which you’ll be shown how to move around the apartment by pointing to your desired way point, and how to interact with objects of your choosing. Once you’re ready for the tasks, this same dragon will give you your first quest. Each task is composed of several smaller sub tasks, most of which you are free to do in any order, some of which are timed. Tasks are given orally, and could be something like “get dressed” , “brush your teeth”, or “make your bed”. After you know everything you need to know, the little dragon will disappear, but don’t worry, he will be back to give you your next task once you’re finished.

 

     So, why?

      I’m not sure why they chose to do certain things, such as have a cartoon dragon host the game, but the purpose of the apartment setting is to view how ADHD children perform in a setting other than a classroom, to see how their symptoms arise while they are doing things as mundane as household chores. While the child is playing the game, everything is monitored. Things such as head movements, number of interactions, the amount of time spent interacting with planted distractors, efficiency of movements around the apartment, and controller movements. All very important data. The child also has a watch, which they can view by looking down at their controller. This is important because it lets the observers see how the child is able to manage their time, giving insight into how they perceive time. ADHD children are known to perceive time differently.

 

      In short, EPELI is another way to use VR for assessing children with ADHD, in a different fashion than the already widely used CPT. This is an example of video games and virtual reality furthering the effectiveness of unbiased computerized testing, helping it towards its full potential.

 

source:

Seesjärvi, E., Puhakka, J., Aronen, E. T., Lipsanen, J., Mannerkoski, M., Hering, A., Zuber, S., Kliegel, M., Laine, M., & Salmi, J. (2022). Quantifying ADHD Symptoms in Open-Ended Everyday Life Contexts With a New Virtual Reality Task. Journal of Attention Disorders, 26(11), 1394–1411. https://doi.org/10.1177/10870547211044214

https://journals.sagepub.com/doi/10.1177/10870547211044214