IAmHero: Preliminary Findings of an Experimental Study to Evaluate the Statistical Significance of an Intervention for ADHD Conducted through the Use of Serious Games in Virtual Reality
Abstract
:1. Introduction
2. Material and Methods
2.1. Study Sample
2.2. Experimental Design and Clinical Assessment
2.3. IAmHero
- (1)
- Topological Categories:
- (2)
- Infinite Runner:
- (3)
- Space Coding:
2.4. Statistical Analysis
2.5. Ethical Considerations
3. Results
3.1. Primary Endpoint: Decrease in Scores on Conners 3 Scales
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- Inattention;
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- Hyperactivity/impulsivity;
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- Learning problems;
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- Provocation/aggressiveness;
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- Relations with family.
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- A significant positive correlation exists between the scores of the variable “Hyperactivity/impulsivity” at T0 and T1;
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- A significant positive correlation between the scores related to the variable “Learning problems” at T0 and T1;
- -
- A significant positive correlation between the scores related to the variable “Provocation/aggressiveness” at T0 and T1;
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- A significant positive correlation between the scores related to the variable “Relationship with family members” at T0 and T1.
3.2. Primary Endpoint: Improvement in BIA and TOL Test Scores
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- Sustained visual attention (identified from the number of omissions in the continuous performance subtest);
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- Impulsive behavior (calculated from the number of errors in the MF subtest);
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- Inhibitory control (identified with the response time of the MF subtest);
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- Selective auditory attention (represented by the auditory attention test score);
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- Motor inhibition (obtained from the frogs test score).
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- Organisation and planning (representing the number of moves score);
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- Problem-solving (obtained from resolution time);
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- Executive functions (calculated from the main score of the test).
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- A significant positive correlation between the values of the scores for the variables “Sustained Visual Attention”, “Impulsive Behaviour”, “Inhibitory Control”, and “Auditory Selective Attention” of the BIA test at T0 and T1;
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- A significant positive correlation between the values of the scores for the variables “Organisation and planning”, “Problem solving”, and “Executive functions” of the TOL test at T0 and T1.
4. Discussion
5. Conclusions
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- Expand the reference sample to enjoy a larger dataset and move in the direction of standardizing the instrument;
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- Provide, in a hypothetical subsequent trial, for the setting of an additional follow-up phase to monitor treatment progress and compare it with the data collected by the management platform;
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- Conduct the study over a longer time frame in order to monitor the longitudinal effects of the virtual reality intervention. Despite this, for the time being, the results obtained both from our study and from other studies in the literature appear encouraging. We, therefore, consider it useful to continue experiments in this field in order to develop a new resource in the treatment of ADHD;
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- Evaluate the acceptability of such tools by children and especially better define what contribution they can provide in terms of collaboration in rehabilitation settings.
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Diagnosis of ADHD in accordance with DSM-5 diagnostic criteria made with standardized scales with/without neuropsychiatric comorbidities (learning disorder, language disorder) |
Chronological age between 5 and 12 years |
Rehabilitation plan in accordance with the goals of the intervention |
Native Italian-speaking children or adolescents |
Written informed consent from parents or legal guardians |
Inattention (T1) | Hyperactivity/ Impulsivity (T1) | Learning Problems (T1) | Provocation/ Aggressiveness (T1) | Relations with Family (T1) | |
---|---|---|---|---|---|
Inattention (T0) Sig. (2-tailed) | 0.319 0.197 | ||||
Hyperactivity/Impulsivity (T0) Sig. (2-tailed) | 0.618 * 0.006 | ||||
Learning Problems (T0) Sig. (2-tailed) | 0.539 * 0.021 | ||||
Provocation/Aggressiveness (T0) Sig. (2-tailed) | 0.630 * 0.012 | ||||
Relations with Family (T0) Sig. (2-tailed) | 0.507 * 0.032 |
Paired Variables | Mean | Standard Deviation |
---|---|---|
Inattention (T0) Inattention (T1) | 63.72 60.78 | 9.58 5.90 |
Hyperactivity/Impulsivity (T0) Hyperactivity/Impulsivity (T1) | 65.68 59.78 | 8.50 3.78 |
Learning Problems (T0) Learning Problems (T1) | 65.17 59.72 | 10.52 5.10 |
Provocation/Aggressiveness (T0) Provocation/Aggressiveness (T1) | 57.17 50.72 | 18.04 5.03 |
Relations with Family (T0) Relations With Family (T1) | 60.22 56.17 | 13.81 4.72 |
Mean Difference | Sign. (2-Tailed) | |
---|---|---|
Inattention (T0) − Inattention (T1) | 2.94 | 0.208 |
Hyperactivity/Impulsivity (T0) − Hyperactivity/Impulsivity (T1) | 5.90 | 0.030 |
Learning Problems (T0) − Learning Problems (T1) | 5.45 | 0.007 |
Provocation/Aggressiveness (T0) − Provocation/Aggressiveness (T1) | 6.45 | 0.000 |
Relations with Family (T0) − Relations with Family (T1) | 4.05 | 0.012 |
RCI | |
---|---|
Inattention | 1.10 |
Hyperactivity/impulsivity | 1.82 |
Learning problems | 1.95 |
Provocation/aggressiveness | 1.55 |
Relationships with family | 1.88 |
Sustained Visual Attention (T1) | Impulsive Behaviour (T1) | Inhibitory Control (T1) | Selective Auditory Attention (T1) | Motor Inhibition (T1) | |
---|---|---|---|---|---|
Sustained visual attention (T0) Sig. (2-tailed) | 0.617 * 0.006 | ||||
Impulsive behaviour (T0) Sig. (2-tailed) | 0.525 * 0.039 | ||||
Inhibitory control (T0) Sig. (2-tailed) | 0.513 * 0.004 | ||||
Selective auditory attention (T0) Sig. (2-tailed) | 0.781 * 0.001 | ||||
Motor inhibition (T0) Sig. (2-tailed) | 0.425 0.215 |
Organisation and Planning (T1) | Problem-Solving (T1) | Executive Functions (T1) | |
Organisation and planning (T0) Sig. (2-tailed) | 0.632 * 0.013 | ||
Problem-solving (T0) Sig. (2-tailed) | 0.698 * 0.004 | ||
Executive functions (T0) Sig. (2-tailed) | 0.687 * 0.035 |
Variables | Mean | Standard Dev. |
---|---|---|
Sustained visual attention T0 Sustained visual attention T1 | 16.63 9.15 | 12.44 5.10 |
Impulsive behaviour (T0) Impulsive behaviour (T1) | 20.25 13.61 | 3.14 2.11 |
Inhibitory control (T0) Inhibitory control (T1) | 18.97 15.25 | 3.87 2.27 |
Selective auditory attention (T0) Selective auditory attention (T1) | 7.21 9.00 | 0.65 0.36 |
Motor inhibition (T0) Motor inhibition (T1) | 21.44 22.13 | 8.44 6.68 |
Variables | Mean | Standard Dev. |
---|---|---|
Organisation and planning (T0) Organisation and planning (T1) | 94.05 79.52 | 12.76 5.47 |
Problem-solving (T0) Problem-solving (T1) | 377.24 266.0 | 42.92 35.75 |
Executive functions (T0) Executive functions (T1) | 24.45 27.79 | 5.65 3.66 |
Mean Differences | Sign. (2-Tailed) | |
---|---|---|
Sustained visual attention (T0) − Sustained visual attention (T1) | 7.48 | 0.001 |
Impulsive behaviour (T0) − Impulsive behaviour (T1) | 6.64 | 0.045 |
Inhibitory control (T0) − Inhibitory control (T1) | 3.72 | 0.513 |
Selective auditory attention (T0) − Selective auditory attention (T1) | −1.79 | 0.001 |
Motor inhibition (T0) − Motor inhibition (T1) | −0.69 | 0.853 |
Mean Differences | Sign. (2-Tailed) | |
---|---|---|
Organisation and planning (T0 − T1) | 14.53 | 0.013 |
Problem solving (T0 − T1) | 11.24 | 0.004 |
Executive functions (T0 − T1) | −3.34 | 0.035 |
RCI | |
---|---|
Sustained visual attention | 1.89 |
Impulsive behavior | 1.82 |
Inhibitory control | 1.11 |
Selective auditory attention | 1.99 * |
Motor inhibition | 0.77 |
Planning and organisation | 1.79 |
Problem solving | 1.94 |
Executive functions | 1.68 |
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Schena, A.; Garotti, R.; D’Alise, D.; Giugliano, S.; Polizzi, M.; Trabucco, V.; Riccio, M.P.; Bravaccio, C. IAmHero: Preliminary Findings of an Experimental Study to Evaluate the Statistical Significance of an Intervention for ADHD Conducted through the Use of Serious Games in Virtual Reality. Int. J. Environ. Res. Public Health 2023, 20, 3414. https://doi.org/10.3390/ijerph20043414
Schena A, Garotti R, D’Alise D, Giugliano S, Polizzi M, Trabucco V, Riccio MP, Bravaccio C. IAmHero: Preliminary Findings of an Experimental Study to Evaluate the Statistical Significance of an Intervention for ADHD Conducted through the Use of Serious Games in Virtual Reality. International Journal of Environmental Research and Public Health. 2023; 20(4):3414. https://doi.org/10.3390/ijerph20043414
Chicago/Turabian StyleSchena, Annamaria, Raffaele Garotti, Dario D’Alise, Salvatore Giugliano, Miriam Polizzi, Virgilio Trabucco, Maria Pia Riccio, and Carmela Bravaccio. 2023. "IAmHero: Preliminary Findings of an Experimental Study to Evaluate the Statistical Significance of an Intervention for ADHD Conducted through the Use of Serious Games in Virtual Reality" International Journal of Environmental Research and Public Health 20, no. 4: 3414. https://doi.org/10.3390/ijerph20043414