scholarly journals The usefulness of virtual, augmented, and mixed reality technologies in the diagnosis and treatment of attention deficit hyperactivity disorder in children: an overview of relevant studies

2022 ◽  
Vol 22 (1) ◽  
Author(s):  
Saeideh Goharinejad ◽  
Samira Goharinejad ◽  
Sadrieh Hajesmaeel-Gohari ◽  
Kambiz Bahaadinbeigy

Abstract Background Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental condition characterized by attention problems, excessive physical activity, and impulsivity. ADHD affects not only the patients but also their families. The development and use of technologies such as virtual reality (VR), augmented reality (AR), and mixed reality (MR) for ADHD has increased over recent years. However, little is known about their potential usefulness. This overview aimed to clarify the current knowledge about the use of these three innovative technologies for the diagnosis and treatment of children with ADHD. Methods This overview was conducted using the PubMed, Web of Science, and Scopus databases until January 24th, 2021. The following descriptive information was compiled from the identified studies: country, year of publication, sample size, study design, ADHD diagnosis methods, applied technology, hardware equipment, clinical target, and main findings. Results The initial database searches yielded 409 articles, but 103 were removed as duplicates. Eventually, 30 eligible studies remained for analysis, the majority of which were case-control (n = 22, 73%). Regarding the applied technology/hardware equipment, VR (n = 27; 90%), head-mounted displays (n = 19, 63%), VR-based continuous performance tests (VR-CPT) (n = 21, 70%) were most frequently used. Most studies (n = 21, 70%) used the DSM criteria for the diagnosis of childhood ADHD. They primarily evaluated the utility of these technologies in assessing ADHD symptoms (n = 10, 33%) and improving the ADHD diagnostic process (n = 7, 23%). Conclusion This comprehensive overview evaluated the studies on the use of VR, AR, and MR technologies for children with ADHD. These technologies seem to be promising tools for improving the diagnosis and management of ADHD in this population.

2021 ◽  
Author(s):  
Yair Bannett ◽  
Alex Dahlen ◽  
Lynne C. Huffman ◽  
Heidi M. Feldman

Importance: Little is known about changes in health care in the first year of the pandemic for the large population of school-aged children with attention-deficit/hyperactivity disorder (ADHD), who were especially impacted by lockdowns, school closures, and remote learning. Objective: To assess temporal trends in rates of primary care provider (PCP) diagnosis and treatment of school-aged children with ADHD in the first year of the COVID-19 pandemic as compared to pre-pandemic years, and to investigate disparities in care. Method: We retrospectively analyzed electronic health records from all primary care visits (in-person and telehealth) of children ages 6-17 years seen between 01/2016 and 03/2021 in a community-based primary healthcare network in California (n=77,298 patients). Study Outcomes: (1) # of primary care visits, (2) # of visits with ADHD diagnosis (ADHD-related visits), (3) # of first ADHD diagnoses, (4) # of PCP prescriptions for ADHD medications (stimulants, alpha-2 agonists, atomoxetine), (5) # of first PCP prescriptions of ADHD medications. Interrupted time-series analysis evaluated changes in rates of study outcomes during 4 quarters of the pandemic year (3/15/2020-3/15/2021) compared to pre-pandemic years. Patient demographic characteristics were compared pre-pandemic to pandemic year. Results: In the first quarter (Q1) of the pandemic year, all primary care visits dropped by 62% (CI 54.9-67.2%); ADHD-related visits dropped by 33% (95% CI 22.2-43.6%). In Q2-4, while all primary care visits remained significantly below pre-pandemic rates, ADHD-related visits returned to pre-pandemic rates. Conversely, rates of first ADHD diagnoses remained at half of pre-pandemic rates throughout the year (Q1-4). ADHD medication prescription rates remained stable throughout the pandemic year. The proportion of patients living in low-income neighborhoods who received ADHD-related care (ADHD-related visits and first ADHD diagnoses) were lower during the pandemic year compared to pre-pandemic years. Females comprised a higher proportion of first ADHD diagnoses compared to pre-pandemic years (34% vs. 28%, absolute standardized difference=0.13, p=0.03). Conclusion: Ongoing treatment for school-aged children with ADHD was maintained during the pandemic, especially in children from high-income families. Socioeconomic differences in ADHD-related care emphasize the need to improve access to care for all children with ADHD in the ongoing pandemic and beyond.


2015 ◽  
Vol 29 (1) ◽  
pp. 26-32 ◽  
Author(s):  
Ching-Wen Huang ◽  
Chung-Ju Huang ◽  
Chiao-Ling Hung ◽  
Chia-Hao Shih ◽  
Tsung-Min Hung

Children with attention deficit hyperactivity disorder (ADHD) are characterized by a deviant pattern of brain oscillations during resting state, particularly elevated theta power and increased theta/alpha and theta/beta ratios that are related to cognitive functioning. Physical fitness has been found beneficial to cognitive performance in a wide age population. The purpose of the present study was to investigate the relationship between physical fitness and resting-state electroencephalographic (EEG) oscillations in children with ADHD. EEG was recorded during eyes-open resting for 28 children (23 boys and 5 girls, 8.66 ± 1.10 years) with ADHD, and a battery of physical fitness assessments including flexibility, muscular endurance, power, and agility tests were administered. The results indicated that ADHD children with higher power fitness exhibited a smaller theta/alpha ratio than those with lower power fitness. These findings suggest that power fitness may be associated with improved attentional self-control in children with ADHD.


2017 ◽  
Vol 68 (2) ◽  
pp. 279-283
Author(s):  
Mihail Silviu Tudosie ◽  
Elena Truta ◽  
Ana Maria Davitoiu ◽  
Luminita Stanciulescu ◽  
George Jinescu ◽  
...  

During one year (september 2013 � september 2014), 50 children from the residential institution for children SOS Satele Copiilor Bucharest, where included in our research. The children were distributed in two groups: Group A which consisted of 25 children (12 girls, 13 boys) who were not diagnosed with attention deficit hyperactivity disorder (ADHD) and Group B which consisted of 25 children (14 boys, 11 girls) who were diagnosed with ADHD. Initially, the two groups were subjected at a psycho-diagnostic battery of tests, one of them being the Evaluating the Health State of children with ADHD questionnaire elaborated by us, particularly for this research, with the purpose of highlighting the direct link between the children health state and their ADHD symptoms. This study sought to determine the concentration of copper in urine samples from a group of children with ADHD and a group of normal children, to highlight the role of copper in the development of ADHD symptoms. Levels of copper concentration in urine samples from the two groups were processed by Student�s t-Test. Statistical analysis showed that the arithmetic averages of copper concentration in urine samples, of the two groups do not differ significantly, so copper may be causing ADHD symptoms occur. The copper content in urine samples has been determined using atomic absorption spectrometry with graphite furnace.


2020 ◽  
Vol 10 (01) ◽  
pp. e97-e103
Author(s):  
Irene Rethemiotaki

AbstractAttention-deficit hyperactivity disorder (ADHD) is an increasingly recognized chronic neurodevelopmental disorder. This work aims at studying the prevalence and clinical characteristics of children with ADHD in the United States in the period between 2009 and 2018. Data from the National Health Interview Survey were analyzed by univariate and multivariate statistics to assess the role of socioeconomic factors in the development of ADHD. It has been studied 615,608 children, 51.2% male and 48.7% female. The prevalence of ADHD was 9.13%, with males predominating over females. The number of children with ADHD increased from 2009 to 2018 by 14.8%. As specified by multiple logistic regression analysis, males (odds ratio [OR] 2.38) who have neither mother nor father (OR 1.76) are twice as likely to have ADHD compared with their peers. In addition, family income (OR 1.40) and parent's education (OR 1.12) were significantly associated with ADHD. It has been highlighted the significance of deprivation of both family and financial comfort as primary indicators for ADHD in children. Moreover, children with ADHD were more likely to be males in the age group of 12 to 17.


2015 ◽  
Vol 22 (1) ◽  
pp. 1-11 ◽  
Author(s):  
Ashley N. Simone ◽  
Anne-Claude V. Bédard ◽  
David J. Marks ◽  
Jeffrey M. Halperin

AbstractThe aim of this study was to examine working memory (WM) modalities (visual-spatial and auditory-verbal) and processes (maintenance and manipulation) in children with and without attention-deficit/hyperactivity disorder (ADHD). The sample consisted of 63 8-year-old children with ADHD and an age- and sex-matched non-ADHD comparison group (N=51). Auditory-verbal and visual-spatial WM were assessed using the Digit Span and Spatial Span subtests from the Wechsler Intelligence Scale for Children Integrated - Fourth Edition. WM maintenance and manipulation were assessed via forward and backward span indices, respectively. Data were analyzed using a 3-way Group (ADHD vs. non-ADHD)×Modality (Auditory-Verbal vs. Visual-Spatial)×Condition (Forward vs. Backward) Analysis of Variance (ANOVA). Secondary analyses examined differences between Combined and Predominantly Inattentive ADHD presentations. Significant Group×Condition (p=.02) and Group×Modality (p=.03) interactions indicated differentially poorer performance by those with ADHD on backward relative to forward and visual-spatial relative to auditory-verbal tasks, respectively. The 3-way interaction was not significant. Analyses targeting ADHD presentations yielded a significant Group×Condition interaction (p=.009) such that children with ADHD-Predominantly Inattentive Presentation performed differentially poorer on backward relative to forward tasks compared to the children with ADHD-Combined Presentation. Findings indicate a specific pattern of WM weaknesses (i.e., WM manipulation and visual-spatial tasks) for children with ADHD. Furthermore, differential patterns of WM performance were found for children with ADHD-Predominantly Inattentive versus Combined Presentations. (JINS, 2016, 22, 1–11)


PEDIATRICS ◽  
1995 ◽  
Vol 96 (2) ◽  
pp. 320-325 ◽  
Author(s):  
Jeffrey D. Kent ◽  
Joseph C. Blader ◽  
Harold S. Koplewicz ◽  
Howard Abikoff ◽  
Carmel A. Foley

Objective. This study evaluated the effects on behavior and sleep of methylphenidate (MPH) administered at 4 PM to children with attention-deficit hyperactivity disorder (ADHD). Methodology. Twelve children admitted to a child psychiatric inpatient service with ADHD participated in a double-blind, crossover study in which they received a 4 PM dose of either 15 mg of MPH, 10 mg of MPH, or a placebo in random order for 12 consecutive days. Ratings of behavior, including ADHD symptoms, pertaining to the period from dose administration until sleep onset, were supplied nightly by hospital staff. Sleep latency and sleep adequacy were also assessed for each night. Results. MPH resulted in markedly improved behavioral control compared with placebo; there was no difference between 15-mg and 10-mg MPH doses. MPH did not alter sleep latencies observed with the placebo. Children were more often rated as less tired on awakening after nights that they received 10 mg of MPH compared with 15 mg of MPH and the placebo. Weight loss was apparent among 83% of the patients, but dinner intake did not vary with third-dose condition. Conclusions. Morning and noon administration of stimulants to children with ADHD is a near-universal practice, but many clinicians avoid a third, late-afternoon administration for fear of inducing insomnia. This study's findings show that children with ADHD derive substantial symptom reduction from MPH administered in late afternoon, with no untoward effects on sleep. Therefore, three-times-a-day dosing should be considered for those children exhibiting ADHD symptoms in the evening. Adverse effects on sleep latency were not apparent in the sample overall. Nonetheless, monitoring for possible aggravation of sleep problems and weight loss remains sound treatment practice.


Author(s):  
Tessa L. Rausch ◽  
Diane L. Kendall ◽  
Sara T. Kover ◽  
Elizabeth M. Louw ◽  
Ursula L. Zsilavecz ◽  
...  

Background and objective: Children with attention-deficit hyperactivity disorder (ADHD) experience difficulty with expressive language, including form (e.g. grammatical construction) and content (e.g. coherence). The current study aimed to investigate the effect of methylphenidate-Osmotic Release Oral System® (MPH-OROS®) on the narrative ability of children with ADHD and language impairment, through the analysis of microstructure and macrostructure narrative elements.Method: In a single group off–on medication test design, narratives were obtained from 12 children with ADHD, aged 7–13 years, using wordless picture books. For microstructure, number of words, type–token ratio and mean length of utterance were derived from narrative samples using Systematic Analysis of Language Transcripts conventions. For macrostructure, the narratives were coded according to the Narrative Scoring Scheme, which includes seven narrative characteristics, as well as a composite score reflecting the child’s overall narrative ability.Results: The administration of MPH-OROS® resulted in a significant difference in certain aspects of language macrostructure: cohesion and overall narrative ability. Little effect was noted in microstructure elements.Conclusion: We observed a positive effect of stimulant medication on the macrostructure, but not on the microstructure, of narrative production. Although stimulant medication improves attention and concentration, it does not improve all aspects of language abilities in children with ADHD. Language difficulties associated with ADHD related to language content and use may be more responsive to stimulant medication than language form, which is likely to be affected by cascading effects of inattention, hyperactivity and impulsivity beginning very early in life and to progress over a more protracted period. Therefore, a combination of treatments is advocated to ensure that children with ADHD are successful in reaching their full potential.


2014 ◽  
Vol 45 (8) ◽  
pp. 1601-1612 ◽  
Author(s):  
S. Park ◽  
J.-M. Lee ◽  
J.-W. Kim ◽  
J. H. Cheong ◽  
H. J. Yun ◽  
...  

Background.Previous studies have implicated the relationship between environmental phthalate exposure and attention deficit hyperactivity disorder (ADHD) symptoms of childhood, but no studies have been conducted in children who have a confirmed diagnosis of ADHD obtained through meticulous diagnostic testing. We aimed to determine whether phthalate metabolites in urine would be higher in children with ADHD than in those without ADHD and would correlate with symptom severity and cortical thickness in ADHD children.Method.A cross-sectional examination of urine phthalate metabolite concentrations was performed; scores for ADHD symptoms, externalizing problems, and continuous performance tests were obtained from 180 children with ADHD, and brain-imaging data were obtained from 115 participants. For the control group, children without ADHD (N = 438) were recruited. Correlations between phthalate metabolite concentrations and clinical measures and brain cortical thickness were investigated.Results.Concentrations of phthalate metabolites, particularly the di(2-ethylhexyl) phthalate (DEHP) metabolite, were significantly higher in boys with ADHD than in boys without ADHD. Concentrations of the di-n-butyl phthalate (DBP) metabolite were significantly higher in the combined or hyperactive-impulsive subtypes compared to the inattentive subtype, and the metabolite was positively correlated with the severity of externalizing symptoms. Concentrations of the DEHP metabolite were negatively correlated with cortical thickness in the right middle and superior temporal gyri.Conclusions.The results of this study suggest an association between phthalate concentrations and both the diagnosis and symptom severity of ADHD. Imaging findings suggest a negative impact of phthalates on regional cortical maturation in children with ADHD.


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