Augmented, Virtual, and Mixed Reality Assessment and Training for Executive Functions in Children with ADHD: A Scoping Review

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Abstract

Background: Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by inattention, motor hyperactivity and verbal and cognitive impulsivity. Impairments in executive functions (EFs), in particular working memory, monitoring and organization of daily life-are frequently observed in children diagnosed with ADHD, and are reflected in behavioural, social-emotional and learning difficulties. The development and use of technologies such as virtual reality (VR), augmented reality (AR) and mixed reality (MR) for ADHD have increased in recent years, using a variety of tools to support including PC, video games, wearable devices and tangible interfaces. Objectives: To systematically map the current state of research on the use of AR, VR and MR technologies to assess and/or enhance EFs in children with ADHD. To evaluate the effects on their quality of life and on families’ and caregivers’ burden reduction. To explore the interventions’ clinical validity. Methods: A scoping review according to PRISMA-ScR guidelines was conducted. A systematic search was carried out in the Scopus and Web of Science databases for studies published between 2015 and 2025.Empirical studies published in English that examined children with ADHD aged < 13 years were included. AR, VR, or MR-based interventions focused on EF were considered. For each study, the following features were recorded: year and country of publication, design, objectives, EFs considered, technology and hardware used, main results, and limitations. Results: Twenty studies were identified. The most frequently addressed functional domains were sustained and selective visual attention, working memory, and inhibition. Assessment interventions primarily involved the use of a head-mounted display (HMD) in conjunction with the Continuous Performance Test (CPT). Training interventions included immersive VR, serious video games, VR with motor or dual-task training, and MR. The results suggest that VR can enhance cognitive performance and sustained attention; however, longitudinal studies are required to evaluate its long-term effectiveness and integrate emotional skills. Conclusions: The use of these technologies is a promising strategy for assessment and training of EFs in children with ADHD. These tools provide positive, inclusive feedback and motivating tasks. Nevertheless, larger sample studies, longitudinal follow-ups to confirm the suitability and effectiveness of the technology-based programs are warranted.

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