AR game-based cognitive-motor intervention on executive functioning of children and adolescents with hearing impairment: Psychophysiological markers

Executive dysfunction in children and adolescents with hearing impairment (HI) plays a crucial role in contributing to delays in both learning and psychosocial development. The current investigation aimed to develop and examine the effectiveness of AR game-based cognitive-motor intervention. The ASSURE framework was used to develop the AR intervention involving a focus group and a feasibility study. A two-group pretest-posttest design was used to test the effectiveness of the developed program in 60 children and adolescents with HI. The Connection test was used to index executive functioning and the frontal delta and theta relative power were used to represent the underlying neural processing relating to executive functioning. Findings demonstrated convergent behavioral and EEG evidence supporting the effectiveness of the AR intervention. Participants in the experimental group showed greater improvements in performance scores and response times compared to the control group. Moreover, relative delta power at AF3 and AF4 during eyes-open resting-state conditions significantly increased following the intervention in the experimental group. In contrast, relative theta power showed no significant changes across groups or conditions. In conclusion, this pilot phase suggested the feasibility and high acceptability of the AR intervention, with full adherence across all eight sessions. Behavioral and EEG evidence from the main study indicated that the intervention could foster executive functioning in children and adolescents with HI.