Virtual Reality Game to Objectively Detect ADHD

Researchers have used virtual reality games, eye tracking and machine learning to show that differences in eye movements can be used to detect ADHD, potentially providing a tool for more precise diagnosis of attention deficits. Their approach could also be used as the basis for an ADHD therapy, and with some modifications, to assess other conditions, such as autism.

ADHD is a common attention disorder that affects around six percent of the world's children. Despite decades of searching for objective markers, ADHD diagnosis is still based on questionnaires, interviews and subjective observation. The results can be ambiguous, and standard behavioural tests don't reveal how children manage everyday situations. Recently, a team consisting of researchers from Aalto University, the University of Helsinki, and Åbo Akademi University developed a virtual reality game called EPELI that can be used to assess ADHD symptoms in children by simulating situations from everyday life.

Now, the team tracked the eye movements of children in a virtual reality game and used machine learning to look for differences in children with ADHD. The new study involved 37 children diagnosed with ADHD and 36 children in a control group. The children played EPELI and a second game, Shoot the Target, in which the player is instructed to locate objects in the environment and "shoot" them by looking at them. This short video shows an example of EPELI gameplay, player responses, and the research findings.

"We tracked children's natural eye movements as they performed different tasks in a virtual reality game, and this proved to be an effective way of detecting ADHD symptoms. The ADHD children's gaze paused longer on different objects in the environment, and their gaze jumped faster and more often from one spot to another. This might indicate a delay in visual system development and poorer information processing than other children," said Liya Merzon, a doctoral researcher at Aalto University.

Brushing your teeth with distractions

Project lead Juha Salmitaival, an Academy Research Fellow at Aalto, explains that part of the game's strength is its motivational value. "This isn't just a new technology to objectively assess ADHD symptoms. Children also find the game more interesting than standard neuropsychological tests," he says.

Salmitaival conceived EPELI together with Professor Matti Laine from Åbo Akademi University and Erik Seesjärvi, a doctoral researcher at the University of Helsinki and clinical neuropsychologist at Helsinki University Hospital (HUH). The game is available to neuropsychologists working in pediatric neurology and pediatric psychiatry at HUH.

"Those who are interested can use EPELI as an aid in their clinical work," says Seesjärvi. "The experience has been very positive. All of the neuropsychologists who answered a feedback survey after the first pilot said they had benefit from using virtual reality methods as a complementary tool in their work."

EPELI game development was led by Topi Siro, an Aalto alum who now works at Peili Vision Oy. "The game provides a list of tasks that simulate everyday life, such as brushing your teeth and eating a banana. The player has to remember the tasks despite distractions in the environment, such as a TV being on. The game measures everything: how much the child clicks on the controls and how efficiently they perform the tasks. Efficiency correlates with everyday functioning, whereas children with ADHD often have challenges," says Siro.

Motivation for rehabilitation

The researchers envision broader therapeutic applications for virtual reality games. Beyond assessing symptoms, gaming could also be used as an aid to ADHD rehabilitation. "We want to develop a gamification-based digital therapy that can help children with ADHD get excited about doing things they wouldn’t otherwise do. There’s already an approved game for ADHD rehabilitation in the US," says Salmitaival. The team is exploring rehabilitation possibilities in a project with researchers at the University of Oulu.

Linda Henriksson, a senior lecturer at Aalto University who was also involved in the study, notes the exceptional potential of virtual reality for such applications. "I see virtual reality as an interesting tool, because it can be used to precisely control what happens in the stimulus world while at the same time collecting information about behaviour in a natural situation," says Henriksson, an expert in how the brain processes visual information.

Researchers have already identified other potential applications for EPELI in assessing a wide range of difficulties with everyday challenges. For example, it could be used to measure problems in the planning and flexibility of activities in people with autism. With modifications, this approach could also be used to assess language problems, brain trauma, adult ADHD, symptoms related to cerebral palsy and even the deterioration of memory with age. "Our partners in Geneva are studying aging-related diseases. Key opportunities on the horizon include early detection of Parkinson’s and Alzheimer's diseases," says Salmitaival.

The research used the MAGICS infrastructure, an Aalto-led project specialising in virtual technologies. The research was funded by the Academy of Finland, the Aalto Brain Centre and several foundations. The paper was published in Scientific Reports.

Merzon L, Pettersson K, Aronen ET, Huhdanpää H, Seesjärvi E, Henriksson L, MacInnes WJ, Mannerkoski M, Macaluso E, Salmi J.
Eye movement behavior in a real-world virtual reality task reveals ADHD in children.
Sci Rep. 2022 Nov 24;12(1):20308. doi: 10.1038/s41598-022-24552-4

Most Popular Now

AI Distinguishes Glioblastoma from Look-…

A Harvard Medical School–led research team has developed an AI tool that can reliably tell apart two look-alike cancers found in the brain but with different origins, behaviors, and treatments. The...

AI Body Composition Measurements can Pre…

Adiposity - or the accumulation of excess fat in the body - is a known driver of cardiometabolic diseases such as heart disease, stroke, type 2 diabetes, and kidney disease...

AI can Strengthen Pandemic Preparedness

How to identify the next dangerous virus before it spreads among people is the central question in a new Comment in The Lancet Infectious Diseases. In it, researchers discuss how...

'Future-Guided' AI Improves Se…

In the world around us, many things exist in the context of time: a bird’s path through the sky is understood as different positions over a period of time, and...

New AI Tool Scans Social Media for Hidde…

A new artificial intelligence tool can scan social media data to discover adverse events associated with consumer health products, according to a study published September 30th in the open-access journal...

Study Finds One-Year Change on CT Scans …

Researchers at National Jewish Health have shown that subtle increases in lung scarring, detected by an artificial intelligence-based tool on CT scans taken one year apart, are associated with disease...

New AI Tools Help Scientists Track How D…

Artificial intelligence (AI) can solve problems at remarkable speed, but it’s the people developing the algorithms who are truly driving discovery. At The University of Texas at Arlington, data scientists...

Yousif's Story with Sectra and The …

Embarking on healthcare technology career after leaving his home as a refugee during his teenage years, Yousif is passionate about making a difference. He reflects on an apprenticeship in which...

AI Tool Offers Deep Insight into the Imm…

Researchers explore the human immune system by looking at the active components, namely the various genes and cells involved. But there is a broad range of these, and observations necessarily...

New Antibiotic Targets IBD - and AI Pred…

Researchers at McMaster University and the Massachusetts Institute of Technology (MIT) have made two scientific breakthroughs at once: they not only discovered a brand-new antibiotic that targets inflammatory bowel diseases...

Highland to Help Companies Seize 'N…

Health tech growth partner Highland has today revealed its new identity - reflecting a sharper focus as it helps health tech companies to find market opportunities, convince target audiences, and...