Concentration problems, lack of self-control and excessive physical activity are some of the more and more frequent reasons of consultation for children. Assessing accurately if there are alterations in these behaviors is the key to making a good diagnosis
The task is a Continuous Performance Test -CPT- played via virtual reality glasses and headphones where the instructions are received. As indicated, the assessed subject must respond to different stimuli by pressing a button.
The evaluator visualizes on their computer screen, in real time, the same thing that the subject can see via the glasses. Motor activity during the test is registered by motion sensors in the glasses.
The scenario is similar to a school class and the perspective places the subject at a desk looking towards the blackboard. Head movements are captured by the glasses and the software updates the scene accordingly, giving the real feeling of being in class (by moving your head you can see the different parts of the classroom just like in a real class). A teacher explains the instructions of the tasks and the classmates “behave” in a realistic and dynamic way. The subject has to perform the task that is presented on the board (visually) or that the teacher explains (auditive). Regarding ecological validity, a series of usual school classroom distractors have been introduced.: a car passes by the street, a companion calls the subject, the concierge knocks on the door of the classroom, etc.
The sample of these studies consists of 1,302 subjects aged between 5 and 22 years, with a mean of 10.47 and a standard deviation of 2.92. The results obtained showed statistically significant differences between men and women in all age groups and in almost all of the variables measured and statistically significant differences between the ages of 6, 7, 8, 9, 10, 11 and those over 12 years. No differences were found between the groups of 12 years and older. These results were derived in 14 different groups of scales, by sex and age. Depending on the groups (doctors and psychologists), potential users of the tests, the results were measured in percentile scales and T scales. In order to facilitate the interpretation and comparison of the results, it was decided that the T scales were normalized.
The last of the studies of convergent validity that have been carried out with Nesplora Aula have been with the EDAH55 test and with the diagnostic criteria of the DSM-IV27. For this study samples of 188 and 360 children respectively were used. The analysis of similarity of cosines were the analysis selected for these studies. The results show low – moderate correlations between Nesplora Aula and EDAH, with the highest correlations in the variable inattention (between, 406 and, 544); between Nesplora Aula and the DSM-IV, the highest correlation values were also for inattention (between, 379 and 473).
Concerning the convergent validity, the different nature of Nesplora Aula as an objective measure of cognition, EDAH and DSM-IV as an observational scale, suggests that they measure different aspects or dimensions of the patient’s behavior, in addition, they can complement one another to increase the accuracy of the diagnosis of ADHD.
In order to analyze the factorial validity of the instrument created, an Exploratory Factor Analysis was carried out in the first place (a collection of data for the study and determination of the number of factors involved). Exploratory factorial analysis (AFE), we do not know or do not have accurate information about the number of existing factors). Being a new test and with a format far removed from traditional tests, it was decided to explore different multidimensional models to compare the indices obtained in each of them and establish which was better suited to the data obtained in the normative group. The results obtained support the one-dimensional structure initially proposed and that would form a single factor. This factor collects the cognitive variables that correlate with an initial diagnosis of ADHD in any of its variants, that is, with a group of the 18 variables collected by the test we can observe a cognitive alteration that corresponds to one or another subtype of ADHD.
Emotional disorders are very common and can interfere negatively in social life, the development of social skills and even academic performance. High levels of anxiety often adversely affect different cognitive functions, including attention. The Nesplora Aula test allows you to analyze the child’s attentional profile, adapting the treatment and monitoring. During the treatment we can observe the changes in the cognitive profile of the person evaluated, the decrease in the attentional signs being an indicator of improvement of the anxiety problems.
Impulsivity is often an important pillar in behavior problems and social relationships but the deficit in impulse management is not reflected solely in behavioral problems or social skills. Many times these difficulties can also affect the learning process. An objective evaluation of attentional processes and inhibitory control is of special importance in these cases. Nesplora Aula allows us to know the attentional profile, impulse management and motor activity of each person to be able to intervene more effectively adapting to that profile and thus improve behavioral and social skills problems, whether by impulsivity or by a deficit at attention level.
It is usual to be confused between attentional problems and problems of reading and writing. The profile of reading difficulties of children diagnosed with ADHD may be confused with that of dyslexia diagnosis, especially in early stages, since there is a great coincidence with the types of error most frequent in visual dyslexia. In this case, Nesplora Aula can help us detect if it is a problem of reading and writing or if it is an attentional problem and provide reliable and objective data for the differential diagnosis.
Learning problems and difficulties in the school environment are usually one of the most frequent queries. In the report generated automatically, it is shown in the child’s complete attention profile. In the report we can analyze what kind of task the subject performs best, in which environment they have a better performance, which stimuli they can process better, in case of showing excessive motor activity, we can know if it is a sterile movement or if it is caused by the distractors of the environment. All this information can help us adapt to the needs of children, use specific strategies, plan interventions and thus, obtain better performance in their day to day.
It allows us to make a more reliable diagnosis, since the attentional difficulties that lead to a diagnosis of ADHD are often a “bad diagnosis” for basing that diagnosis on subjective perceptions of the child’s environment and with this test we have objective data to complement other information and confirm or rule out attentional difficulties. It also facilitates the differentiation between subtypes of ADHD.
Within a complete neuropsychological evaluation, we can administer Nesplora Aula as a reliable and objective measure of the patient’s attention processes. We obtain information on sustained and selective attention, impulsiveness, auditory and visual processing, motor activity, execution in the presence and absence of distractors, speed of processing and quality of attention focus.
It allows us to analyze the complete profile of the child, to know in what conditions he / she has a better performance, to plan a treatment and to monitor it.
The alterations manifested after a brain injury can have physical, sensory, cognitive, emotional, communication and language implications, and / or functional autonomy. Among the main alterations after a DCA there may be attentional alterations such as: Inability to detect, focus, maintenance of the surveillance level, reduction of the resistance to interference, distractibility, reduction of the capacity and speed of information processing, problems to attend stimuli simultaneously or successively, negligence, alterations related to diffuse or focal lesions (frontal lobes). FEDACE, 2006
In this case it is of vital importance to carry out a thorough evaluation and in this context Nesplora Aula gives us useful information about the profile of the person evaluated. It allows us to analyze their attentional capacity, processing speed, the distractibility for execution in the presence and absence of distractors, the processing of auditory and visual stimuli presented in combination and impulsivity. In addition, it allows to monitor the rehabilitation carried out and facilitates the comparison between the results obtained in the first pass of the test with those obtained in the following passages, being able to observe the evolution of the minor.
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