Research presented at the 2026 National Academy of Neuropsychology (NAN) conference explores how Nesplora Aula contributes to a more comprehensive understanding of executive functioning in children with ADHD.
Assessing attention and executive functioning in children with Attention-Deficit/Hyperactivity Disorder (ADHD) requires more than a single perspective. While parent and teacher rating scales provide valuable insights into children’s everyday behavior, objective cognitive assessments offer an additional way to examine how children perform on tasks requiring attention, inhibition, planning, and other cognitive abilities.
Research presented at the 2026 NAN conference in Chicago highlights the importance of incorporating both approaches into comprehensive ADHD evaluations. The study examined relationships between parent-reported executive functioning and objective neuropsychological assessments, including Nesplora Aula, a virtual reality-based continuous performance test.
Examining Different Measures of Executive Functioning
The study included 62 children between the ages of 6 and 16 who had been diagnosed with ADHD according to DSM criteria. Researchers examined relationships among three assessment instruments:
- Nesplora Aula: A virtual reality-based continuous performance test providing objective measures of attention, processing speed, vigilance, motor activity, and inhibitory control.
- Cognitive Assessment System, Second Edition (CAS-2): A standardized cognitive assessment, with selected subtests examining planning and attention-related abilities.
- Behavior Rating Inventory of Executive Function, Second Edition (BRIEF-2): A behavioral rating scale used to gather parent observations of children’s executive functioning in everyday settings.
Researchers investigated whether parent-reported executive functioning was associated with children’s performance on objective cognitive measures. They also examined relationships between individual measures obtained through Nesplora Aula and the CAS-2.
Key Findings: Different Assessments Provide Different Perspectives
The study found no statistically significant correlations between parent-reported BRIEF-2 ratings and the objective neuropsychological measures examined.
These findings suggest that a child’s performance during structured cognitive testing may not directly correspond to how their executive functioning is perceived and reported in everyday environments.
Importantly, this does not mean that one approach is more accurate than another. Rather, behavioral rating scales and objective assessments may capture different dimensions of cognitive and behavioral functioning, each contributing valuable information to the clinical evaluation process.
The researchers also identified statistically significant correlations between certain Nesplora Aula measures and individual CAS subtests. These relationships suggest that some cognitive abilities measured through Aula correspond with aspects of performance captured by another established neuropsychological assessment.
Together, these findings reinforce the importance of using multiple assessment methods to develop a more comprehensive understanding of executive functioning in children with ADHD.
The Value of Virtual Reality in Cognitive Assessment
Nesplora Aula brings an innovative approach to objective cognitive assessment by using immersive virtual reality technology to evaluate performance within a simulated classroom environment.
Unlike behavioral rating scales, which rely on observations and reports from parents or teachers, Aula captures performance-based information while children complete standardized tasks. Its virtual environment also incorporates classroom-like distractions, providing an opportunity to examine attention and related cognitive processes under controlled conditions that reflect elements of everyday learning environments.
Through this approach, clinicians can obtain objective measures of multiple aspects of cognitive performance, including sustained attention, processing speed, inhibitory control, and motor activity.
The findings presented at NAN are particularly relevant to this multimethod approach. The absence of significant correlations between parent ratings and objective measures highlights why relying exclusively on behavioral observations may leave important aspects of cognitive performance unexplored.
Meanwhile, the observed relationships between certain Aula measures and CAS-2 subtests provide additional research evidence supporting the relevance of VR-based performance measures within broader neuropsychological assessment.
Supporting More Comprehensive ADHD Evaluations
ADHD is a complex neurodevelopmental condition, and understanding how its symptoms affect an individual child requires consideration of multiple sources of information.
Parent and teacher reports remain essential for understanding behavior across everyday environments. Objective assessments contribute a different perspective by measuring cognitive performance directly during standardized tasks.
As the researchers concluded, evaluations of children with ADHD should incorporate both objective measures of executive functioning and reports of observed behavior.
Nesplora Aula offers clinicians an additional tool for bringing these perspectives together, combining immersive technology with objective cognitive performance data to support a more comprehensive assessment process.
As research continues to explore the relationships between real-world behavior and performance-based cognitive measures, findings such as these highlight the potential contribution of virtual reality technology to modern neuropsychological practice.
Research presented: Isaacs, K. J., Galvan, N., & Nicholls, C. J. (2026). Objective measures of attention-deficit/hyperactivity disorder (ADHD) diagnosed children’s executive functions do not correlate with parent ratings on the Behavior Rating Inventory of Executive Functions. Research poster, National Academy of Neuropsychology Annual Conference, Chicago, Illinois.