Research
Own publications, collaborations and notable references
Clinical Applications of School Neuropsychology: Clinical Disorders
A company called Nesplora has two CPTs that are administered in virtual reality. Children ages 6–15 can be administered Aula (Climent et al., 2011), which places them in a virtual classroom with a teacher, classmates, and all the furnishings of a classroom. They are asked to respond to some tar- gets that they hear or see on the blackboard and ignore other stimuli, including traditional classroom distractions like peers talking, things happening outside the classroom window, and other students passing notes. Adolescents over the age of 16 and adults can be administered Nesplora’s Aquarium (Climent, 2018), which takes place in a virtual aquarium and has more cognitively demanding and challenging rules for responding to targets that test not only attention but also working memory. Recall that working memory is related to Mirksy’s encode concept, meaning that Aquarium is tap- ping into multiple layers of Mirsky’s attention model. At this point, these are the only commercially available CPTs administered in virtual reality; they have the advantage of modeling real-world atten- tion demands and distractions in a way that is hard to replicate with traditional CPTs administered on desktop and laptop computers.
Best Practices in School Neuropsychology: Guidelines for Effective Practice, Assessment, and Evidence-Based Intervention, Second Edition. Edited by Daniel C. Miller, Denise E. Maricle, Christopher L. Bedford, and Julie A. Gettman. © 2022 John Wiley & Sons, Inc. Published 2022 by John Wiley & Sons, Inc.
Full text: https://onlinelibrary.wiley.com/doi/book/10.1002/9781119790563
Cognitive and Emotional Mapping With SEEG
Over the last 2 years, virtual tasks have exploded, with ecologically realistic or episodic memory in a shop environment (252, 253), spatial orientation (254), attention (255), and large-scale spatial learning (256). Similarly, standard objects to use in creating these environments (257), and free programming tools (e.g., Unity by Unity Technologies) are making this easier and more standardized (See Figure 8)
Drane Daniel L., Pedersen Nigel P., Sabsevitz David S., Block Cady, Dickey Adam S., Alwaki Abdulrahman, Kheder Ammar. Cognitive and Emotional Mapping With SEEG. Frontiers in Neurology. 10.3389/fneur.2021.627981 .
EFEC'O scale for assessing executive functions in self-report format
EFEC'O questionnaire is an instrument that allows assessing executive functions from an ecological perspective because it is based on a day-by-day behavioral report of an individual. The aim was to validate EFEC'O questionnaire in a self-report format. Participants were 250 Ecuadorian adolescents aged between 13 and 18 years (3/a?e=16.23. SD=\.Ti). As results, there was found a significant internal consistency (a=.64-.95), correlation among items (r=.32-.62), correlation among sub-scales (r=.40-76). confirmatory factor analysis of two factors (x2=3S.S7, CFI=98, RMSEA=. 065 [035-094], SRMR=027) and discriminant capacity in monitoring, cognitive flexibility. organization of material, initiative, working memory and planning of adolescents with differences on academic performance. In the discussion part, results are presented in relation to previous findings and taking on account the importance of having an instrument with an ecological validity to assess executive functions.
Full article: https://www.aidep.org/sites/default/files/2019-01/RIDEP50-Art7.pdf
Ramos-Galarza, Carlos & Bolanos-Pasquel, M. & García Gómez, Andrés & Siiarez, P.M. & Jadan-Guerrero, Janio. (2019). Efeco scale for assessing executive functions in self-report format. Revista Iberoamericana de Diagnostico y Evaluacion Psicologica. 51. 83-93.
Evaluación psicométrica del test de AULA NESPLORA

For psychological assessment it is necessary to have instruments with adequate psychometric properties, therefore, this paper deals with the application of an evaluative quality questionnaire for psychometric tools (CET-R) on the computerized test in Virtual Reality format AULA NESPLORA for attentional functions. In the process, both tools, their properties and articles about the practical work that professionals do with them are defined. The results indicate that AULA NES-PLORA is a test that marks quality in the evaluation standards of the CET-R and can be included in the list of tests recommended for professional use.
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La tecnología hoy en día nos permite realizar nuevas medidas y técnicas de evaluación, ésta nos permite basar la medición en modelos teóricos, en la teoría del ítem, aplicar nuevas fórmulas de deseabilidad social, automatizar el registro de conductas, actualización continua de los baremos, nuevos formatos de ítems, nuevos modelos psicométricos, autoinforme e incluso presentar distintas situaciones de conflicto laboral, según Olea et al., (2010) los test informatizados podrían cubrir nuevas demandas sociales ya que la mejor estandarización de las pruebas y sus condiciones de aplicación pueden superar las exigencias de calidad.
Ésta diferencia con respecto a test clásicos se muestra a la hora de estudiar variables en estudios experimentales. Así, Rodríguez-Barranco et al., (2016) tratan de distinguir los efectos perjudiciales o positivos para la salud en exposición a trazas de metales.
Para ello utilizaron diversas pruebas y encontraron que los autoinformes que completan padres y profesores no fueron válidos para enseñar asociaciones significativas. Debido a esta necesidad, surgen trabajos como el de García y González (2015) en el que tratan de recopilar las escalas específicas más conocidas y utilizadas para la evaluación de las variables atencionales o TDAH en niños y adolescentes para realizar un diagnóstico correcto y conocer el perfil de funcionamiento cognitivo.
Las ventajas que aportan los cuestionarios son la fácil aplicación y accesibilidad, sin embargo, son pruebas subjetivas, indirectas e inespecíficas y las respuestas pueden diferir de acuerdo al informante. (Herrán et al., 2014) Por otra parte, las pruebas de desempeño son objetivas y directas, aunque consumen mayor tiempo de aplicación y requieren de espacios acondicionados con equipos de computadoras o hardware no tan accesibles.
¿Qué caracteriza entonces a los test informatizados? Según Olea et al., (2010) deben cumplir dos requisitos: la disponibilidad de sus propiedades psicométricas y que los ítems se presenten y respondan en un ordenador. En el caso de AULA Nesplora (Climent y Banterla, 2016), el test se responde en un hardware de realidad virtual que consiste en unas gafas de realidad virtual, las cuales monitorizan desde un visor un software interactivo con controles, como un ordenador. Encontramos en la literatura con que los test informatizados tipo Continous Performance Test, en adelante CPT, usualmente son conocidos por tener una extraordinaria validez interna, pero no externa, hay revisiones con una visión crítica ante cómo los distintos paradigmas de tarea se convierten en un test, sin serlo realmente debido a que tienen una estandarización o normativo.
Critican cómo los estímulos se presentan solo visual, solo auditivo o con un paradigma u otro. Además, critica la validez ecológica de las pruebas y problemas con los tiempos de respuesta (Kessels, 2018) Respecto al formato de realidad virtual, Delgado y Moreno (2012), encuentran diversas evidencias que apoyan la validez ecológica de la realidad virtual para medir procesos relacionados con la atención, con la actividad motora, o un mejor control de las situaciones ambientales.
Por todo esto, el presente trabajo busca revisar este test mediante el cuestionario de evaluación de Test (CET-R) con el objetivo de arrojar luz sobre las características de estos nuevos tipos de test y proporcionar un informe de la calidad de los mismos en línea con el trabajo de la Comisión Nacional de Test del Colegio Oficial de Psicólogos.
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Excelente TFG. GRACIAS Alberto Infantes por tu trabajo y Felicidades por tu nota sobresaliente.
Texto completo: https://nesplora.com/wp-content/uploads/2020/07/FG-Grado-en-PSICOLOGI%CC%81A-2020_21_Evaluacio%CC%81n-psicome%CC%81trica-del-test-de-AULA-NESPLORA_APLICACIO%CC%81N-Alberto-Infantes-Garci%CC%81a.pdf
TFG Grado en PSICOLOGÍA 2020_21_Evaluación psicométrica del test de AULA NESPLORA_APLICACIÓN Alberto Infantes García
The effectiveness of a virtual reality attention task to predict depression and anxiety in comparison with current clinical measures
Previous studies have revealed that attention and inhibition are impaired in individuals with elevated symptoms of depression and anxiety. Virtual reality (VR)-based neuropsychological assessment may be a valid instrument for assessing attention and inhibition given its higher ecological validity when compared to classical tests. However, it is still unclear as to whether a VR assessment can predict depression and anxiety with the same or higher level of effectiveness and adherence as classical neuropsychological measures. The current study examined the effectiveness of a new VR test, Nesplora Aquarium, by testing participants with low ( N = 41) and elevated ( N = 41) symptoms of depression and anxiety. Participants completed a continuous performance test where they had to respond to stimuli (species of fish) in a virtual aquarium, as well as paper-and-pencil and computerised tests. Participants’ performance in Nesplora Aquarium was positively associated with classic measures of attention and inhibition, and effectively predicted symptoms of depression and anxiety above and beyond traditional cognitive measures such as psychomotor speed and executive functioning, spatial working memory span. Hence, VR is a safe, enjoyable, effective and more ecological alternative for the assessment of attention and inhibition among individuals with elevated anxiety and depression symptoms.
Voinescu, A., Petrini, K., Stanton Fraser, D. et al. The effectiveness of a virtual reality attention task to predict depression and anxiety in comparison with current clinical measures. Virtual Reality (2021).
Full text: https://doi.org/10.1007/s10055-021-00520-7
The Effects of Choice on the Reading Comprehension and Enjoyment of Children with Severe Inattention and no Attentional Difficulties
It has been proposed that enhancing motivation supports the learning of children with Attention Deficit Hyperactivity Disorder (ADHD). Less is known if inattentive children with no ADHD diagnosis may similarly benefit, when being motivated to engage in an academic task. Using a repeated-measures design, this study investigated the effects of text choice as an intrinsic motivator on the reading comprehension and enjoyment of Year 4 children attending mainstream primary schools (N = 92; aged 8–9 years; 48 boys); comparing those with no attentional difficulties and severe inattention. We hypothesized that 1) choice would increase reading comprehension and enjoyment 2) choice would increase the reading comprehension and enjoyment of children both with severe inattention and no attentional difficulties 3) choice effects would be significantly greater for children with severe inattention than those with no attentional difficulties. Children participated in a reading intervention that included a Choice (experimental) and a No Choice (control) condition. Child inattention was measured via a Virtual Reality Continuous Performance Task (Omission errors, Reaction Time Variability) and Teacher Ratings. Choice significantly increased reading comprehension, but not enjoyment compared with no choice. Choice improved the reading comprehension of children with both severe inattention and no attentional difficulties. Choice did not benefit the reading of severely inattentive children more than that of children with no attentional difficulties. These findings underline the educational benefits of choice for young readers both with severe inattention and no attentional difficulties, which are further discussed drawing on existing theory and research.
Kakoulidou, M., Le Cornu Knight, F., Filippi, R. et al. The Effects of Choice on the Reading Comprehension and Enjoyment of Children with Severe Inattention and no Attentional Difficulties. Res Child Adolesc Psychopathol (2021). https://doi.org/10.1007/s10802-021-00835-8
Full text: https://doi.org/10.1007/s10802-021-00835-8
The technological tools of the diagnosis and treatment of attention deficit disorder and hyperactivity
… AQUARIUM, es semejante a AULA. En este caso se trata de un acuario donde se mide los procesos de atención para edades de análisis entre los 16 y los 90 años 11 . …
Attention deficit disorder and hyperactivity (ADHD) is the main reason for consultation in most Pediatric Neurology units in Spain. The new technologies also associate benefits for both patients and professionals and the health system itself, which makes its rational implementation essential. Genetics, neuroimaging or virtual reality, for example, are clear exponents of the results that can be achieved by optimizing traditional processes.
The different technologies that we collect in this article are fully operational and have thousands of experience in patients. The incorporation of them to the usual clinical practice is in our hands.
Fernández, Manuel & Morillo, María & Gilibert, Noelia & Carvalho, Carla & Bello, Sabina. (2020). The technological tools of the diagnosis and treatment of attention deficit disorder and hyperactivity. Medicina. 80 Suppl 2. 67-71.
Full text: http://www.scielo.org.ar/pdf/medba/v80s2/v80s2a15.pdf
Aplicación de realidad virtual (Nesplora Aquarium) en la valoración cognitiva y control de incapacidad temporal por contingencia común en pacientes con trastorno psiquiátrico menor

Objetivos: Demostrar que pacientes con quejas subjetivas de déficits cognitivos muestran procesos de incapacidad temporal más largos. Demostrar que dichas quejas no siempre se corresponden con déficits reales utilizando pruebas específicas de Realidad Virtual (Nesplora Aquarium), lo que permitiría acortar la duración de la incapacidad en buenas condiciones para el trabajador. (…) Los resultados pueden ser de gran utilidad en prevención laboral y facilitar el adecuado retorno al trabajo tras una IT por TPm. Con el presente estudio, hemos establecido una clara vía de investigación, poniendo de relieve la importancia de utilizar modernas y actuales técnicas de realidad virtual en la valoración psiquiátrica de las funciones cognitivas de los pacientes en situación de IT.
J.L. González. Aplicación de realidad virtual (Nesplora Aquarium) en la valoración cognitiva y control de incapacidad temporal por contingencia común en pacientes con trastorno psiquiátrico menor. Rev Asoc Esp Espec Med Trab 2020; 29(3): 223-235
Texto completo: https://nesplora.com/wp-content/uploads/2020/10/Gonzalez_2020.pdf
Attentional profile of adolescents with ADHD in virtual-reality dual execution tasks: A pilot study
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder that is highly prevalent in children and adolescents, with estimated prevalence ranges from 5.9 to 7.1% globally and 1 to 6.8% in Spain. This has commonly been associated with deficits in attention threads and executive functions. This paper aims to study the cognitive-executive performance of adolescents between the ages of 17 and 23 with an ADHD diagnosis, relative to a control group. The total sample consisted of 120 male participants who were given the Nesplora Aquarium test. Dual execution tasks assessed attention, response speed, and inhibition capability. When comparing the experimental and control groups, statistically significant differences were detected in processing speed, selective attention, and cognitive inhibition [general execution (T_correct_n) (p ¼ 0.008), attention arousal (T_omission_n) (p ¼ 0.008), and processing speed (T_correctreactime_mean) (p ¼ 0.008)]. We demonstrate that a new virtual reality tool, designed to measure attention in people over the age of 16 years, is effective at measuring attention and working memory. In addition, item difficulty and discrimination values were also acceptable.
Jose Antonio Camacho-Conde & Gema Climent (2020) Attentional profile of adolescents with ADHD in virtual-reality dual execution tasks: A pilot study, Applied Neuropsychology: Child, DOI: 10.1080/21622965.2020.1760103
A Four-Step Method for the Development of an ADHD-VR Digital Game Diagnostic Tool Prototype for Children Using a DL Model
Aceres et al. (14) presented a VR-CPT test (Nesplora Aquarium) for adolescents and adults that was designed to measure executive function. The study used the Adult ADHD Self-Report Scale (ASRS) as the ADHD symptom scale. The results showed that the VR test Nesplora Aquarium significantly predicted current and retrospective ADHD symptoms.
Wiguna, Tjhin & Wigantara, Ngurah & Ismail, Raden & Kaligis, Fransiska & Minayati, Kusuma & Bahana, Raymond & Dirgantoro, Bayu. (2020). A Four-Step Method for the Development of an ADHD-VR Digital Game Diagnostic Tool Prototype for Children Using a DL Model. Frontiers in Psychiatry. 11. 829. 10.3389/fpsyt.2020.00829.
Full text: https://doi.org/10.3389/fpsyt.2020.00829