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Diagnosis of ADHD using virtual reality and artificial intelligence: an exploratory study of clinical applications

Introduction: Diagnosis of Attention Deficit/Hyperactivity Disorder (ADHD) is based on clinical evaluation of symptoms by a psychiatrist, referencing results of psychological tests. When diagnosing ADHD, the child’s behavior and functionality in real-life situations are critical components. However, direct observation by a clinician is often not feasible in practice. Therefore, such information is typically gathered from primary caregivers or teachers, which can introduce subjective elements. To overcome these limitations, we developed AttnKare-D, an innovative digital diagnostic tool that could analyze children’s behavioral data in Virtual Reality using Artificial Intelligence. The purpose of this study was to explore the utility and safety of AttnKare-D for clinical application.

Method: A total of 21 children aged between 6 and 12 years were recruited for this study. Among them, 15 were children diagnosed with ADHD, 5 were part of a normal control group, and 1 child was excluded due to withdrawal of consent. Psychological assessments, including K-WISC, Conners CPT, K-ARS, and K-CBCL, were conducted for participants and their primary caregivers. Diagnoses of ADHD were confirmed by child and adolescent psychiatrists based on comprehensive face-to-face evaluations and results of psychological assessments. Participants underwent VR diagnostic assessment by performing various cognitive and behavioral tasks in a VR environment. Collected data were analyzed using an AI model to assess ADHD diagnosis and the severity of symptoms.

Results: AttnKare-D demonstrated diagnostic performance with an AUC of 0.893 when compared to diagnoses made by child and adolescent psychiatrist, showing a sensitivity of 0.8 and a specificity of 1.0 at a cut-off score of 18.44. AttnKare-D scores showed a high correlation with K-ARS scores rated by parents and experts, although the correlation was relatively low for inattention scores.

Conclusion: Results of this study suggest that AttnKare-D can be a useful tool for diagnosing ADHD in children. This approach has potential to overcome limitations of current diagnostic methods, enhancing the accuracy and objectivity of ADHD diagnoses. This study lays the groundwork for further improvement and research on diagnostic tools integrating VR and AI technologies. For future clinical applications, it is necessary to conduct clinical trials involving a sufficient number of participants to ensure reliable use.

 

This article is part of the Research TopicDigital Technologies for Screening, Diagnosing, and Treating ADHD and Related Disorders published in Frontiers of Psychology.

Oh S, Joung Y-S, Chung T-M, Lee J, Seok BJ, Kim N and Son HM (2024) Diagnosis of ADHD using virtual reality and artificial intelligence: an exploratory study of clinical applications. Front. Psychiatry 15:1383547. doi: 10.3389/fpsyt.2024.1383547

 


 

This article cites the normative study of Nesplora Attention Kids Aula within its references and text:

 

» […] research conducted by Iriarte et al. (2016) and Areces et al. (2018) introduced a classroom-based VR-CPT that enables movement tracking (17, 18). A meta-analysis published in 2019 reported that classroom-based VR-CPT reliably distinguishes between the attentional performance of ADHD and control groups (19). VR-CPT enhances ecological validity compared to traditional CPT by consistently controlling distractions and conducting assessments in an environment similar to daily life. It also offers additional neuropsychological indicators through movement tracking that are not available in traditional CPT. «

  • Iriarte Y, Diaz-Orueta U, Cueto E, Irazustabarrena P, Banterla F, Climent G. AULA-advanced virtual reality tool for the assessment of attention: normative study in Spain. J attention Disord. (2016) 20:542–68. doi: 10.1177/1087054712465335

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