Immersive Virtual Reality for Cognitive Evaluation in Spanish-Speaking Children With ADHD

Abstract

Objective: Fully immersive virtual reality (FIVR)-based assessments may enhance ecological validity in pediatric neuropsychological evaluation, particularly for attention-deficit/hyperactivity disorder (ADHD). However, concerns remain regarding cultural, linguistic, and psychometric validity in Spanish-speaking populations. This review synthesizes current literature on FIVR-based assessments in children, focusing on their ability to differentiate ADHD from typically developing peers. Method/Data Selection: Articles were identified through APA PsycInfo, PubMed, and Google Scholar using combinations of the following search terms: “virtual reality” OR “VR,” AND “Spanish,” AND “assessment” OR “test.” Studies were selected based on relevance to pediatric populations, particularly those using the Nesplora AULA platform and ADHD samples. Results/Data Synthesis: FIVR-based tools, particularly Nesplora AULA, differentiated children with ADHD from controls across multiple domains, including inattention, impulsivity, processing speed, motor activity, and attentional focus. Children with ADHD demonstrated greater inattention, higher impulsivity, slower processing speed, and increased motor activity compared to control groups. They also showed impairments in working memory and processing speed, with less consistent convergent validity across domains. These tools were sensitive to treatment effects, distinguishing medicated from unmedicated children. Although the immersive format may increase engagement, performance may be influenced by familiarity with gaming and VR environments. Additionally, task performance involves motor responses, which may affect the interpretation of cognitive performance. Conclusions: FIVR-based assessments show strong potential for identifying attentional deficits in Spanish-speaking children with ADHD. Their largely non-verbal format may support cross-linguistic applicability; however, performance may be influenced by familiarity and motor demands. Future research should expand validation in diverse Spanish-speaking pediatric populations.