Efficacy of a Continuous Performance Test Based on Virtual Reality in the Diagnosis of ADHD and Its Clinical Presentations

Objective: To analyze the diagnostic effectiveness of the AULA Nesplora test to discriminate the different ADHD presentations: impulsive/hyperactive (I/H), inattentive, and combined.Method: A total of 117 students (76.9% male and 23.1% female) between 5 and 16 years of age (M = 11.18 years, SD = 3.10 years) participated, and were divided into three groups with ADHD according to their presentation, and a control group. Results: Each of the test conditions allowed the discrimination between the I/H and combined presentations with respect to the control group, and between the I/H and inattentive presentations. However, differences among ADHD presentations were only evident when the results were separately analyzed for the visual and auditory modalities. Conclusion: This study showed that the indicators offered by the AULA Nesplora test (omissions, commissions, response times, and motor activity) make it possible to establish a differential diagnosis of ADHD presentations when analyzed under different contextual conditions.

[1]  S. Faraone,et al.  How persistent is ADHD? A controlled 10-year follow-up study of boys with ADHD , 2010, Psychiatry Research.

[2]  T. Tinius,et al.  The Integrated Visual and Auditory Continuous Performance Test as a neuropsychological measure. , 2003, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[3]  Rex B. Kline,et al.  Principles and Practice of Structural Equation Modeling , 1998 .

[4]  R. Barkley,et al.  Impairment in occupational functioning and adult ADHD: the predictive utility of executive function (EF) ratings versus EF tests. , 2010, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[5]  U. Díaz-Orueta,et al.  AULA—Advanced Virtual Reality Tool for the Assessment of Attention , 2016, Journal of attention disorders.

[6]  S. Steinau.  Diagnostic Criteria in Attention Deficit Hyperactivity Disorder – Changes in DSM 5 , 2013, Front. Psychiatry.

[7]  C. Fabrigoule,et al.  Impact of time on task on ADHD patient's performances in a virtual classroom. , 2012, European journal of paediatric neurology : EJPN : official journal of the European Paediatric Neurology Society.

[8]  J. Ramos-Quiroga,et al.  Diagnóstico y tratamiento del trastorno por déficit de atención/hiperactividad en adultos , 2012 .

[9]  O. Bueno,et al.  Performance patterns in Conners' CPT among children with attention deficit hyperactivity disorder and dyslexia. , 2012, Arquivos de neuro-psiquiatria.

[10]  Unai Díaz-Orueta,et al.  AULA virtual reality test as an attention measure: Convergent validity with Conners’ Continuous Performance Test , 2014, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[11]  Celestino Rodríguez Pérez,et al.  FUNCIONES EJECUTIVAS EN NIÑOS Y ADOLESCENTES: IMPLICACIONES DEL TIPO DE MEDIDAS DE EVALUACIÓN EMPLEADAS PARA SU VALIDEZ EN CONTEXTOS CLÍNICOS Y EDUCATIVOS , 2014 .

[12]  D. Wechsler.  Wechsler Intelligence Scale for Children , 2020, Definitions.

[13]  C. Rodríguez Pérez,et al.  Psychometric characteristics of the BRIEF scale for the assessment of executive functions in Spanish clinical population. , 2014, Psicothema.

[14]  O. Dan,et al.  Reliability and Validity of the Online Continuous Performance Test Among Children , 2014, Assessment.

[15]  Albert A. Rizzo,et al.  The Virtual Classroom: A Virtual Reality Environment for the Assessment and Rehabilitation of Attention Deficits , 2000, Cyberpsychology Behav. Soc. Netw..

[16]  J. Egeland.  Differentiating attention deficit in adult ADHD and schizophrenia. , 2007, Archives of clinical neuropsychology : the official journal of the National Academy of Neuropsychologists.

[17]  R. Joober,et al.  Is the Inattentive Subtype of ADHD Different From the Combined/Hyperactive Subtype? , 2010, Journal of attention disorders.

[18]  David Walker,et al.  Behavior Assessment System for Children (BASC) , 1999 .

[19]  E. Walker,et al.  Diagnostic and Statistical Manual of Mental Disorders , 2013 .

[20]  Luis Álvarez,et al.  TDAH y Dificultades de Aprendizaje en escritura: comorbilidad en base a la Atención y Memoria Operativa ADHD and Writing learning disabilities: comorbidity in basis of attention and working memory. , 2009 .

[21]  Gracia Delgado-Pardo,et al.  Tests de ejecución continua: Integrated Visual and Auditory Continuous Performance Test (IVA/CPT) y TDAH. Una revisión , 2015 .

[22]  P. González-Castro,et al.  Attention Deficit Hyperactivity Disorder, differential diagnosis with blood oxygenation, beta/theta ratio, and attention measures , 2013 .

[23]  R. Adams,et al.  Distractibility in Attention/Deficit/ Hyperactivity Disorder (ADHD): The Virtual Reality Classroom , 2009, Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence.

[24]  P. González-Castro,et al.  EXECUTIVE FUNCTIONS IN CHILDREN AND ADOLESCENTS: THE TYPES OF ASSESSMENT MEASURES USED AND IMPLICATIONS FOR THEIR VALIDITY IN CLINICAL AND EDUCATIONAL CONTEXTS , 2014 .

[25]  M. L. Plume,et al.  SPSS (Statistical Package for the Social Sciences) , 2002, Encyclopedia of Information Systems.

[26]  L M Greenberg,et al.  Developmental normative data on the test of variables of attention (T.O.V.A.). , 1993, Journal of child psychology and psychiatry, and allied disciplines.

[27]  Jacob Cohen.  Statistical Power Analysis for the Behavioral Sciences , 1969, The SAGE Encyclopedia of Research Design.

[28]  P. Lachenbruch.  Statistical Power Analysis for the Behavioral Sciences (2nd ed.) , 1989 .

[29]  E. Barratt,et al.  Psychiatric aspects of impulsivity. , 2001, The American journal of psychiatry.

[30]  G. Salum,et al.  ADHD prevalence estimates across three decades: an updated systematic review and meta-regression analysis. , 2013, International journal of epidemiology.

[31]  Adrian Angold,et al.  Relations Between Continuous Performance Test Performance Measures and ADHD Behaviors , 2003, Journal of abnormal child psychology.

[32]  G. Gioia,et al.  Executive Function in the Real World: BRIEF Lessons From Mark Ylvisaker , 2010, The Journal of head trauma rehabilitation.