Skip to main content
OpenTrials
Recruiting

NCT Number: NCT06123741

Virtual Reality in Rehabilitation of Executive Functions in Children With Attention Deficit Hyperactivity Disorder.

Attention deficit hyperactivity disorder (ADHD) is caused by an abnormality in the development of the central nervous system. Children with attention and executive function difficulties often need long-lasting rehabilitation and there is an increasing need for timely, cost-effective, and feasible rehabilitation interventions, where the training is targeted to support everyday life functional capacity. The use of Virtual Reality (VR) in the rehabilitation of children with attention and executive function deficits offers opportunities to practice skills required in everyday life in environments emulating real-life situations.

The major aim of this research project is to develop a novel effective VR rehabilitation method for children with deficits in attention, activity control and executive functions by using the virtual environment that corresponds to the typical everyday life. In this randomized control study VR glasses are used to present the tasks, and the levels of difficulty are adjusted according to the child's progress.

Researchers expect that; 1) Intensive training improves the attention regulation, activity control skills and executive functions of the children in the intervention group; 2) Training of executive skills with motivating tasks in a virtual environment that is built to meet challenging everyday situations transfers to the child's everyday life, 3) The duration of the training effect does not depend on the success of the VR training itself, but on how well the child adopts new strategies that make everyday life easier and how the parent is able to support the child's positive behaviour in everyday life.

Recruiting

Interested in participating?

Request Info

Key information

Age range

8 year–12 year

Sex eligibility

All sexes

Study type

Interventional

Phase

Not applicable

Primary location

Oulu University Hospital

Oulu, 90029, Finland

Location status: Recruiting

Location contact

Johanna Uusimaa, MD, PhD

CONTACT

[email protected]

Johanna Uusimaa, MD, PhD

SUB_INVESTIGATOR

Merja Nikula, M.Psych.

CONTACT

[email protected]

Merja Nikula, M.Psych.

PRINCIPAL_INVESTIGATOR

Mirjami Mäntymaa, MD, PhD

SUB_INVESTIGATOR

Who can participate

Healthy volunteers accepted: No

Only the study team can determine whether someone qualifies for participation.

Inclusion criteria

  • Diagnosis of ADHD (ICD-10 F90.0) and
  • Methylphenidate medication and
  • Age 8-12 years and
  • Finnish as a native language

Exclusion criteria

  • Sensitivity to flashing light,
  • Epilepsy (ICD-10 G40),
  • Mental retardation (ICD-10 F70-F79),
  • Pervasive developmental disorders (ICD-10 F84),
  • Inflammatory diseases of the central nervous system (ICD-10 G00-G09),
  • Severe cerebral palsy syndrome (ICD-10 G80, GMFCS 4-5, MACS 3-5),
  • Traumatic brain injury ((ICD-10 S06),
  • Brain tumour, and
  • Multiple pregnancy

Treatment and study plan

Parental Guidance

Behavioral

Parents get guidance for children's positive behaviour support by using parts of Self-Help Program on the MentalHub.fi (in Finnish: Mielenterveystalo.fi) website regarding children's challenging behaviour (in Finnish: Lasten haastavan käytöksen omahoito-ohjelma) .

Other names: Self-Help Program of children's challenging behaviour (Program name in Finnish: Lasten haastavan käytöksen omahoito-ohjelma).

Virtual Reality Game

Behavioral

Virtual reality game for rehabilitation of attention, activity control and executive functions by using the virtual environment that corresponds to the typical everyday situations at home.

Primary outcomes

  1. Epeli (Executive Performance in Everyday LIving) task

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    A virtual reality task for attention, executive function, and prospective memory. Change in total score, task efficacy, navigation efficacy, controller motion, and total action.

  2. ADHD-rating scale IV (ADHD-RS) (parent report)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    The ADHD-RS (parent report) is an assessment of a child's ADHD symptoms with 18 items based on the child's behaviour over the past 6 months. 4-point Likert scale. The total score ranges 0-54, scores in inattention subscale and hyperactivity/impulsivity subscale range 0-27. Change in the total score, inattention subscale score, and hyperactivity/impulsivity subscale score on a parent-rated ADHD-RS. A lower score means a better outcome.

  3. Epeli Questionnaire (parent report)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    An assessment of a child's functional ability and the amount of positive feedback given by the parent to the child over the past 4 weeks. 5-point Likert scale. 2 subscales: Functional ability subscale where score ranges 4-20, and Positive feedback subscale where score ranges 4-20. Change in Functional ability subscale score and Positive feedback subscale score on parent-rated Epeli- questionnaire. A higher score means a better outcome.

  4. Epeli Questionnaire (child report)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    An assessment of a child's functional ability and the amount of positive feedback given by the parent to the child over the past 4 weeks. 5-point Likert scale. 2 subscales: Functional ability subscale where score ranges 4-20, and Positive feedback subscale where score ranges 4-20. Change in Functional ability subscale score and Positive feedback subscale score on child-rated Epeli- questionnaire. A higher score means a better outcome.

Secondary outcomes

  1. Behavior Rating Inventory of Executive Function (BRIEF-2) (parent form)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    A measure of executive functions of children and adolescents in natural settings containing 63 items rated by the parent. 3-point Likert scale. Change in Global Executive Composite score, Behavior regulation score, Emotion regulation score, and Cognitive regulation score on parent-rated BRIEF-2. In case the data in the Behavior regulation, Emotion regulation, and Cognitive regulation subscales are not too strongly correlated (r<0.7) and there will be a significant effect of the intervention on the BRIEF-2 Global Executive Composite score, we will use the subscales to conduct a post hoc analysis examining which domains of executive functions are affected. A higher score means a worse outcome.

  2. Behavior Rating Inventory of Executive Function (BRIEF-2) (teacher form)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    A measure of executive functions of children and adolescents in natural settings containing 63 items rated by the teacher. 3-point Likert scale. Change in Global Executive Composite score, Behavior regulation score, Emotion regulation score, and Cognitive regulation score on teacher-rated BRIEF-2. In case the data in the Behavior regulation, Emotion regulation, and Cognitive regulation subscales are not too strongly correlated (r<0.7) and there will be a significant effect of the intervention on the BRIEF-2 Global Executive Composite score, we will use the subscales to conduct a post hoc analysis examining which domains of executive functions are affected. A higher score means a worse outcome.

  3. Concentration questionnaire (in Finnish: Keskittymiskysely)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    An assessment of attention and executive function difficulties in school-aged children with 55 items. 3-point Likert Scale, Total score range 0-110. Change in Total score, Distractibility score (range 0-8), sum of Impulsivity and Motor hyperactivity subscales scores (range 0-32), sum of Directing, Sustaining and Shifting Attention subscales scores (range 0-30), and sum of Initiative, Planning, Execution and Evaluation of Action subscales scores (range 0-40) on teacher-rated Concentration questionnaire. In case the data in the Distractibility subscale, Impulsivity and Motor hyperactivity subscales, Attention subscales and Executive subscales are not too strongly correlated (r<0.7) and there will be a significant effect of the intervention on Concentration questionnaire Total score, we will use the subscales to conduct a post hoc analysis examining which domains of executive functions are affected. A higher score implies a worse outcome.

  4. Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents Revised Version ( KINDL-R) (parent version)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    An assessment of Health-Related Quality of Life in children and adolescents with 24 items. 5-point Likert scale. Change in Total score on parent-rated questionnaire. A higher score means a better outcome.

  5. Questionnaire for Measuring Health-Related Quality of Life in Children and Adolescents Revised Version (KINDL-R) (self-report version)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    An assessment of Health-Related Quality of Life in children and adolescents with 24 items. 5-point Likert scale. Change in Total score on child-rated questionnaire. A higher score means a better outcome.

  6. N-back test

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    A test for a working memory. Change in 2-back and 1-back hitrate and reaction time.

  7. The Conners Continuous Performance Test 3rd Edition (Conners CPT3)

    Time frame: Baseline, 4-6 weeks, 6 months and 12 months.

    A computerized attention task validated in individuals aged 8 years and older. Change in scores on Conners Continuous Performance Test (CPT-3).

Study contacts

Contact information is provided by the study sponsor or research team.

Johanna Uusimaa, MD, PhD

CONTACT

[email protected]

Merja Nikula, M.Psych.

CONTACT

[email protected]

+3588315 5218

Sponsors and collaborators

Lead sponsor

Merja Nikula

Other

Collaborators

  • Aalto University
  • Helsinki University Central Hospital
  • University of Helsinki
  • University of Oulu

Registry information

Official study title

Virtual Reality in Rehabilitation of Executive Functions in Children (VREALFUN)

Acronym: VREALFUN-ADHD

Important dates

Study start
2024
Primary completion
2025
Study completion
2025
First posted
Nov 9, 2023
Registry last updated
Sep 5, 2025

OpenTrials presents study information sourced from ClinicalTrials.gov. The official registry record should be consulted for the latest information.

View the official ClinicalTrials.gov record (opens in a new tab)

This listing is for discovery and informational purposes only. It is not medical advice, does not guarantee that a study is recruiting, and does not determine eligibility. Contact the study team and a qualified healthcare professional when considering participation.

Published trials that share one or more normalized conditions with this study.