Quantifying ADHD symptoms in open-ended everyday life contexts with a new virtual reality task

Abstract

Objective: In the assessment of attention deficit hyperactivity disorder (ADHD) there is a need for methods that would reflect ADHD symptoms in naturalistic yet controlled situations objectively. Method: We developed a novel virtual reality task, EPELI (Executive Performance in Everyday LIving), and used it to quantify goal-directed behavior in ADHD children (n = 38) and typically developing controls (n = 38) in everyday home situations. Results: The ADHD group exhibited higher percentage of irrelevant actions out of all actions, reflecting lower attentional-executive efficacy, and more controller movements and more total game actions, both indicative of hyperactivity-impulsivity. Five main EPELI measures combined exhibited excellent discriminatory ability, with area under curve being 88 %. The efficacy measure of EPELI was strongly correlated with parent evaluations of everyday executive problems (r = .57) and ADHD symptoms (r = .55). Conclusion: Virtual reality assessment can successfully quantify ADHD symptoms in a rich naturalistic context.