RECENT RESEARCH
meta-analysis of the effects of AAIs in treating children with ADHD. We conducted a set of random-effects metaanalyses to estimate standardised mean differences( SMD) with 95 % confidence intervals( CI) using subgroup data by different outcome domains extracted from eight randomised controlled trials, in relation to changes in behavioural, mental and physical functioning in a total of 307 children with ADHD before and after the intervention.
Results: In comparison with non-AAI groups, AAIs significantly improved attention problems in children with ADHD( SMD =-0.42, 95 % CI =-0.71 to-0.13), self-esteem( 0.46, 0.14 to 0.78), learning and cognition problems(-0.69,-0.98 to-0.39) and motor proficiency( 0.77, 0.11 to 1.42). The pooled effect of AAIs on the severity of ADHD symptoms in the experimental group was not significantly different from the effect of conventional treatments in the control group( 0.10,-0.31 to 0.52). Similarly, AAIs had no significant positive effects on social interaction(-0.22,-0.51 to 0.06), social skills(-0.32,-0.87 to 0.24), problematic behaviours(-0.10,-0.54 to 0.35) or emotional problems, including depression and anxiety(-0.13,-0.51 to 0.24).
Conclusions: As an ADHD management strategy complementary to gold-standard approaches, such as medication or multimodal interventions, AAIs did not appear to be more effective in improving the majority of core
ADHD outcomes in children. Future studies should incorporate rigorous study designs with large sample sizes and a standard protocol to achieve more valid and reliable conclusion.
Martin-Moratinos M, Bella-Fernández M, Rodrigo-Yanguas M, González-Tardón C, Li C, Wang P, Royuela A, Lopez-Garcia P, Blasco- Fontecilla H. Effectiveness of a Virtual Reality Serious Video Game( The Secret Trail of Moon) for Emotional Regulation in Children With Attention-Deficit / Hyperactivity Disorder: Randomized Clinical Trial. JMIR Serious Games. 2025 Jan 8; 13: e59124. doi: 10.2196 / 59124. PMID: 39773848; PMCID: PMC11754979.
Background: Difficulties in emotional regulation are often observed in children and adolescents with attention-deficit / hyperactivity disorder( ADHD). Innovative complementary treatments, such as video games and virtual reality, have become increasingly appealing to patients. The Secret Trail of Moon( MOON) is a serious video game developed by a multidisciplinary team featuring cognitive training exercises. In this second randomized clinical trial, we evaluated the impact of a 20-session treatment with MOON on emotional regulation, as measured by the Strengths and Difficulties Questionnaire.
Objective: We hypothesize that patients with ADHD using MOON will show improvements in( 1) emotional regulation,( 2) core ADHD symptoms,( 3) cognitive functioning, and( 4)
academic performance, compared to a control group; additionally, we anticipate that( 5) changing the platform( from face-to-face using virtual reality to the web) will not affect emotional regulation scores; and( 6) the video game will not cause any clinically significant side effects.
Methods: This was a prospective, unicentric, randomized, unblinded, pre- and postintervention study with block-randomized sequence masking. Participants included individuals aged between 7 and 18 years who had a clinical diagnosis of ADHD and were receiving pharmacological treatment. They were randomized into 2 groups using an electronic case report form: the MOON group, receiving standard pharmacological treatment plus personalized cognitive training via a serious video game, and the control group, receiving standard pharmacological treatment. We provided both the groups with psychoeducational support on ADHD. Analysis was conducted using the Student 2-tailed t test and 2-factor ANOVA. An independent monitor supervised the study.
Results: A total of 76 patients with ADHD participated in the trial, with an equal randomization( MOON: n = 38, 50 % and control: n = 38, 50 %) and a total dropout rate of 7. The primary hypothesis, a 3- or 4-point reduction in the global Strengths and Difficulties Questionnaire score, was not met.
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