Empowering Social Growth Through Virtual Reality–Based Intervention for Children With Attention-Deficit/Hyperactivity Disorder: 3-Arm Randomized Controlled Trial (Preprint)

Abstract

BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) usually begins in childhood and is often accompanied by impairments in social functioning. Virtual reality (VR) has emerged as an adjunctive tool to embed in social skills training to enhance the social skills of children with ADHD, but its effectiveness requires further investigation. OBJECTIVE This study aims to enhance the social skills of children with ADHD by examining the feasibility and effectiveness of VR-based training in comparison to traditional social skills training. METHODS A 3-arm randomized controlled trial was conducted with 90 children with ADHD aged 6-12 years. Participants were randomly assigned to 3 weeks of 12-session VR-based social skills training, traditional social skills training, or a waitlist control group of equivalent duration. Outcome measures included assessments by a clinical psychologist who was blinded to group assignments, the Social Skills Improvement System Rating Scale, the Behavior Rating Inventory of Executive Function, and the Simulator Sickness Questionnaire, conducted at baseline and after the intervention. RESULTS The preliminary results support the feasibility and acceptability of VR training for children with ADHD aged 6-12 years. Analysis showed that the VR and traditional social skills training groups experienced a statistically significant improvement in the clinical psychologist assessment of social skills and parent-rated self-control, initiative, and emotional control after the intervention compared with baseline. The VR group performed significantly better than the traditional social skills group on social skills assessed by clinical psychologists (<i>F</i><sub>2,85</sub>=76.77; <i>P</i><.001) and on parent-rated self-control (<i>F</i><sub>2,85</sub>=18.77; <i>P</i><.001), initiative (<i>F</i><sub>2,85</sub>=11.93; <i>P</i><.001), and emotional control (<i>F</i><sub>2,85</sub>=17.27; <i>P</i><.001). No significant between-group differences were found for parent-rated cooperation and inhibition (all <i>P</i>>.05). CONCLUSIONS The findings provide preliminary evidence supporting the feasibility and superior effectiveness of VR-based social skills training compared to traditional approaches for enhancing social skills and related executive functions in children with ADHD. These results suggest that VR may be a valuable tool to embed within social skills interventions for this population. Further research is warranted to explore the long-term impacts and generalizability of these benefits. CLINICALTRIAL ClinicalTrials.gov NCT05778526; https://clinicaltrials.gov/study/NCT05778526 INTERNATIONAL REGISTERED REPORT RR2-10.2196/48208