Virtual reality games, eye tracking and machine learning can be used to detect ADHD
Researchers have used virtual reality games, eye tracking, and machine learning to show that differences in eye movements can be used to detect ADHD, potentially providing a tool for more accurate diagnosis of attention deficits. His approach could also be used as the basis for ADHD therapy and, with some modifications, to test for other conditions, such as autism.
ADHD is a common attention disorder that affects around six percent of the world’s children. Despite decades of searching for objective markers, the diagnosis of ADHD is still based on questionnaires, interviews, and subjective observation. The results can be ambiguous, and standard behavior tests do not reveal how children handle everyday situations. Recently, a team of researchers from Aalto University, the University of Helsinki and Åbo Akademi University developed a virtual reality game called EPELI that can be used to assess ADHD symptoms in children by simulating everyday life situations. .
Now, the team tracked the children’s eye movements in a virtual reality game and used machine learning to look for differences in the children with ADHD. The new study involved 37 children diagnosed with ADHD and 36 children in a control group. The children played EPELI and a second game, Shoot the Target, in which the player is instructed to locate objects in the environment and “shoot” them by looking at them.
We tracked the children’s natural eye movements as they performed different tasks in a virtual reality game, and it turned out to be an effective way to spot ADHD symptoms. Children with ADHD gazed longer at different objects in the environment, and their gaze jumped more quickly and more frequently from one place to another. This could indicate a delay in the development of the visual system and a worse processing of information than other children.’
Liya Merzon, Doctoral Researcher, Aalto University
brushing teeth with distractions
Project leader Juha Salmitaival, an Aalto academic researcher, explains that part of the game’s strength is its motivational value. “This is not just a new technology to objectively assess ADHD symptoms. Children also find the game more interesting than standard neuropsychological tests,” he says.
Salmitaival conceived EPELI together with Professor Matti Laine of Åbo Akademi University and Erik Seesjärvi, PhD researcher at the University of Helsinki and clinical neuropsychologist at Helsinki University Hospital (HUH). The game is available to neuropsychologists working in pediatric neurology and pediatric psychiatry at HUH.
‘Those who are interested can use EPELI as an aid in their clinical work,’ says Seesjärvi. ‘The experience has been very positive. All neuropsychologists who responded to a feedback survey after the first pilot said they had benefited from using virtual reality methods as a complementary tool in their work.’
The development of the EPELI game was led by Topi Siro, an Aalto student who now works at Peili Vision Oy. ‘The game provides a list of tasks that simulate everyday life, such as brushing your teeth and eating a banana. The player has to remember the tasks despite distractions in the environment, such as the television on. The game measures everything: how much the child clicks on the controls and how efficiently he performs the tasks. Efficiency correlates with daily functioning, whereas children with ADHD are often challenged,” says Siro.
Motivation for rehabilitation.
The researchers envision broader therapeutic applications for virtual reality gaming. Beyond assessing symptoms, the games could also be used to aid ADHD rehabilitation. “We want to develop a game-based digital therapy that can help kids with ADHD get excited about doing things they wouldn’t otherwise do. There is already a game approved for ADHD rehabilitation in the US,’ says Salmitaival. The team is exploring rehabilitation possibilities in a project with researchers from the University of Oulu.
Linda Henriksson, a senior professor at Aalto University who was also involved in the study, points to the exceptional potential of virtual reality for such applications. “I see virtual reality as an interesting tool, because it can be used to precisely control what’s going on in the world of stimuli and at the same time collect information about behavior in a natural situation,” says Henriksson, an expert on how VR brain processes sight. information.
Researchers have already identified other potential applications for EPELI in assessing a wide range of difficulties with everyday challenges. For example, it could be used to measure activity planning problems and flexibility in people with autism. With modifications, this approach could also be used to assess for language problems, brain trauma, adult ADHD, cerebral palsy-related symptoms, and even memory decline with age. ‘Our partners in Geneva are studying diseases related to ageing. Key opportunities on the horizon include early detection of Parkinson’s and Alzheimer’s diseases,” says Salmitaival.
The research used the MAGICS infrastructure, a project led by Aalto that specializes in virtual technologies. The research was funded by the Academy of Finland, the Aalto Brain Center, and various foundations. The article was published in scientific reports.
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Magazine reference:
Merzon, L. et al. (2022) Eye movement behavior in a real world virtual reality task reveals ADHD in children. Scientific reports. doi.org/10.1038/s41598-022-24552-4.