Two game-like, computerized devices are seeking FDA approval to make the diagnosis and treatment of ADHD—one of the most common childhood mental health concerns—a digital phenomenon.
For diagnosis, a virtual reality tool known as the Virtual Classroom was submitted to the FDA by technology company Cognitive Leap in late 2018. If granted approval, it will be the first fully immersive, VR program available to help doctors diagnose ADHD. On the treatment side, startup Akili Interactive recently submitted AKL-T01, a video game specifically designed to improve attention in children with ADHD. It would be the first video game that’s available only by prescription, like a traditional pharmacological intervention.
Commercial virtual reality regularly transports users to fictional worlds; Cognitive Leap’s VR Classroom generates a more realistic environment. After putting on the headset, a child finds himself somewhere he knows well: sitting at a desk in a classroom at school. Cars drive by outside; paper airplanes glide; classmates sneeze.
The Classroom offers more than immersive graphics, however. It measures attention and inhibition via a neuropsychological assessment called a continuous performance test (CPT). The Classroom aims to bring objectivity to a notoriously subjective diagnostic process.
Since symptoms can be intermittent and hard to quantify, current best practices rely on standardized rating scales filled out by parents and teachers to assess inattention and impulsivity in various domains. The scales require a significant time investment, and because they’re based on memory and subjective interpretations, ratings are subject to human error.
Cognitive Leap views VR as a game-changer, but it isn’t the first company that’s tried to upgrade assessment. Over the years, “there have been a number of attempts to bring in more objective diagnostic tools,” says David Rabiner, a psychologist who researches ADHD at Duke University. He points to simpler CPTs, as well as a quantitative EEG measure that uses brainwave patterns to assess attention levels. Although several of these secured FDA clearance, “none of them have been adopted in any meaningful way,” he says.
There was research at this time into video games that helped rather than harmed the brain—particularly a program called NeuroRacer, designed by neuroscientist Adam Gazzaley of the University of California, San Francisco to strengthen cognitive control. That program and others inspired Martucci and Akili cofounders to seek the first “digital treatment” for ADHD. AKL-T01 is their flagship product; similar games in the pipeline could one day target symptoms of autism, depression, and multiple sclerosis.
In many ways, Martucci notes, it’s been designed to “feel familiar” to a child and to play much like a commercial video game, with rewards, music, and high-quality graphics.
Martucci believes FDA approval will distinguish AKL-T01 from other “brain-training” programs claiming to improve attention, memory, or overall cognition. But not everyone is convinced such a distinction exists—at least, not without more evidence or full release of the data gathered so far.
Reflexive Analysis
Virtual reality is more than just interactive collaboration, it can be a tool of diagnosis as well! The technology is still relatively new, so we are observing people figure out how and where to use it most effectively. Using VR in unexpected ways is a surefire sign that this technology will continue to expand in many ways until it has become a social normality for all involved.
This article is relevant to my research because it opens the door to conversations about what else VR can be utilized for. Beyond Dominion Middle School, what Columbus communities could use the Hyve-3D for processes not previously thought about? What could the VR space inside the Hyve-3D bring to people that will help them recognize its use as a versatile tool? Is there room to be adaptable? Is it possible to prepare ahead of time for an inevitable technological advancement or technique improvement? Could the services the Hyve-3D offer one day include more grandiose goals, such as diagnosing neuro-atypical people?
Frye, Devon. "The Future of Focus." Psychology Today, American Psychological Association (APA), 15 Mar. 2019, www.psychologytoday.com/us/articles/201903/the-future-focus. Accessed 7 Sept. 2022.
