Virtual reality might one day be the preferred method of diagnosing and rehabilitating attention deficit hyperactivity disorder (ADHD) among students, according to a researcher from the University of Southern California who is investigating the use of virtual reality therapy in a number of clinical applications.
From diagnosing Alzheimer’s disease to distracting burn victims from their pain during treatment to curing phobias, virtual reality might have a future in psychology, said Albert Rizzo, assistant research professor at the university’s Integrated Media Systems Center. It might even help children with ADHD, he said.
For this ADHD diagnosis, a child sits at a physical desk wearing a head-mounted virtual display. When the child looks down, he sees himself sitting at a computer-generated desk in a computer-generated classroom.
Similar to video games, the classroom imagewhich appears three-dimensionalis complete with desks, a chalkboard, a doorway, and a window that overlooks a playground and the street.
A virtual teacher conducts basic lessons at the front of the class. Standing by the blackboard, she says to the class, “This is a cat,” and a picture appears. The child has to agree or disagree.
“We have your basic listen, look, respond test,” Rizzo said.
This virtual classroom also has typical auditory and visual distractionssuch as a paper airplane flying across the room, coughing noises, someone entering the room, or a car driving by the windowwhich the tester can control and measure.
“The child is supposed to be focused on the board, but if one of these distractions happens, then [the students] are looking out the window and lost in their own world,” Rizzo explained.
Generally, tests for ADHD involve behavior observation or questionnaires, with no direct control over the stimuli, he said. Because virtual-reality technology is immersive, interactive, and computer-generated, the tester can control the environment completely.
“Like an aircraft simulator, this virtual environment helps assess real environments,” Rizzo said. “We can systematically deliver auditory or cognitive challenges through the device while the child has to sit and experience the systematic distractions.”
The technology also can distinguish between video and audio distractions.
“It’s a psychologist’s dream to be able to systematically record reaction to controlled stimuli in an automated environment,” Rizzo said.
So far, he has tested this procedure on 11 kids, with no typical virtual-reality side effects like claustrophobia or nausea.
“We’ve shown that it is usable. The next stage is to show if it is useful. That’s where we are now,” Rizzo said. He plans to begin initial trials to test group performance in this environment.
“I can’t say how this will pan out over the long run,” Rizzo said. “But, logically and rationally [virtual reality environments] will be better at testing and assessing.”
Not everyone agrees, however.
“The only problem I have with this test is that it is a ‘here and now’ test,” said Dr. Larry B. Silver, clinical professor of psychiatry at Georgetown University Medical Center.
He is concerned this test will show that the subject is temporarily distracted by noises and is impulsive, and it will ignore the chronic and pervasive components of the disorder.
According to Silver, the signs of ADHDinattention, impulsiveness, and hyperactivityshow before age 6. “ADHD is something you’re born with, so it’s always been there,” he said.
Although ADHD is diagnosed and treated by physicians, teachers often recognize it and notify parents. Since ADHD is chronic and pervasive, doctors try to identify the pervasiveness of the symptoms by piecing together the observations teachers, coaches, and parents make throughout the child’s life.
Others say Rizzo’s approach is impractical, because virtual-reality equipment still is so expensive.
“There’s a lot of glitz here and very little substance,” said Chris Dede, the Timothy Worth professor of learning technology at Harvard’s Graduate School of Education. “This is something that can be done much more cheaply than using virtual reality.”
He said, “I’m not an expert about ADHD, but I know a little bit about it. I can think of cheaper ways to control distractions than using virtual reality.”
Dede said virtual-reality technology would better serve education by demonstrating intangible concepts such as force and gravitythings that cheaper technology isn’t successful at showing.
In response, Rizzo said the virtual reality application “is not meant to eliminate all other forms of assessment … .rather, it is one more tool that may add information to this process.”
Also, cost is not the issue at this stage in the experiment, Rizzo said: “We are developing a prototype system to demonstrate proof of concept–eventually this technology will be affordable. Remember when VCRs cost $400?”
Whether approached via virtual reality or more traditional means, ADHD continues to be a problem in schools, because of its significant impact on kids’ ability to learn.
“ADHD kids are overly sensitive in taking in that kind of stimuli and they just don’t pay attention,” said Ann Koranbelt, executive director of the Learning Disabilities Association. “In schools, that’s where the problem is.”
ADHD students get up to sharpen pencils or go to the bathroom, talk, and look out the window, she said.
Rizzo is hopeful that, in a few years, his research in diagnosing ADHD using virtual reality will be more affordable, accessible, accurate, and helpful.
“We can now use this technology for more than just entertainment,” he said.
Rizzo published a paper about his research, called “The Virtual Classroom: A Virtual Reality Environment for the Assessment and Rehabilitation of Attention Deficits,” in CyberPsychology and Behavior, a bimonthly peer-reviewed journal that explores the impact of the internet, multimedia, and virtual-reality technology on behavior and society.
USC’s Integrated Media Systems Center
Georgetown University Medical Center
Learning Disabilities Association
CyberPsychology and Behavior