The study aims to explore whether the treatment using fNIRS-based neurofeedback training for children with attention-deficit/hyperactivity disorder (ADHD) is useful. Furthermore, the study hopes to evaluate whether the use of virtual reality (VR) technology will have an impact on the treatment's effectiveness. The program includes the following components: Participants will be randomly assigned to one of three intervention groups: the neurofeedback with virtual reality (VR) group, the 2D neurofeedback group (with no VR technology applied), and the VR without neurofeedback group. All participants will complete academic-related tasks in simulated lessons. Participants in the VR neurofeedback group will wear VR goggles and a neurofeedback device that measures blood oxy-hemoglobin levels in brain cortical tissue and provides feedback via visual images or auditory sounds to the participants. Those in the 2D neurofeedback group will use a computer to complete the tasks, with all other settings (e.g., neurofeedback settings) remaining the same. The VR without neurofeedback group will wear VR goggles to complete tasks, but without the neurofeedback component. All participants will complete a total of 16 training sessions over 8 weeks (twice a week), with each session lasting approximately 35 to 60 minutes. To investigate the intervention's effectiveness, children will be asked to complete a set of cognitive tests covering inhibitory control, attention, and working memory before the intervention (i.e., Time 1), immediately after the 8-week training (i.e., Time 2), and 2 months after the training (i.e., Time 3, a 2-month follow-up). The assessment will take around 1 hour and will be conducted at the laboratory at the University of Hong Kong. Additionally, parents and teachers will be asked to complete a questionnaire assessing children's behavior at home and at school at three time points.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
TREATMENT
Masking
NONE
Enrollment
110
fNIRS-based neurofeedback is provided during a simulated classroom scenario where the child participants are asked to learn to regulate their attention based on the feedback provided by the fNIRS on the oxygenated haemoglobin level in their prefrontal cortex.
A simulated classroom scenario is integrated in VR setting and children are asked to complete academic tasks in the simulated classroom.
The University of Hong Kong
Hong Kong, Hong Kong
Children's ADHD symptoms
Parents will be asked to complete the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV) measuring children's inattentive, hyperactive and impulsive symptoms with a 4-point Likert scale (ranges from 0 to 3). The minimum total score is 0 while the maximum total score is 78, with a higher score indicating a higher level of inattentive, hyperactive and impulsive symptoms.
Time frame: Pre-intervention Assessment (within 4 weeks before the commencement of the intervention)
Children's ADHD symptoms
Parents will be asked to complete the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV) measuring children's inattentive, hyperactive and impulsive symptoms with a 4-point Likert scale (ranges from 0 to 3). The minimum total score is 0 while the maximum total score is 78, with a higher score indicating a higher level of inattentive, hyperactive and impulsive symptoms.
Time frame: Immediate Post-intervention Assessment (within 4 weeks after the completion of the intervention)
Children's ADHD symptoms
Parents will be asked to complete the Swanson, Nolan, and Pelham Version IV Scale (SNAP-IV) measuring children's inattentive, hyperactive and impulsive symptoms with a 4-point Likert scale (ranges from 0 to 3). The minimum total score is 0 while the maximum total score is 78, with a higher score indicating a higher level of inattentive, hyperactive and impulsive symptoms.
Time frame: Delayed Post-intervention Assessment (a 2-month follow up after the completion of the intervention)
Conners Continuous Performance Test 3rd Edition (CPT 3)
A standardized computerized test on sustained attention and inhibitory control
Time frame: Pre-intervention Assessment (within 4 weeks before the commencement of the intervention)
Conners Continuous Performance Test 3rd Edition (CPT 3)
A standardized computerized test on sustained attention and inhibitory control
Time frame: Immediate Post-intervention Assessment (within 4 weeks after the completion of the intervention)
Conners Continuous Performance Test 3rd Edition (CPT 3)
A standardized computerized test on sustained attention and inhibitory control
Time frame: Delayed Post-intervention Assessment (a 2-month follow up after the completion of the intervention)
Functional NIRS
The levels of oxygenated and deoxygenated hemoglobin of the prefrontal cortex will be measured during the direct assessment task of Conners Continuous Performance Test 3rd Edition (CPT3) using functional NIRS.
Time frame: Pre-intervention Assessment (within 4 weeks before the commencement of the intervention)
Functional NIRS
The levels of oxygenated and deoxygenated hemoglobin of the prefrontal cortex will be measured during the direct assessment task of Conners Continuous Performance Test 3rd Edition (CPT3) using functional NIRS.
Time frame: Immediate Post-intervention Assessment (within 4 weeks after the completion of the intervention)
Functional NIRS
The levels of oxygenated and deoxygenated hemoglobin of the prefrontal cortex will be measured during the direct assessment task of Conners Continuous Performance Test 3rd Edition (CPT3) using functional NIRS.
Time frame: Delayed Post-intervention Assessment (a 2-month follow up after the completion of the intervention)
Number subtest of Children's Memory Scale (CMS)
A verbal working memory test using digit span, with a higher score indicating a higher level of verbal working memory. The total score of this test ranges from 0 to 30.
Time frame: Pre-intervention Assessment (within 4 weeks before the commencement of the intervention)
Number subtest of Children's Memory Scale (CMS)
A verbal working memory test using digit span, with a higher score indicating a higher level of verbal working memory. The total score of this test ranges from 0 to 30.
Time frame: Immediate Post-intervention Assessment (within 4 weeks after the completion of the intervention)
Number subtest of Children's Memory Scale (CMS)
A verbal working memory test using digit span, with a higher score indicating a higher level of verbal working memory. The total score of this test ranges from 0 to 30.
Time frame: Delayed Post-intervention Assessment (a 2-month follow up after the completion of the intervention)
Behavioural ratings on children's executive functions
Parents and teachers will be asked to complete Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) measuring a range of executive functions, including behavioural, emotional and cognitive regulation
Time frame: Pre-intervention Assessment (within 4 weeks before the commencement of the intervention)
Behavioural ratings on children's executive functions
Parents and teachers will be asked to complete Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) measuring a range of executive functions, including behavioural, emotional and cognitive regulation
Time frame: Immediate Post-intervention Assessment (within 4 weeks after the completion of the intervention)
Behavioural ratings on children's executive functions
Parents and teachers will be asked to complete Behavior Rating Inventory of Executive Function, Second Edition (BRIEF2) measuring a range of executive functions, including behavioural, emotional and cognitive regulation
Time frame: Delayed Post-intervention Assessment (a 2-month follow up after the completion of the intervention)
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