A Feasibility and Efficacy Study of NeuroTrainer Cognitive Training in Students With and Without Attention-Related Difficulties

Abstract Attention Deficit Hyperactivity Disorder (ADHD) affects approximately 11% of children and adolescents, leading to impairments in cognitive functions and decreased academic performance. Cognitive training presents a promising non-pharmaceutical intervention for ADHD, although the benefits often exhibit limited transfer to real-world tasks. This study aims to address this gap by testing a virtual reality (VR) cognitive training approach called NeuroTrainer, which integrates physical activity, prolonged training near performance threshold, and variability in task dynamics and demands. These factors are shown to be key for transfer success in diverse populations. VR technology provides immersive, ecologically valid, and physically engaging environments that motivate and engage students' attention. Preliminary testing of NeuroTrainer has shown feasibility in school-based settings and potential efficacy for students at risk for ADHD. The current proposal seeks to develop a commercially viable VR cognitive training intervention for students with ADHD and aligned with National Institute of Mental Health (NIMH) strategies and funding topics. The study will focus on improving attentional and executive control function (Aim 1), evaluating efficacy of NeuroTrainer to engage the target of ADHD inattention symptoms (Aim 2), and demonstrate transfer of skill with improvement in academic behaviors (Aim 3) within a sample of 155 students in school settings. The primary outcome measures are effect sizes for attentional and executive control function, clinical inattention symptoms, and academic behaviors (classroom engagement and attentiveness) in both ADHD and non-ADHD groups. By leveraging VR technology, this study aims to contribute to the development of an innovative, accessible, and effective intervention for ADHD students and a supplementary tool for others, with potential for broad dissemination and applicability in diverse contexts.