Virtual Reality Assessment of Classroom - Related Attention: An Ecologically Relevant Approach to Evaluating the Effectiveness of Working Memory Training.

Benjamin Coleman,Anne Nolty,Janiece Turnbull,Sarah Marion,Albert Rizzo

doi:10.3389/fpsyg.2019.01851

Abstract

Computerized cognitive interventions to improve working memory also purport to improve ADHD-related inattention and off task behavior. Such interventions have been shown to improve working memory, executive functioning, and fluid reasoning on standardized neuropsychological measures. However, debate continues as to whether such programs lead to improvement on ecologically relevant outcomes, such as classroom behavior. This study sought to propose a novel, ecologically relevant approach to evaluate the effectiveness of working memory training on real-world attention performance. Participants included 15 children, aged 6–15, identified as having attention problems were assessed via the virtual classroom continuous performance task (VCCPT) before and after completing 5 weeks of Cogmed working memory training. The VCCPT is a validated measure of sustained and selective attention set within a virtual reality (VR) environment. Several key areas of attention performance were observed to improve, including omission errors, reaction time, reaction time variability, and hit variability. Results suggest that working memory training led to substantial improvements in sustained attention in a real-life scenario of classroom learning. Moreover, the use of psychometrically validated VR measurement provides incremental validity beyond that of teacher or parent report of behavior. Observing such improvements on ecologically relevant measures of attention adds to the discussion around how to evaluate the effectiveness of working memory training as it pertains to real-life improvements and serves to inform consumer awareness of such products and their claims.

Highlights

Virtual reality (VR) provides an exciting medium in which to gather evidence for ecological relevance that goes beyond traditional cognitive assessment (e.g., Schultheis and Rizzo, 2001; Rizzo and Koenig, 2017), enabling researchers to observe behaviors in simulated real life settings with participants less aware of the examiner while immersed in the simulated environmentVirtual Reality (Draeger et al, 1986; Baumgartner et al, 2008)
The virtual classroom has the potential to measure the ability of cognitive training to improve attention by approximating a scenario in which attention, working memory, and executive abilities can be measured in an environment comparable to what is experienced by the subject in the real world
15 participants completed the working memory subtests of the WISC-IV and pre- and post-assessments, 2 participants were not included in the virtual classroom data analysis due to non-compliance with task directions on the virtual classroom, and 2 participants were omitted from the working memory measure analysis due to missing data

Summary

Introduction

Virtual reality (VR) provides an exciting medium in which to gather evidence for ecological relevance that goes beyond traditional cognitive assessment (e.g., Schultheis and Rizzo, 2001; Rizzo and Koenig, 2017), enabling researchers to observe behaviors in simulated real life settings with participants less aware of the examiner while immersed in the simulated environmentVirtual Reality (Draeger et al, 1986; Baumgartner et al, 2008). The virtual classroom (Rizzo et al, 2000), a CPT embedded within a virtual environment, depicts a real-life setting more accurately than traditional designs. In this virtual scenario, the user must respond to stimuli as viewed on the chalkboard from his or her desk chair while resisting distractions typical of an academic setting (e.g., peers throwing paper airplanes, whispering, and windows through which traffic can be seen and heard). Research using the virtual classroom has shown that children with ADHD attend to distractions on 25% of the trials that they miss, as compared to only 1% for the control group (Parsons et al, 2007). The virtual classroom has the potential to measure the ability of cognitive training to improve attention by approximating a scenario in which attention, working memory, and executive abilities can be measured in an environment comparable to what is experienced by the subject in the real world

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