Effects of the ECogFun‑VR program on executive functioning in children and adolescents with ADHD: A randomized controlled trial
Abstract
BACKGROUND
Executive‑function (EF) difficulties, particularly in planning and organization, substantially limit daily‑life autonomy in children and adolescents with ADHD. Virtual reality (VR)-based interventions offer ecologically valid environments that may enhance strategy learning and promote functional generalization. This study evaluated the efficacy of ECogFun‑VR, a multimodal, manualized program integrating explicit EF strategy instruction with immersive VR practice.
METHODS
A parallel‑group randomized controlled trial was conducted with 80 participants aged 9-17 years diagnosed with ADHD. Participants were allocated to ECogFun‑VR (n = 38) or a waitlist control group receiving standard pharmacological care (n = 42). The intervention comprised 12 weekly individual sessions. Assessments were completed at baseline (T0) and post‑intervention (T1). Primary outcomes were functional planning and daily‑life performance (Zoo Map subtest, W‑ADL). Secondary outcomes included parent‑reported EF (BRIEF‑2), emotional competencies (EQ‑i:YV), temporal organization (Time‑S), sensory‑executive functioning (EPYFEI‑Escolar), and neuropsychological indices (WISC‑IV Digit Span; NEPSY‑II Auditory Attention; TMT; Stroop). Analyses followed an ANCOVA‑adjusted intention‑to‑treat approach, complemented by Complier Average Causal Effect (CACE) estimates.
RESULTS
No significant between‑group differences were found for primary outcomes (Zoo Map indices; W‑ADL). A significant improvement emerged…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 80 participants or records.
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