Can social robots and brain-computer interface video games help manage ADHD?

In a systematic review published in the journal Brain Sciences, scientists have discussed the utility and usefulness of social robots and brain-computer interface video games in treating young people with attention deficit hyperactivity disorder (ADHD).  

Background

Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental psychiatric disorder characterized by a lack of attention, impulsivity, and hyperactivity. In children, ADHD can result in poor tolerance, mood change, and low self-esteem. If the condition persists into adulthood, it can potentially increase the risk of substance abuse, self-harm, and suicide tendency.

Therapeutic interventions for ADHD include pharmacological, behavioral, cognitive, and psychological treatments. Novel technologies have been developed with the aid of computer science to deal with ADHD, including social robots, brain-computer interface (BCI) video games, virtual reality, augmented reality, eye trackers, and artificial intelligence.

Social robots and BCI video games are used during therapy sessions to make them more attractive to children, which helps improve their motivation. BCI video games also offer cognitive and neurofeedback training to children living with ADHD.

In particular, social robots are used to help children with homework activities and support therapists by automating the supervision, coaching, motivation, and companionship aspects of interactions with children living with ADHD.    

Social robots and BCI video games to manage children with ADHD

A total of 17 studies investigating the impact of social robots on children and adolescents with ADHD were included in this systematic review. Similarly, a total of 19 studies related to the application of BCI video games for ADHD therapy were included. Both healthcare and engineering aspects of the applied technologies were assessed in the review.

The types of applications used in selected studies were categorized into three groups. The first group included applications related to rehabilitation therapies; the second group included applications related to ADHD diagnosis; and the third group included applications related to neuroscience research. One of the applications included in the second group reported having 97% confidence in diagnosing ADHD.

The most common robots used in robot-based applications were humanoid robots such as Nao, Silbot, Robotis Bioloid, Pepper, Sanbot Elf, and Ifbot. Among real, virtual, and hybrid environments used in these applications, the usage of real environments was the highest. In BCI-based video game applications, 3D, 2D, virtual reality, and mixed reality environments had the highest usage.

The studies related to healthcare applications of social robots and BCI-based video games primarily focused on the effectiveness of applications and their usefulness in supporting neuroscience research. In addition, one study investigating acceptability levels reported positive acceptance of BCI-based video game applications by children with ADHD.

In studies investigating healthcare effectiveness, social robot- and BCI video game-based applications were mainly designed to reduce attention deficit and improve learning, writing, spatial memory, working memory, communication, and interaction skills in children with ADHD.

The majority of applications used in these studies were in the developing and testing phases. Only two applications, namely Focus Pocus and EndeavorRx, were commercialized and prescribed for treating children with ADHD.

About 88% of robot-based applications were tested on young people with ADHD. Moreover, some of these applications were tested on young people with ADHD who had additional developmental disabilities, including autism spectrum disorder, oppositional defiant disorder, cerebral palsy, or learning disability.     

These applications were tested for different purposes, including functional validity and healthcare benefits. Overall, studies related to social robot-based applications reported promising outcomes in children with ADHD.

Studies related to BCI-based video games had evaluated the effectiveness and usability of the applications among healthy children and those living with different levels of ADHD. In one study, a BCI-based video game application showed higher effectiveness in maintaining attention compared to the most commonly used cartoon-based neurofeedback system.

Other comparison studies showed that both pharmacological interventions and BCI-based video game applications have similar effectiveness in reducing inattentive symptoms in children with ADHD. Studies involving healthy children showed that BCI-based video game applications can improve attention levels in both healthy and ADHD children.

Potential challenges

By analyzing all selected studies, this systematic review identified certain challenges for developing computational applications based on social robots or BCI video games to treat ADHD. 

Because of individual-level variability in ADHD symptoms, it could be challenging to develop a general application for diagnosing people with different forms of ADHD. Another challenge is to customize cognitive training applications according to the characteristics of each person.

Proper safe control measure is an important parameter to consider while developing robot-based applications. This is particularly essential to avoid physical harm during human-robot interactions.

At the ethical level, it is important to make sure that the applications do not compromise the social–emotional development of children. 

Written by

Dr. Sanchari Sinha Dutta

Dr. Sanchari Sinha Dutta is a science communicator who believes in spreading the power of science in every corner of the world. She has a Bachelor of Science (B.Sc.) degree and a Master's of Science (M.Sc.) in biology and human physiology. Following her Master's degree, Sanchari went on to study a Ph.D. in human physiology. She has authored more than 10 original research articles, all of which have been published in world renowned international journals.