Enhancing academic engagement in college students with ADHD through virtual reality: A randomized controlled trial using ecologically valid study contexts

Virtual reality (VR) technology offers a novel and scalable approach to support the attention, motivation, and effort of individuals with ADHD completing less engaging or aversive tasks over longer periods of time, such as homework or studying. VR can remove external distractions and provide frequent and consistent feedback to promote sustained attention and improved task performance. This pilot randomized trial examined the effects of immersion in a distraction-free VR environment and continuous behavioral feedback on students' attention. Forty-nine college students with ADHD ages 18-25 (M = 21.13, 51.9% female) were randomized into three groups: (1) VR in passthrough mode (no virtual environment), (2) VR with a virtual study environment, and (3) VR with a virtual study environment plus real-time attention feedback. Primary outcomes included self-reported concentration problems, effort, and motivation. Secondary outcomes included reading comprehension performance and attention assessed via computer activity. Repeated measures ANOVAs and paired t-tests indicated all groups improved on some metrics. However, the virtual study environment with feedback condition yielded the largest and most consistent effects on effort, motivation, and concentration, was the only condition to improve in reading comprehension accuracy, and achieved the highest computer-activity based attention score (95%). Acceptance was high with 81% of participants reporting they would recommend VR to other students. VR with real-time feedback may provide an effective and acceptable intervention to enhance the attention of individuals with ADHD during academic and work-related tasks. By embedding adaptive attention signaling, this approach applies principles of behavioral feedback through automated attention signaling.