Background: VR Therapy and ADHD
Virtual Reality Exposure Therapy (VRET) is an established method in anxiety and trauma therapy, where patients are gradually exposed to anxiety-provoking stimuli in virtual environments. In the context of Attention Deficit/Hyperactivity Disorder (ADHD), the evidence for traditional exposure therapy is still thin. The majority of VR research on ADHD focuses more on cognitive training, diagnostics, and "exergaming" rather than explicit exposure. Nevertheless, there are initial projects that use VR to teach individuals with ADHD how to manage distracting stimuli, which is similar to an exposure approach. These early works suggest that VR-supported attention exercises in realistic scenarios are indeed feasible and promising. However, there is still a lack of extensive controlled studies with long-term follow-up.
VR Exposure Approaches in ADHD: Current Studies
A example of a VR-based exposure approach is the “Virtual Reality Attention Management (VRAM)” program at UC Davis. Here, the aim is to make children with ADHD less sensitive to everyday distractions in VR through repeated confrontation with these stimuli. “Our intervention uses a virtual reality environment to train resistance to common distractions (e.g., the ticking of a clock or the chatter of colleagues),” explains the study description. (Schweitzer et al., VRAM). This VR setting is based on principles of habituation and is designed to help ADHD patients better filter out distracting noises and visual distractions..
A similar direction is being pursued by a current pilot RCT involving young adults (18–25 years) with ADHD: In this Rutgers study (NCT06454604) College students are learning to focus while studying by completing homework in a VR environment. Three groups are compared: a VR environment without feedback, VR with concentration feedback, and a control group with "VR Passthrough," meaning the real environment is visible through the headset. The goal of this pilot study is to test the effects of a VR program that improves the ability of young adults with ADHD to concentrate while completing homework and studying. Objective performance data (keyboard/mouse activity) and subjective concentration ratings are collected to see if VR-supported learning increases attention and is preferred by users over traditional learning. Both projects are still ongoing, but they show that VR exposure to distracting stimuli is being seriously researched as a therapeutic element for ADHD..
Efficacy of VR Interventions for ADHD: Reviews 2024/2025
Even though dedicated VRET studies on ADHD are rare, there are now several review articles on VR interventions (of a general nature) for ADHD. A meta-analysis of Zheng et al. (2025) summarized 11 RCTs with 640 children and found a moderate effect of VR-based interventions on attention deficits (Standardized Mean Difference ~ -0.33). However, the authors emphasize that "VR-based interventions show potential in alleviating attention deficits in children with ADHD. However, study heterogeneity and limited long-term data warrant caution" – in other words: The existing study results are promising but inconsistent, and there is a lack of robust long-term data..
Another systematic review byYu et al., 2024 examined 9 RCTs (370 children) and confirmed significant improvements through VR in ADHD: “VR technology can improve ADHD children’s attention (Cohen d = –0.68… p<.001) and motor ability (Cohen d = 0.48… p<.001). Attention, in particular, could be increased moderately to significantly (d≈0.6–0.7 corresponds to a medium effect). However, the authors rated the quality of this evidence as low due to study limitations – for both attention and motor skills, the GRADE framework only provided “low quality evidence.” This supports the assessment that more high-quality, large studies are needed before VR interventions can be routinely used in ADHD therapy..
Even beyond pure attention training therapies, the benefits of VR are evident: Sun et al. (2025) focused on VR-based physical training (“exergaming”) for adolescents with ADHD. In their review (6 studies, n=192), they found that “VR-supported training with moderate to high intensity has positive effects on several subdomains of executive functions (inhibitory control, attention, working memory, shifting, and planning) and clinical symptoms in young people with ADHD. Furthermore, fully immersive and semi-immersive VR-based exercise interventions yielded similar results. In other words, virtual sports and movement offerings can improve executive functions such as inhibition, working memory, and cognitive flexibility, as well as reduce ADHD symptoms. Interestingly, fully immersive 3D VR and simpler semi-immersive systems were similarly effective. The authors conclude: “VR-supported training effectively improves executive functions and is feasible for young people with ADHD, with benefits observed across all age groups and in sessions longer than 30 minutes. Therefore, sessions of at least 30 minutes seem reasonable, and the approaches are well implementable across age groups..
A comprehensive scoping review of Sarai et al. (2025) illuminated both VR and simulator-based exercises for ADHD. It found that such technologies can enhance not only cognitive functions but also the motivation and therapy adherence of users. At the same time, there are technical and individual adaptation barriers (e.g., limited personalization, technical equipment) that still need to be addressed. The authors advocate for "participant-centered approaches" that integrate both cognitive and motor therapy goals and are tailored to the needs of users. Long-term data is also lacking here – many studies had short follow-up periods, which leaves the sustainability of the VR effects unclear..
Overall, the current reviews paint a picture that VR interventions for ADHD can achieve short-term measurable improvements in attention and executive functions, although they are heterogeneous in method and quality.
VR in ADHD Diagnosis: Outlook for Exposure
Currently, researchers are even combining immersive scenarios with eye tracking, motion sensors, and EEG to objectively identify ADHD.. Wiebe et al. (2024) developed a VR seminar room where adults with and without ADHD work on tasks with distracting stimuli, while simultaneously measuring gaze behavior, head movements, brain activity, and behavior. A machine learning model achieved an impressive accuracy rate of 81% in distinguishing between ADHD and healthy adults. This state-of-the-art VR diagnostics demonstrates how mature immersive technologies have become in capturing attention responses in a realistic manner. Such VR setups could also be used therapeutically, for example, to specifically distract patients and practice their attention control (exposure to distracting stimuli followed by feedback)..
Conclusion and Outlook
Pure VRET protocols for ADHD are still in their early stages, but VR-supported distraction exposure and attention exercises are gaining importance. Ongoing studies such as the VRAM project or the Rutgers VR study are applying classical exposure principles in the context of ADHD. Initial reviews show moderate effects of VR interventions on attention and executive functions, but also point to heterogeneous findings, small sample sizes, and low evidence quality. Therefore, larger, methodologically robust RCTs with longer follow-up are necessary to confirm effectiveness..
For therapists, this means: VR technology is making its way into ADHD treatment, primarily as a supplementary training tool in realistic scenarios such as virtual classrooms. The potential lies in graduated distraction exposure, high acceptance among young patients, and objective measurement data for monitoring progress. However, before widespread application, questions regarding technology, training, and standardized protocols still need to be addressed. It will be crucial to determine whether the positive pilot findings can be confirmed in larger studies. If so, VR could soon become a permanent component of multimodal ADHD therapy..
