Exploring virtual reality based executive function training for primary-aged students with executive dysfunction: A mixed methods case series

Overview

Executive dysfunction in primary-aged students correlates with diminished academic performance and reduced psychosocial wellbeing. Virtual reality-based executive function training represents an emerging intervention modality, yet empirical evidence regarding its efficacy and mechanisms of action in children with executive dysfunction remains limited. This case series examined the experiential dimensions of VR-based executive function training, with particular attention to the constructs of presence and agency as potential mechanisms supporting learning outcomes.

Methods and approach

A mixed-methods case series design was implemented with four participants identified as experiencing executive dysfunction. The intervention consisted of twelve fifteen-minute sessions of VR-based training delivered over four weeks using the executive function training game Koji's Quest. Quantitative assessment of executive function was conducted via standardized testing at baseline and post-intervention. Qualitative data were obtained through participant feedback collected following each training session. Comparative analysis contextualized outcomes against a previously assessed neurotypical comparison sample. Thematic analysis of qualitative data informed interpretation of quantitative findings regarding changes in executive function, mindset, and motivation.

Key Findings

Participants demonstrated variable progress on objective executive function measures following the training protocol. Qualitative analysis suggested differential roles for presence and agency in shaping the learning environment for children with executive dysfunction. The VR-based context demonstrated feasibility as a delivery platform for executive function training in this population. Comparative analysis with neurotypical controls revealed distinct patterns of progress and engagement, suggesting potential differential responsiveness to the intervention by participant group.

Implications

Virtual reality environments may provide novel contextual advantages for executive function training in children with executive dysfunction, though mechanisms underlying differential outcomes require further investigation. The constructs of presence and agency warrant targeted examination as potential moderators or mediators of training efficacy, suggesting that intervention design should explicitly consider how immersive technologies support the subjective experience of embodied agency and environmental presence. Future research should employ larger sample sizes, more rigorous control conditions, and longitudinal follow-up to establish the durability and generalizability of VR-based executive function interventions.