The BlockQuest Game: Digital Behavioral Phenotyping of ADHD Using Embodied Serious Game in VR

The BlockQuest game introduces a novel, embodied virtual reality (VR) paradigm designed to improve the digital behavioral phenotyping of Attention-Deficit/Hyperactivity Disorder (ADHD). The core thesis posits that traditional, outcome-oriented assessments fail to capture the real-time interaction between perception, cognition, and motor processes. By shifting from stationary, rule-based testing to an immersive, embodied environment that requires physical locomotion and spatial interaction, the game provides a more accurate reflection of how individuals with ADHD navigate daily life.

The methodology centers on a serious game designed for school-aged children and adults, featuring five levels of increasing cognitive and motor complexity. Within a 320 cm by 406 cm play boundary, participants engage in block-construction tasks that require information searching, strategic planning, and working memory. The system utilizes head-mounted displays and computer vision to record high-dimensional data, including eye gaze, body and hand positioning, and object dynamics. This approach moves beyond simple reaction times or final scores, instead analyzing the moment-to-moment behavioral patterns that characterize ADHD, such as foraging tendencies, motor variability, and organizational inefficiencies.

By integrating these diverse measurements into a single, engaging platform, the paradigm addresses significant limitations in current diagnostic tools, such as the ceiling effects and lack of ecological validity found in traditional Continuous Performance Tests. The game serves as a modernized tool for identifying developmental trajectories and underlying mechanisms of ADHD, offering a more nuanced understanding of how cognitive and motor deficits manifest in active, goal-oriented environments. This research underscores the potential for VR-based serious games to transform neurodevelopmental assessment by grounding cognitive evaluation in physical experience.