The objective measures of effect used to assess the effect of the intervention were Conners’ Continuous Performance Test (CPT) and the Virtual Classroom Task Assessment (VCTA). The CPT assesses sustained attention and vigilance for a simple task over a time interval [12]. It can be used in children aged four years to adulthood. The child must press a key when a letter appears on the computer screen, except when it is the letter “X”. The test lasts approximately 14 min. There are 324 non-X stimuli interspersed with 36 X stimuli, presented in blocks of trials with interstimulus intervals of 1, 2, and 4 s, which vary between blocks. Results for CPT performance include number of hits, number of omission errors, number of commission errors, hit reaction time (RT), perceptual sensitivity (d’), and response bias (B). The omissions refer to the lack of response to the target stimuli. Therefore, omissions indicate inattention, which can be motivated by a temporary lack of response or by looking away when the stimuli are presented. Commission errors, which refer to the responses given to stimuli other than the target stimulus, are caused by the inability to inhibit motor responses as a consequence of an impulsive response trend. Perceptual sensitivity (d’), which refers to errors due to difficulties in the discrimination of perceptual characteristics, is related to selective attention. Response bias (B) represents an individual’s response tendency.

The VCTA [13] is based on a continuous performance test and consists of a virtual system that uses a head-mounted display (HMD) that recreates a classroom with three rows of desks, a blackboard, and the teacher’s desk. One of the sides of the classroom is a window that overlooks a playground with buildings, vehicles, and people, while the other three sides are walls. The virtual teacher instructs the children to press the mouse when they see the letter “K” preceded by the letter “A”. There are auditory distractors (e.g., footsteps) visual distractors (e.g., a paper plane flying in the classroom), and mixed distractors (auditory and visual), like a car rumbling outside the window. The experiment consists of five blocks (over a period of 100 s each) with 20 targets (AK). Five hundred stimuli were presented throughout the task (500 s). The test registers the number of correct answers (number of cases in which an answer occurred together with target “AK”) and commission errors (number of cases in which a joint response occurred with a non-target).

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