RECOGNITAComparaison de la remédiation cognitive, du méthylphénidate et de la psychothérapie de soutien chez les enfants atteints de TDAH

Virtual reality offers the possibility to develop environments approaching situations of daily life that can be used to target evaluation but also for therapeutic purposes. As the school classroom is a daily life situation for children, Rizzo team has developed a virtual classroom software (Rizzo et al., 2006). This virtual classroom is a tool for the diagnosis of ADHD based on the exploration of attention deficit (distractibility, sustained attention ...), impulsivity and hyperactivity. On the other hand, the playfulness of the application helps the child to "forget" quickly that he is placed in a test situation. In the virtual classroom, the requested task is a letter detection task. The subject had to click on the mouse only when he sees the letter "K" preceded by the letter "A" appearing. The child had to perform this task, while the disruptive elements are distracting. These may be auditory (the bell ringing), visual (a paper airplane flying in the class) or visual and auditory distractors (the sound of the teacher who is moving). Cognitive remediation using virtual reality is an innovative approach in the care of children. We want to examine whether a cognitive remediation program based on the virtual classroom software can be a therapeutic tool for children suffering from ADHD. In our study, cognitive remediation will be accomplished through cognitive intervention such as a "training" of attentional and executive functions (such as planning, working memory, selective attention, ...). The cognitive remediation sessions will include the execution of the virtual classroom protocol, a stage of metacognition and again the virtual classroom assessment. Our remediation program will include 12 sessions (twice a week for 6 to 8 consecutive weeks), lasting 30 minutes each. The effects of cognitive remediation will be compared to the effects of two other major interventions usually proposed: drug treatment with methylphenidate and supportive psychotherapy. 60 ADHD children aged 7 to 11 years will participate in our study, 20 in each treatment group (drug treatment vs. cognitive remediation vs. supportive psychotherapy). We expect that cognitive remediation and drug treatment improve attentional abilities of children with ADHD.