Technology-Based Interventions for Children and Adolescents with ADHD: A Systematic Review and Meta-Analysis

Abstract

Aims: To analyze the effectiveness of technology-based interventions utilizing non-immersive and immersive digital formats across cognitive, behavioral, and functional domains in children and adolescents with attention deficit hyperactivity disorder (ADHD). Meta-analysis evaluated executive function outcomes across immersion levels in randomized controlled trials (RCTs). Methods: MEDLINE, Web of Science, and the Cochrane Library databases were searched for studies published between 2020 and 2025. Two reviewers independently screened studies and extracted data. Pooled standardized mean differences (SMDs) were calculated using a random-effects model, and heterogeneity was assessed. Subgroup analyses compared immersive and non-immersive interventions. Results: Thirty-four studies met the inclusion criteria, including 14 randomized controlled trials (RCTs) included in the meta-analysis. Technology-based interventions demonstrated a small-to-moderate positive effect on executive functions overall (SMD = 0.24, 95% CI [−0.01, 0.48], p = 0.059), with substantial heterogeneity (I2=68.3%). Domain-specific analyses showed significant improvements in working memory (k = 10; SMD = 0.36, p = 0.008) and cognitive flexibility (k = 11; SMD = 0.30, p < 0.05), whereas improvements in inhibitory control were not statistically significant (k = 14; SMD = 0.18, p = 0.064). Conclusions: Technology-based interventions may enhance core executive functions in children and adolescents with ADHD. Non-immersive tools offer practical, implementable benefits, while immersive approaches may support complex learning despite limited evidence.