Virtual reality and tablet cognitive training improve attention and academic skills without dose effects

We evaluated the effects of a closed-loop video game intervention on cognitive and academic outcomes delivered in virtual reality (VR) and tablet formats at two different dosages in a school-based setting. This randomized controlled trial included 158 children aged 8–9 years who completed 30 training sessions over 10 weeks. Compared with an expectancy-matched active control group, both VR and tablet training improved objective measures of attention, including performance-based attention and eye-tracking outcomes.

Teacher-rated inattention showed nominal improvement relative to the control group but did not remain statistically significant following correction for multiple comparisons. However, the intervention did not significantly surpass the active control condition for reading or math fluency improvements, indicating no between-group academic advantage. Both VR and tablet versions of the intervention produced comparable outcomes across most measures, with a platform-specific advantage for VR observed only on the performance-based attention measure.

Intervention dose did not significantly moderate outcomes, suggesting that efficacy may depend more on achieving sufficient engagement than on total duration. These findings support the use of digital cognitive training to enhance objective measures of attention in school settings, while highlighting the importance of cautious interpretation of academic outcomes in the presence of an active control. (Trial registration: ISRCTN75915439; https://doi.org/10.1186/ISRCTN75915439). We would like to thank all the participating teachers, school administrators, students, and parents from each school for being a part of this study, as well as the team of research coordinators (P Rzeszotarska, N Ahmed, T Tahat, I Giannikou, T Piasek, D Dimitrova) who helped with data collection for this study.

Thanks to M Kloss and the team at Alternova for assistance with software testing and providing support throughout the study. Thanks to X Lui for initial analyses of the Vanderbilt Teacher data, and L Wan for assistance interrogating training adherence data. Thanks to E Marco and A Aitken for thoughtful commentary regarding initial versions of this manuscript.

This research was funded by Mastermind Cognitive Training™. School of Sport, Psychology and Social Science, University of Bedfordshire, Luton, UK MRC Cognition and Brain Sciences Unit, University of Cambridge, Cambridge, UK Department of Neurology, Neuroscape Center, University of California, San Francisco, CA, USA Ariel M. Anguera Department of Psychiatry, University of California, San Francisco, CA, USA Mastermind Cognitive Training, Naperville, IL, USA The academic research team had full access to all study data and independently conducted all statistical analyses.

Industry partners contributed to study design and intervention development but had no role in data analysis, interpretation of results, or manuscript preparation. All analytic decisions and reporting were determined solely by the academic investigators. A.G. was paid to act as the project lead by Mastermind Cognitive Training™ for this project.