UNSTRUCTURED This study aimed to verify the effectiveness of a newly developed virtual reality-based cognitive control training game for children with ADHD symptoms. Specifically, the study focused on exploring the sustainability of the training through a three-month follow-up evaluation and analyzing training response patterns and influential factors. A total of 29 children (21 males and 8 females) and adolescents aged 10 to 14 years participated in the study. Their mean intelligence quotient (IQ) was 94 (SD = 16.53). Measurements included the Korean Wechsler Intelligence Scale for Children-Fourth Edition (K-WISC-IV), the Stroop Test, the Color Trails Test, the National Institutes of Health Toolbox, and the Child Behavioral Checklist (CBCL). Each participant was required to engage in a minimum of 20 minutes of daily training for 20 consecutive days, with an initial assessment followed by post-training and follow-up evaluations. The repeated measures ANOVA results showed significant main effects for the Stroop color-word test (F = 5.22, p = 0.008, ηp² = 0.162), CBCL Total Problems (F = 20.361, p < .001, ηp² = 0.430), CBCL Attention Problems (F = 11.772, p < .001, ηp² = 0.304), and CBCL ADHD (F = 3.406, p = 0.040, ηp² = 0.112). Post hoc analysis revealed significant differences between the initial assessment and subsequent evaluations. K-means clustering demonstrated three distinct clusters, with Clusters 1 and 3 showing significant differences in IQ variables and training effectiveness. he results showed that the newly developed VR-based cognitive control training game effectively improved ADHD-related symptoms, with training effects persisting three months after the training period. The training effects were influenced by IQ. CoConUp might be expected to contribute as a promising future therapeutic intervention. CRIS number: KCT0009447 (from March 08, 2021).
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