Preliminary convergent validity and group discrimination of a serious game for assessing attention in children and adolescents with and without clinician-established ADHD

Background Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental disorder characterized by developmentally inappropriate inattention and/or hyperactivity-impulsivity. Diagnosis requires a comprehensive, multi-informant clinical assessment; performance on a single attention task is neither necessary nor sufficient. This cross-sectional study examined the preliminary convergent validity, reliability, and group discrimination of Attention Robots, a serious game designed to assess attention-related performance. Methods Participants were 117 children and adolescents aged 6–18 years: 47 with a clinician-established ADHD diagnosis and 70 community comparison participants without a recorded ADHD diagnosis. Attention Robots scores were examined alongside CARAS-R and CogniFit measures using correlations, age- and sex-adjusted group comparisons, split-half reliability, and exploratory ROC analyses. Results Attention Robots scores were associated with CARAS-R inhibitory-control and several CogniFit measures. After adjustment for age and sex and correction for multiple comparisons, participants with ADHD showed lower Attention Robots concentration and working-speed scores than community comparison participants, whereas error percentage did not differ between groups. Among the CogniFit outcomes, only visual perception remained significantly different between groups after Holm correction. The game-only ROC model showed limited discrimination (AUC = 0.61; sensitivity = 0.28; specificity = 0.80). A model that also included sex yielded an AUC of 0.73, with sensitivity of 0.57 and specificity of 0.76; however, the higher AUC cannot be attributed to the game because sex was unevenly distributed between groups. Conclusions Attention Robots may provide complementary information about attention-related performance, but the present two-gate, single-site findings do not support stand-alone screening or diagnosis. Independent validation with consistently verified, sex-balanced, clinically heterogeneous samples is required.