I Can Do It Better: A Creative VR Latte Art–Based Approach to Cognitive and Motor Skills Training for Adults with ADHD (Preprint)

<sec> <title>BACKGROUND</title> Background:Adults with attention deficit hyperactivity disorder (ADHD) often experience difficulties with sustained attention and fine motor coordination, which can impact daily life. Traditional interventions, such as medication and cognitive behavioral therapy, have limitations, including side effects and minimal impact on motor skills. Emerging digital therapies, particularly mixed reality (MR), offer promising alternatives by integrating immersive environments with real-world interactions. </sec> <sec> <title>OBJECTIVE</title> Objective:This study evaluated the effectiveness of EMLatte, an MR-based latte art training system, in improving attention regulation and fine motor skills in adults with ADHD. The system integrates embodied interaction, progressive task design, and reflective prompting (RP) to enhance metacognitive awareness and skill acquisition. </sec> <sec> <title>METHODS</title> Methods:A mixed methods approach was employed. A preliminary user study, including questionnaires and semi-structured interviews with six adults with ADHD, informed the system design. Subsequently, 23 participants completed a two-week EMLatte intervention consisting of three phases: task instruction, simulation practice, and hands-on practice using real tools. The system provided real-time feedback through visual, auditory, and tactile cues. Before and after the intervention, researchers assessed participants' attention and motor skills using the Continuous Performance Test (CPT), the Nine-Peg Test, and the Finger Tapping Test. Qualitative feedback was also collected through post-intervention interviews. </sec> <sec> <title>RESULTS</title> Results: Quantitative results showed significant improvements: CPT omission errors decreased by 27.8%, reaction time decreased by 312 milliseconds, and performance on fine motor tasks improved (e.g., completion time on the Nine-Peg Test decreased by 5.2 seconds). Over 78% of participants achieved proficiency (≥85% performance) in the subsequent training phase. Qualitative feedback highlighted the system's immersive design, real-time guidance, and reflective practice (RP) as key factors in improving focus and confidence. Participants reported reduced distractions and increased task engagement. </sec> <sec> <title>CONCLUSIONS</title> Conclusions:The EMLatte system demonstrated its feasibility as a non-pharmacological intervention for adults with Attention Deficit Hyperactivity Disorder (ADHD), effectively bridging cognitive and motor skill training through mixed reality (MR) and embodied interaction. Future research should expand sample sizes, optimize hardware comfort, and explore long-term memory effects. </sec>