EFSim Test

EFSim Test is a medical device designed for assessing ADHD symptoms in children aged 8–13.

EFSim Test simulates a home-like environment within a virtual reality setting and measures various aspects of attention, executive function, and prospective memory.

EFSim Test is intended for use by healthcare professionals to support diagnostic work. Test results are always interpreted by a healthcare professional. Based on these objective data results, the indicative levels of executive function, attention, and prospective memory deficits in children, as well as their support needs, can be determined. If EFSim Test results deviate from the relevant reference group, it may require further healthcare investigations to confirm and diagnose potential conditions.

EFSim Test


ADHD diagnosis is typically based on subjective methods such as interviews, observations, and questionnaires. EFSim Test is a unique assessment method as it provides objective information about ADHD traits in the environment where symptoms occur. Concrete data streamlines communication among different parties and aids in potential diagnosis and treatment planning.


EFSim Test is a medical device developed in collaboration with top researchers in their field. The research behind the software includes expertise from psychologists and child psychiatrists from the University of Helsinki, Aalto University, and Åbo Akademi University. While traditional tests measuring executive function skills have a weak correlation with everyday problems, EFSim Test demonstrates high ecological validity. It simulates everyday situations in a home-like environment, where symptoms typically manifest.


When healthcare is strained, waiting times for ADHD assessments are typically long. Diagnosing ADHD is a multi-step process, and access to treatment can be slow. Because ADHD significantly impacts a person’s quality of life and functioning, early identification and intervention are crucial. EFSim Test supports healthcare professionals in their diagnostic work by providing rapid and efficient information about potential ADHD traits. The data from EFSim Test aids in the early identification of even hidden ADHD traits, assists in prioritizing waiting lists, and expedites access to assistance.


PsyArXiv Preprints (2023) (ENG)
Salmi, J., Merzon, L., Eräste, T., Seesjärvi, E., Huhdanpää, H., Aronen, ET., Mannerkoski, M., MacInnes, WJ., Laine, M.
Fluctuations of attention during self-paced naturalistic goal-directed behavior in ADHD.

Temporal fluctuations of attention detected in externally paced neuropsychological tests is a potential behavioral marker for attention-deficit/hyperactivity disorder (ADHD). Here we examined whether intra-individual variability (IIV) in response latencies (RLs) can be detected also in open-ended virtual real-world situations where the participants perform goal-directed behaviors at their own pace.

Frontiers (2023) (ENG)
Seesjärvi, E., Laine, M., Kasteenpohja, K., Salmi, J.
Assessing goal-directed behavior in virtual reality with the neuropsychological task EPELI: children prefer head-mounted display but flat screen provides a viable performance measure for remote testing

EPELI (Executive Performance of Everyday LIving) is a Virtual Reality (VR) task that was developed to study goal-directed behavior in everyday life contexts in children. In this study, we had 72 typically developing 9- to 13-year-old children to play EPELI with an immersive version implemented with a head-mounted display (HMD) and a non-immersive version employing a flat screen display (FSD) in a counterbalanced order to see if the two versions yield similar results.

PLOS ONE (2023) (ENG)
Jylkkä, J., Ritakallio, L., Merzon, L., Kangas, S., Kliegel, M., Zuber, S., Hering, A., Salmi, J., Laine, M.
Assessment of goal-directed behavior with the 3D videogame EPELI: Psychometric features in a web-based adult sample

EPELI (Executive Performance in Everyday LIving) is a recently developed gaming tool for objective assessment of goal-directed behavior and prospective memory (PM) in everyday contexts. This pre-registered study examined psychometric features of a new EPELI adult online version, modified from the original child version and further developed for self-administered web-based testing at home.

PsyArXiv Preprints (2023) (ENG)
Jylkkä, J.
Assessment of goal-directed behavior and prospective memory in adult ADHD with an online 3D videogame simulating everyday tasks

The diagnosis of ADHD is based on real-life attentional-executive deficits, but they are harder to detect in adults than in children and objective quantitative measures reflecting these everyday problems are lacking.

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