Executive functions refer to higher-order cognitive processes that supervise and guide goal-directed and adaptive behaviors in response to everyday situations. The traditional measures used to assess executive functions include paper-and-pencil tests and/or computerized tests that have been found to have a moderate level of ecological validity in predicting real-world performance. Serious games (SG) represent a novel methodological approach, allowing investigating subjects' performance in real-simulated situations. Serious games are computer games whose primary purposes include investigating human behaviors and changes. Furthermore, SG can also vary according to the technology used and the interaction. Indeed, a SG can be rendered via a nonimmersive screen-based (2D) or via an immersive virtual reality game (3D). Starting from these premises, we compared a narrative-contextualized SG in 2D and 3D, correlating them with traditional tests. Findings showed different condition correlations with the traditional tasks and the comparison between the two systems have revealed that 3D is able to generate lower reaction times, higher correct answers, and lower perseverative responses in attentional abilities, inhibition control, and cognitive shifting than 2D condition. The present study yielded evidence on the use of more ecological tools to identify the functional cognitive status in real-simulated contexts along with traditional evaluation.
Keywords: Ecological validity; executive functions; neuropsychology; serious games; virtual reality.