No full-text available
To read the full-text of this research,
you can request a copy directly from the authors.
Changing Family Practices with Assistive Technology: MOBERO Improves Morning and Bedtime Routines for Children with ADHD
Abstract and Figures
Families of children with Attention Deficit Hyperactivity Disorder (ADHD) often report morning and bedtime routines to be stressful and frustrating. Through a design process involving domain professionals and families we designed MOBERO, a smartphone-based system that assists families in establishing healthy morning and bedtime routines with the aim to assist the child in becoming independent and lowering the parents’ frustration levels. In a two-week intervention with 13 children with ADHD and their families, MOBERO significantly improved children’s independence and reduced parents’ frustration levels. Additionally, use of MOBERO was associated with a 16.5% reduction in core ADHD symptoms and an 8.3% improvement in the child’s sleep habits, both measured by standardized questionnaires. Our study highlights the potential of assistive technologies to change the everyday practices of families of children with ADHD.
Figures - uploaded by Tobias Sonne
Author content
All figure content in this area was uploaded by Tobias Sonne
Content may be subject to copyright.
Supplementary resources (2)
Data
July 2016
Data
July 2016
... The majority of existing approaches focus on empowering children with ADHD and supporting their well-being by addressing specific symptoms, driven by the medical model of disability [72][73][74]. For instance, HCI researchers have developed interactive technologies that aim to train executive functions [78,81], or self-regulation of their behaviour and emotions [22,23,43], or establishing effective morning and bedtime routines for increased child independence and lowered parental frustration [70]. ...
... In particular, it includes both "heat of the moment" strategies, for moments of duress, as well as reflective strategies, which can be practised at any time. Sonne et al. [70] developed a smartphone-based system that aims to support families in establishing healthy morning and bedtime routines, with the goal to assist children with ADHD in becoming independent and lowering the parents' frustration levels. Apart from designing assistive technologies, the research interest in designing for individuals with ADHD can be observed in various reviews published on the subject. ...
... For their user study of a paper prototype, they included three child-parent pairs. Sonne et al. 's [70] work on an assistive technology aimed at improving morning and bedtime routines for families of children with ADHD involved parents of children with ADHD and eight ADHD domain professionals in their design process. In their user study, they involved 11 families, including 13 children with ADHD. ...
Designing for children with ADHD has been of increasing interest to the HCI community. However, current approaches do not adequately involve all relevant stakeholders, and primarily focus on addressing symptoms, following a medical model of disability that is extrinsic to neurodivergent interests.
To address this, we employed a multi-step, multi-stakeholder approach (N=31).
First, we conducted 1) interviews with children with ADHD and their care ecosystem followed by 2) a co-design pilot with one child with ADHD and his therapists and an interview with a UX designer and an occupational therapist.
We then employed 3) co-design sessions with neurotypical children and children with ADHD, and 4) a focus group with their therapists.
We identified communication and reflection as key concepts for empowering and promoting the well-being of children with ADHD and their care ecosystem. We contribute design implications for future systems aiming to promote the overall well-being of this population.
... In this paper, they posit that current sleep tracking tools are focused only on adults and not appropriate for family tracking collaboratively and describe how children can be active trackers and work together with parents. Similarly, Saksono et al. [96] evaluated the design of Storywell, a system that combines wristband activity tracking among parents and children with social rewards in the form of storybooks, stories with graphical and narrative components that promote goal setting and reflection [101]. Despite this progress, visualizations in the HCI and health literature have rarely been tailored specifically to ADHD children. ...
... Like, it would notify me when I had my next class. Set routines and schedules are important for children with ADHD to help them to focus on one activity at a time, which makes their tasks more manageable [69,101]. During the Covid-19 pandemic, children s schedules became less consistent as they were moved from school to home. ...
... Challenges with sleep are common among children with ADHD [101]; yet adequate sleep is important in achieving self-regulation [108]. As such, sleep apps have the potential to help users obtain awareness about their sleep patterns and take action to improve sleep habits [85,91,101]. ...
Children with ADHD can experience a wide variety of challenges related to self-regulation, which can lead to poor educational, health, and wellness outcomes. Technological interventions, such as mobile and wearable health systems, can support data collection and reflection about health status. However, little is known about how ADHD children interpret such data. We conducted a deployment study with 10 children, aged 10 to 15, for six weeks, during which they used a smartwatch in their homes. Results from observations and interviews during this study indicate that children with ADHD can interpret their own health data, particularly in the moment. However, as ADHD children develop more autonomy, smartwatch systems may require alternatives for data reflection that are interpretable and actionable for them. This work contributes to the scholarly discourse around health data visualization, particularly in considering implications for the design of health technologies for children with ADHD.
... For example, ParentGuardian by Pina et al. [50] provides guidelines to parents of children with ADHD when it detects stress, such as "Take a deep breath", via a wearable physiological sensor. Sonne et al. [62] aimed to support families of children with ADHD to establish effective morning and bedtime routines. Zuckerman et al. [77] developed a tablet-based app that measures selective and sustained attention, and a social robotic device for students with ADHD, providing immediate feedback for inattention or impulsivity events in the form of gestures. ...
... One author then coded the rest of the material. [9,11,23,31,37,41,56], Not applicable [42,61] Involved in user studies Children with ADHD [7,9,30,31,47,56,59,60,62,63,70,76], Experts [3,9,30], Parents of children with ADHD [7,30,47,60,62,70,76], Caregivers [9,23,56], ...
... One author then coded the rest of the material. [9,11,23,31,37,41,56], Not applicable [42,61] Involved in user studies Children with ADHD [7,9,30,31,47,56,59,60,62,63,70,76], Experts [3,9,30], Parents of children with ADHD [7,30,47,60,62,70,76], Caregivers [9,23,56], ...
This paper presents a systematic review of HCI literature focusing on children with ADHD, the prevailing mental health diagnosis in children. Its aim is to (i) chart the state-of-the-art in this domain (e.g. methods used), (ii) identify the ways the HCI community has addressed the needs of children with ADHD (e.g. technologies deployed), and (iii) describe the involvement of the various stakeholders playing a role in their everyday experiences (i.e. their care ecosystem). Our findings show limited engagement of the care ecosystem in the design, development and user studies of current technologies, and shortcomings in designing for multiple ecosystem stakeholders, despite their crucial role. We also find that most HCI contributions are systems aiming to address ADHD-related symptoms. Based on our findings, we provide suggestions for further research and design considerations for future systems that empower and promote the well-being of children with ADHD, while considering their care ecosystem.
... Many authors further emphasised the burden to family, caregivers, teachers, and broader society. For example: "there is a significant burden on those affected, their families and society" [148]; "ADHD can be challenging for a parent or caregiver with an individual who has this disorder" [1]; "a big threat for public health" [97]; and "can have a huge emotional and economic impact on families" [ibid] (see also: [55,80,126,145,147,148]). Here, these research projects become legitimised by an unsubstantiated assertion that the family unit is suffering as a result of the ADHD person. ...
... Many authors further emphasised the burden to family, caregivers, teachers, and broader society. For example: "there is a significant burden on those affected, their families and society" [148]; "ADHD can be challenging for a parent or caregiver with an individual who has this disorder" [1]; "a big threat for public health" [97]; and "can have a huge emotional and economic impact on families" [ibid] (see also: [55,80,126,145,147,148]). Here, these research projects become legitimised by an unsubstantiated assertion that the family unit is suffering as a result of the ADHD person. ...
... Other work by Sonne et al. [146,148] focuses on 'involving families' in improving morning and bedtime routines of children with ADHD, and includes parents and domain professionals (i.e., clinicians) in the design process. They developed a mobile app that reminds children of a bedtime routine and steps them through it using timers and 'star' rewards. ...
... (ADHD) e.g. [6,10,11,13]. ADHD is a mental disorder that affects approximately 5% of all school age children [5], and the consequences of the disorder include challenges in sustaining attention, increased hyperactivity, academic underachievement, disruptive behaviors, bedtime resistance and poor self-regulation of emotions [1,8]. ...
... The limited existing research on assistive technologies for children with ADHD has mostly focused on providing structure for the child during morning [10,13] and bedtime routines [10]. However, the challenges associated with poor self-regulation of emotions have currently not been investigated, though more than every third child with ADHD is reported to have a high level of emotional challenges and problems coping with frustration [12]. ...
... The limited existing research on assistive technologies for children with ADHD has mostly focused on providing structure for the child during morning [10,13] and bedtime routines [10]. However, the challenges associated with poor self-regulation of emotions have currently not been investigated, though more than every third child with ADHD is reported to have a high level of emotional challenges and problems coping with frustration [12]. ...
Breathing exercises have been shown to have multiple benefits for children with Attention Deficit Hyperactivity Disorder (ADHD). However, these children can have issues retaining attention to such an exercise. In this paper we present a study of ChillFish, a respiration game for children with ADHD. Our findings show tendencies that the game works in terms of having a calming effect. However, the study also highlighted issues of evaluating biofeedback games with children with ADHD that are not present when evaluating with adults. This work presents an iteration in the ChillFish development cycle that will hopefully result in a stable system that can assist children with ADHD in their everyday life.
... This approach involves users in all stages of development, from early design to prototyping to full system development and user studies. For example, Sonne et al. (11) conducted a contextual inquiry to design an initial version of MOBERO, a mobile application supporting families that include children with ADHD during morning and bedtime routines. They piloted the tool with two families to gather more requirements and evolve MOBERO functionality. ...
... In HCI and related fields, a formative evaluation to test the usability, usefulness, acceptability, and user experience can be conducted even with a small number of participants [e.g., (57,58)] and sometimes "in-the-wild" [e.g., (11,59,60)]. The inclusion and exclusion criteria, despite often being as strict as clinical fields, are frequently not well-described in publications [e.g., (61,62)]. ...
... Mobile and wearable technologies have been used to support children with ADHD to become more organized in family and home settings [45][46][47][48]. For example, MOBERO [47,48], a tool to support families living with at least one child diagnosed with ADHD during their morning and bedtime routines, was tested for one month with 13 families. ...
... Mobile and wearable technologies have been used to support children with ADHD to become more organized in family and home settings [45][46][47][48]. For example, MOBERO [47,48], a tool to support families living with at least one child diagnosed with ADHD during their morning and bedtime routines, was tested for one month with 13 families. This study indicated that such technology could improve parent frustration and conflict levels around morning and bedtime routines. ...
Distance learning in response to the COVID-19 pandemic presented tremendous challenges for many families. Parents were expected to support children’s learning, often while also working from home. Students with Attention Deficit Hyperactivity Disorder (ADHD) are at particularly high risk for setbacks due to difficulties with organization and increased risk of not participating in scheduled online learning. This paper explores how smartwatch technology, including timing notifications, can support children with ADHD during distance learning due to COVID-19. We implemented a 6-week pilot study of a Digital Health Intervention (DHI) with ten families. The DHI included a smartwatch and a smartphone. Google calendars were synchronized across devices to guide children through daily schedules. After the sixth week, we conducted parent interviews to understand the use of smartwatches and the impact on children’s functioning, and we collected physiological data directly from the smartwatch. Our results demonstrated that children successfully adopted the use of the smartwatch, and parents believed the intervention was helpful, especially in supporting the development of organizational skills in their children. Overall, we illustrate how even simple DHIs, such as using smartwatches to promote daily organization and task completion, have the potential to support children and families, particularly during periods of distance learning. We include practical suggestions to help professionals teach children with ADHD to use smartwatches to improve organization and task completion, especially as it applies to supporting remote instruction.
... The effect of 10 weeks' treatment with a polyunsaturated acid mixture on children with ADHD's behavior (n = 78, 40 in treatment group) showed significant improvement in quality of life, ability to concentrate, hemoglobin levels and sleep quality (Yehuda et al., 2011). Sonne et al. (2016), studied the effect of MOBERO, a smartphone-based system that assists families in establishing healthy morning and bedtime routines in a 2-week intervention with children with ADHD (n = 13, 6-12 years). The intervention was associated with 8.3% improvement in sleep habits, including positive change in seven of the eight CSHQ subscales (bedtime resistance, sleep duration, sleep anxiety, night wakenings, parasomnias, sleep disordered breathing and daytime sleepiness) and 16.5% reduction in core ADHD symptoms (Sonne et al., 2016). ...
... Sonne et al. (2016), studied the effect of MOBERO, a smartphone-based system that assists families in establishing healthy morning and bedtime routines in a 2-week intervention with children with ADHD (n = 13, 6-12 years). The intervention was associated with 8.3% improvement in sleep habits, including positive change in seven of the eight CSHQ subscales (bedtime resistance, sleep duration, sleep anxiety, night wakenings, parasomnias, sleep disordered breathing and daytime sleepiness) and 16.5% reduction in core ADHD symptoms (Sonne et al., 2016). ...
Objective
Children and adults with ADHD often report sleep disturbances that may form part of the etiology and/or symptomatology of ADHD. We review the evidence for sleep changes in children with ADHD.
Methods
Systematic review with narrative synthesis assessing sleep and circadian function in children aged 5 to 13 years old with a diagnosis of ADHD.
Results
148 studies were included for review, incorporating data from 42,353 children. We found that sleep disturbances in ADHD are common and that they may worsen behavioral outcomes; moreover, sleep interventions may improve ADHD symptoms, and pharmacotherapy for ADHD may impact sleep.
Conclusion
Sleep disturbance may represent a clinically important feature of ADHD in children, which might be therapeutically targeted in a useful way. There are a number of important gaps in the literature. We set out a manifesto for future research in the area of sleep, circadian rhythms, and ADHD.
... There is evidence that helping children with autism self-direct cliche behavior is possible [15]. Analysts utilized cell phone-based equipment to assist individuals with autism accomplish their regular schoolwork more freely [16]. For example, software enables with improving sleep habits and managing home cleanliness and daily schedules [17,18]. ...
Autism is one of the large-scale challenges amongst the kids in United States. According to the survey, Research shows that one out of each 88 youngsters in the United States has some type of ASD. In the view of survey in 2008, information from the Center of the Disease Control shows a 26 percent increase as compared to 2006 and a 71 percent increase as compared to 2002. Behavioral observations are used to diagnose autism spectrum disorder (ASD). To design a data-driven screening and diagnostic technique for ASD. Analyzing the behavioral patterns in the autistic patients is extremely important. Technological solutions play a huge role in automatically detecting patterns such as Spike in the Autistic kids. In this paper, we propose a Bio-Medical Innovation utilizing remote sensor networks. The major behavioral change which needs to be measured is repetitive motion in the Autistic kids. The paper portrays the framework which will assist the physicians and caretakers of the autistic kids to keep a track of the activities and give them feedback on real time when there is an unusual movement. The major objective of the research is to help the patients with autism to get out of social challenges and compete with the normal people in all occupations. The proposed framework is required to analyze the data by the clinicians and give the reports on real time basis.
... Sonne et al report on MOBERO [33], a smartphone-based system that assists families in establishing healthy morning and bedtime. In a two-week intervention with children with ADHD (N=13) and their families, using MOBERO was found to improve children's independence, to reduce parents' frustration levels and was associated with a 16.5% reduction in core ADHD symptoms and an 8.3% improvement in the child's sleep habits, both measured by validated and widely used questionnaires. ...
... Pina et al. have designed a mobile application to support parents of children with Attention-Defcit/Hyperactivity Disorder (ADHD) by detecting parental stress and ofering in-situ cues that remind parents of behavioural strategies to practice in those moments [65]. MOBERO is a smartphone-based system designed to assist families of children with ADHD in establishing efective morning and bedtime routines [85]. Finally, smartphonebased system WAKEY [11] helps parents use better communication strategies to encourage their children to carry out their morning routines and reduce parent-child confict. ...
Emotion-related parent-child interactions during early childhood play a crucial role in the development of emotion regulation, a fundamental life skill central to well-being. However, limited work in HCI has explored howtechnology could support parents in adopting supportive emotion socialisation practices. In this paper, we explore how an embodied, in-situ intervention in the form of a smart toy can impact emotion-related parent-child interactions in the home. We draw on (1) interviews with 29 parents of young children who had the smart toy for at least 1 month; (2) co-design workshops with 12 parents and 8 parenting course facilitators. We discuss how the smart toy impacted parent-child interactions around emotions for a subset of families, and draw on workshop data to explore how this could be designed for directly. Finally, we propose a set of design directions for technology-enabled systems aiming to elicit and scafold specifc parent-child interactions over time.
... MAMAS [35] aids mealtime situations with specialized hardware that tracks the child's eating habits, along with an app for parent reflection. MOBERO [71] assists parents with children affected by ADHD by guiding them through morning and bedtime routines. ParentGuardian [59] also supports parents with ADHD children by detecting moments of high stress, then providing guidance to lower stress levels. ...
To acquire language, children need rich language input. However, many parents find it difficult to provide children with sufficient language input, which risks delaying their language development. To aid these parents, we design Captivate!, the first system that provides contextual language guidance to parents during play. Our system tracks both visual and spoken language cues to infer targets of joint attention, enabling the real-time suggestion of situation-relevant phrases for the parent. We design our system through a user-centered process with immigrant families--a highly vulnerable yet understudied population--as well as professional speech language therapists. Next, we evaluate Captivate! on parents with children aged 1-3 to observe improvements in responsive language use. We share insights into developing contextual guidance technology for linguistically diverse families.
... For instance, a group of studies has investigated effective strategies to support family values [3,18,47,71], coordination of domestic work [18,29,86,101,117], preserving family memories and traditions [13,61], family entertainment [109], collaborative tasks [104,105], parental monitoring of children's media usage [9,30,42,54,80], and family-based health behavior support systems [21,64,[109][110][111]123]. These studies examined different relational aspects of the families to build strategies that promote user engagement and achieve the family goals mentioned above through technology use. ...
Diverse fields, including CSCW, Communication, and Human Development studies, have investigated how technologies can better support parent-child relationships. While these studies are scattered across literature, little effort has been made to synthesize the findings. We conducted a review of studies that examined the factors associated with parent-child relationships that are mediated by technologies. Specifically, we synthesized previous studies based on children's age groups and different family contexts, including cohabitation. From a total of 12,942 search results from two databases, and 32 results from the hand-searching process, we conducted a full-text review of 190 articles and identified 19 suitable studies. An additional search during the revision cycle resulted in 6 more full-text reviews and 1 additional study being included in the data analysis. We analyzed challenges and facilitators in designing CSCW systems supporting parent-child relationships for families living together or apart and families with children of different developmental stages. Findings showed two common challenges, which should be addressed in technology designed to support parent-child relationships: discrepancies in expected communication between parents and child(ren) and the complex emotions of parents toward parenting caused by their busy schedules. Challenges specific to families who are living apart included consequences from being physically distant and having limited access to communication resources. The following factors commonly helped facilitate parent-child relationships: (1) reciprocity norms of the family (2) reinforcement of transparency, affection, and trust, (3) a physical proxy of each other through an object or interface design, (4) accessibility, the sophistication level of technology, and communication resources, (5) enjoyable, age-appropriate shared content among parents and children, and (6) situational awareness and routine as ways to increase parent-child relationships. Media richness and synchronicity in system design and privacy preservation without interruption facilitated parent-child relationships of families living apart. Based on the findings, we discuss opportunities for technological innovation for physically co-located families and the importance of considering children's age and developmental stages in designing technology for parent-child relationships.
... While some studies have focused on child autonomy, others have emphasized the need for caregivers to also receive structural, technical, self-care, and mental health support [63]. Family-centered design can encourage mutual benefits for caregivers and children through clarity in communicating boundaries, supporting shared family tasks, and implementing as well as reinforcing routines [65]. CSCW research using co-design with caregivers and children reinforces the effectiveness of the method to engage each population independently through reflection and ideation sessions on topics of caregiving and family coordination [38,71]. ...
The COVID-19 pandemic upended the lives of families with young children as school closures and social distancing requirements left caregivers struggling to facilitate educational experiences, maintain social connections, and ensure financial stability. Considering families' increased reliance on technology to survive, this research documents parents' lived experiences adapting to technology's outsized role alongside other shifts in family life associated with the COVID-19 pandemic. In this paper, we describe a 10-week study with 30 enrolled families with children aged 3 to 13 in the United States using the asynchronous remote communities (ARC) methodology to 1) understand the benefits and challenges faced by families as they adapted technology at home to navigate the pandemic, and 2) to ideate improvements to those experiences through co-design. We found that amidst gaps in infrastructural support from schools, workplaces, and communities, parents experienced deep anxiety and took on new roles, including tech support, school administrator, and curator of meaningful activities for their children. As parents shared bold and creative technology-based solutions for improving family well-being, schooling experiences, social life, and beyond, they demonstrated their capacity to contribute to new models of learning and family life. Our findings are a call to action for CSCW researchers, designers, and family-focused practitioners to work with learning communities that incorporate parent, teacher, and technology experiences in their academic and community planning.
... The term is often used interchangeably with usability tests Bastien (2010). (2011) Diary keeping Sonne, Müller, Marshall, Obel, and Grønbaek (2016) ''Diary studies enable participants to record data in their own time, at particular times of day or when a particular trigger occurs. Diary entries may be more or less structured.' ' Blandford et al. (2016)(pag. ...
Child-Computer Interaction (CCI) is a steadily growing field that focuses on children as a prominent and emergent user group. For more than twenty years, the Interaction Design for Children (IDC) community has developed, extended, and advanced research and design methods for children’s involvement in designing and evaluating interactive technologies. However, as the CCI field evolves, the need arises for an integrated understanding of interaction design methods currently applied. To that end, we analyzed 272 full papers across a selection of journals and conference venues from 2005 to 2020. Our review contributes to the literature on this topic by (1) examining a holistic child population, including developmentally diverse children and children from 0 to 18 years old, (2) illustrating the interplay of children’s and adults’ roles across different methods, and (3) identifying patterns of triangulation in the methods applied while taking recent ethical debates about children’s involvement in design into account. While we found that most studies were conducted in natural settings, we observed a preference for evaluating interactive artifacts at a single point in time. Method triangulation was applied in two-thirds of the papers, with a preference for qualitative methods. Researchers used triangulation predominantly with respect to mainstream methods that were not specifically developed for child participants, such as user observation combined with semi-structured interviews or activity logging. However, the CCI field employs a wide variety of creative design methods which engage children more actively in the design process by having them take on roles such as informant and design partner. In turn, we see that more passive children’s roles, e.g., user or tester, are more often linked to an expert mindset by the adult. Adults take on a wider spectrum of roles in the design process when addressing specific developmental groups, such as children with autism spectrum disorder. We conclude with a critical discussion about the constraints involved in conducting CCI research and discuss implications that can inform future methodological advances in the field and underlying challenges.
... When examining the use of proxies as a function of community of focus, we found that proxies were most common in studies focusing on autism (22.6%, N=7/31), followed by cognitive impairment (17.4%, N=8/46) and IDD (21.4%, N=3/14). Common reasons included seeking the domain expertise of specialists or caregivers (e.g., IDD [107,144], cognitive impairment [139]) and communication difficulties (e.g., autism [53,109], cognitive impairment [85]). At the other end of the spectrum, there were no instances of DHH-focused papers that included proxies. ...
Accessibility research has grown substantially in the past few decades, yet there has been no literature review of the field. To understand current and historical trends, we created and analyzed a dataset of accessibility papers appearing at CHI and ASSETS since ASSETS' founding in 1994. We qualitatively coded areas of focus and methodological decisions for the past 10 years (2010-2019, N=506 papers), and analyzed paper counts and keywords over the full 26 years (N=836 papers). Our findings highlight areas that have received disproportionate attention and those that are underserved--for example, over 43% of papers in the past 10 years are on accessibility for blind and low vision people. We also capture common study characteristics, such as the roles of disabled and nondisabled participants as well as sample sizes (e.g., a median of 13 for participant groups with disabilities and older adults). We close by critically reflecting on gaps in the literature and offering guidance for future work in the field.
... Specifically, several studies emphasized the role of caregivers when dealing with children's health. Researchers investigated how to support parents of children with certain health conditions (e.g., newborn jaundice [24], preterm infants [62], ADHD [90], Type 1 Diabetes [96]). In addition, the parents' role has also been highlighted in assessing children's developmental status to detect developmental delays in the early stage. ...
Many parents of young children find it challenging to deal with their children's eating problems, and parent--child mealtime interaction is fundamental in forming children's healthy eating habits. In this paper, we present the results of a three-week study through which we deployed a mealtime assistant application, MAMAS, for monitoring parent--child mealtime conversation and food intake with 15 parent--child pairs. Our findings indicate that the use of MAMAS helped 1) increase children's autonomy during mealtime, 2) enhance parents' self-awareness of their words and behaviors, 3) promote the parent--child relationship, and 4) positively influence the mealtime experiences of the entire family. The study also revealed some challenges in eating behavior interventions due to the complex dynamics of childhood eating problems. Based on the findings, we discuss how a mealtime assistant application can be better designed for parents and children with challenging eating behaviors.
... Family-centered tracking research has focused primarily on parents as trackers. WAKEY [9], Estrellita [25], Baby Steps [30], ParentGuardian [47], Mobero [53], and work on health promotion in families [49,50] focus on technologies to help parents track aspects of their children's lives or to support parent interactions with their children. Other research has explored remotely monitoring children's health and sharing the information with parents. ...
Parents and their school-age children can impact one another's sleep. Most sleep-tracking tools, however, are designed for adults and make it difficult for parents and children to track together. To examine how to design a family-centered sleep tracking tool, we designed DreamCatcher. DreamCatcher is an in-home, interactive, shared display that aggregates data from wrist-worn sleep sensors and self-reported mood. We deployed DreamCatcher as a probe to examine the design space of tracking sleep as a family. Ten families participated in the study probe between 15 and 50 days. This study uses a family systems perspective to explore research questions regarding the feasibility of children actively tracking health data alongside their parents and the effects of tracking and sharing on family dynamics. Our results indicate that children can be active tracking contributors and that having parents and children track together encourages turn-taking and working together. However, there were also moments when family members, in particular parents, felt discomfort from sharing their sleep and mood with other family members. Our research contributes to a growing understanding of designing family centered health-informatics tools to support the combined needs of parents and children.
... We should create friendly environments where children feel secure and supported by their caregivers. Previous research in HCI has shown the importance of designing applications for families of children with disabilities [44], a finding echoed in this work. ...
... We should create friendly environments where children feel secure and supported by their caregivers. Previous research in HCI has shown the importance of designing applications for families of children with disabilities [44], a finding echoed in this work. ...
... First, the sample sizes are too small for meaningful statistics. However, like Sonne et al. [68], we argue "that it is more important to first uncover potential problems and understand the use of the technology, than to conduct longer and larger efficacy studies." Furthermore, UZA is one of the five biggest hospitals in the country and is specialized in pectus surgery. ...
... MOBERO is a mobile application that assists families in establishing healthy morning and bedtime routines aiding the child to become more independent and lowering the parents' frustration [61] [62]. ...
This paper presents the findings of a literature review on smart technologies for neurodiverse users. The analysis of the literature indicates that most technologies implemented consist of games to train neurodiverse individuals on self-regulation, attention, and communication skills. The studies are conducted in the field, often involving a limited number of participants. The age of the participants is skewed towards children and the gender of the participant sample is predominantly male. The studies combine mixed-methods, including observations, interviews, and usability evaluations. The participants include end users, as well as caregivers and practitioners. Neurodiversity is prevalent, and emerging technologies are promising to assist neurodiverse individuals in their daily activities. Despite the importance of involving neurodiverse users in the technology design, guidance for investigators to conduct inclusive studies is currently limited. This paper provides concrete recommendations for practitioners seeking to design UX studies to include neurodiverse users.
... MOBERO is an assistive mobile application that provides activities and support for parents of children with Attention Deficit Hyperactivity Disorder (ADHD). The application rewards the children, and assists families in establishing morning and bedtime routines that are healthier and more effective for the children [27]. A web-based learning system for iPad was implemented to help Individuals with Developmental Disabilities (DD) to learn basic mathematical skills [18,3]. ...
Smartwatches have a large potential to support everyday activities. However, their potential as assistive technologies in inclusive academic environments is unclear. To investigate how smartwatches can support students with intellectual and developmental disabilities (IDDs) to perform activities that require emotional and behavioral skills and involve communication, collaboration and planning, we implemented WELI. WELI (Wearable Life) is a wearable application designed to assist young adults with IDDs attending a postsecondary education program. This paper reports on the user-centric design process adopted in the development of WELI, and describes how smartwatches can assist students with IDDs in special education. The results reported are drawn from 8 user studies with 58 participants in total. WELI features include behavioral intervention, mood regulation, reminders, checklists, surveys and rewards. Results indicate that several considerations must be taken into account when designing for students with IDD, and that overall the students are enthusiastic about adopting an innovative smartwatch application in class, as they reacted positively about the technology and features provided.
... The number of participants (in total 26) and the absence of a control condition can be seen as a limitation of our current work. However, like Sonne et al. [42] "we argue [...] that it is more important to first uncover potential problems and understand the use of the technology, than to conduct longer and larger efficacy studies." Furthermore, to allow for a comparison between participants we used a non-personal realistic medication regimen instead of asking each participant to bring their own medication. ...
In this paper, we investigate whether augmented reality visualization techniques can empower older adults to explore and understand medication information in an effective and timely manner. Through a user-centered design process involving older adults and health professionals we developed an interactive camera-projector system called MeViTa (Medication Visualization Table) that projects medication information surrounding medication boxes laid on a table. Six designs were iteratively developed. In total 26 older adults, with a mean age of 71 (±7), participated in the user studies. Although no time benefits were observed, participants perceived MeViTa as an effective means to explore and understand medication information, and as more engaging than the traditional patient information leaflet. Furthermore, by visualizing medication information, our approach provides qualitative findings of the relative ease and difficulty for older adults to learn more about medication information.
... The reverse alarm clock, a design research project from Carnegie Mellon University, is designed to keep young children from interrupting their parents' sleep in the middle of the night [4]. Mobero is a smartphone application that assists children in building independence and easing parental frustration at bedtime [7]. There have been a number of commercial applications of bedtime related tools by companies like Johnson and Johnson (Bedtime app) and Philips (Sonicare). ...
This paper documents an attempt to support parents and children in co-creating dynamic, fun and consistent bedtime routines through immersive and interactive storytelling. The proposed system, Iyagi, would be designed to ease the friction experienced by parents and children as they transition from evening activities into the bedtime routine as well as move between different stages and spaces within the bedtime routine. The key features of Iyagi would include: (1) Unfolding of a story across multiple rooms in which key bedtime activities take place; (2) Incorporating the physical space, projection of stories, objects, and the parent and child into the story; (3) Unique interactions with tangible objects, tied to the immersive story; (4) Natural interactions through voice, motion and tangible interactions; (5) Progressively calming activities and environments to ease children to sleep. The work presented follows a non-linear process that moved back and forth between user-centered research, idea generation, prototyping and evaluation. Outlined in this paper are learnings and insights from research that evolved into a proof-of-concept prototype. We've also included preliminary thoughts on opportunities for future development of the concept.
Children often experience sleep problems that can negatively impact their well-being and development. Clinicians ask parents to record in a journal information about their child’s sleep, but such parental reports can be biased. Sleep diaries suitable for children can triangulate parental reports and allow children to be actively involved in their treatment. Earlier attempts at sleep diaries for children rely on written text input, which is not suitable for younger children. We designed EP-Sleepy, an interactive console that allows children aged six to eight to report on their sleep experience. EP-Sleepy was designed in two iterations, which explored different interaction mechanisms for keeping children engaged for the required by clinicians period of two weeks. We evaluated the appliance with parents and children demonstrating the feasibility of self-reporting for children six to eight, and how storytelling can motivate children to adhere to a daily self-reporting regime.KeywordsSleep diarySelf-trackingChildren
Attention Deficit Hyperactivity Disorder (ADHD) child patients have difficulty in starting and completing daily tasks successfully on time due to executive function impairment. As a result, issues arise due to the patient having low self-efficacy and frequent troubles with parents. This study is a parallel pilot randomized controlled trial that suggests the usefulness of a voicebot to assist children with ADHD in performing daily tasks. A dialogue structure to help children’s self-instruction training and a token-based economies method for task performance were applied to the voicebot. Sixteen children and their parents [Intervention group (n = 7), Control group (n = 9)] participated in an 8-week, home-based field study. We developed the voicebot using Raspberry Pi and allowed children with ADHD to use it four times a day through voice interaction. We found that children’s use of the voicebot helped them to increase their self-efficacy, decrease the inattentiveness, increase self-control in completing daily tasks, and decrease the severity of behavioral problems. The study also revealed that it can help improve parent-child relationships. This study will be informative for researchers who engage in future studies that seek to provide insights into the area of assistive care for children with ADHD.
Context
Given the growing interest in digital health interventions (DHI) and increasing number of commercial products targeting youth with ADHD, we conducted a mapping review of the current evidence for DHI for children and adolescents with ADHD.
Objective
To identify DHI designed to support or extend ADHD treatment.
Data sources
Electronic databases (PubMed, ACM Digital Library, and IEEE Xplore) were searched for studies published in English from January 1, 2004, through January 1, 2022. Search keywords included ADHD and terms for technology (e.g., digital, smartphone, computer) and treatment (e.g., treatment, intervention, cognitive training, neurofeedback).
Study selection
Two reviewers reviewed titles, abstracts, and articles. Prior reviews and meta-analyses for two clusters of DHI (cognitive training and neurofeedback) were identified and summarized. The remaining 1,246 records focused on other DHI, and 51 studies representing 16 countries met eligibility criteria. These DHI addressed functioning in domains commonly targeted in treatments for ADHD and were classified based on targeted domains, users, technological platforms, and intended settings.
Results
The 51 DHI studies described interventions delivered via serious games or e-learning, the web, mHealth, telehealth, and augmented or virtual reality. DHI targeted a range of domains relevant to ADHD treatment: cognition, social-emotional skills, behavior management, academic/organizational skills, medication adherence, vocational skills, motor behaviors, and clinical care. Twelve well-designed, adequately powered randomized clinical trials reported positive outcomes from interventions delivered using telehealth, the web, mHealth applications, exergaming, and clinician decision-making support tools.
Limitations
Keyword selection, terminology usage, and digital libraries in the DHI space were not consistent within or across disciplines, nor across countries, which limited study identification. Few studies had evidence from randomized, controlled trials which limited information on the efficacy of most tools.
Conclusions
Research supports the use of several DHI and describes emerging DHI, not yet available for implementation in community settings. Our review provides a map of the current field, identifies gaps and potentials for future research, and highlights the need to increase translation from early designs to robust evidence-based products.
Este estudo visa anunciar o planejamento e início da condução de uma revisão sistemática de literatura (RSL) à comunidade científica de Informática na Educação, evitando-se desperdício de esforços desta comunidade. A revisão analisará o desenvolvimento, na literatura, sobre o tema Jogos Digitais, Design de Interação e Transtorno de Déficit de Atenção e Hiperatividade (TDAH), por meio de estudos publicados de Jan/2011 a Dez/2020 em bases científicas relacionadas a área da Educação, Computação, Psicologia ou Psiquiatria. Pretende-se responder à seguinte questão de pesquisa principal: o que tem sido feito sobre os cuidados a crianças e adolescentes com TDAH em idade escolar no contexto do design de interação em jogos digitais?
ABSTRACT This study aims to announce the planning and start of the conduction of a systematic literature review to the Education Informatics scientific community, avoiding the waste of efforts by this community. The review will analyze the development in the literature on the topic of Digital Games, Interaction Design and Attention-Deficit/Hyperactivity Disorder (ADHD), through studies published from Jan/2011 to Dez/2020 on scientific bases related to Education, Computing, Psychology, or Psychiatry. It is intended to answer the following main research question: what has been done about the care of school-age children and teenagers with ADHD in the context of interaction design in digital games?
Attention Deficit Hyperactivity Disorder (ADHD) is the most prevalent childhood psychiatric condition. Children with ADHD display symptoms of inattention and hyperactive/impulsive behaviors. Behavioral interventions are promising as approaches for improving the control of attention and impulsivity and in developing self-regulation skills. Self-regulation involves controlling one’s behavior, emotions, and thoughts to pursue long-term goals and is fundamental to adaptive developmental tasks at all stages of life. Innovative approaches for supporting children with ADHD include using both novel and consumer off-the-shelf technologies to support the self-regulation of emotions and behaviors. This review aims to provide a resource to summarize the current evidence for technological interventions that assist and assess the self-regulation of behaviors and emotions supporting children with ADHD. This review included 36 papers that used multiple technological emerging platforms (i.e., personal computers; mobile; sensors, wearables; virtual and augmented reality; robots) used by children with ADHD. Most technologies are suspended in the design and prototyping phases. However, studies that included robust enough technologies for deployment studies or pilot random control trials exhibit promising implications for supporting self-regulation in children with ADHD.
Behavioral Activation (BA)therapy has shown to be effective in treating depression. Recommending healthy activities is a core principle in Behavioral Activation (BA), which is typically done by the therapist. However, most BA smartphone applications do not recommend specific activities. This article reports quantitative results from an 8-week feasibility study of a previously presented smartphone-based BA recommender system. The system supports the planning and enacting of pleasurable activities and promotes activation of diverse activity types. Enrollment included 43 clinically depressed patients who installed the system on their phone and initiated activity scheduling. Twenty-nine patients used the system daily for more than a week.These patients presented a significant reduction in depressive symptoms during the study period. They displayed a more personalized usage approach and created recurring health goals comprising of their own customized activities. Furthermore, they took inspiration within various types of activities, thereby displaying more activity diversity. This study suggests that enacting a diverse mixture of activities that promote good sleep, personal hygiene, exercise, social contact, and leisure time can be essential in managing depressive symptoms. A smartphone-based activity recommender system can help patients achieve this.
Attention Deficit Hyperactivity Disorder (ADHD) is the most common mental disorder in children. Commonly children with ADHD are treated through stimulant drugs that can be dangerous. Also, behavioral therapy sessions are carried out to help ADHD. No doubt it is useful for children, but these are hectic and expensive as well. Smartphone and tablet applications are widely used in healthcare and educational context. The objective of this study is to heighten the learnability of ADHD children using tablet apps. The developed app will provide endless opportunities for ADHD children. The objective is to help ADHD children in their learning activities via a friendly and interactive environment. The investigation is conducted by employing the proposed app using a sample of five children with ADHD to assess the applicability. A survey is conducted from the parents and caregivers of these children to measure the level of satisfaction and acceptance for learning content. The result demonstrates that the app is interesting, engaging, and improves learnability. Lastly, parents are satisfied and appreciated the design and functionality of “Say-it and learn.”
Attention Deficit Hyperactivity Disorder (ADHD) is a chronic mental and behavioral disorder that interferes with everyday activities and has three core symptoms: inattention, hyperactivity, and impulsivity. To help in reducing the effects of ADHD symptoms, there are multiple treatments, but none of them help in curing ADHD. Assistive technologies offer great opportunities in delivering treatments, especially those related to behavioral interventions, monitoring, and changing in a more flexible, acceptable and accessible way. Focusing on assistive technology for children with ADHD is very important as early support during childhood prevents the manifestation of its symptoms before entering adulthood. This systematic literature review paper investigates the available studies covering assistive technologies for children with ADHD. The contribution of this paper can help Human-Computer Interaction researchers to identify the procedures and research methods used throughout requirements, design, and evaluation phases in developing assistive technology for children with ADHD. Moreover, it provides researchers with information regarding frameworks and protocols of conducting studies on ADHD, current available solutions, and their limitations.
Mental health represents a huge disease and societal burden and a significant body of research in ubiquitous computing has been devoted to the design of technologies for continuous monitoring, diagnosis, and care of mental health conditions. This paper reviews a decade of research into technologies for mental health, focusing on the use of mobile and wearable technology. The review found 46 systems that are analyzed in a historical context and discussed according to which mental disorder they target, the type of technology, and the type and size of the clinical studies they have been used in. Finally, the paper presents inputs from nine leading researchers in the domain and discuss important technical and clinical challenges in the design of ubiquitous computing technology for the next decade.
Sleep is a critical component of overall wellness, and pervasive and ubiquitous computing technologies have shown promise for allowing individuals to track and manage their sleep quality. However, sleep quality is also affected by interpersonal factors, especially for families with young children. In this study, we adopted a family informatics approach to understand opportunities and challenges for sleep technologies at the family level. We conducted home-based interviews with 10 families with young children, asking them about their current practices, values, and perceived role for technology. We describe challenges across three phases: bedtime, nighttime, and waking. We show that family-based sleep technologies may have the greatest impact by supporting family activities and rituals, encouraging children's independence, and providing comfort.
Digital behaviour change interventions, particularly those using pervasive computing technology, hold great promise in supporting users to change their behaviour. However, most interventions fail to take habitual behaviour into account, limiting their potential impact. This failure is partly driven by a plethora of overlapping behaviour change theories and related strategies that do not consider the role of habits. We critically review the main theories and models used in the research to analyse their application to designing effective habitual behaviour change interventions. We highlight the potential for Dual Process Theory, modern habit theory, and Goal Setting Theory, which together model how users form and break habits, to drive effective digital interventions. We synthesise these theories into an explanatory framework, the Habit Alteration Model, and use it to outline the state of the art. We identify the opportunities and challenges of habit-focused interventions.
Smart technologies (wearable and mobile devices) show tremendous potential in the detection, diagnosis, and management of Autism Spectrum Disorder (ASD) by enabling continuous real-time data collection, identifying effective treatment strategies, and supporting intervention design and delivery. Though promising, effective utilization of smart technology in aiding ASD is still limited. We propose a set of implications to guide the design of ASD-support technology by analyzing 149 peer-reviewed articles focused on children with autism from ACM Digital Library, IEEE Xplore, and PubMed. Our analysis reveals that technology should facilitate real-time detection and identification of points-of-interest, adapt its behavior driven by the real-time affective state of the user, utilize familiar and unfamiliar features depending on user-context, and aid in revealing even minuscule progress made by children with autism. Our findings indicate that such technology should strive to blend-in with everyday objects. Moreover, gradual exposure and desensitization may facilitate successful adaptation of novel technology.
Parent-child communication is an essential element in behavioral and character development in early childhood; however, parents may find it difficult to be aware of how they talk to their children. Through extensive field studies with experts and parents, we found that parents are more likely to experience communication conflict with preschool children (3-6 years old) on school mornings. In consultation with domain professionals and families, we designed WAKEY, a technology-based approach that helps parents use better communication strategies to teach preschool children to carry out their morning routines. Following the intervention with WAKEY, parents reported significantly reduced levels of frustration during morning routines and greater independent behavior by children. Furthermore, parents reported experiencing changes in their parenting attitudes and finding new insights into communication.
In this paper, we present a design framework for ADHD assistive technologies that aims to give researchers grounding in the background research on the condition, to provide a lingua franca, and to highlight potential research directions for HCI researchers within assistive technology. The design framework couples ADHD patient challenge areas to technological opportunities and it provides a set of practical design strategies for developing successful assistive technologies for people with ADHD. The framework is based on empirical studies, ADHD research, and related work on assistive technologies. We map existing assistive technologies and potential new research efforts to the framework concepts. This way we show how it is used to support and advance the research and development of novel assistive technologies for the ADHD domain.
Parent-training is commonly used to support intervention of children with language delay. Unfortunately, parents find it difficult to apply the training to their child in everyday life and often give up on their parent-child interaction. In this work, we propose and evaluate TalkLIME -- a mobile system that provides real-time feedback to improve the parent-child interaction and reinforce parent-training intervention. We first conduct a survey to understand parents' feedback preference for the mobile system and determine that a non-invasive feedback using the mobile phones screen is preferable. TalkLIME was developed to provide real-time feedback through the mobile phone screen while also providing motivation to the parents to consistently continue parent-child interaction through both short-term and long-term goals. A six-weeks user study was conducted with eight parents and their children with language delay. Our results show that the experimental group who used TalkLIME showed a significant improvement in the child's initiation ratio, an important metric in the language development of children.
Study Objectives
To present psychometric data on a comprehensive, parent-report sleep screening instrument designed for school-aged children, the Children's Sleep Habits Questionnaire (CSHQ). The CSHQ yields both a total score and eight subscale scores, reflecting key sleep domains that encompass the major medical and behavioral sleep disorders in this age group.
Design
Cross-sectional survey.
Setting
Three elementary schools in New England, a pediatric sleep disorders clinic in a children's teaching hospital.
Participants
Parents of 469 school-aged children, aged 4 through 10 years (community sample), and parents of 154 patients diagnosed with sleep disorders in a pediatric sleep clinic completed the CSHQ.
Interventions
N/A
Measurements and Results
The CSHQ showed adequate internal consistency for both the community sample (=0.68) and the clinical sample (=0.78); alpha coefficients for the various subscales of the CSHQ ranged from 0.36 (Parasomnias) to 0.70 (Bedtime Resistance) for the community sample, and from 0.56 (Parasomnias) to 0.93 (Sleep-Disordered Breathing) for the sleep clinic group. Test-retest reliability was acceptable (range 0.62 to 0.79). CSHQ individual items, as well as the subscale and total scores were able to consistently differentiate the community group from the sleep-disordered group, demonstrating validity. A cut-off total CSHQ score of 41 generated by analysis of the Receiver Operator Characteristic Curve (ROC) correctly yielded a sensitivity of 0.80 and specificity of 0.72.
Conclusions
The CSHQ appears to be a useful sleep screening instrument to identify both behaviorally based and medically-based sleep problems in school-aged children.
Children with mental disorders like Attention Deficit Hyperactivity Disorder (ADHD) often experience challenges in school as they struggle to maintain their attention. Based on empirical studies conducted in school contexts and together with teachers and ADHD domain professionals, we identified design criteria in relation to three core components (sensing, recognizing, and assisting) for designing real time assistive technologies for children with ADHD. Based on these design criteria, we designed the Child Activity Sensing and Training Tool (CASTT), a real time assistive prototype that captures activities and assists the child in maintaining attention. From a preliminary evaluation of CASTT with 20 children in several schools, we and found that: 1) it is possible to create a wearable sensor system for children with ADHD that monitors physical and physiological activities in real time; and that 2) real time assistive technologies have potential to assist children with ADHD in regaining attention in critical school situations.
Assistive technologies have proven to support and empower people with a variety of mental diagnoses in performing self-care activities in their everyday lives. However, little research has explored the potentials for assistive technologies for people with Attention Deficit Hyperactivity Disorder (ADHD). In this paper, we identify a set of challenges that children with ADHD typically experience, which provides an empirical foundation for pervasive health researchers to address the ADHD domain. The work is grounded in extensive empirical studies and it is contextualized using literature on ADHD. Based on these studies, we also present lessons learned that are relevant to consider when designing assistive technology to support children with ADHD. Finally, we provide an example (CASTT) of our own work to illustrate how the presented findings can frame research activities and be used to develop novel assistive technology to empower children with ADHD and improve their wellbeing.
Manual tracking of health behaviors affords many benefits, including increased awareness and engagement. However, the capture burden makes long-term manual tracking challenging. In this study on sleep tracking, we examine ways to reduce the capture burden of manual tracking while leveraging its benefits. We report on the design and evaluation of SleepTight, a low-burden, self-monitoring tool that leverages the Android's widgets both to reduce the capture burden and to improve access to information. Through a four-week deployment study (N = 22), we found that participants who used SleepTight with the widgets enabled had a higher sleep diary compliance rate (92%) than participants who used SleepTight without the widgets (73%). In addition, the widgets improved information access and encouraged self-reflection. We discuss how to leverage widgets to help people collect more data and improve access to information, and more broadly, how to design successful manual self-monitoring tools that support self-reflection.
Habit formation is an important part of behavior change interventions: to ensure an intervention has long-term effects, the new behavior has to turn into a habit and become automatic. Smartphone apps could help with this process by supporting habit formation. To better understand how, we conducted a 4-week study exploring the influence of different types of cues and positive reinforcement on habit formation and reviewed the functionality of 115 habit formation apps. We discovered that relying on reminders supported repetition but hindered habit development, while the use of event-based cues led to increased automaticity; positive reinforcement was ineffective. The functionality review revealed that existing apps focus on self-tracking and reminders, and do not support event-based cues. We argue that apps, and technology-based interventions in general, have the potential to provide real habit support, and present design guidelines for interventions that could support habit formation through contextual cues and implementation intentions.
Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common childhood disorders (American Psychiatric Association, 2000); however, recent research suggests that there is a potential for faux-ADHD diagnoses (Pressman & Imber, 2011) which may be due to externalizing problems with a different etiology. One etiology that has received attention is sleep-related behaviors, in so far as they have been correlated with behavioral problems (Presman & Imber, 2011; and see Thunström, 2002 for research on severe infant sleep problems predicting later ADHD diagnoses). This paper adds to the research in suggesting further factors that should be considered by researchers and clinicians.
An increasing number of pervasive healthcare systems are being designed, that allow people to monitor and get feedback on their health and wellness. To address the challenges of self-management of mental illnesses, we have developed the MONARCA system - a personal monitoring system for bipolar patients. We conducted a 14 week field trial in which 12 patients used the system, and we report findings focusing on their experiences. The results were positive; compared to using paper-based forms, the adherence to self-assessment improved; the system was considered very easy to use; and the perceived usefulness of the system was high. Based on this study, the paper discusses three HCI questions related to the design of personal health technologies; how to design for disease awareness and self-treatment, how to ensure adherence to personal health technologies, and the roles of different types of technology platforms.
Language delay is a developmental problem of children who do not acquire language as expected for their chronological ages. Without timely intervention, language delay can act as a lifelong risk factor. Speech-language pathologists highlight that effective parent participation in everyday parent-child conversation is important to treat children's language delay. For effective roles, however, parents need to alter their own lifelong-established conversation habits, requiring extensive period of conscious effort and staying alert. In this paper, we present new opportunities for mobile and social computing to reinforce everyday parent-child conversation with therapeutic implications for children with language delays. Specifically, we propose TalkBetter, a mobile in-situ intervention service to help parents in daily parent-child conversation through real-time meta-linguistic analysis of ongoing conversations. Through extensive field studies with speech-language pathologists and parents, we report the multilateral motivations and implications of TalkBetter. We present our development of TalkBetter prototype and report its performance evaluation.
The bedroom environment can have a significant impact on the quality of a person's sleep. Experts recommend sleeping in a room that is cool, dark, quiet, and free from disruptors to ensure the best quality sleep. However, it is sometimes difficult for a person to assess which factors in the environment may be causing disrupted sleep. In this paper, we present the design, implementation, and initial evaluation of a capture and access system, called Lullaby. Lullaby combines temperature, light, and motion sensors, audio and photos, and an off-the-shelf sleep sensor to provide a comprehensive recording of a person's sleep. Lullaby allows users to review graphs and access recordings of factors relating to their sleep quality and environmental conditions to look for trends and potential causes of sleep disruptions. In this paper, we report results of a feasibility study where participants (N=4) used Lullaby in their homes for two weeks. Based on our experiences, we discuss design insights for sleep technologies, capture and access applications, and personal informatics tools.
Objective:
To investigate the effects of social-skills training and a parental training program on children with ADHD as measured by the children's attachment competences.
Method:
The SOSTRA trial is a randomized, parallel-group, outcome-assessor-blinded, superiority trial evaluating 8 weeks social-skills training and parental training plus standard treatment versus standard treatment alone for 8- to 12-year old children with ADHD.
Results:
There were no significant differences in attachment competences at 6 months between the experimental (n = 25) and the control (n = 22) groups (odds ratio = 1.06, 95% confidence interval = [0.31, 3.58], p = .91). In total, 17 children (36%) changed their entry status, 1 (2%) from secure to insecure attachment, while 16 (34%) changed from insecure to secure attachment.
Conclusion:
The experimental treatment does not seem to affect attachment competences compared with standard treatment alone. Children in the SOSTRA trial improved their attachment competences significantly at 6-month follow-up.
Sleep is a basic physiological process essential for good health. However, 40 million people in the U.S. are diagnosed with sleep disorders, with many more undiagnosed. To help address this problem, we developed an application, ShutEye, which provides a peripheral display on the wall-paper of the user's mobile phone to promote awareness about recommended activities that promote good sleep quality. Based on preferences about the user's desired bed-time and activities' for example - consuming caffeine or performing vigorous exercise - ShutEye displays guidance about when engaging in those activities is likely to affect sleep without requiring any explicit interaction from the user. In this paper, we describe ShutEye and results from a four-week field study with 12 participants. Results indicate that a simple, recommendation-based peripheral display can be a very low-effort but still effective method for improving awareness of healthy sleep habits. We also provide recommendations about designing peripheral displays and extend insights for designing health-based mobile applications.
Objective.-To deal with public and professional concern regarding possible overprescription of attention-deficit/hyperactivity disorder (ADHD) medications, particularly methylphenidate, by reviewing issues related to the diagnosis, optimal treatment, and actual care of ADHD patients and of evidence of patient misuse of ADHD medications. Data Sources.-Literature review using a National Library of Medicine database search far 1975 through March 1997 on the terms attention deficit disorder with hyperactivity methylphenidate, stimulants, and stimulant abuse and dependence, Relevant documents from the Drug Enforcement Administration were also reviewed. Study Selection.-All English-language studies dealing with children of elementary school through high school age were included. Data Extraction.-All searched articles were selected and were made available to coauthors for review, Additional articles known to coauthors were added to the initial list, and a consensus was developed among the coauthors regarding the articles most pertinent to the issues requested in the resolution calling for this report, Relevant information from these articles was included in the report. Data Synthesis.-Diagnostic criteria for ADHD are based on extensive empirical research and, if applied appropriately, lead to the diagnosis of a syndrome with high interrater reliability, good face validity, and high predictability of course and medication responsiveness, The criteria of what constitutes ADHD in children have broadened, and there is a growing appreciation of the persistence of ADHD into adolescence and adulthood, As a result, more children (especially girls), adolescents, and adults are being diagnosed and treated with stimulant medication, and children are being treated for longer periods of time, Epidemiologic studies using standardized diagnostic criteria suggest that 3% to 6% of the school-aged population (elementary through high school) may suffer from ADHD, although the percentage of US youth being treated for ADHD is al most at the lower end of this prevalence range, Pharmacotherapy, particularly use of stimulants, has been extensively studied and generally provides significant short-term symptomatic and academic improvement, There is little evidence that stimulant abuse or diversion is currently a major problem, particularly among those with ADHD, although recent trends suggest that this could increase with the expanding production and use of stimulants. Conclusions.-Although some children are being diagnosed as having ADHD with insufficient evaluation and in some cases stimulant medication is prescribed when treatment alternatives exist, there is little evidence of widespread overdiagnosis or misdiagnosis of ADHD or of widespread overprescription of methylphenidate by physicians.
Thematic analysis is a poorly demarcated, rarely acknowledged, yet widely used qualitative analytic method within psychology. In this paper, we argue that it offers an accessible and theoretically flexible approach to analysing qualitative data. We outline what thematic analysis is, locating it in relation to other qualitative analytic methods that search for themes or patterns, and in relation to different epistemological and ontological positions. We then provide clear guidelines to those wanting to start thematic analysis, or conduct it in a more deliberate and rigorous way, and consider potential pitfalls in conducting thematic analysis. Finally, we outline the disadvantages and advantages of thematic analysis. We conclude by advocating thematic analysis as a useful and flexible method for qualitative research in and beyond psychology.
Early intervention efforts designed to assist parents, teachers, and child therapists to promote children's optimal social and emotional competencies and reduce behavior problems can help lay a positive foundation and put children on a trajectory for future success. The Incredible Years (IY): Parents, Teachers, and Children Training Series is a set of three separate but interlocking evidence-based programs designed to prevent and treat conduct problems and promote social and emotional competence in young children. The first program is for parents, the second for teachers, and the third is for children with conduct or social problems or attention-deficit/hyperactivity disorder. In this chapter, we focus primarily on describing the child-directed play interaction and coaching sections of each of the three IY programs, describing their rationale, theories, and practical uses and how we adjust our approaches to meet the particular developmental needs of each child and family. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
A sedentary lifestyle is a contributing factor to chronic diseases, and it is often correlated with obesity. To promote an increase in physical activity, we created a social computer game, Fish'n'Steps, which links a player's daily foot step count to the growth and activity of an animated virtual character, a fish in a fish tank. As further encouragement, some of the players' fish tanks in- cluded other players' fish, thereby creating an environment of both cooperation and competition. In a fourteen-week study with nineteen participants, the game served as a catalyst for promoting exercise and for improving game players' at- titudes towards physical activity. Furthermore, although most player's enthusi- asm in the game decreased after the game's first two weeks, analyzing the re- sults using Prochaska's Transtheoretical Model of Behavioral Change suggests that individuals had, by that time, established new routines that led to healthier patterns of physical activity in their daily lives. Lessons learned from this study underscore the value of such games to encourage rather than provide negative reinforcement, especially when individuals are not meeting their own expecta- tions, to foster long-term behavioral change.
Personal, mobile displays, such as those on mobile phones, are ubiquitous, yet for the most part, underutilized. We present results from a field experiment that investigated the effectiveness of these displays as a means for improving awareness of daily life (in our case, self-monitoring of physical activity). Twenty-eight participants in three experimental conditions used our UbiFit system for a period of three months in their day-to-day lives over the winter holiday season. Our results show, for example, that participants who had an awareness display were able to maintain their physical activity level (even during the holidays), while the level of physical activity for participants who did not have an awareness display dropped significantly. We discuss our results and their general implications for the use of everyday mobile devices as awareness displays.
Recent advances in small inexpensive sensors, low-power processing, and activity modeling have enabled applications that use on-body sensing and machine learning to infer people's activities throughout everyday life. To address the growing rate of sedentary lifestyles, we have developed a system, UbiFit Garden, which uses these technologies and a personal, mobile display to encourage physical activity. We conducted a 3-week field trial in which 12 participants used the system and report findings focusing on their experiences with the sensing and activity inference. We discuss key implications for systems that use on-body sensing and activity inference to encourage physical activity. Author Keywords
New technologies for encouraging physical activity, healthy diet, and other types of health behavior change now frequently appear in the HCI literature. Yet, how such technologies should be evaluated within the context of HCI research remains unclear. In this paper, we argue that the obvious answer to this question - that evaluations should assess whether a technology brought about the intended change in behavior - is too limited. We propose that demonstrating behavior change is often infeasible as well as unnecessary for a meaningful contribution to HCI research, especially when in the early stages of design or when evaluating novel technologies. As an alternative, we suggest that HCI contributions should focus on efficacy evaluations that are tailored to the specific behavior-change intervention strategies (e.g., self-monitoring, conditioning) embodied in the system and studies that help gain a deep understanding of people's experiences with the technology.
Getting the right amount of quality sleep is a key aspect of good health, along with a healthy diet and regular exercise. Human-computer interaction (HCI) researchers have recently designed systems to support diet and exercise, but sleep has been relatively under-studied in the HCI community. We conducted a literature review and formative study aimed at uncovering opportunities for computing to support the important area of promoting healthy sleep. We present results from interviews with sleep experts, as well as a survey (N = 230) and interviews with potential users (N = 16) to indicate what people would find practical and useful for sleep. Based on these results, we identify a number of design considerations, challenges, and opportunities for using computing to support healthy sleep behaviors, as well as a design framework for mapping the design space of technologies for sleep.
In this paper, we propose design strategies for persuasive technologies that help people who want to change their everyday behaviors. Our strategies use theory and prior work to substantially extend a set of existing design goals. Our extensions specifically account for social characteristics and other tactics that should be supported by persuasive technologies that target long-term discretionary use throughout everyday life. We used these strategies to design and build a system that encourages people to lead a physically active lifestyle. Results from two field studies of the system—a three-week trial and a three-month experiment—have shown that the system was successful at helping people maintain a more physically active lifestyle and validate the usefulness of the strategies.
This paper presents a handheld mobile game, Grocery Hunter that encourages children to take on healthy eating habits. Children can use a pocket PC to play the Grocery Hunter game to learn about food nutrition and healthy food choices. Childhood obesity in the United States has already reached epidemic proportions. The best way to help children attain and maintain healthy weight is through physical activity and nutritious eating. Our design addresses nutrition directly by teaching children healthy eating habits using an interactive game in the grocery store.
The present article provides a brief overview of the clinical use of two of the most commonly used and effective therapies for Attention Deficit-Hyperactivity Disorder (ADHD) in children: stimulant medication treatment and training parents in child behavior management skills. The clinical issues involved in the use of each treatment, as well as their limitations, are reviewed, along with evidence for their efficacy. It is concluded that ADHD is a developmental disorder of attention, impulse control, and regulation of activity level that requires multiple treatment methods, which must be applied over long time intervals if they are to produce an impact on the outcome of children with ADHD.
To present psychometric data on a comprehensive, parent-report sleep screening instrument designed for school-aged children, the Children's Sleep Habits Questionnaire (CSHQ). The CSHQ yields both a total score and eight subscale scores, reflecting key sleep domains that encompass the major medical and behavioral sleep disorders in this age group.
Cross-sectional survey.
Three elementary schools in New England, a pediatric sleep disorders clinic in a children's teaching hospital.
Parents of 469 school-aged children, aged 4 through 10 years (community sample), and parents of 154 patients diagnosed with sleep disorders in a pediatric sleep clinic completed the CSHQ.
N/A.
The CSHQ showed adequate internal consistency for both the community sample (p=0.68) and the clinical sample (p=0.78); alpha coefficients for the various subscales of the CSHQ ranged from 0.36 (Parasomnias) to 0.70 (Bedtime Resistance) for the community sample, and from 0.56 (Parasomnias) to 0.93 (Sleep-Disordered Breathing) for the sleep clinic group. Test-retest reliability was acceptable (range 0.62 to 0.79). CSHQ individual items, as well as the subscale and total scores were able to consistently differentiate the community group from the sleep-disordered group, demonstrating validity. A cut-off total CSHQ score of 41 generated by analysis of the Receiver Operator Characteristic Curve (ROC) correctly yielded a sensitivity of 0.80 and specificity of 0.72.
The CSHQ appears to be a useful sleep screening instrument to identify both behaviorally based and medically-based sleep problems in school-aged children.
Attention deficit/hyperactivity disorder (ADHD) may affect all aspects of a child's life. Indeed, it impacts not only on the child, but also on parents and siblings, causing disturbances to family and marital functioning. The adverse effects of ADHD upon children and their families changes from the preschool years to primary school and adolescence, with varying aspects of the disorder being more prominent at different stages. ADHD may persist into adulthood causing disruptions to both professional and personal life. In addition, ADHD has been associated with increased healthcare costs for patients and their family members.
The worldwide prevalence estimates of attention deficit hyperactivity disorder (ADHD)/hyperkinetic disorder (HD) are highly heterogeneous. Presently, the reasons for this discrepancy remain poorly understood. The purpose of this study was to determine the possible causes of the varied worldwide estimates of the disorder and to compute its worldwide-pooled prevalence.
The authors searched MEDLINE and PsycINFO databases from January 1978 to December 2005 and reviewed textbooks and reference lists of the studies selected. Authors of relevant articles from North America, South America, Europe, Africa, Asia, Oceania, and the Middle East and ADHD/HD experts were contacted. Surveys were included if they reported point prevalence of ADHD/HD for subjects 18 years of age or younger from the general population or schools according to DSM or ICD criteria.
The literature search generated 9,105 records, and 303 full-text articles were reviewed. One hundred and two studies comprising 171,756 subjects from all world regions were included. The ADHD/HD worldwide-pooled prevalence was 5.29%. This estimate was associated with significant variability. In the multivariate metaregression model, diagnostic criteria, source of information, requirement of impairment for diagnosis, and geographic origin of the studies were significantly associated with ADHD/HD prevalence rates. Geographic location was associated with significant variability only between estimates from North America and both Africa and the Middle East. No significant differences were found between Europe and North America.
Our findings suggest that geographic location plays a limited role in the reasons for the large variability of ADHD/HD prevalence estimates worldwide. Instead, this variability seems to be explained primarily by the methodological characteristics of studies.
The predictive validity of symptom criteria for different subtypes of ADHD among children who were impaired in at least one setting in early childhood was examined. Academic achievement was assessed seven times over 8 years in 125 children who met symptom criteria for ADHD at 4-6 years of age and in 130 demographically-matched non-referred comparison children. When intelligence and other confounds were controlled, children who met modified criteria for the predominantly inattentive subtype of ADHD in wave 1 had lower reading, spelling, and mathematics scores over time than both comparison children and children who met modified criteria for the other subtypes of ADHD. In some analyses, children who met modified criteria for the combined type had somewhat lower mathematics scores than comparison children. The robust academic deficits relative to intelligence in the inattentive group in this age range suggest either that inattention results in academic underachievement or that some children in the inattentive group have learning disabilities that cause secondary symptoms of inattention. Unexpectedly, wave 1 internalizing (anxiety and depression) symptoms independently predicted deficits in academic achievement controlling ADHD, intelligence, and other predictors.
Children with Attention Deficit and Hyperactivity Disorder (ADHD) experience a deficit in cognitive processes responsible for goal-directed behaviors, known as executive functioning (EF). In an effort to assist them, we developed TangiPlan -- a prototype of a tangible assistive technology intended to improve EF during morning routines. TangiPlan was designed based on the following guidelines: implement intervention techniques recommended by experts; reduce conflicts with caregivers; avoid intrusion; support flexibility and autonomy. These design guidelines were implemented in a prototype consisting of six tangible objects, each representing a task that needs to be completed during a child's morning routine, and a tablet application for planning tasks and matching them with objects. An initial evaluation of the prototype with two case studies resulted in improved organization and time management, increased satisfaction, and fewer conflicts with parents during morning routines.
In this paper, we explore the qualities of sharing biometric data in real-time between athletes, in order to increase two motivational factors for gym-goers: Enjoyment and social interaction. We present a novel smartphone application, called Race By Hearts, which enables competition based on heart rate data sharing between users in real-time. Through an empirical study conducted in the gym, we show that sharing biometric data in real-time can strengthen social relations between participants, increase motivation, and improve the enjoyment of the fitness activity. Nevertheless, we found that introducing competition based on real-time sharing of biometric data can cause exasperation and discouragement for some athletes. Based on our findings from the study, we discuss how technology can facilitate and modify competition in fitness exercises in general.
Parenting is always demanding, but families coping with neurodevelopmental disorders, such as ADHD, experience unique challenges. To address these challenges, research in the area of Parental Behavioral Therapy is accelerating. This type of therapy focuses on behavioral strategies that, if practiced regularly, can have a positive impact on the child's long-term behavior, as well as a reduction in parental stress. While these strategies are simple, there are hurdles to putting them into practice. First, parents often struggle with their own-often-undiagnosed-mental health challenges. Second, due to the needs of their children, parents are under immense stress in addition to regular, daily life stresses. Our work explores how to monitor parental stress and offers in situ support to remind parents of behavioral strategies to practice in moments of duress. We gained insight into how to design for the dynamics of families with ADHD children by using a prototype of our system as a probe. Our goal was to bring to the forefront simple strategies that can positively impact family ties and enhance the wellbeing of the child. We present results that suggest that when interventions are cued during moments of duress, technology might prove useful in supporting behavioral therapy.
Children with Attention Deficit and Hyperactivity Disorder (ADHD) experience a deficit in cognitive processes responsible for purposeful goal-directed behaviors, known as executive functioning (EF). In an effort to improve EF, we are developing TangiPlan-a set of tangible connected objects that represent tasks children perform during their morning routine. We describe the initial stages of a user-centered design process, consisting of interviews with both domain experts and potential users, followed by paper prototyping. Based on our findings, we formulated preliminary design principles for EF assistive technology: facilitate organization, time management and planning; involve caregivers in the process, but strive to reduce conflict; implement intervention techniques suggested by experts; avoid distraction by mobile phones; avoid intrusion. We discuss the benefits of implementing these principles with a tangible interface, present our prototype design, and describe future directions.
Color blindness is a highly prevalent vision impairment that inhibits people's ability to understand colors. Although classified as a mild disability, color blindness has important effects on the daily activity of people, preventing them from performing their tasks in the most natural and effective ways. In order to address this issue we developed Chroma, a wearable augmented-reality system based on Google Glass that allows users to see a filtered image of the current scene in real-time. Chroma automatically adapts the scene-view based on the type of color blindness, and features dedicated algorithms for color saliency. Based on interviews with 23 people with color blindness we implemented four modes to help colorblind individuals distinguish colors they usually can't see. Although Glass still has important limitations, initial tests of Chroma in the lab show that colorblind individuals using Chroma can improve their color recognition in a variety of real-world activities. The deployment of Chroma on a wearable augmented-reality device makes it an effective digital aid with the potential to augment everyday activities, effectively providing access to different color dimensions for colorblind people. Copyright
Download Free Sample
Development, deployment, and evaluation of interactive technologies for individuals with autism have been rapidly increasing over the last decade. There is great promise for the use of these types of technologies to enrich interventions, facilitate communication, and support data collection. Emerging technologies in this area also have the potential to enhance assessment and diagnosis of individuals with autism, to understand the nature of autism, and to help researchers conduct basic and applied research. This book provides an in-depth review of the historical and state-of-the-art use of technology by and for individuals with autism. The intention is to give readers a comprehensive background in order to understand what has been done and what promises and challenges lie ahead. By providing a classification scheme and general review, this book can also help technology designers and researchers better understand what technologies have been successful, what problems remain open, and where innovations can further address challenges and opportunities for individuals with autism and the variety of stakeholders connected to them.
Table of Contents: Introduction / Methods and Classification Scheme / Personal Computers and the Web / Video and Multimedia / Mobile Technologies / Shared Active Surfaces / Virtual and Augmented Reality / Sensor-Based and Wearable / Robotics / Natural User Interfaces / Discussion and Conclusions / References
Social and emotional skills are crucial for all aspects of our everyday life. However, understanding how digital technology can facilitate the development and learning of such skills is yet an under-researched area in HCI. To start addressing this gap, this paper reports on a series of interviews and design workshops with the leading researchers and developers of 'Social and Emotional Learning' (SEL) curricula. SEL is a subfield of educational psychology with a long history of teaching such skills, and a range of evidence based curricula that are widely deployed in primary and secondary schools. We identify the shared challenges across existing curricula that digital technology might help address: the support for out-of-session learning, scaffolding for parental engagement, and feedback for the curricula developers. We argue how this presents an opportunity for mutually beneficial collaborations , with the potential for significant real-world impact of novel HCI systems, and can inform HCI work on supporting social and emotional skills development in other domains.
Objective: to perform a meta-analysis of subjective (i.e., based on questionnaires) and objective (i.e., using poly-somnography or actigraphy) studies comparing sleep in children with attention-deficit/hyperactivity disorder (ADHD) versus controls.
Method: we searched for subjective and objective sleep studies (1987–2008) in children with ADHD (diagnosed according to standardized criteria). Studies including subjects pharmacologically treated or with comorbid anxiety/depressive disorders were excluded.
Results: sixteen studies, providing 9 subjective and 15 objective parameters and including a total p