Hideki Negoro’s research while affiliated with Nara University of Education and other places

Aim Current clinical guidelines for attention‐deficit/hyperactivity disorder (ADHD) put shared decision making (SDM) at the center of care. However, there remain challenges in SDM in ADHD management, particularly regarding the decision to continue or discontinue medication after ADHD remission in adult patients. We aimed to develop a decision aid (DA) for adult patients with ADHD regarding the continuation or discontinuation of their ongoing ADHD medications after they have attained remission. Method We systematically developed a DA according to the International Patient Decision Aid Standard (IPDAS). First, we created a DA prototype using the results of our previous systematic review and meta‐analysis that identified the consequences of continuing and discontinuing ADHD medications. Second, we administered a mixed‐method questionnaire (alpha acceptability testing) to adult patients with ADHD and healthcare providers to improve the DA prototype and develop it into a final version that is acceptable for clinical settings. Results Our DA consisted of ADHD description, the option to continue or discontinue ADHD medications, the advantages and disadvantages of the consequences, as well as value clarification exercises for each option. Patients ( n = 20) reported that the DA had acceptable language (85%), adequate information (75%), and a well‐balanced presentation (53%). Healthcare providers ( n = 19) provided favorable feedback. The final DA met all six IPDAS requisite criteria. Conclusions Our results could facilitate the SDM process between patients and healthcare providers on the continuation or discontinuation of ADHD medication following remission. Further studies should verify the effects of using the DA during the SDM process among patients across the age spectrum with ADHD and healthcare providers.

Objective: This study aimed to compare the effect of continuing and discontinuing medications on quality of life of patients with attention-deficit/hyperactivity disorder (ADHD). Data sources: PubMed, Cochrane Library, and Embase databases were searched using generic terms for ADHD, discontinuing, continuing, pharmacotherapy, and randomized controlled trials without date or language restrictions. Study selection: Of the 3,672 screened studies, 9 met the predefined inclusion criteria on patients with ADHD; 5 of these 9 studies reporting on 1,463 patients (children and adolescents, n = 894; adults, n = 569) measured quality of life and were included in this meta-analysis. Only randomized, double-blind, placebo-controlled withdrawal trials of ADHD medications were included. Data extraction: Data were independently extracted according to the Cochrane Handbook for Systematic Reviews of Interventions. Analyses were based on random-effects models. Results: Compared with continuing medications, discontinuing them significantly worsened quality of life score in patients with ADHD (standardized mean difference [SMD] = 0.19; 95% CI, 0.08 to 0.30]). Moreover, discontinuing medications worsened this score in children and adolescents with ADHD (SMD = 0.21; 95% CI, 0.06 to 0.36) but not in adults with ADHD (SMD = 0.02; 95% CI, -0.46 to 0.50). Conclusions: Discontinuing medications was associated with a small but statistically significant decrease in quality of life among children and adolescents with ADHD but not in adults with ADHD. Quality of life can be applied in pharmacologic interventions regarding continuing and discontinuing medication because this concept is related to individuals' appraisal of their situation. Quality of life is an important factor for planning individualized ADHD medication treatment.

Listening skills are critical for human communication. Social skills training (SST), performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches speaking skills through interaction with a computer agent. Even though previous work that simulated social skills training considered speaking skills, the SST framework incorporates other skills, such as listening, asking questions, and expressing discomfort. In this paper, we extend our automated social skills training by considering user listening skills during conversations with computer agents. We prepared two scenarios: Listening 1 and Listening 2, which respectively assume small talk and job training. A female agent spoke to the participants about a recent story and how to make a telephone call, and the participants listened. We recorded the data of 27 Japanese graduate students who interacted with the agent. Two expert external raters assessed the participants’ listening skills. We manually extracted features that might be related to the eye fixation and behavioral cues of the participants and confirmed that a simple linear regression with selected features correctly predicted listening skills with a correlation coefficient above 0.50 in both scenarios. The number of noddings and backchannels within the utterances contributes to the predictions because we found that just using these two features predicted listening skills with a correlation coefficient above 0.43. Since these two features are easier to understand for users, we plan to integrate them into the framework of automated social skills training.

Social skills training (SST) is implemented to improve adaptation in everyday life situations, by elevating self-esteem through repeated experience of success with social skills such as inviting, conversation, and emotion-control. A certain degree of efficacy has been reported for SST in children with attention-deficit/hyperactivity disorder (ADHD). However, the majority of such studies have been in the form of behavioral assessments by caregivers and other such individuals, with few if any reports on evaluation in terms of biological indicators. Study of event-related potentials (ERP) in children with ADHD has shown prolonged latency and reduced amplitude of P300 as well as reduction in amplitude of mismatch negativity (MMN) compared to normal controls. We measured both P300 and MMN before and after SST in 15 children diagnosed with ADHD, and found significantly greater MMN amplitudes after SST at C4, demonstrating efficacy of SST for children with ADHD from the biological perspective.

Social skills training, performed by human trainers, is a well-established method for obtaining appropriate skills in social interaction. Previous work automated the process of social skills training by developing a dialogue system that teaches social skills through interaction with a computer agent. Even though previous work that simulated social skills training considered speaking skills, human social skills trainers take into account other skills such as listening. In this paper, we propose assessment of user listening skills during conversation with computer agents toward automated social skills training. We recorded data of 27 Japanese graduate students interacting with a female agent. The agent spoke to the participants about a recent memorable story and how to make a telephone call, and the participants listened. Two expert external raters assessed the participants' listening skills. We manually extracted features relating to eye fixation and behavioral cues of the participants, and confirmed that a simple linear regression with selected features can correctly predict a user's listening skills with above 0.45 correlation coefficient.