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ITAG 2014, Nottingham, 17/10/2013 
From SnappyApp to Screens in the Wild: Gamifying an Attention Deficit Hyperactivity Dis...
2 
Nottingham MindTech: Mental Health & Dementia 
Sheffield: Devices for Dignity 
Cambridge: Brain Injury 
Bart’s: Gastroi...
Contents 
1.Motivations: Public awareness of mental health 
2.Attention Deficit Hyperactivity Disorder in Adults 
3.Screen...
Public awareness of Mental Health 
•Motivations 
–Address stigma 
–Provide information for the public 
–Align with MindTec...
What is Attention Deficit Hyperactivity Disorder? 
•ADHD is a common neurodevelopmental condition 
•ADHD affects around 3-...
Core Characteristics of ADHD 
Inattention 
Difficultly concentrating/completing tasks, forgetful, disorganised, easily dis...
Why is it important to raise public awareness about ADHD in adults? 
Despite advancements in research validating the condi...
What are the consequences of this? 
•Research has found public uncertainty about the validity of ADHD as a diagnosis and s...
A film about living with ADHD 
•Developed with 5 service users from local adult ADHD clinic 
•Describe their experiences o...
10
Very few examples of games for public mental health awareness 
–Flash game: Talk Out Loud Mental Health Stigma Programme 
...
Screens in the Wild Network 
12 
Application server 
Video link 
24/7 
Management 
Maintenance 
CCTV IP Cam 
Content Sched...
13 
SITW continues during 2014 
UoN supports network for 12 months from January 2014 
Outreach work: 
•Promoting science a...
ADHD Continuous Performance Tests (CPT) 
Computer based task widely used to objectively measure attention and impulsivity...
Snappy App 
A CPT on a smartphone 
Objective measure of attention, impulsivity and activity 
Capture of movement data d...
SnappyApp video 
16
17 
→ 
→ 
+ 
Evolution of ‘Attention Grabber’ 
•Fruit instead of letters 
•Simpler ‘test’ 
•Add score and hi-score 
•Encou...
18 
Evaluation questionnaire 
Question 
Rating scale 
Q1. Did playing the game make you think about your own attention spa...
19 
Initial results 
•4 sites (BW, WA, LE, NA) 
•Official launch 4th Sept 
•520 plays by 1st Oct: 
– 156 (BW), 183 (WA), 1...
20 
Results (LE) 
•Leytonstone Library (LE) 
•134 plays 
•47(Q1), 47(Q2), 47(Q3), 34(Q4) 
Question 
Rating scale 
Q1. Did ...
21 
Results (BW) 
•Broadway Cinema (BW) 
•156 plays 
•71(Q1), 70(Q2), 63(Q3), 58(Q4) 
Question 
Rating scale 
Q1. Did play...
Conclusions 
•Evidence of good engagement with the game and film 
•However, different ADHD awareness at different screen l...
Dr. Michael Craven, NIHR MindTech Healthcare Technology Co-operative 
Senior Research Fellow (Technology), University of N...
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From SnappyApp to Screens in the Wild: Gamifying an Attention Hyperactivity Deficit Disorder continuous performance test for public engagement and awareness

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From SnappyApp to Screens in the Wild: Gamifying an Attention Hyperactivity Deficit Disorder continuous performance test for public engagement and awareness

Michael P. Craven, Zoe Young, Lucy Simons, Holger Schnädelbach and Alinda Gillott

Interactive Technologies and Games (ITAG) Conference 2014
Health, Disability and Education
Dates: Thursday 16 October 2014 - Friday 17 October 2014
Location: The Council House, NG1 2DT, Nottingham, UK

Published in: Education
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From SnappyApp to Screens in the Wild: Gamifying an Attention Hyperactivity Deficit Disorder continuous performance test for public engagement and awareness

  1. 1. ITAG 2014, Nottingham, 17/10/2013 From SnappyApp to Screens in the Wild: Gamifying an Attention Deficit Hyperactivity Disorder continuous performance test for public engagement and awareness NIHR MindTech Healthcare Technology Co-operative Michael Craven, Zoe Young, Lucy Simons, Holger Schnädelbach, Alinda Gillott University of Nottingham: Institute of Mental Health +Faculty of Engineering +School of Computer Science & IT Nottinghamshire Healthcare NHS Trust Intellectual and Developmental Disabilities Service
  2. 2. 2 Nottingham MindTech: Mental Health & Dementia Sheffield: Devices for Dignity Cambridge: Brain Injury Bart’s: Gastrointestinal Disease Guy’s: Cardiovascular Disease Leeds: Colorectal Therapies Bradford: Wound Care Birmingham: Trauma Management •A catalyst for the development of new technologies •Focusing on 8 areas of high unmet clinical need •Working with NHS, service users, academia &industry NIHR Healthcare Technology Co-operatives
  3. 3. Contents 1.Motivations: Public awareness of mental health 2.Attention Deficit Hyperactivity Disorder in Adults 3.Screens in the Wild public screen network 4.SnappyApp – ADHD App 5.Attention Grabber design 6.Initial results 7.Conclusions 3
  4. 4. Public awareness of Mental Health •Motivations –Address stigma –Provide information for the public –Align with MindTech domain interests –Neurodevelopmental disorders – (Adult) ADHD –Use new technologies –Explore gamification 4
  5. 5. What is Attention Deficit Hyperactivity Disorder? •ADHD is a common neurodevelopmental condition •ADHD affects around 3-5% of the general population •Approximately two-thirds of children with ADHD will continue to experience symptoms in adulthood (2.5% adult population; Simon et al., 2009) •Many adults with ADHD have never been formally diagnosed •Frequent co-morbidities, substance misuse, offending (Xenitidis, Maltezos & Pitts, 2011); wide social & economic impact •Diagnosis can have a significant positive impact for the individual and help to direct appropriate treatment and support
  6. 6. Core Characteristics of ADHD Inattention Difficultly concentrating/completing tasks, forgetful, disorganised, easily distracted, unable to listen Hyperactivity Fidgety, unable to sit still, talks excessively, always on the go, inner restlessness Impulsivity Acting quickly without thinking, interrupting other people, difficulty waiting turn
  7. 7. Why is it important to raise public awareness about ADHD in adults? Despite advancements in research validating the condition, ADHD remains controversial ‘ADHD doesn’t exist’ ‘its an excuse for bad behaviour’ ‘its an excuse for poor parenting’ ‘you grow out of ADHD’ ‘its invented by the pharmaceutical industry to sell medication’
  8. 8. What are the consequences of this? •Research has found public uncertainty about the validity of ADHD as a diagnosis and scepticism towards ADHD treatment (Mueller et al, 2012) •Could need to negative response in disclosing an ADHD diagnosis (isolation) •Significant implications for access & engagement with appropriate diagnosis and treatment
  9. 9. A film about living with ADHD •Developed with 5 service users from local adult ADHD clinic •Describe their experiences of living with ADHD as a child and now •Used in the clinic as post- diagnostic support tool & training resource
  10. 10. 10
  11. 11. Very few examples of games for public mental health awareness –Flash game: Talk Out Loud Mental Health Stigma Programme –Depression Quest: narrative-based adventure game –Few evaluations of mental awareness campaigns 11 C. Henderson and G. Thornicroft, “Evaluation of the Time to Change programme in England 2008-2011,” British Journal of Psychiatry, vol. 202, suppl. 55, pp. s45-s48, 2013.
  12. 12. Screens in the Wild Network 12 Application server Video link 24/7 Management Maintenance CCTV IP Cam Content Scheduling www.screensinthewild.org
  13. 13. 13 SITW continues during 2014 UoN supports network for 12 months from January 2014 Outreach work: •Promoting science and scientific outcomes •Supporting 3rd party non-profit organisations Commercialisation: •Sponsored experiences •Technical test bed for corporations •Sale of network / copies of the network
  14. 14. ADHD Continuous Performance Tests (CPT) Computer based task widely used to objectively measure attention and impulsivity and response to medication Requires the detection of low probability targets and inhibit response to non-targets A-X task highly specific – ADHD and controls clearly differentiated (van Leeuwen et al., 1998) Methylphenidate can improve performance on CPT (Klorman et al., 1981) One CPT (QbTest) includes measurement of motor activity - activity higher in ADHD children and adults and co-varied with cognitive performance (Lis et al., 2010) – QbTest
  15. 15. Snappy App A CPT on a smartphone Objective measure of attention, impulsivity and activity Capture of movement data during the test Early stages of development Objective Establish whether a new smartphone application combining the cued CPT with a physical activity measure could be appropriate for monitoring symptoms in a clinical population.
  16. 16. SnappyApp video 16
  17. 17. 17 → → + Evolution of ‘Attention Grabber’ •Fruit instead of letters •Simpler ‘test’ •Add score and hi-score •Encouraging messages •Include ADHD film •Share hi-scores •Player video-streams •Pose questions
  18. 18. 18 Evaluation questionnaire Question Rating scale Q1. Did playing the game make you think about your own attention span? A lot Some A little Not at All Q2. How much do you know about ADHD? A lot Some A little None at All Q3. How aware are you that ADHD affects adults? A lot Some A little Not at All Q4. How much has the film increased your knowledge of ADHD? A lot Some A little Not at All
  19. 19. 19 Initial results •4 sites (BW, WA, LE, NA) •Official launch 4th Sept •520 plays by 1st Oct: – 156 (BW), 183 (WA), 134 (LE), 47 (NA) •47% played game until end (answered Q1) •18% watched film until end (answered Q4)
  20. 20. 20 Results (LE) •Leytonstone Library (LE) •134 plays •47(Q1), 47(Q2), 47(Q3), 34(Q4) Question Rating scale Q1. Did playing the game make you think about your own attention span? A lot 2 Some 3 A little 24 Not at all 18 Q2. How much do you know about ADHD? A lot 4 Some 15 A little 5 None at all 21 Q3. How aware are you that ADHD affects adults? A lot 7 Some 0 A little 13 Not at all 25 Q4. How much has the film increased your knowledge of ADHD? A lot 11 Some 9 A little 12 Not at all 3
  21. 21. 21 Results (BW) •Broadway Cinema (BW) •156 plays •71(Q1), 70(Q2), 63(Q3), 58(Q4) Question Rating scale Q1. Did playing the game make you think about your own attention span? A lot 9 Some 16 A little 29 Not at all 17 Q2. How much do you know about ADHD? A lot 43 Some 10 A little 13 None at all 4 Q3. How aware are you that ADHD affects adults? A lot 25 Some 17 A little 7 Not at all 8 Q4. How much has the film increased your knowledge of ADHD? A lot 39 Some 12 A little 7 Not at all 0
  22. 22. Conclusions •Evidence of good engagement with the game and film •However, different ADHD awareness at different screen locations – demographics? •Ethical issues – health anxiety vs. benefits of awareness (e.g. K. A. Robb, A. Miles, J. Campbell, P. Evans, and J. Wardle, “Can cancer risk information raise awareness without increasing anxiety? A randomized trial,” Preventative Medicine, vol. 43, no. 3, pp. 187-190, 2006.) •Gamifying the original ADHD App? 22
  23. 23. Dr. Michael Craven, NIHR MindTech Healthcare Technology Co-operative Senior Research Fellow (Technology), University of Nottingham, United Kingdom michael.craven@nottingham.ac.uk www.mindtech.org.uk @NIHR_MindTech Thank you 23

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