The document describes three assistive technologies designed to support children with ADHD: CASTT, ChillFish, and MOBERO. CASTT uses wearable sensors and machine learning to detect physical activity patterns and help children regain concentration in school. ChillFish is a biofeedback game that uses breathing detection to help children relax. Studies found it improved relaxation similar to traditional exercises. MOBERO supports morning and bedtime routines through a mobile app. A study found it reduced ADHD symptoms by 19% and improved sleep quality by 10% for children and lowered parental frustration with routines.

1. 1
www.tobiassonne.com
Tobias Sonne
IT STØTTE TIL BØRN MED ADHD

2. AGENDA
• Introduktion
• Koncentrations-støtte (CASTT)
• ‘Calming’-støtte(ChillFish)
• Søvn-støtte(MOBERO)
• Opsummering
2

3. INTRODUKTION
3

4. DESIGN PROCESSEN
Hands-on training
(Center for ADHD)
Design processer med
ADHD professionelle
and familier
Empiriske studier
med børn med
ADHD + familier.
Observationer,
interviews, og
litteratur reviews
4

5. AGENDA
• Introduktion
• Koncentrations-støtte (CASTT)
• ‘Calming’-støtte(ChillFish)
• Søvn-støtte(MOBERO)
• Opsummering
5

6. CASTT
Koncentrations-støtte
Sonne, T., Marshall, P., Obel, C., Thomsen, P. H., & Grønbæk, K. (2016). An Assistive Technology Design Framework for ADHD. In Proceedings of the Annual Meeting of the
Australian Special Interest Group for Computer Human Interaction. New York, NY, USA: ACM.
Sonne, T., & Grønbæk, K. (2015). Designing Assistive Technologies for the ADHD Domain. In S. Serino, A. Matic, D. Giakoumis, G. Lopez, & P. Cipresso (Eds.), Pervasive
Computing Paradigms for Mental Health (pp. 259–268). Springer International Publishing. https://doi.org/10.1007/978-3-319-32270-4_26

7. CASTT
Formål
• Objektiv detektering af fysisk og fysiologisk
aktivitet
• Bruge machine-learning (maskin-læring) til at
genkende et udsnit af karakteristiske ADHD
bevægelses-mønstre.
• Undersøge hvordan teknologi kan støtte børn
med ADHD til at vedholde og/eller genvinde
koncentrationen i skolesituationer.
7

8. 8
CASTT
Implementering

9. CASTT
Implementering
9

10. 10
Fem forskellige skoler med:
11 børn uden ADHD
6 børn med ADHD
CASTT
Empiriske studier

11. LESSONS LEARNED
11

12. BARNETS AKTIVITETSNIVEAU
I 2 minutters Intervaller

13. CASTT
Opsummering
• CASTT er et wearable system som
støtter børn med ADHD til at genvinde
koncentrationen i skolesituationer.
• CASTT var iterativt designet og
evalueret med 5 skoler med børn
med og uden ADHD.
• CASTT studierne viste mulighederne
for at støtte et barn med ADHD til at
genvinde koncentrationen i ‘kritiske’
skole situationer.
13

14. AGENDA
• Introduktion
• Koncentrations-støtte (CASTT)
• ‘Calming’-støtte(ChillFish)
• Søvn-støtte(MOBERO)
• Opsummering
14

15. CHILLFISH
Calming Assistance
15
Sonne, T., & Jensen, M. M. (2016a). ChillFish: A Respiration Game for Children with ADHD. In Proceedings of the TEI ’16: Tenth International Conference on Tangible,
Embedded, and Embodied Interaction (pp. 271–278). New York, NY, USA: ACM. https://doi.org/10.1145/2839462.2839480
Sonne, T., & Jensen, M. M. (2016b). Evaluating the ChillFish Biofeedback Game with Children with ADHD. In Proceedings of the The 15th International Conference on
Interaction Design and Children (pp. 529–534). New York, NY, USA: ACM. https://doi.org/10.1145/2930674.2935981

16. CHILLFISH
Eksisterende praksis
16
Åndedrætsøvelser
(“forestill dig at du dufter til en rose…”)

17. CHILLFISH (VIDEO)
17

18. CHILLFISH
Designet specielt til børn
18
Designed for children
(Calming and playfull game experience)
Uses a tangible LEGO fish
to detect breathing patterns
+

19. CHILLFISH
Studier
19
16 voskne 12 børn with ADHD

20. CHILLFISH
Study Design (1st study)
20
Play test:
ChillFish
2 min
Play test:
ChillFish
2 min
Relaxation
exercise
2 min
Conversation
/ introduction
2-4 min
Conversation
/ interview
2-6 min
Conversation
/ interview
2-6 min
Play test:
Pac-Man
2 min

21. CHILLFISH
Quantitative Findings
21
NormalizedHRV(RMMSD)
0
0,15
0,3
0,45
0,6
Talk 1 ChillFish Pac-man ChillFish Talk 2 Relaxation Exercise Talk 3
0,363
0,434
0,332
0,507
0,208
0,424
0,326

22. CHILLFISH
2nd study - Children with ADHD
22

23. CHILLFISH
Quantitative Findings (Children with ADHD)
23

24. CHILLFISH
Opsummering
• ChillFish er det første biofeedback spil
designed specifik til at hjælpe børn med
ADHD til at falde til ro og slappe af.
• ChillFish er revalueret med både voksne
og børn med ADHD
• ChillFish giver en ligende eller bedre
afslappende effekt end en traditionelt
åndedrætsøvelse.
• (Bonus) ChillFish er også testet med
success på Skejby Sygehus i forbindelse
med at børn fik taget blodprøver.
24

25. AGENDA
• Introduktion
• Koncentrations-støtte (CASTT)
• ‘Calming’-støtte(ChillFish)
• Søvn-støtte(MOBERO)
• Opsummering
25

26. MOBERO
Søvn-støtte
26
Sonne, T., Müller, J., Marshall, P., Obel, C., & Grønbæk, K. (2016). Changing Family Practices with Assistive Technology: MOBERO Improves Morning and Bedtime
Routines for Children with ADHD. In Proceedings of the 34th Annual ACM Conference on Human Factors in Computing Systems. New York, NY, USA: ACM.
Sonne, T., Marshall, P., Müller, J., Obel, C., & Grønbæk, K. (2016). A Follow-up Study of a Successful Assistive Technology for Children with ADHD and Their
Families. In Proceedings of The 15th International Conference on Interaction Design and Children (pp. 400–407). New York, NY, USA: ACM.

27. MOBERO
Søvn problemer og ADHD
Anne Virring, Rikke Lambek, Per H. Thomsen, Lene R. Møller, and Poul J. Jennum. 2016. Disturbed sleep in attention-deficit hyperactivity disorder (ADHD) is not a question of psychiatric comorbidity or ADHD
presentation. Journal of Sleep Research. http://doi.org/10.1111/jsr.12377
70%of all children with ADHD have sleep problems
27

28. 28
Indlæring Adfærd Wellbeing Kognitive
Funktioner
Cortese, S. et al. 2009. Sleep in Children With Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Subjective and Objective Studies.
Journal of the American Academy of Child & Adolescent Psychiatry
Dewald, J.F. et al. 2010. The influence of sleep quality, sleep duration and sleepiness on school performance in children and adolescents: A meta-analytic review.
Sleep Medicine Reviews.
MOBERO
Søvn problemer og ADHD

29. Cortese, S. et al. 2009. Sleep in Children With Attention-Deficit/Hyperactivity Disorder: Meta-Analysis of Subjective and Objective Studies.
Journal of the American Academy of Child & Adolescent Psychiatry

30. Mor: “Der er en råben og skrigen fra alle sider, selv
fra vores, op til 30min før han [barnet] er kommet
seng”
Far: “Når du endelig kommer nedenunder, falder
du simplethen bare om”
Mor: “Der har været gange hvor jeg næsten ikke
har haft kræfter til at lægge ham i seng”

31. MOBERO
Morning & Bedtime Routines
31

32. MOBERO
Morning & Bedtime Routines
32

33. MOBERO
Morning & Bedtime Routines
33

34. MOBERO
Morning & Bedtime Routines
34

35. MOBERO
Morning & Bedtime Routines
35

36. MOBERO
Morning & Bedtime Routines
36

37. MOBERO
Study Design
37

38. 13 børn med ADHD
4 piger
9.3 gennemsnitsalder
7 tog ADHD medicin
38

39. 39
Baseline
2 uger
Intervention
2 uger
13 Children with ADHD

40. 40
Baseline
2 uger
Intervention
2 uger

41. 41
ADHD Rating Scale-IV
(ADHD-RS)
Faries, D.E. et al. 2001. Validation of the ADHD Rating Scale as a clirlician administered and scored instrument. Journal of Attention Disorders.

42. 42
ADHD Rating Scale-IV
(ADHD-RS)
The Children's
Sleep Habits Questionnaire
(CSHQ)
Owens, J.A. et al. 2000. The Children’s Sleep Habits Questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep.

43. 43
ADHD-RS
CSHQ
Start Baseline Start Intervention End of study
Week 2 Week 4Week 0
ADHD-RS
CSHQ

44. 44
rt Intervention End of study
Week 2 Week 4
ADHD-RS
CSHQ
Week 8
Interviews
End of follow-up study

45. 19%
reduction
ADHD SYMPTOMS
45

46. ADHD-RS
Parent rated ADHD Symptoms
46
6
11
17
22
Inattention Hyperactivity/Impulsivity Behaviour
8,6
15,8
17,2
11,7
17,9
21,5
Baseline Intervention

47. 10%
improvement
SLEEP QUALITY
47

48. “[Barnets navn] var selvkørende under sengerutinen”
Baseline
Intervention
0 % 20 % 40 % 60 % 80 % 100 %
2 %
20 %
12 %
15 %
20 %
22 %
38 %
35 %
28 %
7 %
Meget enig Enig Neutral Uenig Meget uenig
48

49. “Jeg oplevede sengerutinen som frustrerende”
Baseline
Intervention
0 % 20 % 40 % 60 % 80 % 100 %
3 %
20 %
12 %
13 %
20 %
25 %
32 %
32 %
33 %
11 %
Meget uenig Uenig Neutral Enig Meget enig
49

50. “Also, it [a paper-based tool] is not involving
in the same way, I mean, a piece of paper
appeals to something for adults right?”
QUALITATIVE FINDINGS
The qualities of a technological approach
50

51. “We have tried several different [physical]
charts, but after a few days there are torn
apart or have vanished. This [MOBERO] is
always there, so that is convenient”
51
QUALITATIVE FINDINGS
The qualities of a technological approach

52. “Because it is on the phone
he accepts the sequence completely”
QUALITATIVE FINDINGS
Children do not question tasks in MOBERO
52

53. 53
“I do not have to tell him to wash his hands.
Before, he did not want to
and there would be a bloody fight
if he had to wash his hands
– and now he also just does that”
QUALITATIVE FINDINGS
Children do not question tasks in MOBERO

54. “[…] then he put his socks on, he has never done that
before, but now there is an activity saying “put socks
on”, and then he just does it (laughing)
54
QUALITATIVE FINDINGS
Children do not question tasks in MOBERO

55. “He thinks today is the worst day in his life
because you come and pick up
the phone [MOBERO]”
55
QUALITATIVE FINDINGS
Children integrated MOBERO into their daily routines

56. MOBERO
Opsummering
• 4 ugers studie med 13 børn med ADHD
og deres familier der benyttede MOBERO
• Forældrene rapporterede:
• 19% Reduktion i ADHD symptomer
• 10% Forbedret søvnkvalitet
• Lavere frustration hos forældrene
omkring morgen og sengerutiner
• Højere grad af selvstændighed hos
børnene
56
MOBERO

57. AFRUNDING
• Teknologi holder unikke muligheder for
at forbedre eksisterende praksis,
analoge redskaber og give støtte til
børn med ADHD.
• CASTT, ChillFish og MOBERO er
eksempler på hvordan teknologi kan
støtte og styrke børn med ADHD (og
deres familier).
• Teknologi bør støtte og ikke erstatte
fagprofessionelle og/eller eksisterende
behandlinger.
57

58. TAK
www.tobiassonne.com
t.sonne@ucl.ac.uk
58
Tobias Sonne

59. SPØRGSMÅL / KOMMENTARER?
59
www.tobiassonne.com
t.sonne@ucl.ac.uk
Tobias Sonne