ADHD Treatment Through Neuroplasticity

2
One of the biggest problems with the way ADHD
is viewed today is the fact that many children are being
diagnosed or over-diagnosed and prescribed narcotics
(Ritalin) to treat ADHD. This affects their lives negatively,
and the long term effects are uncertain. We want to
address the problem by finding an alternative method to
treat ADHD by exploring the executive functions and the
way they can be developed with Neuroplasticity.
“

3
ADHD
Executive functions and
dysfunctions
Diagnosis
Brain functions
ADHD-journey
Digital tools
Preventive work
Mindgames
Rafael Centeret
Research summary
Beginning of mapping
ADHD other diagnoses
Mapping while researching
Mapping the school system
Mapping patient journey
First iteration
Reliable methods
Evaluation of concepts
Implementation
Mapping Rafael Centeret
Mapping research on
Neuroplasticity
Last iteration of map
Mapping research & result
Mapping summary
Early sketching
Creative workshop
Concept “Blinking ball”
Concept
“Physical controls”
Concept “Utilising Kinect”
Concept “iPad-game”
Production of iPad-game
The experience of the iPad-
game
Concept
“Tangible Memory”
Production of
Tangible Memory
The experience of Tangible
Memory
Production summary
Reflections
References
9
13
15
17
19
23
25
27
29
30
35
37
43
44
47
48
50
52
54
57
59
61
62
65
69
71
72
74
76
78
81
87
89
91
95
96
100
102
RESEARCH MAPPING PRODUCTION
Index

4
Valeria Gaitan
STUDENTS
SUPERVISORS
Berit Killingbergtrø Havåg
Charlotte Lunde
Team
Sven Håkon Voldum
Mosse Sjaastad Birger Sevaldson

5
Introduction
for cognitive training that are
beneficial for children with an
ADHD-diagnose (amongst
others). This was our starting
point, and we have mainly
focused on neuroplasticity and
ADHD throughout the project.
In our research phase we
decided to go very broad
to understand as much as
possible of these areas and
the related systems, which we
then mapped out to gain an
overview of it all and find our
desired points of impact.
We have divided this report
into three sections; Research,
mapping and production.
This project was part of the
course Systems Oriented
Design at the Oslo School of
Architecture and Design in the
fall of 2013. We chose to work
with the subject Neuroplasticity
in collaboration with Charlotte
Lunde (MD) and her company
Lundelab. She is in the
process of developing an
iPad-game based on methods

8
1775
MelchiorAdamWeikardmentionsADHD-like
behaviourin“DerPhilosophischeArtz.”
1798
AlexanderCrichton
“Diseasesofattention”
Oneofthefirstdoctorstolookatmental
diseasesfromapsychologicalperspective.
Hewritesaboutthelackofattentionasa
possibleindicatorofadisease.
Healsorecognizedthatthechildrenwith
ADHDneededspecialfascilitationinschool
andthattheycouldnotconcentratenomatter
howhardtheytried.
1846
HeinrichHoffmannwroteastory
aboutafamilywhopresumably
hadasonwithADHD,called
“FidgetyPhil.”
1902
GeorgeFriedrichStill
England’sfirstprofessorinchild
medicinewroteaboutbehavioural
problemsinchildrenwithnormal
intelligence.
Cognitive Traning
Parents sometimes labelled “bad
parents” because of unruly children
“Normal”methods for disciplining the
child can have opposite effect
Genes
Brain Trauma
Smoking and drinking
during pregnacy
Chemical Exposure
Culture
Diet
Bad parenting
Stressful home environment
Parents who
refused to accept
ADHD.
Feeling of helplessness
Many lack the tools for
observing when it comes to
ADHD or similar problems
Observation 1 day, depending on the person observing.
Procedure to identify ADHD:
PPT (Pedagogisk Psykologisk Tjeneste)
Is a local government advisory service that acts as
an expert authority in matters of children, youth
and adult education situations and special needs.
Sit in an office to interview (Both parents and child).
Teachers help children to take their pills
during school day. 2-3 times per day.
Physical training
Cognitive training
Suspect ADHD
All factors combined: Is it likely to be ADHD?
If yes: patient is referred to a specialist. (usually BUP)
The specialist can be a part of BUP
or is employed by a different public
or private institution
All factors combined:
Is it likely to be ADHD?
Couple therapy for parents of children with ADHD.
If yes: patient is referred to a specialist.
Medication can only be prescribed if diagnosis is
made by a specialist in child & youth psychiatry,
paediatrics, psychiatry or neurology
or by GP together with medical specialist
“Norsk med tegnstøtte”
Beneficial Methods in
the schools system What is it? Objective
Talking both with oral
messages and hand
gestures
Stimulating more senses
to increase focus. “Double
messaging”
knowing what comes
minimizes the amount of
emotions produced
To create tasks that are
manageable/foreseeable
Take away the stigma of
forgetting books
Music removes all other
distractions, makes it easier
to focus on the task at hand.
Increase mastering
situations, and therefore
motivate to learn more.
e.g. always starting class
at the same time
Splitting larger tasks into
several smaller ones
One set of books at home,
one set of books at school
Students are allowed to
listen to music on their
headsets in class
Figure out how students
learn best; physically,
auditively, visually, etc.
Strict Routines
Dividing tasks
Double set of books
Listening to music while
working
Correct and individual
learning methods
Sees if symptoms can be related to ADHD
Asks patient and/or parents what they think
the problem is
Considers severity and impact of symptoms on
daily life.
Medical history given by patient or parents
Physical check-up incl. blood tests
(Drug test for grown-ups)
Retrieves information from school,
psychologist and other ext. Institutions
Return patient responsibility to GP
Assist GP in further treatment
Perform annual check-up
The long term side effects are
uncertain
-- Increased risk of
developing Parkinson disease
30% of Ritalin users get
sleeping disorders and are
put on sleep medication.
--Ritalin leads to appetite
reduction and from that
to growth reduction
--Apathy
--Sleep deprivation
Unable to
concentrate
Feeling stupid
“difficult child”
Begin treatment
Ritalin
YES
Ritalin has an effect
NO
Ritalin has no effect
Continue on medication,
sometimes up to
adulthood
Stop/change treatment and/or
medication
Side effects
Digital training
Hard to make friends
Child
4-5 (Behavioral treatment)
6-11(Behavioral treatment, possible medication)
Confused and afraid about being sick
PPT work together with schools.
Implemetation of different methodologies to work around learning
disabilities.
Waiting time for the diagnosis of their child
Parents fill out a form that describes the child’s behaviour
Adult
12-18 (Medication and behavioral treatment)
Sometimes schools have to ask
for a budget to their municipality
and therefore they calculate the
quantity of children they will have
with learning disabilities before
the semester starts.
Screening for other clinical conditions
Might be temporary condition and not ADHD
--Parents divorcing.
--Maybe children that have a neurological
condition
Treatments
In some cases the children are refered to BUP
(Barne- og ungdompsykiatrien). This institution
has specialists who can perform a diagnosis.
Unnatural context. Patient
rarely observed in real life.
Taking medication tends to give a
label to children, in other words they
feel stigmatized.
“There was a case where a child was
peeling off the lable of the drug, in
order to hide that he had ADHD.”
ADHDPATIENTRELATIVESSCHOOLGeneralPracticionerAuxilliarinstitutions
ADHD PATIENT JOURNEY
ALTERNATIVE TREATMENTS
DIAGNOSIS AND THEIR SYMPTOMS
sis under the umbrella term: Executive dysfunction.
HD as a case of study. However, the different diagnosis
ed with the ADHD symptoms, specially those under the
ecutive dysfunctions. In other words, by improving some
e ADHD patient, we can also have an impact on other
diagnosis.
Cerebral Palsy Epilepsy Tourettes Dyslexia
Prematurely
born chiledren
Chronic Tic
disorder
Learning
disabilities
medicine.
Hewroteaboutbehavioural
problemsinchildrenwithnormal
intelligence.
1950´s
Clinicaldefinition:
ADHD
1952
DSM-1waspublished.
Definitionsofmentaldisorders
Researchonritalinas
treatment(metylphenidate)
1976
Clinicaldefinition:
ADHD
2010
Childandadolescent
psychiatryincreasedin
Norway
2011
Projectstart
CharlotteLundeandgames
astreatmentforADHD.
Alternative Treatments (Active)
Regular Treatment
(Passive)
POSSIBLE CAUSES PRESENCE OF SYMPTOMS TESTING FOR ADHD EVALUATION TREATMENT OUTCOME
IT IS ADHD!
IS THIS
ADHD?
The chance of getting an ADHD diagnosis is about 6-7%
of children when diagnosed via the DSM-IV criteria
(American System) and 1-2% when diagnosed via the
ICD-10 criteria (European System).
Could one of the reasons for this be that the economical
healthcare system in the USA is supported in big parts
by drug companies?
NEUROPLASTICITY AND ITS EFFECT ON ADHD
The Rafael center is a center that offers counselling, treatment and therapy to people of all ages. They
have a program directed towards children with ADHD in collaboration with the schools and the
parents.
The program is based on physical exercises, therapy sessions, drawing as a therapy, and close
collaboration with parents and teachers. The results from the program have been very good.
All of the children who completed the program, experienced better
social skills and higher life quality.
The Arrowsmith school was funded by Barbara Arrowsmith, also known as ”The woman who changed
her brain”. She has developed a series of exercises that help develop the executive functions. The
school says they can help people with ADHD, dyslexia and other types of learning disabilities. The aim
of the school is to help children who are experiencing difficulties with regular education by offering
specialized education for a given period of time, so that they can return to school after a while in the
special program.
Miss Arrowsmith says that if all schools implemented her methods in
their everyday school day, then we wouldn´t have children with special
needs anymore since their symptoms would be helped.
?
Physical
by combin
exercises w
otenti
Self part
by letting t
the game,
ownership
continues.
Sending
by giving a
sign messa
increase th
Self corr
by allowing
strengthen
feeling of s
Collabor
the social a
it is collabo
important t
dialogue b
P
utive function in clinical practice
dhd/guide/adhd-causes
ntion-Deficit/Hyperactivity Disorder: A Meta-Analytic Review
Rafael centeret
(Denmark)
Arrowsmith school
(Canada and USA)
Teachers fill out a form that describes the child’s behaviour
Special Licence to prescribe Ritalin is
needed.
Straterra = Atomoxetim
It is not a Narcotic, therefore some
prescribe it, instead of Ritalin, since
license is not needed.
Ritalin= Methylphemidat
This inhibits the reuptake of dopamine.
Meaning that the enzymes degrade less
dopamine after the transmition. There-
fore Ritalin is consider a Narcotic and
license is needed to prescribe it.
Evaluate treatment and/or medication
during the first year
Berit Killingbergtrø Havåg
berithavaag@gmail.com
+47 906 30 780
Valeria Gaitan
vpgaitan@gmail.com
+47 405 77 993
Sven Håkon Voldum
shvoldum@gmail.com
+47 916 11 629

9
ADHD
1950s
ADHDappearsasaclinical
definition,andreseachon
Ritalin(metylphenidate)asa
treatmentbegins.
1952
DSM-1ispublished,with
definitionsofmentaldisorders.
2010
Childandadolescentpsychiatry
increasedinNorway.
We also started building an
“ADHD Patient Journey”,
which show an overview of all
potential involved parts before,
in the process off and after a
diagnosis is given.
During this research it became
clear to us that there are
many personal variations
when it comes to symptoms,
diagnosing and the process of
finding the proper diagnosis.
We also saw that many of the
symptoms are highly related to
social issues; Both as a cause
and result of the diagnosis.
Prior to our first workshop with
Charlotte, and to start off our
project, we began gathering all
the information we could find
on ADHD as a diagnosis.
To get some perspective
on the issues at hand, we
researched the history of it and
created a timeline based on
that, which is shown below.
Initial research

11
ADHD
possible ways to aid them, and
also to gain more insight on
the process of diagnosing and
medicating ADHD.
We learned that ADHD is one
of many diagnoses under
the umbrella term executive
dysfunctions. These are all
related to challenges in the
frontal lobe of the brain, and
the majority of the symptoms
related to ADHD can be
connected to one or multiple
other diagnoses. We also
learned that nearly half of
those diagnosed with epilepsia
has ADHD as well.
After this workshop we
decided to include most
of the diagnoses related to
executive dysfunctions in our
research, and we looked into
the overlapping of symptoms
to get an overview of where
we could create the biggest
impact.
After the first round of research
on ADHD, we had a workshop
with Charlotte to share and
add to our findings.
In preparation to this, we had
researched the diagnosis,
made a timeline of the history
of these kinds of behavioural
problems, and made a patient
journey for children suspected
of having ADHD. We were
keen to learn more about
the various symptoms and
Workshop with Charlotte

13
Executive functions
and dysfunctions
Executive functions is
an umbrella term for the
management of cognitive
processes like:
- Organizing
- Planning
- Paying attention
- Remembering details
- Task switching flexibility
- Inhibition
- Managing time and space
- Logic
Executive functions are the
brain’s ability to organize and
perform everyday tasks. The
executive functions help us
in keeping focused on a task
for a period of time, organize
our time, remembering
faces, listening and reading,
and managing complexity.
Directly corresponding to
this, executive dysfunctions
are related to challenges with
these abilities.
Executive dysfunctions refers
to problems in the executive
functions and covers several
different diagnoses:
- ADHD
- Asperger
- Autism
- Cerebral palsy
- Epilepsy
- Tourettes
- Dyslexia
- Prematurely born children
- Chronic tic disorder
- Other learning disabilities

14
Hyperactivity
Trouble maker
Constant
motion
Working
memory problems
Not following instructions
Attention
Impulsivity
Daydreaming
ADHD
Asperger
Autism
Epilepsy
Dyslexia
Learning disabilities
Impatient
Distraction
Not seeming
to listen
Not completing
tasks
Losing things
No organization
Problems processing
information
Inappropriate comments
Talk nonstop
Constant interruption
ADHD PATIENT
Difficulty
regulating
behaviors
and emotions
Sudden
Rage
Poor social skills
Anxiety
Mania (exessive
happines/ euphoria)
Depression
Impetuos behaviour.
Overreacting or
acting out
Difficulties using
and understanding
language
Poor
coordination
Tourettes

15
Diagnosis
We compared symptoms of
these diagnoses and made
this overview over all the
ones overlapping with ADHD.
The differences between the
diagnoses are unclear in many
cases and the symptoms are
similar in many of them.
Having learned about executive
functions and dysfunctions, we
started gathering information
on diagnoses related to this as
well as their symptoms.
We divided all of the symptoms
into four categories according
to what they were related to;
Body, brain, emotions and
speach.
In other words, by focusing
on some of the ADHD related
symptoms we can also have
an impact on other diagnoses
Overlapping of symptoms

17
Brain functions
represents for the development
of our project.
This was not only a possibility
to gather insight, but also
a chance to validate the
information we had already
found together with the expert.
During this session we
learnt about neurons and
We interviewed Dr. Abhilash
D. Pandya, who just finished
his PHD on molecular, cellular
and organ related changes
in inflammatory disease. The
objective was to understand
how the brain works, how
the information is transmitted
between the neurons and
what the term “neuroplasticity”
their functions, hormones,
neuroplasticity, as well as
processes that enhance
learning. We even got to see
the screening of a mouse
brain, in order to visualize how
the connections between the
neurons work.
Meeting with Dr. Abhilash D. Pandya at Ullevål Sykehus

19
To learn more about the role
of the educational institutions
in the diagnosis of ADHD, we
had a workshop together with
kindergarden teacher Ylva and
special education teacher Siw.
From this we learned about the
role of Pedagogisk Psykologisk
Tjeneste (PPT) and Barne-
og Ungdomspsykiatrien
(BUP). When the school or
kindergarden suspects special
needs of a child, they are
reported to PPT and BUP,
who then assess the child
and develop a treatment
plan for it and the school or
kindergarden.
PPT and BUP are locally
based external agencies, to
avoid conflicts of interest with
the school system.
ADHD-journey
Educational institution

20
GOOD
OK
BAD
BREAKDANCE
NEW
TEACHER
EQ
UAL
PUPIL
EQ
UAL
PUPIL
10years
12.5years
Jacob is one of five boys in his class that are considered “more trouble-
some” than average. Might have a bit more challenges than average
learning, but does well socially.
Jacob gets a new “old-school” teacher who
immediately points him out as different and
worse than the rest. Jacob looses contact with
his friends as a result of being frozen out by
the teacher.
The teacher contacts PPT and dictates a
report saying that Jacob has ADHD, dyslexia
and epilepsia.
The school and Jaboc’s parents agrees to work
on his math at home so that he can stay in class
all the time. Things have improved significantly,
Jacob is doing better at school and has a group
of new friends.
The teachers at
the new school
considers Jacob
a more-or-less
normal boy, but
due to problems
with math he is
withdrawn from
class together
with one pupil
with tourettes and
another with a
brain injury. Fear-
ing he’ll be con-
sidered different
again, this solu-
tion doesn’t help.

21
ADHD-journey
downward spiral both socially
and educationally when PPT
was dictated by the teacher in
how to deal with his behaviour.
Singled out as a problem, he
was soon losing friends at
school as well as struggling to
keep up with the curriculum.
After he was transferred to a
new school, things began to
improve, although he is still
behind in some subjects.
We met with Lisbeth, the
mother of a boy in the process
of being evaluated for many
diagnoses. Living in a small
place near Lillestrøm, they
experienced first hand how
problematic things can get
when the system is faulty.
Her son’s new teacher and
the local PPT had close
connections, which led to a
This meeting emphasized our
notion that ADHD is very much
a social issue, and not merely
a clinical diagnosis.
Parental point of view

23
Digital tools
interesting findings she has
had is how self-driven children
often are when it comes to the
use of these tools. With very
few guidelines, kids will easily
divide tasks, share knowledge
and work towards the objective
of the game.
Another interesting discovery
from this is that children who
need additional resources and
support in specific areas, can
use the digital tools to work
on their challenges. This is
of course provided that the
Referred to us by Charlotte,
Cathrine Darre is the
pedagogical manager in
Myrertoppen kindergarden.
She has been studying the
implementation and use of
digital tools at kindergarden
level, with the focus on
“learning-through-play.”
Through testing various games
and applications, mainly on
iPads, she has gained insight
in how these can be beneficial
and also what works and
what doesn’t. One of the most
quality of the application is
good, and that the possibility
to adapt them to personal
requirements are present.
Cathrine also explained how
the iPad-games were used to
enhance the social position of
children with special needs.
They had extra playtime with
the games and became good
at them. That way they could
teach the other children about
the game.
iPad in kindergarden
image source: http://myrertoppenbarnehage.blogspot.no/2012/12/digitale-fortellinger-kreativitet.html
game displayed on iPad: ToonTastic

25
Preventive work
in getting to know their new
pupils. When necessary, this
would also include PPT and
BUP, allowing them to develop
a plan for the individuals at
an earlier stage than what is
normal today.
Since the parents are involved
in this communication process
as well, it creates a feeling
of security for them (as well),
knowing that their children’s
needs are shared and taken
We found out that the design
office LiveWork recently
finished a pilot project to
improve healthservices and
-systems related to children.
The main objective of the
project was to create a way
of communication between
kindergarden and school. By
doing so, experience could
be shared between the two
institutions in order to give the
school faculty a head start
seriously. The project also
creates a lower threshold
for the arenas if they want to
contact the different institution,
having met representatives
face to face and been given
their contact information from
day one.
The project focuses on the
qualities of the children as well
as achievements and creating
a sense of mastering.
Bridge-building between
kindergarden and school

26
COGNIFIT
MEMORY
GYM
BRAIN
FITNESS
JUNGLE
MEMORY
COGMED
LUMOSITY
COMPLETE
MEMORY
TRAINING
BRAIN
METRIX
Memory
Visual & Spacial
Memory
Short-Term
Memory
Concentration
Focus
Creativity
Stretching
Speed
Flexibility
Attention
Problem-
Solving
Perception
Will
Power
IQ
Working Memory
3D
3D
3D
3D
3D
3D

27
Methods
that are meant for casual
gaming instead of clinical
use/training though. One of
the most promising of these
commercial games is called
Lumosity, and looking at the
various tasks offered by them
shows that they also make
use of what is considered
to be working methods for
stimulating brain functions.
All of the games we found
consist of a bunch of individual
tasks rather than a continuous
gameplay with integrated
methods.
In the brain training game
Charlotte is developing, she
is making use of methods
found in competitor Cogmed’s
game RoboMemo. This is a
game with documented results
within cognitive training, but
it requires the player to be
coached by a trained person
and is by many considered to
be rather boring.
We looked into RoboMemo to
learn more about the methods
applied, but also found
other games that claim to be
beneficial for the brain. Most of
these are commercial games
We only found two other
digital tools with a clinical
background; NeuroRacer
and Interactive Metronome.
Respectively, these are
focusing on multitasking and
the timing/coordination of the
brain. In addition Interactive
Metronome is the only game
that actually includes physical
activity.
Mindgames

29
Methods
each child. They also have a
bottom-up way of approaching
challenges, meaning that
they start with making sure
that the basic senses are
in order before focusing on
more complex issues. In their
treatment they also focus
a lot on the importance of
both physical and cognitive
stimulation.
We visited the center as well
as a few of their specialized
therapists in Copenhagen,
and were guided through
their approach and applied
In a TV-documentary called
“I hate ADHD,” we saw 12
children at a primary school in
Denmark go through treatment
by Rafael Centeret. These
12 children all had attention
challenges of some sort, and
Rafael Centeret is a center for
alternative treatment not only
for ADHD-diagnoses, but any
kind of behavioural challenges.
Various methods are applied
depending on the need of
the child in question, but they
are always focused around
the individual differences of
methods. It was a very
inspiring visit, and a nice
contrast to the empirically
based medical environment we
had researched so far.
Seeing the positive results
from their treatment inspired
us to further investigate the
possibility to integrate physical
elements and/or activites in our
work.
Rafaelcenteret, DK

30
for improving this, and thus an
important focus for us in this
project.
With two main areas in place,
social impact and working
memory training, we began
narrowing down which
methods to apply in order to
create an intervention with
the best possible impact. We
looked at methods used by
Rafael Centeret, Klingberg Lab
and Lumosity among others,
and narrowed down the most
important ones.
Throughout the research
phase we found several
indications that social
challenges were present both
before and after diagnose
was set. Difficulties at home
or at school could disturb the
behaviour of a child, causing
it to perform irrational actions
not considered normal. This
again could lead to changes
in how the surroundings relate
to them, further confusing
the child. We also found
examples of behaviour and
learning abilities improving
when the social challenges
were improved. Based on
these findings we concluded
that our intervention should be
stimulating for the social life of
those suspected of an ADHD
diagnose.
Looking at diagnoses related
to executive functions, it
quickly became clear that
working memory problems
were an important area. Being
closely related to everyday
tasks like paying attention,
maintaining a conversation and
organizing time, it is crucial to
have a well functioning working
memory. Luckily cognitive
training is particularly beneficial

31
Research
summary
At the Rafael Center in
Denmark we learned many
ways to improve symptoms
related to executive
dysfunctions. Many of them
were physical exercises
that could be translated into
different tasks in a gaming
experience. Some of the most
interesting of these were:
- Spinning around
- Mirroring shapes
- Touch stimulation
- Eye coordination
The tasks in Lumosity uses
many of the same methods as
those found in RoboMemo, but
these are generally wrapped in
a more pleasing package. With
less focus on proven results,
their tasks are still proper brain
training and also the source
of these methods that we’ve
chosen to continue working
with:
- Mirrored visuo-spatial
- Auditive sequence memory
Cogmed’s methods used in
their game RoboMemo, were
developed by Klingberg Lab.
Their main focus was the part
of our brain taking care of our
working memory, which is a
part of the executive functions.
From their methods, these
were the ones we found to
have the most potential:
- Visual orientation
- Sequence memory
- Visuo-spatial recollection
Methods
Rafael Centeret Klingberg Lab Lumosity

35
information that we could look
more deeply into.
The information gathered
during the first iteration was
used as a starting point for
our research. We looked into
the principal causes of ADHD,
general information about
the patient journey and both
different ways to treat the
diagnoses: Ritalin vs. digital/
analog training.
The goal of this mapping was
to have an overview, but also
have a tool where we could get
the right information from our
partner Charlotte Lunde, MA.
In our first meeting with
Charlotte, we brought a map
with some information on it
from the first mapping, but
we also deliberately left a lot
of white space for her to fill
in information. Because we
didn´t include too much of the
information from our first map,
she met us with a fresh mind
and we got new directions
around the area of Executive
Functions. We learned that
many diagnoses are covered
by this umbrella term, meaning
that a lot of the diagnoses have
many symptoms in commom
with ADHD.
At the beginning of the
semester we had a
presentation from the potential
partners in our course System
Oriented Design. We listened
to their weak points, strengths,
procedures, type of work,
employees and other things
included in the brief. So we
took notes and did a short
research on the Internet about
each of the partners. After this
we began to map out what
we called a “first draft of the
system”. Each person from the
class wrote down on a brown
paper the information they
got from their sources about
each partner, then we got
an overview of the cluster of
Start Mapping

36
Asperger and ADHD have
some symptoms in common.
Different diagnosis and their relation to ADHD

37
2. Explore
Travel through an unknown
area to learn about it.
For example, regarding the
previous example I can choose
to go through the different
diagnoses that are related to
ADHD. They might have areas
in common, like symptoms.
Different diagnoses were
listed with their respective
symptoms. There was no
order, just selection of colours:
Purple for the diagnosis and
orange for the symptoms.
3. Reconfigurate
To rearrange the elements
or setting in many possible
ways in order to start finding
patterns.
In this case, lines were drawn
to connect symptoms to their
respective diagnoses. The
goal was to find common or
overlapping symptoms among
the diagnoses.
1. Select
To find the most suitable
information that might
be beneficial to start the
exploration of the topic.
For example, the topic:
Neuroplasticity and its effect
on ADHD. After briefly reading
about the topic, the potential
type of information could be:
what is neuroplasticity? What
is ADHD? How is the brain
affected by ADHD? Are there
any other diagnoses related
to ADHD? Existing treatments
and alternative treatments? etc.
Categories of interaction with visualization within this System
ADHD and its relation
to other diagnoses
Here we deployed some of the interactions we had with the visualization within this system. The
next categories are based on a publication called “Toward a Deeper Understanding of the Role
of Interaction in Information Visualization”. These are organized around the user’s interaction with
a system. These categories can act as a framework to help discuss and evaluate interaction
techniques and lay an initial foundation toward a deeper understanding of the system.
Diagnoses
Symptoms

38
Calssification of
symtoms
Categories of symptoms according diagnoses

39
5. Abstract/Elaborate
To consider the important
points of the information
to create organizational
parameters.
Here is where we started
abstracting or taking the most
important information from
the table, in other words we
started to use it as a tool for
our own research. Here we
noticed that one of the areas
where we should have an
impact on with our design is in
"Working Memory", since this
is a common denominator in
most of the diagnoses under
the umbrella of "Executive
Dysfunctions". Furthermore,
we can also see that the
overlapping of symptoms of
all these diagnoses is more
evident than in the previous
graphic, something that helped
us for the argumentations of
our final design decision.
4. Encode
To convert the information in
a way that can be understood
by the brain. In this image it is
possible to see the beginning
of this process.
The diagnoses were displayed
with their symptoms around
them. But it didn't give any
meaning until colors and
categories were assigned
to divide the symptoms.
However, the disorganization
of the previous visualization
didn't allow us to find that
much, therefore we decided
to make a table out of this
information (See image on the
left). Here you can see how
this table is starting to become
a tool. We took the categories
from the previous visualization
and arranged them under
4 main categories. Just by
listing them, it was easier to
understand the overview of the
diagnoses and how they affect
the patient.

40
Categories of symptoms according diagnoses

41
7. Connect
This is where the discovery
happens.
When you make a logical or
causal relation that can lead
to finding valuable knowledge
that will impact the system.
Our project wants to look at
the impact of neuroplasticity
principles on ADHD and other
diagnoses under the umbrella
term of executive dysfunctions.
Therefore the visualization of
the symptoms are circles with
different sizes, meaning the
bigger it is the more diagnoses
we can impact in a positive
way with our design.
This was a discovery relating
to a small part of our research
but it proved to be valuable
for us when arguing why our
design is beneficial.
6. Filter
A pattern through which
data is passed. Only data
that matches the pattern is
allowed to pass through the
filter.
In other words, it is the way
information is displayed
regarding the parameters
mentioned before. This is how
we interpret the information
and how it is displayed
to communicate the right
message to the right audience.
In this image, the overlapping
of the different diagnoses
from their symptoms is more
visual and evident. However,
we decided just to focus on
displaying the symptoms of
ADHD and not the rest of
the symptoms from the other
diagnoses.

42
The neurotransmitters are chemicals
that transmit signals from a neuron cell
through the axon terminal to a
neighbouring cell.
This connection is called a synapse
Some of the neurotransmitors are
degraded by enzymes, and some of
them are carried back inside the
presynaptic neuron.
AXON
SOMA
TERMINAL
TERMINAL
BUTTON
(LIPID LAYER)
MYELIN
SHEATH
DENDRITE
NEUROTRANSMITTERS
like dopamine
or serotonin etc
The brain
What makes brain
cells,orneurons,
so
special, is the Terminal they use to transmit their signals
The brain
h
asapproximately
100 billion neurons

43
what the term “neuroplasticity”
means for the development of
our project.
We want to highlight that
the interview wasn’t just an
opportunity to gather insights,
but to map the information
together with the expert.
So we decided to display
the information that we had
already, using some diagrams
we had made beforehand, to
grasp briefly the functioning of
the brain.
We had different interviews
with professionals to gather
information so we could
get an overview of the topic
“neuroplasticity and ADHD”.
Among many experts we
interviewed was the Dr.
Abhilash D. Pandya, just
finished with his PHD on
Molecular, cellular and
organ related changes in
inflammatory disease. The
objective was to understand
how the brain works, how
the information is transmitted
between the neurons and
This methodology helped us
to have a faster understanding,
but specifically it helped
the doctor to convey the
information to us in an easier
way. During this session we
learned about neurons and
its functions, hormones,
neuroplasticity and processes
that enhance learning, among
others.
Mapping while Researching

44
“Norsk med Tegnstøtte”
Strict Routines
Dividing tasks
Double set of books
Listening to music while
working
Correct and individual
learning methods
Talking both with oral messages
and hand gestures.
E.g. always starting class at the
same time
Splitting larger tasks into several
smaller ones
One set of books at home, one
set of books at school
Pupils are allowed to listen to
music on their headsets in class
Figure out how pupils learn best:
physically, auditively, visually, etc.
Stimulating more senses to increase
focus. “Double messaging”.
Knowing what comes minimizes the
amount of emotions produced.
To create tasks that are
manageable/foreseeable.
Take away the stigma of forgetting
books.
Music removes all other
distractions, and therefore
motivates them to learn more.
Increase mastering situations, and
therefore motivate to learn more.
Beneficial Methods in the schools system
How it works Objective

45
learning disabilities in high-
school, Siw Risøy.
We look into the different
institutions linked to the
schools like PPT (Pedagogisk-
psykologisk Tjeneste)
and also BUP (Barne- og
ungdomspsykiatrisk). In
this part of the mapping we
found different weak points
where our solution could be
implemented, especially when
we related it to our patient
journey.
We were searching for
information about possible
methodologies to treat
the symptoms of ADHD
based on the principles of
Neuroplasticity. However,
after many iterations on the
map related to this type of
information, we decided on
going to one of the roots, the
school system. We wanted
to know how they treat these
children and if there is any
method that is working already.
So we had a meeting with a
teacher for kinder-garden Ylva
B. and with a counselor for
Mapping the school system in Norway

47
The scenarios were simple
sketches presented almost
like flashcards, the purpose of
this is that these cards allowed
us to move them around
together with Charlotte to add
or subtract elements from our
journey in a forth iteration.
The fifth iteration we had when
we interviewed the mother of a
child (Lisbeth) with suspected
ADHD. She completed our
journey adding different
emotions that opened a door
for us to really understand the
situation of uncertainty that
the family and the child have,
when the diagnose is just a
suspicion.
We started researching the
patient journey in order to find
weak points that our solution
should improve. We had 5
iterations, one that we built up
briefly in out first meeting with
our partner, Charlotte Lunde.
A second iteration together
as a group, where we added
different actors. A third iteration
after the meeting with the
teachers, where we added
different institutions influencing
system in schools and the
way children with learning
disabilities are treated.
When we got all this
information, we decided to
illustrate the scenarios to have
a better overview of the things
happening along the timeline.
Mapping patient Journey

48
Neuroplasticity research
Game research ADHD as a case
The Brief

49
First iteration of the complete system
ADHD patient journey Potential areas to address
witn Neuroplasticity
Alternative Treatments

50
Klingberg Lab research
Torkel Klingberg
Bavelier Lab research
Daphne Bavelier
Lumosity
Human Cognition ProjectRafael Centre

51
We evaluated the possibility of
translating them into a game or
activity, either digitally or in an
analog way.
We added source location
so we could track them back
to the research distributed
in the map and, last but not
least, we added some arrows
to emphasize the relation
between the different areas
affected. Here we discovered
that by improving Working
Memory and Social skills in
the patient, most of the other
symptoms will be improved.
This is what we can call a
positive spiraling effect.
After a thorough research in
the methods that could be
used in our design, we started
looking at the way of displaying
them, not just to communicate
them, but as a tool to find
the most efficient ones and
the ones that will have more
impact on the children.
We started categorizing them
in relation to the areas affected
in the patient, for example,
the ones related to executive
functions, to the emotional
symptoms, the language
symptoms, among others.
After categorizing them, we
wrote briefly how, and in what
area they were going to affect
the patient in a positive way.
Reliable methods

53
skills, etc. We analized the
concepts and decided to stop
two of the concepts. As you
can see in the graph, non
of the concepts is covering
all the areas, but our aim
is to develope two of them
further, inasmuch as with
those we can cover the two
most important areas, which
are Working Memory and the
Social Skills, besides beig easy
to implement and distribute in
the existet patient journey.
On the map, we displayed our
concepts, in order to translate
the methods into opportunities
of desgin. We re-evaluated
our ideas comparing them
with the methods for cognitive
and physical training, among
others. By using a “spider
chart diagram”, we highlighted
the most important areas
covered by the methods,
e.g. Working Memory, the
vestibular sense, logic, social
Evaluation of the design concepts

54
Parents sometimes labelled “bad
parents” because of unruly children
School
School suspects ADHD
Many lack the tools for observing
when it comes to ADHD or similar
problems
Feeling of helplessness
“Normal”methods for
disciplining the child can have
opposite effect
Sometimes schools have to ask
the municipality for a budget and
therefore they calculate the
quantity of children they will have
with learning disabilities before the
semester starts.
Relatives

55
Implementation of the design solution
The mapping of the user
journey helped us analyze
the root of the problem and
how frustrating and painful the
journey can be, not just for the
child, but for the parents as
well.
Visualizing the scenarios and
writing briefly in bullet points
the action of different actors,
helped us in the decision-
making to determine where
the best place for our design
solution to be utlized is.

57
emotional development and
the last part of the stem the
cognitive skills.
From this visualization we
discovered that Rafael Center
focuses more on the root,
whereas Klingberg focuses
on the cognitive training. We
found a missing spot where
those training are not being
combined as we will do with
out design solutions.
When we were at the Rafael
Center, they showed us a type
type of visualization they use
to identify the areas they are
impacting with their methods
to improve the child’s life.
This visualization shows a tree
from the roots to the leaves,
the roots represent the primary
senses, the reflects, reactions
and other basic motor skills;
the stem represents the
Mapping Rafael Centeret

59
So we decided to map out
each of the conferences and
their focus point. This mapping
we did it on a workshop
together with Mosse. For our
surprise we discovered that
the way the researchers were
approaching their research
was touching several of the
areas we are focusing on in
our Design solutions.
I addition we decided to take
some of the methods and
argumentations mentioned by
the neuro scientist Dahpne
Daphne Bavelier during the
conference
During the semester we
researched on how the
brain and its neurons work,
and other topics related to
the function of the cognitive
system. However, we felt that
we were lacking information
about current research
on neuroplasticity. Our
supervisors Mosse Sjaastad
and Charlotte Lunde informed
us about a recent conference
that took place in USA, where
many of the most recognized
neuro-scientists around the
world gathered to talk about
their research and possible
methods to be implemented.
Mapping research on Neuroplasticity

61
Map last iteration
We will call it “Last iteration”
for now, it can still be many
opportunities to modify the
map, but for now this is the
most realistic and useful way
to distribute the research and
the findings. Thus, in our last
iteration we had a serious
paper prototyping, we cut the
previous 4 m long map and
started shuffling the parts
around until the distribution of
those made sense. We took
information away, as well as
we added. This was one of
the most important paper
prototyping processes we had.
This is due to the knowledge
gained during the process
to arrange the information in
different ways so we could get
the big picture of the system.

63
Mapping research
and result

65
"Converting to a graphic
form and searching visually
for patterns and anomalies
is an effective way of prompt
scientific insight" (DiBiase,
MacEachren, Krygier, &
Reeves, 1992).
Visual System thinking,
besides being a tool to gather
insights and for researching,
it is also a powerful tool to
communicate the cause and
effect in context of the solution
given.
The examples we
mentioned before, about
the symptoms and methods
related to ADHD and
Neuroplasticity, are just the
result of some of the "zoom"
areas of our map. The map
consists of many parts that are
all inter-related. Visualization
has facilitated the process of
researching and the proper
communication of those
relations and patterns to the
right audience.
“The purpose of visualization
is insight, not pictures. A
visualization’s function is to
facilitate understanding. This
does not mean that aesthetics
are not important - they are.
Some researchers have
detected correlations between
the aesthetic qualities of a
visualization and how well it
is understood” (Data Flow
2, 2010) Therefore every
vizualization within a system
is an interpretation that can
lead to different and more
appropiate solutions.
In our opinion, Systems
thinking requires the use
of both visual thinking and
visual communication. This
is because when one uses
visualization for rapid learning,
fancy infographics are not
required, rather technical
visualizations to find relations
that can lead to a discovery.
However, in some cases,
when the system thinker starts
communicating the discovery
in better visual ways, he or she
can also find other challenges,
problems or even solutions to
the system.
Mapping
summary

69
Early sketching
After our initial research phase,
we had a creative session
based on all the methods
we had learned that were
benefitial. We sketched out
ideas and presented them to
each other as we went along.
After that, we grouped the
sketches into themes and saw
that they could be devided
into four main areas where
we saw potential for further
development.
The four potential areas to be addressed
with Neuroplasticity are:
Active participation and
self-correction: By allowing the child to
correct him/herself, we strengthen their
confidence, responsibility and feeling of
self worth.
Collaboration: The social aspect
of a game is important. Whether it
is collaboration with a friend or with
a parent, it is important to improve
social skills and to encourage dialogue
between players.
Physical activity: By combining
physical exercises with mental exercises
we emphasize the effect of the task.

Stimulation of multiple senses:
By giving audio messages, visual
messages and sign messages, we
stimulate more senses and increase the
complexity of the tasks.

71
Creative workshop
After these sessions, we
gave a workshop where we
presented the main theme:
“Methods to enhance learning
and social skills” and gave
each group one of our
potential areas. The goal of
the workshop was to get
more ideas or directions for
our solutions. Therefore we
provided them with material
and trigger cards with content
related to our previous
research. Each group had a
different methodology to solve
the brief, this last one was also
provided by us. It consisted
on visual triggers for physical
activities or materials to build
up models related to the
topic “stimulation of different
senses”, among others.
From these four areas, the
participants came up with
many ideas, which
after the workshop were
utilized as directions to be
taken into consideration.
After that, we sketched out
more ideas while we revised
the ideas from the workshop
and adjusted them to fit our
project. In the end, we had five
different directions we could
go in.

73
Concepts
Colour changing ball
The colour changing ball, as
its name describes it, is a ball
that changes colour whenever
it is caught or dropped to the
ground.
One way of playing with it is
to assign the players different
colours and when the ball
lights up in their colour, the
person holding it needs to
remember who the colour
belongs to and throw the ball
to that person. This activity
requires abstract thinking,
working memory, and
fast decision-making. The
complexity of the game will be
increased if the players change
colour often or if they have to
increase the speed of playing
it.
The therapists at the Rafael
center were very excited about
this ball since they always
use balls in their training and
this ball makes the gameplay
more exciting as well as
providing many ways of playing
and training. Variation is an
mportant factor for keeping up
motivation
Strengths:
• Working memory
• Abstract thinking
• Speed
• Focus
Weaknesses:
• Needs monitoring
• Limited cognitive training
Opportunities:
• Simple
• commercial
• cheap

75
Concepts
Physical controls
The physical controls is a
concept for exchanging regular
controls like buttons and
switches with something more
tangible, bigger and more
flexible.
Rapid task switching (also
known as mutitasking) and
managing different objects
stimulates more than just the
finger tips. Having objects
spaced out that need to
be pressed, pulled, moved
or pushed, trains hand eye
coordination, stimulates the
sense of touch and makes for
more stimulating challenges
when it comes to game
controls in specific.
Using bigger movements than
just your fingers, like you do
in regular games, stimulates
parts of the brain that are
normally not used when
playing regular computer- or
video games.
Physical controls can also
be used to strengthen our
mirroring concept at a later
stage.
center thought this was a
good idea. This is because
they aways try to use as many
senses in their training as
possible. The feeling sense is
an important base for cognitive
development.
Strengths:
• Multitasking
• Hand-eye coordination
• Stimulation of different senses
• Physical training
• Impulse control
Weaknesses:
• Needs increased diversity
• Expensive components
Opportunities:
• React to sounds
• Body-tracking
• Commercial opportunity
• Added complexity

77
Concepts
Kinect
The vestibular sense is what
controls our balance and
registers the body´s movement.
It also plays an important role
in children not being able to sit
still. An overactive vestibular
sense gives them a feeling of
seasickness when they are
not moving. At the same time,
a vestibular sense that is too
weak makes the child feel
uneasy when it is in activity
and both situations affect the
social skills very much.
In order to stimulate the
vestibular sense so that it can
work better, big movements
are required, such as spinning
or rocking. This is difficult to
do without a coach but it can
be done by utilizing the kinect
sensor from Microsoft, which is
a controller that registers your
body movement.
As a next step, we would like
to investigate how we can use
the kinect in a game that is fun
and also training the vestibular
sense by using spinning,
hand-eye coordination
exercises, and other training
methods where the whole
body is utilized. However, for
this training to work, the user
needs a kinect and a big sized
screen. In other words, the
implementation of this type of
training would require more
engagement and economical
resources from the family of
the child.
That is the main reason why
we chose not to take this
concept further for now
Strengths:
• Trains the vestibular
sense
• Impulse control
• Body-tracking
Weaknesses:
Opportunities:
• Sounds
• Added working memory
training
All info about the vestibular sense from the Rafael center in Copenhagen

78
Drag buildings to match the
reflections. Once they
match, a new world will
unfold!
Mirrors UnfoldMirrors Unfold
Bring me safely to theportal by the time thenext world unfolds!
Tap on either side of your
hero to make him jump in
that direction!
Reality
Reflection

79
Concepts
iPad game
In the early sketches for the
iPad game, we knew we
wanted to implement mirroring
as an important game
mechanic, and we sketched a
lot to see how that could be.
Mirroring tasks enhance the
visuo-spatial intelligence, which
impacts the working memory
and also our ability to read and
to orient ourselves in space.
These types of tasks already
exist (i.e. robomemo and
lumosity), but not as these
specific mirror tasks. Klingberg
lab has written about the
importance of visuo- spatial
tasks but have mainly
sequence tasks in their game
Robomemo.
When training with
Robomemo, it often feels like
tedious training because the
child jumps from task to task.
In our game we want to hide
the tasks behind a fun story in
an immersive game so that the
children playing it will not get
tired so easily, even when the
tasks are difficult.
Cogmed recommends training
with their computer training
Robomemo for 30-40 minutes
a week. After training with
Robomemo, the children
can choose to play an action
videogame afterwards as a
reward. To us this seems a bit
backwards and we want the
game itself to feel like a reward.
Strengths:
• Spatial orientation
• Visualization
• Abstract thinking
Weaknesses:
• Can be boring without a goal.
Opportunities:
• Added visuals and contrast
Might need a bigger story

80
First sketch of sequence task Last iteration of sequence task

81
We were so lucky to get in
contact with a programmer
who could make our ideas into
a game. The development was
in collaboration with the game
programmer Øyvind Byhring,
and it went from being simple
tasks to being an actual
playable game. During this
process we also managed to
implement sequence memory,
which is an important tool for
training working memory.
By combining mirroring
training and sequence recall
in an iPadgame, we hope to
enhance the effect of both
types of training.
Getting to test the play of the
mirror game was very good
for our process. One thing
we learned was that we had
underestimated how difficult it
would be to mirror the objects
on the screen.
The sequence part started
out with being objects that
you needed to move so they
mirrored the original. We
added a sequence to it so that
you needed to place them
both in the right place and
in the right order. This was a
challenge, but it was also a bit
confusing and we couldn´t get
it to make sence. In the final
iteration the placement of the
objects is taken away and now
it is just a sequence that you
need to remember.
In this last iteration you press
the stones after seing the
sequence blinking in the water.
This forces you to translate
colours and shapes from one
place to another.
Sequence recall
Production of the
iPad game.

82
DIFFICULTY
PROGRESS
LEVEL 2
LEVEL 1
GAME PROGRESS
Mirrored path
EXAMPLESOF
INTEGRATEDMETHODSGAME

83
LEVEL 3
One of the most important
reasons for using a digital
training tool is that the
computer can adjust the
difficulty level to your skill level
as you play so that the tasks
are always difficult enough to
provide efficient training, and
easy enough for the child not
to lose motivation.
This is an illustration of our
overall structure. The yellow
squares show the different
worlds you come to that
provide added complexity
and the blue line shows
the individual ajdustmen of
difficulty level as you progress
in the game.
Overall structure
Production of the
iPad game.
Coloured sequences

84
First sketch
of mirror task
Last sketch
of sequence task

85
Production of the
iPad game.
The mirror tracing was a game
where you saw the original
trace and should try to mirror
it on the bottom half of the
screen. It started out almost
like a musical task where each
level of lines represented one
tone and as you moved you
heard music that helped you
remember where the original
trace had been.
After the first iteration,
we decided to make the
environment into a magical
forest where the first part is
a magical map that shows
the path you should follow
but shows it upside down.
Since it is magical, it can also
show you the path mirrored
in different directions as the
difficulty indreases.
Trying the game as it
progressed was an
important part for our further
development. We also got to
test the game on children in
different age groups including
some with relevant diagnoses.
These tests showed us how
the game would actually be
played and we discovered
many things we needed to fix
in order for the training part of
the game to work.
One of the things we saw
was that in the magical world,
the children saw where the
glowing mushrooms were
instead of looking at the upside
down map. That meant that
we needed to make the world
darker so that the kids didn´t
see where to go without the
map.
Mirror trace

87
The experience
With this iPad-game we
wanted to create an immersive
experience for the children to
want to play. We wanted to
distance ourselves from the
more clinical training form that
Robomemo is. In that training
you get the tasks one by one
and at the end of some of
them the “coach” actually says
“it is good to be done with it”.
Our game is also a low
threshold game. We don´t aim
towards clinical proof that our
training works but we do feel
that it can be tested afterwards
in a clinical setting the way
Klingberg lab has done it.
Only in the first six months
of 2013, Norwegians bought
500.000 tablets. And the sales
are increasing. This means
that games on tablets are very
accessible for many children.
Those who do not have tablets
can also play on smartphones.
The training effect will be
almost as good as with a
tablet.
The magical world was chosen
partly because we wanted
to have a setting that was
suitable for both boys and girls.
It was also a way of distancing
ourselves from Robomemo
where there are robots and a
space environment.
The magical world was also
chosen because it makesit
easier to explain all the strange
things that happen to the map;
why it is first upside down and
later gets flipped n different
mirrored directions.

89
Concepts
Tangible memory
Playing an ordinary memory
game trains your working
memory. With “The Tactile
Memory” we wanted to
enhance the original game by
including more senses.
The person, whos turn it is,
feels inside the box and has to
visualize what he/she is feeling.
This stimulates the sense of
touch and the envisioning
skills. He or she also has to
describe what he or she is
feeling so that the other players
will have a chance of finding
the matching piece.
Describing the textures and
shapes stimulates the verbal
skills and provides a different
challenge than we usually meet
in everyday life.
The other players have to
pay attention to the person
describing the objects inside
the boxes. Because they have
to listen in order to play, it
is social training in the form
of respecting others and
letting them finish what they
are saying without being
interrupted.
They have to guess what
is inside the boxes only by
listening, which stimulates
the hearing and the way the
brain interprets audiosignals.
It also enhances the ability to
envision things and triggers the
imagination.
center were especially positive
to this concept due to the
benefitial effects the feeling
sense can have on children
with cognitive challenges.
Strengths:
• Multitasking
• Stimulation of different senses
• Impulse control
Weaknesses:
• Needs increased diversity
Opportunities:
• React to sounds
• Body-tracking

91
Production of
Tangible memory
The initial idea for our tangible
memory game was that
the children should feel the
texture inside the gameboxes
and then describe what they
were feeling to the rest of
the children playing. Early in
the process, we made some
mockups in order to test the
game in play. The initial test
went very well, and we saw
that it was a strong game
concept. It just needed some
tweeking in size and design.
We took the game with
us to the Rafael center in
Copenhagen and tested
it with the therapists who
work with children in the
user group every day. They
loved the game concept and
they came with suggestions
as to how we could adapt
the game to children who
might have difficulties with
verbal communication. They
suggested that the child could
draw on the blackboard, for
instance, to show what they
felt inside the box.
We have had three tests with
children in different age groups
and each time the children
were eager to describe what
they were feeling while the
others paid close attention.
There were also attempts at
cheating by kneeling down to
look inside or to lie about what
they were feeling, but those
are minor problems that we
chose not to look at since it
is something each and every
gameplayer needs to address
when it occurs.

93
Production of
Tangible memory
After the visit to Copenhagen
we decided to add picture
cards to the game. These
pictures showed what was
inside the boxes and they
allowed for different ways of
playing the game. The child
can point to the picture to
show what they see and can
also read what the material is
called.
When testing the game, we
saw that the cards made
the game easier to play for
all children but it should be
used with care since it is very
tempting to use the cards
instead of your words when
the cards are introduced in the
game.
On the back of the cards, we
put descriptions of what was
inside to allow for even more
ways of playing the game.
We saw that these cards had
some words on them that we
often use in our daily speech
to describe texture but that
these words were new to the
children. They asked what the
words meant and that way
they learnt a new word by
actually feeling the texture it
describes.
The descriptions also allow
for a new way of playing
the game. You read the
descriptions and try to find the
boxes that fit them. Afterwards
you flip the card around to
see if you were right. This is
also a good way to play with
different age groups. Bigger
kids can use the word side of it
while smaller kids can use the
picture side

95
The experience
One of the most important
aspects of this game is the
social training. The fact that the
children have to pay attention
and respect the other player´s
input improves social skills
The game is suitable for all
ages and can easily be played
with both adults and kids.
Either as a regular memory
game or with the cards as
adjustments of difficulty level.
The game is also very flexible
because of the different ways
of playing. This is good to
create variation in for instance
a training situation with a
teacher or other adults.
We wanted to go for the toy-
feel more than training feel,
again to escape the stigma
that comes from the child
using a training tool which only
emphasizes that the child is
different.
Because we are designing it
as a regular game, we can give
the child an opportunity to train
and be good at a game that
other children will want to play.
Showing that he or she can
be better at something is an
important part of strengthening
self confidence and the feeling
of self worth. The game can be
used both at school and in a
home environment.
Since it is a game that the
children would want to play, it
doesn´t feel like training. This
takes away stigma and adds
motivation

96
After going through reliable
methods and other sources
of information, interviews with
professionals, interviews with
institutions and relatives of
children with suspected ADHD.
We decided that our solutions
should be inplemented at
the beggining of the patient
journey, when parents and
teachers meet for the first time
with the question “Does my
child has ADHD?”
Why? Because being uncertain
about the diagnosis of a child
is one of the worst situations
parents and engaged teachers
can have. Our games will
cover different aspects (graph
above), that will help parents
and teachers feel they are
doing something active
towards a possible diagnosis,
even though they don’t know
the results. In addition, these
games provide information
about the benefits not just in
children with a diagnose, but in
any child.
We hope that by implementing
these games at the start of
the patient journey, it can also

97
Production
summary
be an aid that will support the
patient with the other different
treatments.
The distribution in different
schools can be a task done
by PPT or BUP. We want to
take advantage of this, since
they are the intitutions in
charge of the curriculum and
administration of education in
Norway. Besides of being the
ones in charge of testing for
learning disabilities. Our final
concepts are suggestions to
how a solution could be. They
are low threshold solutions
that aim at reaching as many
children as possible rather than
being clinically proven and that
way being very efficient to a
select few.
An iPad game that can be
downloaded in the app store
and can be used on an iPad
or a smartphone, is avaiable to
many children and parents.
A tangible memory game
that can be given to schools
or taken home for those who
want it is low threshold and
doesn´t take up any more
space than a regular board
game.
As interaction designers we
always aim to create good
experiences. User testing is
very valuable for us and is not
so much a process to validate
our concepts but a way of
seeing how people will actually
experience the design. That is
why prototyping has been an
important part of our project.
Seeing and feeling how things
work also triggers new ideas in
our process.

100
Already by this stage we were
struggling to make sense of
all the information we had
gathered, not to mention
linking related findings from
different areas to one another.
We found that mapping out
each field independently was
straightforward enough, but
trying to link the various areas
to each other was a lot more
challenging.
With all of the areas we had
researched placed and linked
together in our GIGA-map, we
started looking for interesting
areas for design interventions.
Our map includes facts on
brain functions, symptoms
and diagnosis, stakeholders
and patient journeys, as well
as traditional and alternative
treatments. To find a suitable
context, we analyzed the
patient journey and findings
related to the system involved
During the course of System
Oriented Design, we have
been learning the methodology
of GIGA-mapping as a tool for
researching within a system in
order to find more adequate
solutions to real problems
or to find opportunities of
design in order to improve
the functioning of the whole
system.
At the beginning of the
semester we were introduced
to possible partner
collaborators for our course.
We chose Charlotte Lunde as
our partner, a researcher on
cognitive training for children
with ADHD. The topic for our
project was Neuroplasticity,
more specifically how the
principles of Neuroplasticity
can be beneficial for children
with ADHD. Working with
such broad fields, we quickly
found ourselves in a bit of a
dilemma; When do we draw
the line when following a lead?
Working in a group of three,
we had the advantage of being
able to investigate several
directions simultaneously, and
then combine our findings and
discuss which areas needed
more investigation and which
were sufficiently explored. This,
on the other hand, also meant
that we had three different
views on what was interesting,
which again meant that we
spent a lot of time debating on
what to research.
After a long period of research,
meetings, workshops and even
an excursion to Denmark, we
generated a GIGA-map (4x1m)
of it all in order to see the big
picture and find connections
that might not have been
discovered otherwise.

101
Project
reflections
in this. By doing so, we
revealed gaps for many
of the involved parts, and
identified the need for a low
threshold intervention in the
early phases of diagnosis
assessment. With the context
in place, we continued to study
findings within treatments and
beneficial methods for the
symptoms we had mapped
out. Based on these studies
we chalked up five directions,
all related to cognitive, physical
and/or social training, in
which we wanted to focus
our design. After several
evaluations of our concepts we
decided to develop just two of
the concepts, but left a starting
point to continue with a third
direction that can offer more
areas of exploration to have a
better impact on the patient.
At the end of the semester we
had researched and mapped
to our four design directions,
and then began adding other
relevant connections to areas
all over. Simply by doing this,
it felt like all the pieces of the
puzzle fell into place, and the
argumentation we knew we
had became real.
It wasn’t about being able
to point to a line between
two parts to prove the
connection, but rather a proof
for ourselves. Seeing the
connections between our work
and our research not only
strengthened our belief in our
concepts, it also allowed us to
better identify the strong and
weak areas within them.
out complex fields related to
neuroplasticity and ADHD. We
had linked all relevant findings
with one another, used the
insight that we have gained to
develop four guidelines for our
design work, and started to
develop concepts.
With work on our concepts
well on the way, we found
that we had to take a step
back and re-do the GIGA-
map once again to clarify
the basis for our ideas. We
found that we needed to link
the research to the design
directions in order to find the
argumentation that we needed
to justify our concepts. Even
though we knew where the
basis for our concepts came
from and were sure of their
credibility, we found it hard to
argue for them without proper
documentation in the map. We
set about linking the concepts

102
Articles:
Arnheim, R. (1969). Visual Thinking, Berkeley, University of California Press.
Parsons, P., & Sedig, K. (2014). Common Visualizations: Their Cognitive Utility. In W. Huang (Ed.), Handbook of Human Centric Visualization (pp.
671–691). Springer New York. Retrieved from http://link.springer.com/chapter/10.1007/978-1-4614-7485-2_27
Yi, J. S., Kang, Y. ah, Stasko, J. T., & Jacko, J. A. (2007). Toward a Deeper Understanding of the Role of Interaction in Information Visualization.
IEEE Transactions on Visualization and Computer Graphics, 13(6), 1224–1231. doi:10.1109/TVCG.2007.70515
Fougnie, D., Vanderbilt University (2008). The Relationship between Attention and Working Memory, Chapter 1 from New Research on Short-Term
Memory. Johansen, N. B. (Ed.).
Klingberg, T., Karolinska Institutet (2011). Dopamine, Working Memory and Training Induced Plasticity: Implications for Developmental Research.
Klingberg, T.; Fernell, E.; Olesen, P. J.; Johnson, M.; Gustafsson, P.; Dahlström, K.; Gillberg, C. G.; Forssberg, H.; Westerberg, H. (2005),
Computerized Training of Working Memory in Children With ADHD - A Randomized, Controlled Trial.
Söderqvist, S.; Nutley, S. B.; Ottersen, J.; Grill, K. M.; Klingberg, T. (2012), Computerized training of non-verbal reasoning and working memory in
children with intellectual disability. Schubert, T. (Ed.).
Olesen, P. J.; Macoveanu. J.; Tegnér. J.; Klingberg. T. (2006), Brain Activity Related to Working Memory and Distraction in Children and Adults.
Nutley, S. B.; Söderqvist, S.; Bryde, S.; Thorell, L. B.; Humphreys, K.; Klingberg. T. (2011), Gains in fluid intelligence after training non-verbal
reasoning in 4-year-old children: a controlled, randomized study.
Jepsen, J., Rafael Centeret (2011), Projektafhandling: Interventionsprojekt Lindevangskolen, Frederiksberg, 01.05.2011-01.12.2011, Ny og
gennemgribende indsats til børn med specifikke vanskeligheder i perioden 01.07.2011-01.11.2011.
Stephenson, S. (2006), ADHD and Montessori A Case Study.
Ph. d. applicant Helle-Valle, A., Restless children: who are they, how can they best be met, and what could be the contribution of music therapy?
Bavelier, D.; Davidson, R. J. (2013), Vol. 494 Nature magazine, Games to do you good.
Totland, K. (2001), article in STÅ PÅ Nr 1 2001, AD/HD illustrert ved «liknelser».
Germinario, E. A. P.; Arcieri, R.; Bonati, M.; Zuddas, A.; Masi, G.; Vella, S.; Chiarotti, F.; Panei, P.; Italian ADHD Regional Reference Centers (2013),
Journal of Child and Adolescent Psychopharmacology, Volume 23, Number 7, 2013, Attention-Deficit/Hyperactivity Disorder Drugs and Growth:
An Italian Prospective Observational Study.

103
References
Valdersnes, A. K., LiveWork Nordic AS (2013), God skolestart: En historie om hvordan helsetjenester kan formes.
Erhardt, R. P. (2006), Sensorimotor Stimulation Activities for Preschool Children with Significant Visual Impairments.
Modern technology is changing the way our brains work, says neuroscientist. (n.d.). Mail Online. Retrieved November 22, 2013, from http://www.
dailymail.co.uk/sciencetech/article-565207/Modern-technology-changing-way-brains-work-says-neuroscientist.html
Greenfield, S. (n.d.). Under the Microscope: When the brain goes down the drain. The Independent. Retrieved October 27, 2013, from http://www.
independent.co.uk/arts-entertainment/under-the-microscope-when-the-brain-goes-down-the-drain-1354092.html
Interviews:
Lene Knudsen (Psychomotor competence, Rafael Centeret)
Pia Schackinger Christensen (Optometrist, sight- and motor skills competence, Rafael Centeret)
Birte Glud (Psychotherapist, Rafael Centeret)
Jonna Jepsen (Manager and consultant, Rafael Centeret)
Siw Risøy (Counselor for learning disabilities in high school)
Ylva B. (Kindergarden teacher)
Lisbeth (Mother of a child with suspected ADHD)
Cathrine Darre (Pedagog with experience in digital tools for children in kindergarden)
Espen Bergå Johansen (Researching behaviour in hyperactive rats)
Abhilash D. Pandya (Neuro-scientist)
Visit to a school in Denmark where the methods from Rafael Centeret were implemented (TV-documentary “Jeg hader ADHD”)
User testing at the school of SSE (Avdeling for kompleks epilepsi)
Øyvind Byhring (Game programmer)

104
One of the biggest problems with the way ADHD is viewed today is
the fact that many children are being diagnosed or over-diagnosed
and prescribed narcotics (Ritalin) to treat ADHD. This affects their
lives negatively, and the long term effects are uncertain. We want
to address the problem by finding an alternative method to treat
ADHD by exploring the executive functions and the way they can be
developed with Neuroplasticity.

ADHD Treatment Through Neuroplasticity

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