ADHD
THERAPY





Design of a visual and behavioral concept for the therapy method “Neurofeedback”.

Year
2015

Partner
Dr. Axel Kowalski













INTRO



ADHD. It is a much debated mental illness – some claim that it is not even existent. However, evidence shows that many people suffer from the symptoms of this illness.

As a designer, I wondered:

︎︎︎ How might we ease the life of people with ADHD in our society?










RESEARCH

















FINDING

Identifying touchpoints


I found that people with ADHD don’t seem to fit into parts of the social system, such as the school system. In order to ‘make them fit’ medication is prescribed, but these have negative side effects.

︎︎︎ How might we facilitate inclusion of people with ADHD without medication prescription?












INTERVIEWS








I can’t change the world, but I can help my child adjust to the world.”


– mother of child with ADHD

“I’m not prescribing medication against ADHD.”

– primary care doctor






FINDING

Alternative Treatment


Through further research I came across a novel therapy method called Neurofeedback. It is a type of biofeedback that uses real-time displays of brain activity to teach self-regulation of brain function. This method is used to treat ADHD. During the sessions, patients are watching films while their brain activity is displayed. The displayed data show how good or bad the patients are concentrating and is used to give direct feedback through the watched films. For example, the film stops while concentration is low and plays when it is on a high level. This helps the patients to regulate their concentration consciously.

This therapy method offers effective treatment for people with ADHD without negative side effects and therefore an alternative to medication.













SYNTHESIS







THE PROBLEM



Due to the novelty of this treatment method, not enough material, such as films, was designed specifically for this method yet. 

︎︎︎ How might we design treatment material to enhance and support the effectiveness of the novel therapy method?





To answer this question, I ran test trials regarding visual perception and attention among ADHD patients. 






Game to test and train attention and decision making ability




Study to test
attention and focus









MAIN TOUCHPOINTS





1
Difficulty in concentration arises differently for either high or low stimulus intensity.  
2
Low motivation among children.
3
Transfer of progress and success into everyday life is hard to achieve.







CONCEPT




1
The animations will have different levels of stimulus intensity that can be adjusted individually for each patient.
2
Gamification of the treatment supplemented by a reward system and avatars for personal identification enhance motivation among children.
3
Implementation of visual stimuli from everyday environments, especially those that are challenging such as school, in therapy sessions.

The activity, such as the eye movement,
resembles natural movement in everyday life.
The conditioned visual material from the therapy sessions is taken into everyday environments in form of bonus cards.







ADHD SYMPTOMS 

︎︎︎ ...and design implications



Light sensitivity
Visual sensitivity
︎︎︎ A variety of visuals can be chosen based on preference and intensity

Noise / sound sensitivity         
Acoustic sensitivity
︎︎︎ Acoustics can be filtered or turned off

Frightfulness
︎︎︎ Images are designed to not frighten and can be selected based on personal preference

Emotional sensitivity
- Feelings of others transfer
- Feel moods of others unpleasantly intense
- Movies can easily make cry, so do not like to watch (certain) movies because of too intense sensations
︎︎︎ Emotional intensity can be adjusted

High vs. low stimulus sensitivity
︎︎︎ Stimulus intensity can be adjusted









Special focus is placed on these two types of ADHD:
High Stimulus Sensitivity
Low Stimulus Sensitivity









DESIGN









Sketches




Storyboards + Prototypes for Animations

The concept is based on the reinforcement theory of motivation. 





Avatar Prototypes

abstract
objects
animals
colors





Conceptualization of Reward System





RESULT






The final deliverable is a kit with movies, stickers and bonus cards that is based on a visual and behavioral concept for animations used during therapy and also bridges the training from the lab into the real world.  

The kit is based on psychological concepts, such as:

Gamification
Reinforcement Theory
Gestalt Psychology
Visual Perception
Conditioning


 




︎ 

The videos entail a game, which requires the patients to follow a character with their eyes to its counter parts along a path. The characters were chosen by the patient before starting the therapy sessions and will remain their personal characters throughout the therapy.

The path is supposed to resemble the naturally occuring movement of the eyes while, for example, reading a book or scanning a room.





︎ 

In some kinds of ADHD concentration is especially difficult when many stimuli are present, and in some kinds the opposite is the case.

Therefore, many different kinds of movies can be layed on top of each other, to adjust the amount of stimuli present while the patients follow the path with the eyes.




︎ 

The intensity of the distracting stimuli is adjustable.




︎ 

Each patient can choose from a variety of figurative and abstract characters. These have counterparts, such as a monkey + banana. The challengeof the game is to bring the avatar and its counterpart together. This supports feelings of accomplishment.




︎ 

After each successfully completed session, the patients receive their personal character as a sticker on a rewards card. This is intended to enhance motivation and positive feedback. 





︎ 

To create a smooth transfer of the trained concentration into the daily life of the patients, backgrounds that the patients are confrontet with outside of therapy in situations of lack of concentration are implemented in the game.



︎ 

The character as well as the eye movement now are conditioned visuals connected to the ability of successful concentration.

For example, the chosen character is then placed as stickers on the top and the bottom of a page. Seeing the character and reading, which entails the eye movement during therapy, will remind them of the times of successful concentration.










THE APP








ADHD SYMPTOMS

︎︎︎ ...and design implications


Light sensitivity
Visual sensitivity
︎︎︎ A variety of visuals can be chosen based on preference and intensity

Noise / sound sensitivity         
Acoustic sensitivity
︎︎︎ Acoustics can be filtered or turned off

Frightfulness
︎︎︎ Images are designed to not frighten and can be selected based on personal preference

Emotional sensitivity
- Feelings of others transfer
- Feel moods of others unpleasantly intense
- Movies can easily make cry, so do not like to watch (certain) movies because of too intense sensations
︎︎︎ Emotional intensity can be adjusted

High vs. low stimulus sensitivity
︎︎︎ Stimulus intensity can be adjusted









Library
Selection of different movies organized in libraries sorted by themes. 
ADHD Consideration
  • Not too many choices
  • small chunks sorted by topic
  • social rating system / personalization
  • Ability to save favorites to come back to




Gamification
The games can be played directly on the phone. 
ADHD Consideration
  • Not too much information to distract from game itself
  • clear signage





Data Monitoring
Data can be tracked and goals monitored. 
ADHD Consideration
  • Not too much information
  • Gamification: Show achievements





Profile
Each user has a profile to personalize the experience.
ADHD Consideration
  • Not too much information to type
  • empathy-generating





Community Feature
Users can connect among each other, select favourites, etc.
ADHD Consideration
  • visual cues
  • information chunking





Challenges
Group challenges and activities enable users to play with and against each other.  
ADHD Consideration
  • clear call to action