From Snappy App to Screens in the Wild: Gamifying an Attention Deficit Hyperactivity Disorder Continuous Performance Test for Public Engagement and Awareness

Abstract

Attention Deficit Hyperactivity Disorder (ADHD) is a neurodevelopmental condition that is characterised by three core behaviours: inattention, hyperactivity and impulsivity. It is typically thought that around 3-5% of school aged children have ADHD, with lifetime persistence for the majority. A psychometric Continuous Performance Test (CPT) had recently been incorporated into an interactive smartphone application (App), Snappy App, to allow the measurement of the three ADHD symptom domains. Snappy App presents a sequence of letters of the alphabet in a pseudo-random manner with responses via the device's touch screen. Following a pilot test in the general population where the CPT showed sensitivity to ADHD-related symptoms (self-reported impulsive behaviour related to CPT measures), a new project was begun to convert the App into a game Attention Grabber based on the functionality of the test, focussing on the attention and impulsivity domains. The Screens in the Wild (SITW) platform is in the process of being employed for public engagement in awareness about ADHD through interactive technology. SITW has deployed a network of four public touch-screens in urban places. Each of the four nodes has a large (46 inch) display, a camera, a microphone and a speaker. The Snappy App web-app was translated for presentation on to the SITW platform. The browser-based App was redesigned, with the input of a commercial graphics design company, based on an initial proof-of-concept whereby the original App was reprogrammed to present sequences of graphical objects (fruit) and to introduce further engagement features including animations. A shortened video about Adult ADHD and a brief questionnaire were incorporated to form a stand-alone edutainment package. The earlier design and user testing of Snappy App is briefly described and details are then provided of the process of gamification to produce Attention Grabber. An evaluation process is described whereby awareness of ADHD and its related symptoms are to be probed. In general, finding out whether and how people engage with interactive screen technology can help in the design of future public engagement and health promotion activities. Ethical considerations are discussed, since public access to this kind of game could potentially raise health anxiety related to self-interpretation of game performance. This risk is balanced with the need to provide health information.