PREMISE

Helping adults with ADHD to focus better while studying by suggesting personalized study strategies using chatbot technology.

SYNOPSIS

ADHD or “Attention Deficit Hyperactivity Disorder” is a neurodevelopmental disorder, mostly characterized by inattention, impulsivity, lack of motivation, and hyperactivity. Individuals with ADHD are diagnosable from early childhood, but the symptoms last into adulthood in most cases. As the pursuit of teachers and parents is lifted after school, adults with ADHD are more likely to struggle with failure during higher education in a system that requires self-regulation. This can cause stress, depression, and disappointment throughout the years. Many study strategies can assist people with ADHD to focus on the task while studying, but not everyone uses them. Many adults with ADHD with focusing problems are unaware of study strategies, believe they are not for them or are overwhelmed by their variety, and are unsure which to use. Thus, personalized study strategies for adults with ADHD can be suggested by chatbot technology.

SUBSTANTIATION

Inattentiveness in ADHD adults

ADHD is a neurodevelopmental disorder that is commonly associated with symptoms including inattentiveness, restlessness, labile mood, quick temper, disorganization, hyperactivity, and impulsiveness (Wender, 1998). Although not everyone with ADHD experiences symptoms in the same way, inattentiveness is often reported as a common issue among ADHD adults (Sroubek et al., 2013). Wender (1998) explains that inattentiveness manifests as difficulty concentrating on conversations, being easily distracted when trying to focus, struggling to filter out irrelevant information, having difficulty staying focused on tasks or reading material, and daydreaming during work or study. These symptoms may lead to academic and professional failure, resulting in depression, stress, and disappointment (Öster et al., 2020). Inattentiveness may be treated with pharmacological and psychological therapies based on the severity of the symptoms(Scholz et al., 2020). While medication is used to influence the neurochemical balance in the brain, psychological interventions aim to develop a range of strategies for symptom control (Lopez et al., 2018).

ADHD coaching- Study strategies

Parker and Boutelle (2009) explained that ADHD coaching, as a psychological intervention method, involves teaching skills, strategies, and perspectives to manage executive function difficulties. The primary responsibility of an ADHD coach is to collect information, identify the root of the problem, and create customized strategies by incorporating existing solutions (Goudreau & Knight, 2018). ADHD coaching doesn’t need a professional psychiatrist and is mainly focused on practical aspects such as time management, study strategies, planning, and problem-solving, making it a more pragmatic approach than other psychological interventions (Prevatt, 2016). Various study strategies have been tested and suggested in the literature to help adult students with ADHD concentrate while studying:

• Note-taking: Note-taking promotes active engagement with the material, aids in comprehension and retention of information, and provides a structure for organizing thoughts, which can be particularly beneficial for individuals with ADHD who struggle with organization and focus (Evans et al., 1994; Gleason, 2012).
• Body doubling: According to Ginapp et al. (2023), body doubling is a technique that can create a structured and supportive environment for ADHD adults, facilitating learning and increasing productivity through motivation and accountability. Moreover, it can provide social connection and reduce isolation for individuals with ADHD who may struggle with social skills (Ginapp et al., 2023).
• White noise: White noise is becoming a popular study strategy among adults with ADHD as it helps to mask other environmental distractions and has a calming effect on the nervous system (Angwin et al., 2017). While some argue that it may be distracting, evidence suggests that it can enhance focus, improve cognitive performance, and manage symptoms for those with ADHD (Roye, 2017).
• Time management: By breaking down tasks, setting specific goals, scheduling breaks, and creating a structured study approach, individuals with ADHD can overcome these challenges and achieve their full potential (Weiss & Weiss, 2004).

Project

This project tries to help adults with ADHD to focus better on their studies by using study strategies. After talking to 10 ADHD adults on Reddit and in person, it was concluded that people who don’t use study strategies fall into three categories:

1. Are not aware of the strategies
2. Are overwhelmed by the variety and can’t choose
3. Think they don’t work for them

In this project, the focus is on the first and the second group as the third group needs a more complex behavioral changing approach.

Chatbots can be trained using supervised, unsupervised, and reinforcement learning techniques to respond accurately and appropriately, as explained by Cameron et al. (2017). Several studies have examined the potential of chatbots in diagnosing and treating adults with ADHD (Jang et al., 2021; Guribye, 2019; Jungmann et al., 2019) yet, none have focused on study strategies.

Chatbot technology was chosen for this project for three reasons:

1. A chatbot can act as a body double, suggesting companionship and supervision
2. As Seo et al. (2015) assert, ADHD people tend to go to their phones when they are stressed. This can be an opportunity for a mobile chatbot agent to help them.
3. Chatbots can be toned to have a persuasive, step-by-step conversation, avoiding the feeling of being overwhelmed and pressured.

ITERATION 1

First, an idea map was created to give a holistic view of the project. Data are collected from literature and experts, the user is asked questions, instructions are given, and then the feedback from the user is gathered to loop back to the beginning.

Voiceflow desktop app was chosen as a no-code conversational agent maker because of its real-time collaboration service and commenting system which make the feedback collection for data-driven solutions easier. Also, the voice agent can be used to engage both vision and audile since we are working with inattentive people. Some study methods were extracted from the literature and others were insights from a student psychologist as an expert.

User testing 1

The prototype was tested with five diagnosed ADHD students over eighteen years old. They were asked to talk to the chatbot before attempting to study. After the task was done, they reported back their feedback about the suggested strategy and the app. A voice agent was also added to avoid distraction during the talk and make the chat more engaging. Users can still type if they don’t feel comfortable talking.

Insights:

• The conversation can be more realistic.
• In 2 cases, It didn’t contain the proper scenario and the solution strategy didn’t suit the person.
• One user pointed out that it would be more encouraging if it were explained how the strategy would help.

ITERATION 2

The second iteration was based on the first user testing. Initially, it was assumed that the button feature would help the user to choose easier but in testing, it was suggested that it doesn’t feel like a chatbot or a conversation anymore. In the second iteration, the answer choices became more conversational and text-based using capture and condition. Also, more scenarios and choices to see the explanation of the way strategy helps were added to the flow.

User testing 2

The second round of user testing was performed like the first round and with the same test group.

Insights:

• Some instructions need too much effort in the user’s idea
• Responses are too quick at some points (commented)

ITERATION 3

The final iteration was based on user testing 2. More utterances and synonyms were added to get fewer no-match responses. To better engage the users and easier access, the strategies that needed a function outside the chat area were connected to a related URL; for example, in the scenario where using white noise was suggested, users can access a youtube channel full of white noise with a click. As the variety of the problems was out of the scope of this research, for no-match ends, AI replies were added to the chatbot to avoid irrelevant answers. During the meditation part, the extra sound was added to divide the sections and give the user more time to meditate. To make the experience better, the chatbot was transformed into a voice assistant.

CONCLUSION

The purpose of this experiment was to help adult students with diagnosed ADHD find better and more personalized study strategies. Looking at the results of user tests, it can be concluded that in most cases a chatbot can help ADHD adults who are looking for study strategies find one that suits them. The main challenge of this test was the variety of ADHD symptoms and the study strategies that were appropriate for each. Thus, it is important to speak with more experts and add more strategies in order to improve the strategy. Although medication use was not a factor in the test results for it not to interfere with the users’ personal lives, it was mentioned if the users took medication during the test. The chatbot’s efficiency can be tested on two different groups with and without medication to see if the medication makes a big difference.

 

REFERENCES

 

Angwin, A. J., Wilson, W. J., Arnott, W. L., Signorini, A., Barry, R. J., & Copland, D. A. (2017). White noise enhances new-word learning in healthy adults. Scientific reports, 7(1), 13045.

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Evans, S. W., Pelham, W., & Grudberg, M. V. (1994). The efficacy of notetaking to improve behavior and comprehension of adolescents with attention deficit hyperactivity disorder. Exceptionality, 5(1), 1-17.

Ginapp, C. M., Greenberg, N. R., Macdonald-Gagnon, G., Angarita, G. A., Bold, K. W., & Potenza, M. N. (2023). The experiences of adults with ADHD in interpersonal relationships and online communities: A qualitative study. SSM-Qualitative Research in Health, 3, 100223.

Gleason, J. (2012). An investigation of the lecture note-taking skills of adolescents with and without attention deficit/hyperactivity disorder: An extension of previous research (Doctoral dissertation, Columbia University).

Goudreau, S. B., & Knight, M. (2018). Executive function coaching: assisting with transitioning from secondary to postsecondary education. Journal of Attention Disorders, 22(4), 379-387.

Guribye, F. (2019, April). A Conversational Interface for Self-screening for ADHD in Adults. In Internet Science: INSCI 2018 International Workshops, St. Petersburg, Russia, October 24–26, 2018, Revised Selected Papers (Vol. 11551, p. 133). Springer.

Jang, S., Kim, J. J., Kim, S. J., Hong, J., Kim, S., & Kim, E. (2021). Mobile app-based chatbot to deliver cognitive behavioral therapy and psychoeducation for adults with attention deficit: A development and feasibility/usability study. International journal of medical informatics, 150, 104440.

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