1. family and parenting
2. children

HOW WEARABLE COMPUTING CAN HELP YOUNG
CHILDREN WITH ADHD TO LEARN
Camila Gernhardt Nakamura
Design & Technology, Parsons
6 E. 16th St., 12th floor, New York, NY 10011
[email protected]
ABSTRACT
New technologies can enable children diagnosed
with Attention Deficit Hyperactivity Disorder
(ADHD) and teachers to contour the disorder and
make it possible to create a healthy environment
to end the struggle that is to learn in the present
educational methods. This paper presents a
discussion about the disease itself, the learning
methods and the emerging possibilities of devices
that can cope with these children allowing them
to learn in an interesting and productive way.
KEYWORDS: WEARABLE COMPUTING ;
CHILDREN; ADHD; LEARNING; FOCUS;
INTRODUCTION
Attention Deficit Hyperactivity Disorder (ADHD) is
defined as a chronic behavior disorder by medicine
and one of the most common childhood disorder.
This disorder can affect children significantly
especially when it comes to their performance
at school because those children have difficulty
Permission to make digital or hard copies of all or part of this work for
personal or classroom use is granted without fee provided that copies are
not made or distributed for profit or commercial advantage and that copies
bear this notice and the full citation on the first page. To copy otherwise, or
republish, to post on servers or to redistribute to lists, requires prior specific
permission and/or a fee.
May 11, 2015, New York, New York, USA
Copyright 2015 Camila Gernhardt Nakamura
staying focused on specific matters and paying
attention and can cause problems to other peers
with their difficulty controlling their behavior and
due hyperactivity. [1]
The problem with ADHD is that usually is
diagnosed late or sometimes the person will go
through a lifetime without knowing they have
this deficit. They struggle with simple tasks such
as reading a small text but at the same time can
focus for hours in a subject that caught their
attention. ADHD is identified as cognitive medical
condition but at the same time these children
should not be taken as wrong just as different. [2]
Once understood it is possible to affirm that ADHD
is open to innovation. Technological interventions
can change how these children behave and how
they relate to the subjects they are exposed to in
the classroom.
This paper will explore the design space to develop
wearable technologies in two different fields,
emotional and didactic ways, to cope with young
children in order to make it possible for them to
deal with the symptoms that ADHD presents and
have a successful learning life. In this case it is
extremely important to understand not only the
singularities of these disorder but also analyze
in the current model of education the learning
curve of a regular child and oppose to a child that
suffers with ADHD. Not less important, once it is
1
being suggested the use of technology as support
on the daily lives of children it becomes essential
to discuss how technology can influence in their
development.
The present paper will also analyze different types
of new technologies being developed and tested
in order to understand what and how those could
help children with ADHD.
CHILDREN, MODERN WORLD, LEARNING AND
TECHNOLOGY
Times have changed and so did the kind of stimuli
available for children in the daily basis. Children
are growing up with access to information through
various types of media. They are bright and
have their own way of understanding the world.
Regarding to learning it is necessary to observe
the child in a way to realize that there is no single
pattern of development and so there is not an
ideal child. There are different contexts, different
cultures and different possibilities, creating
different childhoods for each one of them. Every
child is unique. [3]
Still it is essential to find the specific needs of
each child in the group and this is only possible
if the caregiver observe and listen to what the
they have to say. Adriana Friedmann points out
the importance of records in these case studies so
that they can be processed later, out of context and
even with a new point of view. During her speech,
Friedmann explains some considerations when
applying activities and in the process of learning
in early childhood, whereas, as said before,
children are under the influence of many media
and for this reason are constantly changing. [4]
We live in a society where even though we know
the importance learning have in our lives we still
spent less time, effort and money than we should
to encourage this children to be good citizens and
to have a brighter future. We are teaching most
of them in an outdated form making them feel
bored and discouraged. We are putting brand new
technology in their hands before they can even
talk. We are trying to make them quiet and not
listening to what they have to say.
Seeing the importance that technology has in our
society and in how we are developing to be the
human becoming that Clive Dilnot mentions [5].
Accordingly to him we have to use the artificial as
a world of possibilities where we can cope with it
and build a better future. However lately we are
bringing the technology to a pedestal and letting it
take over our lives forgetting that in fact it is built
to be most likely extensions and not substitutes of
our own skills.
These facts should be our biggest concern regarding
to our children because a proper development
during childhood is essential for the adult they
will become. Thus the learning is a continuous
process which will bring consequences in the
life of every individual and it is not only what is
taught at school. Therefore, access to the right
activities that provide good incentives for children
is essential for achieving the proper results.
In the documentary “The importance of play”, Sue
Palmer explains how with the more stimulation
the child receives those early years - especially
through songs and stories - more chances they
have to become balanced citizens, responsible and
productive. With that is essential to comprehend
that the development of the intellectual is
completely related to the motor development in
a child [3].
The world we live in today is constantly changing
and due to accelerated development is full of new
technologies. So much that when it comes to
discuss how technology have a role in our lives
we realize that every change is seen as life savers
for some and as life threatening to others. The
truth is it can be either way depending on how
people act in the presence of change. Especially
regarding its influence on children development
things can get even more difficult it is then that
begin to appear different types of opinions on the
subject by the media, educators and even parents.
Plowman and McPake (2013)[6] analyzed some of
2
these myths closely following the development
of children aged 3 and 4 years in the presence
of technologies like computers, mobile phones
and tablets. They got into a conclusion that can
in fact help the development of a child helping
their social skills and fueling their creativity. Thus
we arrive at the result that technology can cover
four main areas of learning extending knowledge,
helping to develop the operational learning when
the child understand how to use the products,
showing disposition to learn when they gain selfconfidence and self-esteem for succeeding and at
least helping to fulfill everyday tasks.
in children during the first years of school, from
6 to 12 years old, once these symptoms can also
describe any regular toddler making diagnosis
difficult before those years.
From these facts we can most certainly agree that
technology is not a villain in children’s lives; on
the contrary it can be quite aggrandizing. But it
is extremely important to realize that the use of
technology by itself is not, in any way, guarantee
learning success. It is necessary that the material,
applications and selected programs provide
challenges besides just fun for them.
Accordingly to Richard Friedman for the New
York Times ADHD can be viewed not as a disease
but as a set of behavioral traits that don’t match
the expectations of our contemporary culture.
That because once these patient understands
themselves it becomes possible to create
situations such as environments and interests
that make them able to not only work properly
but usually even better than someone without the
disorder. [9]
Considering all the above, the design possibilities
and liabilities are countless; from developing toys,
apps or better tools for teaching in school. Still
most certainly user-centered design is the method
to be applied to assist in development of a child,
because that seeks to understand interests and
needs so that design extremely functional objects
and is essential that good design is present so
that a person can handle it without instructions.
Besides knowing the user, it is necessary to
design for the misuse, thinking beforehand that
sometimes the product will not be used the way it
was designed.
ADHD
ADHD affects over 18 million people in the
country. From the years of 2003 until 2011 there
was a 41% increase of children diagnosed with
ADHD and it has been increasing since then [7].
People with ADHD have trouble paying attention,
are hyperactive and frequently impulsive acting
before thinking. The diagnose is more common
This illness is frequently connected to
abnormalities of the transmission of dopamine
in the brain. “Dopamine is a crucial chemical for
concentration or sustained attention, working
memory and motivational processes in the brain
and acting as a chemical transmitter between
brain cells by combining with specialized receptors
on nerve cells.” [8]
With a similar opinion from another perspective,
Michael Ruff, M.D, a clinical associate professor
of pediatrics at Indiana University, believes that
the modern way of life has a great impact on
the brain because children develop from early
ages immersed in the information overload and
get accustomed to rapid tempo that does not
adjust well to the slow pace of a classroom. They
have this sense of urgency and unrest having a
disorder aggravated by the modern world and its
technologies. [10]
On the other hand, trying to perceive the disorder
from the eyes of a patient or from a close relative
can be clarifying in many levels. For an example,
Stephen Tonti, a major at Carnegie Mellon explain
that ADHD people have difficulty in completing
tasks that do not excite them at the same time
they can have hyper focus on things that does
excite them, taking them from the underachiever
label to the overachiever one. From his view it is
also important to understand that this so called
disease does not need fixing and that it is not
3
possible to cure it because it is a difference in the
cognition people have, their attention is different.
Because of that it is extremely important to allow
ADHD diagnosed people the freedom to express
themselves by any method they feel comfortable
in. We should let children to teach themselves.
[11]
Rebecca Hession, wife and mother of ADHD
diagnosed people, points out on how these
individuals are simply different from others.
These children do not fit in the industrial age
factory model of education where everything is
generalist and children are taught as all having
the same abilities when sometimes they just
don’t match the criteria utilized in this process.
Thereupon children struggle with school life and
frequently feel discouraged. In numbers, 20% of
these children will grow up and repeatedly skip
school; others 35% will drop out; 30% will repeat
a subject or the year and 20% are expelled. This
because children with attention disorder without
the proper care will make a teacher job more
difficult and this education system does not match
the need of the children that can be extremely
interested, even obsessed, to some kind of topics
and completely demotivated by others. [2]
HOW WEARABLE COMPUTING CAN HELP
The evolution of the computer science towards
the body is eminent. The intention is to empower
the body with an extension of its intellect and
its senses aiming for a possible flawless version
of ourselves [12]. To be able to achieve that with
ADHD children it is possible to take two different
directions that most likely would complement
each other: the emotional aspect understanding
what the children is feeling during classes,
lectures and exposed to certain subjects; and
the didactic aspect that is basically create new
dynamics to teach children making it possible
for them to identify themselves with the content
which will most certainly benefit all children
inside the classroom.
EMOTIONAL
The next step to this achievement is understanding
not only the physiological signals of our bodies
but using it to analyze, map and understand our
emotional responses.
Our bodies are the primary interface to the world.
Is how we are able to communicate with others
and to the world. There is no denying that the
evolution of the technologies is culminating to be
held on the body and to gather each time more
personal data.
Lately the goal is to give computers ability to
pay attention to how the user feels and use that
information to adapt itself to what the users
needs. Thereat what can be called affective
wearables overlap with medical wearables at the
time where both may need sensors to gather data
as to anxiety or distress [13].
“Recent findings on emotions have shown that the
mechanisms associated with emotions are not
only tightly intertwined neurologically with the
mechanisms responsible for cognition, but that
they also play a central role in decision making,
problem solving, communicating, negotiating,
and adapting to unpredictable environments.
Emotions are now therefore considered as
organizing and energizing processes, serving
important adaptive functions.” [14] Because of
that measuring and understanding emotions can
be extremely useful in the daily basis not only
in the health care service but also for education,
helping a child to stay focused and motivated
sensing their attention; saving real time data
by its affective qualities, that can help teachers
to understand the learning curve and attention
of a student; or even to deal with mood swings,
helping a person to calm down, cheer up or focus
through music or visuals.
Some examples of how these measurements
can be achieved are going to be analyzed in the
following pages, providing the first impressions
on these groundbreaking technologies.
4
XOX
One example of these kind of wearable computing
is from XOX - emotional technologies. Xox is
an integrated system that involves a server, a
cloud and a sensory wristband with a number
of biometric sensors. The sensory wristband is
designed to be worn in the upper wrist where
intimate data is read through a number of
biometric sensors. The system is aimed to show
designers and producers allowing them to access
the audience intimate data that is processed in
real time that shines RGB lights accordingly to the
mapped data and is also transmitted to the server
so it can be analyzed posteriorly. [15]
find out the most effective ways to caught their
attention.
Also, the wristband would probably have to be
slightly modified losing off the feedback lights,
otherwise that would easily take off the attention
of the children. Another important thing for the
directed treatment care of each student is to
have them specified in the software to see their
development.
EMOTIV
Emotiv is a 5-channel and wireless headset that
records brainwaves, transforming them into
understandable data and being easy to control and
giving the freedom for the person to move around.
It can measure and keep track of different emotions
such as focus, engagement, interest, excitement,
affinity, relaxation, and stress. Also it recognizes
facial expressions as blink, wink, surprise and
smile that can be fundamental to understand a
human being reaction to happenings. [16]
FIGURE 01 - XOX WRISTBAND THAT READS
PHYSIOLOGICAL DATA
However a modified version of the same
wristband could be used to monitor first grade
students during the year to pinpoint those who
have certain difficulty in different topics and
subjects providing the teacher with a rich data
sheet with the evolution of each student in the
classroom. This sensors could be mapped to
provide different kinds of feedback depending on
what is is necessary to learn about the child for
an example a software could measure the level of
attention the child is having contrasting to what
and in which way - what kinds of media - the
professor is teaching. In this way it is possible to
FIGURE 02 - EMOTIV IS ABLE TO READ
DIFFERENT FEELINGS AND FACIAL EXPRESSIONS
TRANSLATING IT IN UNDERSTANDABLE DATA
5
Although it is really difficult to have consistent
signals from the brain mostly because of the
location on the brain can vary from person to
person the breakthrough Emotiv was to create an
algorithm that unfolds the cortex, mapping the
signals closer to its source, and therefore making it
capable to make readable data even with different
people. [17]
This device can be useful due to the fact the
brain is one of the most complex systems in our
bodies. Being able to read it in its most pure form
without the interference of external interference
such as questions and words can be extremely
advantageous regarding children once it makes it
easier to reach out to them when certain feelings
become hard to explain.
iCalm
Devices with sensors have being used already
in studies such as “Measuring Arousal During
Therapy for Children with Autism and ADHD” [18]
to help children better communicate their internal
emotional state so caregivers better empathize
to their situations. iCalm is a sock like device to
be used around the ankles that can measure the
arousal of children during all kinds of situations.
That creates a graph and combined with footage
of the therapy can be analyzed to understand if
the arousal is from frustration or pleasure.
For children diagnosed with ADHD this kind of
device can be extremely useful for them to get to
know their own frustrations and barriers. Most
times the self-knowledge can help to improve
their ability to communicate to others those
feelings and even help them to behave differently
towards those situations.
With measurements like this children can better
communicate with their parents, professors and
their therapists about what frustrates or excites
them. At the same time it becomes easier for
those who take care of them to provide proper
stimuli and understanding.
Given the strong connection between affect and
cognitions allied to the increasing development of
technologies the desire and possibility to enable
our wearables with affective qualities is extremely
desirable. Understanding in a deeper level the
effects of emotions in the during the process of
learning will empower parents and teachers to
better deal with children with ADHD allowing
them to achieve goals of being more focused and
productive having effective learning.
DIDACTIC
As said before, times have changed. The methods
used before in that so called industrial age of
education it is no longer effective. The results of
these methods can be compared to the reptilian
brain that simply shuts down when it feels
threaten. Examinations and rigid authorities inside
a classroom does that to children in general, let
alone to those with ADHD. Encouragement seems
to be the key for learning. We need to understand
the child. We need to make learning a pleasure
environmental to bring back their confidence and
imagination. [19]
FIGURE 03 - ICALM MEASURES AROUSAL IN
CHILDREN WITH COGNITIVE DEFICIENCY
Sugata Mitra have the opinion that we should
treat learning as a product of a self. Letting the
6
FIGURE 04 - KHAN ACADEMY IS BASED IN A SERIES OF VIDEO CLASSES, WITH PRACTICING AND
COACHING FOR PEOPLE TO LEARN DIVERSE SUBJECTS.
educational process to self-organize and with that
learning will emerge. The idea is to let the process
happen and not make it happen. The teacher
will only set the process in motion, creating the
sparkle for the students and let them resolve. It is
all about making education sexy and interesting.
These ideas can be executed through different
types of learning dashboards and even through
wearable technology that allows children to
simulate certain kinds of nature behaviors and
learn subjects acting on it.
To understand some of those possibilities there
will be explored some of the recent outcomes that
target new methods for education and once again
contrasted to the benefits for students with ADHD.
Khan Academy
Salman Khan believes that is possible to use
technology to do exactly the opposite of many
people thinks it does: re-humanize. Using videos
and other media viewed at home he created the
Khan Academy [20], replacing the one side lectures
in class it is about changing the idea of the “one
size fits all” and allowing the children to learn on
their own pace. Allowing them to work in class,
having the teacher available and discussing topics
with their peers is humanizing the experience
while now they actually have time to interact with
each other. At the same time with this system it
is possible to record data of how the students are
dealing with the subjects, how many times they
are watching and pausing, arming the teachers
with as much data as possible in a way they can
analyze diagnose what’s wrong with the students
so they can make their interaction as productive
as possible. [21]
This is one way to motivate students with different
cognition to learn at the same time that it is
possible to keep track on them analyzing where
they are making the best development.
BeeSim
The called Participatory Simulations are a very
effective way of integrating complex systems in the
learning environment, allowing student to have
a first person perspective of those. Usually these
7
computational simulations are focused in older
children or teens because they are challenging
concepts for a younger crowd. However, BeeSim
builded up with devices such as lily pads and
other smaller coded parts was able to approach
the subject in a very successful way. [22]
BeeSim stimulates children to model the
behaviours of the honeybee nectar collector. In this
participatory simulation the students are divided
in two groups of dueling hives and have to follow
a set of rules to be declared winners. “Children
have a finite amount of time (45 seconds) to collect
and deposit nectar and a finite storage capacity
(3 units). During the allotted time, a child runs
from flower to flower and tries to collect nectar”.
This way several fundamental characteristics for
children development are explored among them
cooperation, competitive edge, dexterity and time
management beyond making them understand
the complex system of a hive.
FIGURE 05 - CHILDREN USING FORAGERBEES
TO COLLECT NECTAR FROM FLOWERS AND
DEPOSIT AT THE BEEHIVE.
Above all things this kind of method allows
students to move around the space taking off the
burden of sitting still for hours straight which is
extremely difficult for kids with ADHD.
These ideas can be executed through different
types of learning dashboards and even through
wearable technology that allows children to
simulate certain kinds of nature behaviors and
learn subjects acting on it.
SIFTEO
FIGURE 06 - STIFEO INTERACTIVE CUBES
8
Sifteo are interactive blocks that composes new
ways to play. Through downloadable games, the
connection through all the faces of the block is
explored to make the cubes interact with one
another and provide several reactions. The games
often brings well known characters that excite
children to play with. The fit of the blocks create
the possibility for the game to develop once the
screen is really small and only this junction makes
the next part of the screen to appear. Because of
that Sifteo explores the logical thinking seeking
for continuity of the game, forcing people to think
fast and with objectivity. [23]
FIGURE 07 - STIFEO TEENAGE MUTANT
NINJA TURTLES INTERACTIVE GAME
Also other explorations of the blocks is to use it as
inert play cubes, stacking them and using other
materials combined with it to explore even more
those interactions. The images inside the screens
will then respond to physics having acceleration
and gravity making the play even more exciting.
happen the easiest [24]. Because of that these
kind of stimuli can bring a rewarding feeling for
students with ADHD, being possible to develop all
kinds of materials for it in a playful and dynamic
way which allows children to move around while
playing and expressing themselves in a singular
way.
CONCLUSION
Adopting those types of technologies cited
throughout this paper would make learning more
exciting, making things more obvious and easier
for the students. Learning should be something
that is done with a cooperation of the student and
the faculty working together not to memorize but
create the knowledge. Children should feel they
have a reason to learn it, allowing them to chose
what is important and valuable is also a way to
give them power to be unique. This self-directed
knowledge will help them to have more passion
and information about what they really want
to do in the future. This way also children can
collaborate among each other in a way that will
humanize more those relationships[24].
At this point is possible to affirm that children
struggling with ADHD needs special attention.
They are often seen as underachievers when
actually they have extremely difficulty in focusing
in tasks that may seem ordinary to many. It is
essential that every child be seen as an unique
creature with different needs and capabilities.
For that a change in the educational system is
more than urgent. The adoption of computing
technology developed focusing the user centered
design would benefit not only those with ADHD but
every child in school once this flow of information
can be given in a more interesting, interactive
way with a distinct pace. Not least important it
is indispensable that teachers act as mentors in a
way children can be comfortable and leveled with
them to reach for help.
The idea behind the company according with
David Merry, president and co-founder of Sifteo,
is that when the learning experience is playful
or explorational oriented it puts people’s minds
into a relaxed state where learning can actually
9
REFERENCES
1. What is Attention Deficit Hyperactivity Disorder (ADHD, ADD). Accessed March 13, 2015.
Online at http://www.nimh.nih.gov/health/
topics/attention-deficit-hyperactivity-disorder-adhd/index.shtml
2. Hession, Rebecca. Not Wrong Just Different
ADHD as Innovators. Accessed March 15,
2015. Online at https://www.youtube.com/
watch?v=60wX9jf5RPg
3. LBHounslow. The importance of play. 2010. Accessed March 14, 2015. Online at http://www.
youtube.com/watch?v=h_-1O_rBLPU
4. Secretaria de Assuntos estrategicos. Fried-
5.
6.
7.
8.
9.
mann, Adriana. Como ocorre o desenvolvimento na primeira infancia?. 2011. Accessed March 12, 2015. Online at http://
www.youtube.com/watch?v=Ss47mjk6jTg&list=PL3699CF21EC23C416
Dilnot, Clive. Design as Future-Making. Reasons to Be Cheerful, 1, 2, 3 … (Or Why the Artificial May Yet Save Us). 20 Nov. 2014. Print
PLOWMAN, L; MCPAKE, J. Seven Myths About
Young Children and Technology. Childhood
Education 89 (1) 27‐33. Accessed March 14,
2015. Online at http:// www.tandfonline.com/
toc/uced20/89/1
ADD & ADHD Health Center. Attention Deficit
Hyperactivity Disorder (ADHD) - Symptoms.
Accessed March 16, 2015. Online at http://www.
webmd.com/add-adhd/tc/attention-deficit-hyperactivity-disorder-adhd-symptoms
Imaging study shows dopamine dysfunction is not the main cause of Attention
Deficit Hyperactivity Disorder (ADHD) Accessed in March 15, 2015. Online at http://
w w w. c a m . a c . u k / r e s e a r c h / n ew s / i m a g ing-study-shows-dopamine-dysfunction-is-not-the-main-cause-of-attention-deficit-hyperactivity
Friedman, Richard A. A Natural fix for ADHD.
Accessed on March 13, 2015. Online at http://
www.nytimes.com/2014/11/02/opinion/sun-
day/a-natural-fix-for-adhd.html
10. Sherman, Carl. Culture Vs. Biology: What Causes ADHD? Accessed on March 13, 2015. Online
at http://www.additudemag.com/adhd/article/1546.html
11. Tonti, Stephen. ADHD As A Difference In Cognition, Not A Disorder. TEDxCMU. Accessed
March 15, 2015. Online at. https://www.youtube.com/watch?v=uU6o2_UFSE
12. Miller, Paul. “Project Glass and the epic history of wearable computers”. June 22, 2012. Accessed March 8, 2015. Online at http://www.
theverge.com/2012/6/26/2986317/google-project-glass-wearable-computers-disappoint-me
13. Picard, R.W. Healey, J. “Affective Wearables”.
MIT Media Laboratory, Cambridge, MA, USA
14. Lisetti, C.L. Nasoz, F. “Using Noninvasive Wearable Computers to Recognize Human Emotions from Physiological Signals”. EURASIP
Journal on Applied Signal Processing 2004:11,
1672–1687.
15. _______. “XOX”. Accessed March 9, 2015. Online at http://www.xoxemotionaltech.com/
16. ________. “Emotiv” https://emotiv.com/
17. Le, Tan. Tan Le: A headset that reads your
brainwaves. Accessed May 05. Online at http://
www.ted.com/talks/tan_le_a_headset_that_
reads_your_brainwaves?language=en
18. Hedman,Elliott; Picard, Rosalind W. “Measuring Arousal During Therapy for Children with
Autism and ADHD”. Accessed in May 05, 2015.
Online at http://affect.media.mit.edu/projects.php?id=3028
19. Mitra, Sugata. Build a School in the Cloud. TED.
Accessed March 14, 2015. Online at http://
www.ted.com/talks/sugata_mitra_build_a_
school_in_the_cloud
20. _________. Accessed March 26, 2015. Online at
https://www.khanacademy.org/
21. Khan, Salman.Let’s use video to reinvent education. TED. Accessed March 15, 2015. Online
at http://www.ted.com/talks/salman_khan_
let_s_use_video_to_reinvent_education?language=en
10
22. Peppler, K; Danish, J; Zaitlen,B; Glosson, D; Jacobs, A; Phelps, D. BeeSim: Leveraging Wearable Computers in Participatory Simulations
with Young Children. Indiana University,
Bloomington
23. Sifteo. Accessed May 10. Online at https://
www.sifteo.com/home
24. Sawyer, Miranda. Children and computers:
State of play. Accessed in May 04, 2015. Online at http://www.theguardian.com/technology/2012/jul/15/children-computers-state-ofplay
11