Stimulating Capabilities: A Proposal for Learning and

Stimulation in Children with ADHD

Elena de la Guía, María D. Lozano and Víctor R. Penichet

Computer Systems Department, University of Castilla-La Mancha,

Albacete, Spain

Abstract. Children with ADHD (Attention Deficit Disorder and Hyperactivity)

experience behavioral and learning problems at home, at school and a lack of

self-control in their lives. We can take advantage of the evolution of new tech-

nologies to develop applications with the aim of enhancing and stimulating the

learning process of children with ADHD. In addition these applications may

help teachers and therapist to monitor and control the children improvements.

In this paper we present a software system based on games to improve the

memory and language abilities in children with ADHD. The collaborative

games are developed in a Multi-Device Environment applying the Distributed

User Interfaces (DUI) paradigm. The interaction with the system is very intui-

tive and simple. The user only has to bring physical objects, with RFID tech-

nology integrated inside closer to a mobile device. In this way children can

play from anywhere in the room and interact with the games projected on the

wall.

1 Introduction

Attention problems are the most frequent at school. In epidemiological studies with

normal population, teachers stated that among the inattentive children almost half of

them were boys and quarters were girls. In the clinical setting, attention problems

have prevalence between three and five percent [1], but just half of the children are

diagnosed through clinical evaluation. Providing special education is a key factor to

tackle this problem.

The Attention Deficit Hyperactivity Disorder or ADHD is a developmental disor-

der of self-control, which includes hyperactivity and the difficulty of maintaining the

attention. In addition, these problems cause deterioration in the child's ability to con-

trol their behavior over time and to keep in minds the goals or future consequences.

Information and Communication Technologies (ICT) are ideal for educational pro-

poses. Indeed, they can contribute to motivate children. In addition, ICT may be also

good for teachers, parents and therapists who through a computerized material can

carry out different tasks and control the evaluation of children. The advantages of

using software systems and educational games in the therapy of children with ADHD

are that they give children more independence from the teacher who does not need to

be present all the time. Besides, it improves socialization through the use of collabo-

de la Guía E., Lozano M. and Penichet V..

Stimulating Capabilities: A Proposal for Learning and Stimulation in Children with ADHD.

DOI: 10.5220/0004101101000109

In Proceedings of the 1st International Workshop on Interaction Design in Educational Environments (IDEE-2012), pages 100-109

ISBN: 978-989-8565-17-4

 2012 SCITEPRESS (Science and Technology Publications, Lda.)

rative applications, the concentration is also improved as children have to focus on

concrete contents, and the appealing and motivating interfaces make products de-

signed for this purpose, an excellent choice in educational processes. The main stimu-

lus for children is the motivation and attraction of using games that make children

enjoy and learn without being aware of the fact that they are being evaluated and

controlled. In order to exploit the advantages offered by multimedia resources and

new technologies, the system we present in this paper aims to improve and stimulate

the learning process of children with ADHD. To enrich the games we have applied

technologies such as RFID and WiFi. This scenario also involves concepts such as

IoT (Internet of Things), MDE (Multi-Device Environments), and DUIs (Distributed

User Interfaces) to improve the user experience during the performance of the differ-

ent activities as explained hereafter in the paper.

2 Related Works

In this section we describe the main works and concepts related to the system we

propose in this paper.

Some games for children with ADHD are the following: MeMotiva [11] is a pro-

gram that includes visual and spatial exercises. It includes a reward system to moti-

vate and encourage them during the performance of these exercises and it is designed

so that teachers, parents and children themselves can manage the results. Caza-Cosas

[10] is a fun set of games designed exclusively for the development of visual

memory. Lumosity [9] is a program designed to train the brain. It is based on the

concept of "neuroplasticity", the ability of the brain to learn and adapt when receiving

an appropriate stimulus. The different games and exercises are designed to train and

improve memory, attention, processing speed and cognitive control. SMART

Braingames [2] are interactive videogames that are intended to simulate real events in

order to stimulate and educate different cognitive capacities.

A virtual environment simulating a regular classroom is described in [4], [5]. The

user sits on a real desk, and immerses within the environment with the use of a Head

Mounted Device (HMD). 58 typical classroom distracters (classroom noise, move-

ment of students, outside events on the street, etc.) were systematically controlled and

manipulated in the Virtual Environment. The tasks were focused on improving the

attention of children.

Recently, there has been a growing interest in the use of online games. These are a

good tool for those children who need to have remote interactions with the therapists

[3].

These are some of the solutions that have been developed for the improvement and

stimulation of children with ADHD. However, the system we present in this paper

provides the flexibility to play collaboratively and individually. The users use com-

mon physical objects, such as cards to interact with the game interface. These objects

are more familiar to users and thus the interaction becomes more simple and easy as it

does not need prior learning. Besides, it is low cost and the devices (cards and mobile

device) are less heavy than helmets, gloves, HDMs and other typical devices for vir-

tual reality.

101

In school settings, Hengeveld described in [12] the value of designing intelligent

interactive games and learning environments for young children with multiple disabil-

ities to increase their language and communication skills. In [8] we can find a pro-

posal that digitalizes toys to help deaf children to learn sign language.

We have also used the concept Internet of Things (IoT) in our proposal. This con-

cept refers to a network of daily life objects being all of them digitalized and inter-

connected [14]. These new scenarios also support DUIs (Distributed User Interfaces).

According to Niklas Elmqvist in [6] DUIs can be defined as a user interface whose

components can be distributed through one or more dimensions. These dimensions

are: input, output, platform, space and time.

3 Description of StiCap System

StiCap, Stimulating Capabilities, is an interactive system to improve attention and

learning in children with ADHD. It is addressed to psychological therapies, in

schools, allowing supervision by professionals, parents, and teachers.

The system consists of three games: two oriented to memory improvement and an-

other one oriented to vocabulary enrichment. It is composed of the following devices:

cards integrating RFID tags used as interactive resources which allow one-way trans-

fer of information between a user and the system; mobile devices are interaction de-

vices incorporating a RFID reader which provides the communication among cards

and the system; and a projector or whatever big display showing the game interface

which is running on any PC or laptop.

This section will briefly describe the StiCap system through the system require-

ments, the different devices, the interaction style, the main modules and the architec-

ture.

3.1 System Requirements

One of the main requirements to be considered for de development of such a kind of

application is simplicity and easiness. In this way, StiCap does not provide excessive

unuseful animation. Children with ADHD lose their concentration easily, for this

reason, it is necessary to motivate them through amusing but simple user interfaces.

Another important requirement is avoiding frustration because of failure. Appropriate

applications show positive and encouraging messages when the user fails. In this

way, the user is motivated to continue playing and learning. Additionally, the degree

of difficulty to learn is considered. Educational programs should offer different diffi-

culty levels so that the children can exploit their potential effectively. Verbal messag-

es facilitate the use of the game and get the attention, enthusiasm, and concentration

of children, who are driven through the interface. Activities performed by using the

application are required to provide tranquility. Some kind of music and characters

with too much action and troublemakers might increase hyperactive and impulsive

reactions. Lastly, playing dynamics encourage ADHD children. These activities rein-

force and enhance children's abilities through the games.

102

3.2 Multi-devices Environments

An amount of devices are used altogether on the environment where the games run:

digitalized objects, mobiles devices, laptop, projector, and so on. These devices

communicate each other through identification (RFID) and wireless (WiFi) technolo-

gies. The application user interface is distributed in such a way that interaction be-

comes more natural. The user do not need to know anything about computers or any

kind of devices, but using the system naturally moving cards, approaching them to

other places and so forth. These movements lead to the performance of task in the

system.

Fig. 1. Multi-Device Environment that support Distributed User Interfaces.

The environment includes different types of interaction depending on the func-

tion of the device.

-IR (Interaction Resources) are the devices that can help the user to interact

with the system. In this project are the cards that integrate RFID or what is the same

physical user interfaces.

-ID (Interaction Devices) are computing devices that handle the input or send

output to IR in order to shows the task executed and its results. This includes devices

such as: desktop computers, tablet PC, mobile phones. In our case the mobile devices

is responsible for interconnecting the physical interfaces (digitalized card) with the

main game- user interface.

3.3 Interaction Style

The user interacts with the system through cards that integrate RFID technology in-

side (see Figure 2). Cards show images corresponding to the running game.

The interaction style consists of getting a card close to the mobile device which in-

corporates an RFID reader, then tasks are performed. A common flow of actions that

a user may perform may be the following one:

103

a) b)

Fig. 2. (a) Cards with RFID tags attached are used as interaction resources. Through them, the

user can play. Every card has an image representing something in the game. (b) New style

interaction, to interact with the system the user must bring closer the cards to mobile devices.

- Updating the results internally in the system and it creates a history of children’s

development.

- The system automatically generates the corresponding game interface. The projector

displays it. According to the action carried out, different messages might be shown.

- The answer is right a message indicating the outcome of the play. This user

interface congratulated and encourages to the children to continue playing. A

few seconds later appear the interface related to the game that is running, but

a higher level than before.

-The answer is wrong a message indicating the outcome of the play. This

user interface motivates and encourages them to try again. The next user interface

is related to the game that is running at the time, but in the same level as

before.

Voices and motivating messages sound in every interface to make the user feel active-

ly accompanied and encouraged. Exit and pause the game is an option always availa-

ble.

3.4 Management and Administration of the Games

Therapist, psychologist, teacher or parents are in charge of saving a game and the

evolution of children. This module of the system is focused on supporting the person

responsible for children who can check the improvements of them. In addition, statis-

tics and charts regarding the evolution of the children are provided. This part runs in

mobile devices, but also may be shown on any other device.

3.5 Game Management

The system consists of three games, each with three levels of difficulty. Each level

increases the difficulty of the game. If a child wins the game, then he/she moves to

the next level, otherwise, he/she continues at the same level. The interfaces of the

games are displayed on the projector, allowing different players to play at the same

time. When the game starts, the instructions appear simultaneously in sound and text.

The user can omit this step. Each user has his/her cards. In order to play they bring

104

Fig. 3. Mobile user interfaces to manage profiles and evolutions.

the cards closer to the mobile device that recognizes the chosen card and checks if it

is the correct one or not. Then, the result is shown in the projector. .

Children with ADHD have low self-esteem and may be easily frustrated; therefore,

when the children lose the game, the displayed messages have to be motivating for

the children to try again. The idea is not to give importance to the fact of having lost.

Hence, the messages designed are as follows. When children win the game, the mes-

sage displayed is “You’ve got it!” and when children fail then the message displayed

is "Try again", as depicted in figure 4. The features of three games composing the

system are detailed hereafter.

Fig. 4. Messages when winning or losing the game to encourage and motivate users.

- Memory and Vocabulary Stimulation Game

The aim of the system developed is to improve the memory and increase the abilities

and attention of children with ADHD. Working memory is Working memory is re-

garded as a complex mechanism that permits the performance of complex cognitive

tasks such as learning, understanding or reasoning.

Therefore, it is very important to work this capacity because this memory is the

one that helps us in our daily activities, especially in the school years. For this reason,

it is important that children with ADHD train their working memory as it helps them

105

to improve their daily life. Below we describe the different games composing the

system.

- Game 1. This game consists on identifying a missing card among a set of

cards previously displayed. As depicted in Figure 5a, the procedure is as fol-

lows. Three or four cards, depending on the level, are displayed on the projec-

tor for a limited time and children have to concentrate and memorize the set of

cards. After ten seconds, the cards disappear and appear again with one card

missing. Children must remember what the missing card is. Then, they have to

identify it among all the cards they have physically on the table and bring it

closer to the mobile device, which is responsible for checking if it is the cor-

rect one or not and then the success or failure message is shown accordingly.

- Game 2. This second game consists in identifying the order in which different

animals appear in the screen. Every 3 seconds an animal appears on the

screen. The number of animals can be three or four, depending on the level of

difficulty. The children have to concentrate and memorize the order in which

animals appear. After ten seconds, all the animals disappear, and then the chil-

dren have to remember the order in which they had appeared, and bring the

appropriate card representing the correct animal closer to the mobile device.

a) b)

Fig. 5. (a) Main User Interface corresponding to the first game. (b) Main User Interface of the

second game.

- Game 3. This game aims to improve linguistic and vocabulary. First, a letter is

shown to the children and then, they have to identify the animal whose name

starts with that letter. They have to choose the card representing the correct

animal and again, bring it closer to the mobile device.

3.6 System Architecture

The StiCap system is a client-server system, designed as follows.

- Client System. The client system runs on the user mobile device. It is connected to

the server application through a wireless network and it is communicated with objects

via RFID when the user approaches the object to the mobile device. A tag (or more)

is integrated inside the object or card depending on the size of the object; each tag

describes a unique identifier. When the RFID reader in the mobile device is ap-

106

proached to the chosen metaphor, the RFID tag inside is excited by electromagnetic

waves sent by the RFID reader, then, the component controller, explained below,

sends the identifier to the server. The server maps this information in the database and

executes the steps necessary to return the information to the mobile device. The

games which are running in the PC are shown in the projector.

- Server System. The server system runs on a desktop computer that is connected to

a wireless network via Wi-Fi connection. The server system contains the control logic

and its function is to check whether the interacting objects are correct or not and

displays the results on the projector.

- Software Components. The software components we have implemented are the

following: Controller is located in the mobile devices and its main function is keep-

ing waiting until an event occurs, like reading a tag ID and then the controller send it

to the web service to execute a specific operation. The Web Service receives the iden-

tifier previously read and check the database to return the information corresponding

to the game displayed. Mobile Games runs on the mobile device and displays the

interaction mode. It also shows the status and feedback of the game and finally Game

system runs on the PC and checks if the user has some interaction with the system. If

an event has occurred, it checks the event and shows the corresponding interface.

4 Conclusions and Discussion

In this paper we present the StiCap (Stimulating Capabilities) system, based on games

to improve cognitive abilities such as memory and vocabulary in children with

ADHD. The games have been developed in a Multi-Devices environment, in such a

way that users interact with different elements in a natural and intuitive way. The

concepts related to the different games, that the users have to handle, are represented

in physical cards with RFID technology inside, so that users interact with the game by

using these cards. The game interfaces are projected on the wall to allow working in

groups and promote collaboration as cards are easily handle for more than one user at

a time. To carry out this new form of interaction, users have to bring the cards con-

taining an RFID tag inside closer to a mobile device with the RFID reader. Therefore,

the game interfaces are distributed in physical objects, mobile devices and a laptop,

PC or Tablet. Besides, the system is portable and flexible as the user may handle the

games remotely from anywhere in the room. It also offers the possibility of playing

the games individually or collaboratively with other users. Another benefit to high-

light is that the system has a low deployment cost since the RFID tags are quite

cheap.

In order to check the benefits of the system, we evaluated it involving ten users in

the experimental study (6 men and 4 women). There were two groups with three

players and four players that played individually. The method used for evaluation was

direct observation [15]. The test was repeated four times to check if some results

improved when using certain cognitive abilities such as memory, attention and vo-

cabulary. The results were as follows. Six out of ten participants enjoyed the games

and wanted to repeat the activities. Four users played individually. They were more

107

introverted and unable to interact with more people. However, when playing alone,

they were motivated and enjoyed the games. The results were positive in children.

They collaborated with each other and when they got a correct answer, they celebrat-

ed it. However, when they failed, they encouraged each other and wanted to continue

playing. When repeated the session, the results were even better than before; they

were more satisfied and motivated. Users considered the use of the system easy. The

new interaction way was nice and attractive for them and they were able to feel them-

selves immersed in the game.

Acknowledgements

This research has been partially supported by the Spanish CDTI research project

CENIT-2008-1019, the CICYT TIN2011-27767-C02-01 project and the regional

projects with reference PAI06-0093-8836 and PII2C09-0185-1030. I would like to

especially thank to Yolanda Cotillas Aranda y Erica González Gutierrez for their

collaboration on this project.

References

1. Montague, M. and Castro, M. (2005). Attention Deficit Hyperactivity Disorder: Concerns

and Issues». In P. Clough, P. Garner, J.T. Pardeck y F. Yuen (Edit.), Handbook of Emo-

tional & Behavioural. London: SEGE Publications.

2. Cromley, J. (2006) Control a car with your thoughts – it’s therapeutic. Los Angeles Times,

May 15, 2006.

3. Wilkinson, N., Ang, R.P., &Goh, D.H., (2008) Online Video Game Therapy for Mental

Health Concerns: A Review. International Journal of Social Psychiatry, 54(4) p.370--382.

4. A. Rizzo, G. Buckwalter, T. Bowerly, A. van Rooyen, J. McGee, C. van der Zaag, U.

Neumann, M. Thiebaux, L. Kim and C. Chua. Virtual environment application for the as-

sessment and rehabilitation of attention and visuospatial cognitive process: an update, in

Proc. 3rd Intl Conf. Disability, Virtual Reality and Assoc. Tech., Alghero, Italy, pp. 197-

207, 2000

5. A. Rizzo, J. G. Buckwalter, T. Bowerly, C. van der Zaag, L. Humphrey, U. Neumann, C.

Chua, C. Kyriakakis, A. van Rooyen and D. Sisemore. The virtual classroom: a virtual real-

ity environment for the assessment and rehabilitation of attention deficits, Cyberpsycholo-

gy and Behavior, no. 3, pp. 483-499, 2000

6. Elmqvist, N. Distributed User Intefaces: State of the Art .Workshop on Distributed User

Interfaces2011 (DUI) at the 29th ACM CHI Conference on Human Factors in Computing

Systems 2011, ISBN: 978-84-693-9829-6, Vancouver, Canadá, May 7-12, 2011

7. Romero,S., Tesoriero,R., González,P. , Gallud,J. A., Penichet, V. M. R.: Sistema Interacti-

vo para la Gestión de Documentos Georeferenciados basado en RFID. Interacción 2009, X

Congreso Internacional de Interacción Persona-Ordenador. Barcelona. Septiembre 2009.

ISBN-13:978-84-692-5005-1

8. Parton et al., Parton BS, Hancock R, duBusdeValempr AD. Tangible manipulatives and

digital content: the transparent link that benefits Young deaf children. In: Proceedings of

the International conference on interaction design and children. 2010

9. Luminosity game. http://www.lumosity.com/

108

10. Caza-Cosas game http://www.edicinco.com/

11. MeMotiva game http://www.rehasoft.com/tdah/memotiva/

12. Hengeveld et al., Hengeveld B, Hummels C, Overbeeke K. Tangibles for toddlers learning

language. In: Proceedings of the tangible and embedded interaction. 2009

13. S. Hinske, M. Langheinrich, and Y. Alter, “Building rfid-based augmented dice with per

fect recognition rates,” in Proceedings of Fun and Games 2008, Eindhoven, The Nether-

lands, LNCS, (Berlin Heidelberg New York), Springer, Oct. 2008.

14. Luigi Atzori , Antonio Iera , Giacomo Morabito, The Internet of Things: A survey, Com-

puter Networks: The International Journal of Computer and Telecommunications Network-

ing, v.54 n.15, p.2787-2805, October, 2010 [doi>10.1016/j.comnet.2010.05.010]

15. Preece J. et al. “Human Computer Interaction” ISBN: 0-201-62769-8. Addison Wesley.

109