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Improving On-Task Behavior in Children and Youth with ADHD: Wearable Technology as a Possible Solution

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Abstract

The objective of this paper is to provide the rational and conceptual foundation used to develop a wearable device to improve on-task behavior. Time spent on task is a primary predictor of academic success. Difficulty sustaining attention is a core symptom of ADHD. Self-monitoring of on-task/off-task behavior has demonstrated promise as a classroom intervention that can improve time on task. Currently, available interventions for self-monitoring are often time-consuming for the teacher, stigmatizing for the student, and disruptive for the classroom. Digital interventions that provide fixed or intermittent vibration cues have been developed to improve self-monitoring, while reducing the level of stigma, but are vulnerable to habituation. To avoid habituation and optimize frequency, a new device was designed with personalized vibration cues aligned with the child’s needs in real time and over time, during the school day. In addition, the device provides coaching in the form of text messages scheduled to be delivered at the time and point of performance when the reminder is most likely to be effective. Lastly, the device continuously collects passive and active data to provide data-driven insight into the fluctuation of attention in different situations to optimize environmental interventions and treatment. These three concepts: (1) digitalization to destigmatize and optimize self-monitoring, (2) in-the-moment coaching, and (3) moment-to-moment collection of data for real-time assessment of on-task behavior form the basis of the current development of a wearable technology to improve on-task behavior. Proof of concept studies and pilot data will be addressed in future publications.

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Acknowledgements

The authors would like to acknowledge Dr. Sarojini Sengupta, Co-founder and CEO of AIMH, who was contracted to assist with manuscript writing and preparation. They would also like to thank Dr. Cecil Reynolds for his comments on an earlier draft of the manuscript.

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  1. Revibe Technologies, 3331 Heritage Trade Dr, Suite 101, Wake Forest, NC, 27587, USA

    Lindsay E. Ayearst & Richard M. Brancaccio

  2. Cambridge Health Alliance, Harvard University, Cambridge, MA, 02459, USA

    Margaret D. Weiss

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RMB and LEA are employees of Revibe Technologies and own stock or stock options in the company. MDW has received consulting fees/honoraria from Tris, Ironshore, Adlon, Idorsia, Revibe Technologies, and Periapt; is on the advisory boards of Ironshore and Periapt; and has received royalties from Multi-Health Systems and Johns Hopkins University Press.

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Ayearst, L.E., Brancaccio, R.M. & Weiss, M.D. Improving On-Task Behavior in Children and Youth with ADHD: Wearable Technology as a Possible Solution. J Pediatr Neuropsychol 9, 175–182 (2023). https://doi.org/10.1007/s40817-023-00152-6

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