Unpacking the Lived Experiences of Smartwatch Mediated Self and Co-Regulation with ADHD Children

Title of the Paper

Unpacking the Lived Experiences of Smartwatch Mediated Self and Co-Regulation with ADHD Children

Paper Information

• Subject Area: Child Development and Educational Technology
• Keywords: Smartwatch, Wearable Devices, Co-regulation, Attention Deficit Hyperactivity Disorder (ADHD), Children, Self-regulation, Family Informatics, Positive Reinforcement

Research Background and Problem

• Problems and Challenges:
  • Children with Attention Deficit Hyperactivity Disorder (ADHD) face challenges in self-regulating behavior, maintaining attention, planning, and achieving goals in daily life.
  • ADHD children often lack sufficient independence in daily activities and require parental assistance for behavioral adjustments and task completion.
  • Existing technologies primarily support specific co-regulation scenarios (real-time collaboration between parents and children), but there is limited support for asynchronous co-regulation technologies.
• Significance:
  • ADHD is one of the most common mental health issues among children, affecting approximately 10% of children in the United States.
  • Using technology to support families and children in co-regulation and self-regulation across multiple tasks and contexts can alleviate parental burdens and encourage behavioral improvements in children.
• Research Motivation and Related Work:
  • ADHD families are increasingly using technologies (e.g., positive reinforcement) to manage children's behavior, rewarding positive actions upon task completion.
  • Existing literature suggests that wearable devices like smartwatches, due to their convenience and accessibility, have the potential to help children develop self-regulation skills, but their practical effectiveness in family settings remains unclear.
  • Optimizing smartwatch design to balance family co-regulation and children's independence is a core research issue.

Solution

• Proposed Solution:
  • Design and implement "CoolTaco," a system comprising a smartwatch and a mobile phone, aimed at supporting ADHD families in task execution, point management, and reward redemption to reinforce positive behavior.
  • Core Features:
    1. Parents set tasks, children record task completion via the smartwatch, and parents remotely approve and assign points.
    2. Points can be redeemed for specific rewards (e.g., screen time, family activities).
    3. Supports children in proactively adding non-reward tasks to foster intrinsic motivation.
  • Innovative Aspects:
    • Provides an asynchronous smartwatch-mediated approach, enabling children to use the system independently in various scenarios, reducing real-time parental dependency.
    • The design carefully considers sensory burdens for ADHD children (e.g., no disruptive notifications, availability of soft wristband options).
    • The system employs an open design, allowing flexibility in task settings (time, category, task content).
• Key Technologies:
  • Behavior intervention design based on positive reinforcement (token economy), including goal setting, behavior performance monitoring, and reward mechanisms.
  • Multi-device system synchronization: parents set and approve tasks via a mobile app, while children track and report task completion in real-time using the smartwatch.

Research Findings

• Study Setup and Process:
  • Ten families, including ADHD children and their parents, participated in the study, using the CoolTaco system for periods ranging from 3 weeks to 6 months.
  • Data analysis included quantitative analysis of task behavior records from system logs and qualitative analysis of family interview content.
• Specific Findings:
  • Positive Outcomes:
    • The smartwatch extended the boundaries of co-regulation, enabling co-regulation to occur outside the same physical space (e.g., during outdoor activities or between separate households).
    • Most families reported that CoolTaco enhanced children's motivation to complete tasks and helped them independently evaluate their behavior.
    • Children appeared more engaged in the self-regulation process through the smartwatch, such as using task lists to track goal completion.
  • Key Advantages:
    • By assigning more immediate responsibility to children, the system reduced the burden on parents for task recording and supervision.
    • The system was effective for both short-term tasks and fostering long-term habit formation.
  • Challenges and Limitations:
    • Challenge 1: The multi-device design required a high level of technical proficiency and engagement from parents. If parents neglected task and reward maintenance, the system's behavioral regulation effectiveness could diminish.
    • Challenge 2: The binary definition of "task completion" (completed/not completed) lacked flexibility and failed to capture partially completed tasks or substandard performance.
    • Challenge 3: Children's reliance on parents for reward distribution could weaken their sense of participation.
    • Technical Limitations: The system did not fully support coordination among multiple caregivers (e.g., grandparents or separated parents), potentially leading to communication and collaboration issues.
• Experimental Results and Data Performance:
  • Statistical data showed that parents and children collectively created 147 tasks and 39 rewards, demonstrating the diverse use of tasks for behavioral education (e.g., chores, health habits, learning activities).
  • Six families exhibited consistent use with high task completion rates; four families showed low or no data contribution due to children's age or insufficient parent-child collaboration.
• Future Directions:
  • Develop a more flexible task and reward system to enable immediate reinforcement for unplanned behaviors.
  • Optimize system functionality to adapt to children's growth and evolving self-regulation needs, gradually enhancing their independence.
  • Explore the potential integration with physical incentive systems (e.g., physical tokens) to support family-level reflection on behaviors and reward rules.