Nancy Nilsson
GAMIFIED PARTICIPATORY DESIGN WORKSHOP FOR CHILDREN
WITH ADHD
Faculty of Information Technology and Communication Sciences Master's Degree Programme in Human-Technology Interaction M. Sc. Thesis Supervisors: Sumita Sharma, Julia Kuosmanen & Janne Paavilainen
May 2019
Nancy Nilsson: Gamified Participatory Design Workshop for Children with ADHD M.Sc. Thesis 70 pages, 4 index and 7 appendix pages
Tampere University
Master’s Degree Programme in Human-Technology Interaction May 2019
This thesis is an exploratory case study on how to organize, create, run and evaluate game design workshop with a combined group of neurotypical children and children diagnosed with ADHD (attention deficit / hyperactivity disorder). The workshop applies principles of gamification and rehabilitation of EXecutive function and ATtention (EXAT) intervention for children with ADHD. This workshop aims to gain knowledge on how to combine game design goals with therapeutic goals in a way that it would both aid in designing an embodied game for remediation purposes for ADHD, and in getting children to feel empowered as well as to help them learn valuable social skills. The workshop used gamified material to guide, support and motivate the children throughout the sessions in both the workshop activities and in social skill training, as well as to collect children's experiences of the workshop. In this thesis, participatory design method, EXAT-based strategies and gamification of the workshops will be described, and conclusions of both efficacy and difficulties of these approaches in this context will be presented. The results of this thesis provide a list of recommendations related to the organization of PD workshop. The children in this work demonstrated improvement in the social skills and they were able to produce creative, usable, and valuable ideas for a game prototype.
Based on the feedback gathered from the children, the workshop and the game design activities were enjoyable and successful in empowering the children.
Keywords and terms: participatory design, game design, children with ADHD, workshop, games, active gaming, gamification, child-computer interaction, embodied interfaces
I would like to thank the people who have helped and supported me with this long thesis process. My supervisors Sumita Sharma, Julia Kuosmanen and Janne Paavilainen for their valued insights, guidance and patience; the research team for pleasant collaboration; the child participants for their amazing input and effort; my fellow student friends who have been sharing this path with me;
and Academy of Finland and Tampere University for making this research possible.
1 INTRODUCTION 5
2 BACKGROUND 10
2.1 Participatory Design with Special Needs Children 10 2.2 Gamification and Therapeutic Games for ADHD 13 2.3 Rehabilitation of Executive Function and Attention (EXAT) 15
2.4 Objectives and Research Questions 16
3 PARTICIPATORY DESIGN AND GAMIFICATION METHODS 20
3.1 Ethics 20
3.2 Team Members 20
3.3 Participatory Design Workshops 22
3.3.1 Facilitation Strategies 24
3.3.2 Workshop Planning 27
3.3.3 Workshop Environment and Apparatus 28
3.3.4 Rapid Idea Implementation 29
3.4 The Pigscape Game 29
3.5 Gamification of the Workshop 32
4 WORKSHOP SESSIONS 36
4.1 Session 1: Introduction and Avatars 36
4.2 Session 2: Postures and Narratives 38
4.3 Session 3: Scenery, Collectables and Obstacles 43
4.4 Session 4: Game demo and Feedback 48
4.5 Session 5: Feedback and Award Ceremony 49
5 FINDINGS 54
5.1 Outcomes of Game Design Goals 54
5.2 Outcomes of Facilitation Goals 57
5.3 Participant Feedback 59
5.4 Design Recommendations 63
5.4.1 Workshop Structure 63
5.4.2 Guidelines 64
6 DISCUSSION 68
7 CONCLUSION 73
References 75
Appendix 1. Session plan and script example 80
Appendix 2. Printed graphic material created 86
1 I N T R O D U C TI O N
P arti ci p at or y D esi g n ( P D) is a m et h o d us e d i n H u m a n- C o m p ut er I nt er a cti o n ( H CI) t o cr e at e i nt er a cti v e pr o d u cts ( Bj er k n es et al., 1 9 8 7). O n e of t h e k e y f e at ur es of P D is t h at it i n v ol v es v ari o us st a k e h ol d ers – d e v el o p ers, b usi n ess r e pr es e nt ati v es, p oli c y m a k ers, a n d e n d us ers – i nt o t h e pr o c ess of c o- cr e ati o n f or b ett er d esi g n o ut c o m es. P D is a c o m pl e x a n d m ultif a c et e d m et h o d t h at c a n b e ti m e- a n d c ost-i nt e nsi v e. H e n c e, it is m ai nl y us e d w h e n a c o m p ut er s yst e m pr oj e ct h as hi g h ris k a n d li k eli h o o d f or f ail ur e b ut als o w h e n t h er e is a hi g h p a y off if t h e pr oj e ct is s u c c essf ul ( L a z ar et al., 2 0 1 7). P D is i d e al f or d e v el o pi n g s yst e ms a n d pr o d u cts es p e ci all y i n t h os e sit u ati o ns w h er e a d e e p u n d erst a n di n g of t h e c o nt e xt is n e e d e d.
I n r e c e nt y e ars, wit h t h e gr o wi n g i nt er est i n g a m es a n d g a mific ati o n ( usi n g g a m e-li k e el e m e nts o utsi d e of g a m es ( Br e w er et al., 2 0 1 3; Sl e g ers et al., 2 0 1 6)), P D is e m pl o y e d f or cr e ati n g g a mi n g a p pli c ati o ns wit h c hil dr e n (s e e e. g M el o ni o, 2 0 1 6). As c o- cr e at ors, c hil dr e n ar e e x p e ct e d t o c o ntri b ut e t o t h e d esi g n pr o c ess as e x p erts of t h eir g a mi n g e x p eri e n c e b y gi vi n g i d e as s o t h at d esi g n ers c a n u n d erst a n d w h at c hil dr e n v al u e, fi n d e nt ert ai ni n g, a n d m oti v ati n g or distr a cti n g ( G e n n ari et al., 2 0 1 7). C hil dr e n ar e n at ur all y cr e ati v e a n d ar e e a g er t o s h ar e t h eir s o m eti m es u n c o n v e nti o n al vi e w p oi nts ( M el o ni o, 2 0 1 6), w hi c h i n t his c as e ar e i m p ort a nt, si n c e t h e y ar e t h e e n d us ers of t h e pr o d u ct. N ot e w ort h y, c hil dr e n's i d e as of f u n mi g ht diff er fr o m t h os e of a d ults ( M a g n uss e n et al. 2 0 0 3).
I n a d diti o n, c hil dr e n of diff er e nt a g es m a y pr ef er diff er e nt g a m e g e nr es, c o nt e nt, a n d c h oi c e o pti o ns a n d h a v e v ari a bl e a biliti es t o m ast er t h e n u a n c es of p arti c ul ar t y p es of g a m es ( B ar a n o ws ki et al., 2 0 1 6). T h er ef or e, it is vit al t o i n v ol v e c hil dr e n i nt o t h e d esi g n pr o c ess alr e a d y at t h e e arl y st a g es of d e v el o p m e nt.
G a mifi c ati o n (s e e H a m ari et al., 2 0 1 4) is a tr e n di n g fi el d n ot o nl y i n
a c a d e mi a b ut als o i n e d u c ati o n, h e alt h c ar e, a n d t h e b usi n ess w orl d. As o ur w a y
of w or ki n g b e c o m es m or e di git al, t h e k n o wl e d g e of vi d e o g a m es a n d e x pl oiti n g
t h e m i n ot h er c o nt e xts t h a n pl a yi n g, h as b e c o m e a n e v er y d a y m et h o d i n
v ari o us fi el ds, i n cl u di n g s c h o ol e n vir o n m e nts as w ell as i n fit n ess a p pli c ati o ns
t o m oti v at e p e o pl e t o t a k e c ar e of t h e ms el v es. T h e us e of g a m e b as e d m et h o ds i n t h e fi el d of ( H CI) h as b e e n a c k n o wl e d g e d (s e e e. g. Br e w er et al., 2 0 1 3) si n c e t h e y c a n pr o vi d e e. g. a s af e a n d c o mf ort a bl e s etti n g f or t h e p arti ci p a nts, e n h a n c e f ut ur e t hi n ki n g ( Sl e g ers et al., 2 0 1 6), a n d i n cr e as e m oti v ati o n ( S ail er et al., 2 0 1 4).
T h er e is i n cr e asi n g a w ar e n ess of i n cl u di n g c hil dr e n wit h n e ur o d e v el o p m e nt al dis or d ers i nt o t h e d esi g n of e d u c ati o n al a n d s kill- b uil di n g g a m es (s e e e. g. M ali n v er ni et al. 2 0 1 4, G u h a et al. 2 0 0 8, B e nt o n et al. 2 0 1 2).
N e ur o d e v el o p m e nt al dis or d ers ar e k n o w n t o i m p air br ai n str u ct ur es r es p o nsi bl e f or e x e c uti v e, m e m or y, a n d p er c e pt u al f u n cti o ni n g, i n m a n y c as es r es ulti n g i nt o diffi c ulti es wit h c o n c e ntr ati o n, w or ki n g m e m or y, pr o bl e m-s ol vi n g, b e h a vi or i n hi biti o n, a n d c o m m u ni c ati o n wit h ot h ers ( D S M- 5, 2 0 1 3) . T h er ef or e, c o- d esi g ni n g wit h c hil dr e n wit h n e ur o d e v el o p m e nt al dis or d ers n e e ds t o t a k e i nt o c o nsi d er ati o n a biliti es a n d li mit ati o ns of t his s p e ci al us er gr o u p. E arli er r es e ar c h i n P D m ai nl y t ar g et e d c hil dr e n wit h A utis m S p e ctr u m Dis or d er ( A S D) a n d ot h er l e ar ni n g dis a biliti es. D es pit e t h e f a ct t h at Att e nti o n D efi cit / H y p er a cti vit y Dis or d er ( A D H D) is t h e m ost pr e v al e nt n e ur o d e v el o p m e nt al dis or d er ( S m all e y et al., 2 0 0 7; Si m o n et al., 2 0 0 9), t h er e s ur prisi n gl y h as b e e n littl e r es e ar c h f o c us e d o n i n cl u di n g c hil dr e n wit h A D H D as c o- d esi g n ers i n p arti ci p at or y d esi g n. T h e c or e d efi cits of A D H D ar e i n att e nti o n or i n a bilit y t o f o c us, h y p er a cti vit y of m o vi n g e x c essi v el y, a n d i m p ulsi vit y ass o ci at e d wit h p o or b e h a vi or i n hi biti o n. T h us, t h er e is a cl e ar n e e d t o cr e at e s p e cifi c all y t ail or e d m et h o ds f or A D H D c hil dr e n. I nst e a d, A D H D c hil dr e n ar e m a d e t o a dj ust t o m ai nstr e a m s etti n gs, es p e ci all y i n e d u c ati o n, w h er e t h e y ar e oft e n off er e d l e ar ni n g t o ols t h at ar e n ot s uit a bl e f or t h eir s p e ci al n e e ds (s e e e. g. M c K ni g ht, 2 0 1 0). E v e n t h o u g h t h er e h as b e e n c oll e cti o ns of g ui d eli n es o n h o w t o d esi g n f or A D H D c hil dr e n ( M c K ni g ht, 2 0 1 0; Kr č a, 2 0 1 6), r ar e, if a n y, st u di es h a v e i n cl u d e d A D H D c hil dr e n i n d esi g n t e a ms or r e p ort e d h o w P D w or ks h o p c o ul d b e pr a cti c all y or g a ni z e d wit h A D H D p arti ci p a nts.
S u c h k n o wl e d g e w o ul d b e e xtr e m el y r e w ar di n g n ot o nl y f or t h e c hil dr e n b ut
als o f or t h e d e v el o p m e nt t e a ms. W hil e e arli er P D r es e ar c h i n v ol v e d c hil dr e n
wit h n e ur o d e v el o p m e nt al dis or d ers s u c h as a utis m, t h e w or ks h o p s essi o ns
t h e ms el v es w er e n ot e x pli citl y att e m pti n g t o s er v e f or r e h a bilit ati o n p ur p os es.
Y et, P D as a n e n vir o n m e nt, gi v e n its c oll a b or ati v e a n d s o ci al n at ur e, c a n s er v e as a n i nt er v e nti o n i n its elf. I n t h e w or k pr es e nt e d i n t his t h esis, c hil dr e n w er e e n c o ur a g e d t o p arti ci p at e i n t h e d esi g n pr o c ess a n d c ert ai n m e as ur es w er e t a k e n t o a c c o m m o d at e t h eir s p e ci al n e e ds (R a nt a n e n et al., 2 0 1 8 ). H o w e v er, c urr e ntl y n o g ui d eli n es e xist o n h o w A D H D r e h a bilit ati o n pri n ci pl es c o ul d b e i m pl e m e nt e d i nt o P D pr a ctis e.
T h e ai m of t his t h esis w as t o d e v el o p a p arti ci p at or y g a m e d esi g n
w or ks h o p s uit a bl e f or c hil dr e n wit h A D H D i n a w a y t h at n ot o nl y pr o d u c es
us a bl e i d e as f or a fi n al g a m e b ut als o e m p o w ers t h e p arti ci p a nts a n d t e a c h es
t h e m s kills t o i m pr o v e s elf- or g a ni z ati o n a n d s o ci al i nt er a cti o n. T his als o a ct e d
as a w a y t o i ntr o d u c e c hil dr e n t o t h e g a m e d e v el o p m e nt pr o c ess. Si n c e c hil dr e n
n e e d e d t o w or k as a p art of t h e t e a m a n d e x p eri e n c e diffi c ulti es of t h e d esi g n
pr o c ess, t h er e is a n e e d t o t e a c h t h e m h o w t o str u ct ur e t h eir w or k t o m e et
d e a dli n es, c o m m u ni c at e a n d pr o vi d e f e e d b a c k. T his is diffi c ult f or c hil dr e n, a n d
p ossi bl y e v e n m or e s o f or A D H D c hil dr e n. T his st u d y w as c o n d u ct e d i n
c oll a b or ati o n wit h a r es e ar c h pr oj e ct b y T a m p er e U nit f or C o m p ut er H u m a n
I nt er a cti o n R es e ar c h C e nt er ( T A U C HI) a n d Ps y c h ol o g y Cli ni c P S Y K E, b ot h
l o c at e d at T a m p er e U ni v ersit y. T h e pr oj e ct ai m e d t o d e v el o p t h er a p e uti c g a m es
f or i n di vi d u ali z e d tr ai ni n g of b e h a vi or al a n d c o g niti v e f u n cti o ns n e e d e d f or
A D H D r e m e di ati o n. T h e P D w or ks h o p utili z e d o n e of t h e e arl y g a m e
pr ot ot y p es i m pl e m e nt e d i n t h e pr oj e ct. T h e p arti ci p a nts h el p e d t o d e v el o p a
Ki n e ct- b as e d t h er a p e uti c g a m e-li k e a p pli c ati o n c all e d Pi gsc a pe , t h at is b ei n g
us e d i n cli ni c al tri als b y P S Y K E si n c e J a n u ar y 2 0 1 9. T h e w or ks h o p´s c hil d
p arti ci p a nts w er e a d dr ess e d as t h e C hil dr e n R es e ar c h A d vis or y Gr o u p,
c o nsisti n g of t w o A D H D a n d t w o n e ur ot y pi c al s c h o ol- a g e d c hil dr e n. D uri n g
t h e w or ks h o p s essi o ns, c hil dr e n w or k e d as m e m b ers of t h e d esi g n t e a m a n d
c o ntri b ut e d t o g a m e d esi g n b y c ust o mi zi n g g a m e c h ar a ct ers, g a m e el e m e nts,
l e v els, a n d cr e ati n g a g a m e n arr ati o n. T h e i nt e nti o n w as t o i n cl u d e c hil dr e n
e arl y o n t o t h e d esi g n pr o c ess, t o off er t h e m a n o p p ort u nit y t o m a k e d e cisi o ns,
a n d s h o w h o w t h eir s u g g esti o ns w er e r e ali z e d, w hi c h w e a nti ci p at e d t o
p ositi v el y aff e ct t h eir s elf- est e e m ( M c N all y et al., 2 0 1 1). T h e i n n o v ati o n of t h e
c urr e nt w or ks h o p w as i n t h e i nt e gr ati o n of pri n ci pl es of E X e c uti v e f u n cti o n a n d A Tt e nti o n ( E X A T) i nt er v e nti o n f or c hil dr e n wit h A D H D d e v el o p e d i n P S Y K E ( R a nt a n e n et al., 2 0 1 8). E X A T is a str u ct ur e d n e ur o ps y c h ol o gi c al m ultil e v el gr o u p i nt er v e nti o n d e v el o p e d f or c hil dr e n wit h e x e c uti v e f u n cti o n d efi cits a n d m or e d et ails of it ar e pr o vi d e d i n s e cti o n 2. 3, w hil e s e cti o n 3. 3. 2 d es cri b es h o w t h os e pri n ci pl es w er e i m pl e m e nt e d i nt o t h e w or ks h o p. M or e o v er, g a mifi c ati o n str at e gi es w er e i n c or p or at e d t o t h e w or ks h o p t o s u p p ort t h e af or e m e nti o n e d pri n ci pl es, f ost er m oti v ati o n a n d i n cr e as e t h e c hil dr e n's e n g a g e m e nt i nt o t h e a cti viti es , a n d t o ai d i n g at h eri n g t h eir o pi ni o ns a b o ut t h e w or ks h o p.
G a mifi c ati o n str at e gi es will b e d es cri b e d i n s e cti o n 3. 5.
C o n v e nti o n al m et h o ds of g at h eri n g c hil dr e n's e x p eri e n c es c a n b e c h all e n gi n g b e c a us e t h e y mi g ht h a v e diffi c ulti es i n e x pr essi n g t h eir o pi ni o ns (T u u k k a n e n et al., 2 0 1 8 ). T o a p pr o a c h t h e c hil dr e n diff er e ntl y t o g at h er t h eir d et ail e d, p er h a ps m or e h o n est o pi ni o ns, a n e w m et h o d w as d e v el o p e d. T his m et h o d us es a c o m bi n ati o n of vis u al c u es, g a mifi e d m at eri al a n d t hi n k al o u d pr ot o c ol, as d es cri b e d i n s e cti o n 4. 5. Q u alit ati v e d at a w as g at h er e d t hr o u g h dir e ct p arti ci p a nt o bs er v ati o ns a n d fi el d n ot es. M or e d at a w as c oll e ct e d t hr o u g h vi d e o r e c or di n gs, pi ct ur es a n d i m a g es, d o c u m e nts, r ati n g s c al es, i nt er vi e ws, a n d c hil dr e n's dr a wi n gs a n d cr e ati o ns.
T h e r es e ar c h q u esti o ns i n t his t h esis ar e a) h o w c a n c hil dr e n f oll o w t h e
pr o p os e d w or ks h o p str u ct ur e a n d a cti viti es, a n d d o E X A T- b as e d str at e gi es ai d
A D H D p arti ci p a nts i n g etti n g i n v ol v e d i nt o t h e d esi g n pr o c ess a n d e n h a n c e
t h eir s o ci al s kills ? a n d b) w h et h er a n d h o w i m pl e m e nti n g g a mifi c ati o n el e m e nts
t o t h e w or ks h o p str u ct ur e a n d a cti viti es aff e ct c hil dr e n's m oti v ati o n t o c o p e
wit h t h e w or ks h o p a cti viti es a n d pr o vi di n g t h eir i m pr essi o ns of t h e w or ks h o p ?
T o a ns w er t h es e q u esti o ns, a m ulti dis ci pli n ar y st u d y w as c o n d u ct e d c o m bi ni n g
k n o wl e d g e a n d usi n g m et h o ds of H CI ( us er- c e nt er e d d esi g n, s oft w ar e
pr ot ot y pi n g), ps y c h ol o g y ( E X A T), a n d g a m e d esi g n ( g a mifi c ati o n, p a p er
pr ot ot y pi n g). T h e o ut c o m e of t his w or k is t o g at h er pr a cti c al first- h a n d
e x p eri e n c es of or g a ni zi n g t his t y p e of w or ks h o ps a n d pr o vi d e a list of
r e c o m m e n d ati o ns f or m ulti dis ci pli n ar y r es e ar c h t e a ms.
T his t h esis f oll o ws a t y pi c al str u ct ur e. Aft er t h e i ntr o d u cti o n, t h e s e c o n d s e cti o n pr es e nts a n o v er vi e w of t h e c urr e nt lit er at ur e a n d k n o wl e d g e o n p arti ci p at or y d esi g n wit h c hil dr e n wit h s p e ci al n e e ds, g a mifi c ati o n a n d t h er a p e uti c g a m es f or A D H D, a n d e x pl ai ns t h e E X A T -str at e gi es w hil e t h e o bj e cti v es a n d r es e ar c h q u esti o ns will b e pr es e nt e d aft er. S e cti o n 3 i ntr o d u c es t h e E X A T -fr a m e w or k a n d g a mifi c ati o n m et h o ds, t h e g a m e pr ot ot y p e a n d t h e o v er all pl a n ni n g of t h e w or ks h o p. S e cti o n 4 t h e n d es cri b es e a c h s essi o n i n d et ail i n cl u di n g t h eir r es p e cti v e ai ms a n d t h e m es wit h o bs er v ati o ns r e g ar di n g t h e c hil dr e n's b e h a vi o ur. S e cti o n 5 dis c uss es t h e fi n di n gs i n t hr e e s u b c at e g ori es:
o ut c o m es of t h e g a m e d esi g n g o als, o ut c o m es of t h e f a cilit ati o n g o als a n d p arti ci p a nt f e e d b a c k. L astl y, g ui d eli n es b as e d o n t h e e x p eri e n c es ar e r e c o m m e n d e d. S e cti o n 6 is d e di c at e d t o t h e dis c ussi o n a n d S e cti o n 7 c o n cl u d es t h e t h esis wit h s u g g esti o ns f or f ut ur e w or k.
2 B A C K G R O U N D
T his c h a pt er e x a mi n es pr e vi o us w or k r e g ar di n g g a m e r el at e d p arti ci p at or y d esi g n wit h c hil dr e n wit h n e ur o d e v el o p m e nt al dis or d ers a n d t h er a p e uti c g a m es f or c hil dr e n wit h A D H D. T h e E X A T -r e h a bilit ati o n i nt er v e nti o n pr o gr a m fr a m e w or k, t h e Pi gs c a p e- g a m e pr ot ot y p e, a n d m y c o ntri b uti o n a n d ai ms of t h e t h esis will b e d es cri b e d.
2. 1 P arti ci p at or y D e si g n wit h S p e ci al N e e d s C hil dr e n
P arti ci p at or y D esi g n ( P D) wit h c hil dr e n h as b e e n e m pl o y e d d esi g n t e c h n ol o g y
( R e a d et al., 2 0 1 4; Dr ui n et al., 1 9 9 8; Dr ui n, 1 9 9 9; Dr ui n, 2 0 0 2) b ut r e c e ntl y it h as
als o e x p a n d e d i nt o t h e fi el d of g a m e d esi g n: n ot o nl y t o u n d erst a n d t h e g a m e
d esi g n pr o c ess ( G e n n ari et al., 2 0 1 7) a n d pr o d u ci n g b ett er pr o d u cts ( M ali n v er ni
et al., 2 0 1 4; K h al e d & V as al o u, 2 0 1 4), b ut als o t o e x pl or e w h at c hil dr e n g ai n
fr o m t h eir p arti ci p ati o n i n s u c h pr o c ess es ( M c N all y et al., 2 0 1 7; S c h e p ers et al.,
2 0 1 8). M ali v er ni´s gr o u p ( 2 0 1 7) pr o p os es a n i n cl usi v e m o d el f or g a m e d esi g n
wit h c hil dr e n wit h n e ur o d e v el o p m e nt al dis or d ers. T his m o d el m er g es
t h er a p e uti c t e c h ni q u es, g a m e d esi g n, a n d c hil dr e n's i nt er ests i nt o a c o h er e nt
w h ol e, w hi c h r e q uir es diff er e nt st a k e h ol d ers i n v ol v e d i n v ari o us st a g es of t h e
d esi g n pr o c ess. T h e m o d el f oll o w f o ur st e ps, w hi c h st arts wit h pr o p erl y
d efi ni n g t h er a p e uti c g o als a n d t h e str u ct ur e of t h e e x p eri e n c e. T h e n, t h e
c o ntri b uti o ns fr o m c hil dr e n, i n t his c as e c hil dr e n wit h A S D, ar e eli cit e d ai m e d
t o w ar ds t h eir i nt er ests. N e xt, t h e c o ntri b uti o ns fr o m t h e e x p erts a n d c hil dr e n
ar e i nt e gr at e d i n or d er t o d efi n e t h e g a m e e x p eri e n c e as a w h ol e, i n cl u di n g t h e
g a m e m e c h a ni cs a n d el e m e nts. T h e f o urt h a n d fi n al st e p is t h e e x pl or at or y
e v al u ati o n of g a m e s uit a bilit y wit h c hil dr e n wit h A S D. G e n n ari´s gr o u p ( 2 0 1 7)
c o n d u ct e d a st u d y wit h pri m ar y s c h o ol c hil dr e n t h at ass ess e d, h o w c hil dr e n
p erf or m i n g a m e d esi g n a n d if t h e y ar e e n g a g e d i n d esi g n t as ks. B e c a us e g a m es
ar e c o m pl e x t o d esi g n, t h e t as ks s h o ul d b e a d a pt e d t o t h e p arti ci p a nts s kills a n d
k n o wl e d g e. P D s h o ul d e n a bl e c hil dr e n t o p erf or m w ell i n t h e d esi g n t as ks – s o
t h at c hil dr e n ar e e n g a g e d i n t h e a cti viti es. G e n n ari´s gr o u p us e d a p arti ci p at or y
g a m e d esi g n m et h o d c all e d G a mifie d C O- desi g n wit h C o o per ati ve le ar ni n g ( G a C o C o), t h at e m pl o y e d g a mifi c ati o n t o or g a ni z e d esi g n s essi o ns a n d t as ks as i n a g a m e. H er e, c o o p er ati v e l e ar ni n g r ef ers t o a c o nstr u cti vis m b as e d l e ar ni n g m et h o d ol o g y s u p p orti n g p ositi v e r el ati o ns t o a c hi e v e c oll a b or ati o n b et w e e n c hil dr e n a n d a d ults ( Sl a vi n, 1 9 9 1). T his w as m a nif est e d b y usi n g g a mifi e d m at eri al wit h cl e ar a n d i nt uiti v e f u n cti o n aliti es f or c hil dr e n t o e n h a n c e pr o gr essi o n, c o ntr ol, a n d r el at e d n ess as w ell as c o o p er ati o n t hr o u g h t h e a cti viti es a n d s essi o ns. G a mifi e d m at eri al c a n b e, e. g. a pr o gr essi o n m a p t h at g ui d es t h e c hil dr e n t hr o u g h t h e d esi g n a cti viti es a n d s h ar es t h eir a c c o m plis h m e nts ( G e n n ari et al., 2 0 1 7).
T h er e h a v e b e e n m ulti pl e st u di es (s e e e. g. B e nt o n et al., 2 0 1 2; P or ci n o et al., 2 0 1 5; G u h a et al., 2 0 0 8; R e a d et al., 2 0 1 7; M ali n v er ni et al., 2 0 1 7) o n P D wit h s p e ci al n e e ds c hil dr e n, es p e ci all y t h os e wit h A utis m S p e ctr u m Dis or d ers.
M ali n v er ni et al. ( 2 0 1 4) c o n d u ct e d P D w or ks h o p wit h A S D c hil dr e n w h er e t h e ai m w as t o i nt e gr at e t h e c hil dr e n's c o ntri b uti o ns i nt o t h e d esi g n of a Ki n e ct- b as e d g a m e. T h e y a c k n o wl e d g e d t h at e v e n t h o u g h t his gr o u p c o ul d b e n efit fr o m p arti ci p ati o n t h e m ost, t h eir r ol e i n t h e d esi g n pr o c ess c a n b e diffi c ult t o d efi n e pr o p erl y. It is a d eli c at e iss u e t o fi n d t h e b al a n c e b et w e e n s uffi ci e ntl y r e c o g ni zi n g c hil dr e n's s kills a n d c o ntri b uti o ns a n d wit h o ut o v er w h el mi n g t h e m. T h eir fi n di n gs s h o w t h at s e v er al c o nt e xt u al a n d m at eri al as p e cts, s u c h as t h e c o nst a n c y of t h e s etti n g a n d t h e us e of p ers o n al st or a g e b o x es, s u p p ort e d P D a cti viti es wit h A S D c hil dr e n. W h e n w or ki n g wit h A S D c hil dr e n, it is i m p ort a nt t o b al a n c e b et w e e n t h e s o ci o- aff e cti v e n e e ds of t h e c hil dr e n ( of f e eli n g e m p o w er e d a n d g ai ni n g m e a ni n g fr o m p arti ci p ati o n) a n d t h e f u n cti o n al c o nstr ai nts i n d esi g ni n g a w or ks h o p. T his w o ul d b e a si g nifi c a nt as p e ct i n d esi g ni n g a cti viti es t h at ar e b ot h us ef ul f or d esi g n a n d e m p o w eri n g f or c hil dr e n. As m a n y st u di es h a v e f o c us e d o n h o w t o o v er c o m e d efi cits, s u c h as i n att e nti o n or h y p er a cti vit y, B e nt o n et al., ( 2 0 1 4) cr e at e d a fr a m e w or k
“ Di v ersit y f or D esi g n ” ( D 4 D) w hi c h i nst e a d c a pit ali z es o n n e ur o di v ers e
c hil dr e n's str e n gt hs a n d s u p p ort p ossi bl e diffi c ulti es. T h e fr a m e w or k ai ds i n
g ui di n g d esi g n r es e ar c h a n d P D m et h o ds t o e n a bl e t h e p arti ci p ati o n of
n e ur o di v ers e p o p ul ati o ns. T h e k e y pri n ci pl es i n t his fr a m e w or k ar e: a)
u n d erst a n di n g c ult ur e, k n o wi n g t h e c h ar a ct eristi cs o bs er v e d i n t h e c o n diti o n; b) t ail ori n g f or t h e i n di vi d u al, t h at is k n o wi n g t h e c h ar a ct eristi cs s p e cifi c t o t h e i n di vi d u al s u c h as s kills l e v els, s p e ci al i nt er est, or p ers o n alit y; c) str u ct uri n g t h e e n vir o n m e nt, i. e. cr e ati n g pr e di ct a bilit y i n t h e s e q u e n c e of a cti viti es a n d m at c hi n g t h e e n vir o n m e nt t o t h e i n di vi d u al's a biliti es; d) a n d pr o vi di n g s u p p ort, s u c h as pr o vi di n g vis u al r e pr es e nt ati o ns of t as k i nstr u cti o ns i n a d diti o n t o v er b al e nf or c e m e nt. I n t his t h esis w or k, t h e ai m is ali g n e d wit h D 4 D, w hi c h is d esi g ni n g t o s u p p ort str e n gt hs i nst e a d of o nl y o v er c o mi n g d efi cits.
Dr ui n ( 2 0 0 2) i d e ntifi e d f o ur diff er e nt r ol es t h at c hil dr e n c a n pl a y i n t h e d esi g n of t e c h n ol o g y. T h es e ar e user, tester, i nf or m a nt a n d desi g n p art ner . W h e n i n t h e r ol e of d esi g n p art n er, t h e r ol e of t h e c hil d is c o nsi d er e d e q u al wit h ot h er st a k e h ol d ers t hr o u g h o ut t h e d esi g n pr o c ess of n e w t e c h n ol o gi es, c o ntri b uti n g t o t h e pr o c ess i n w a ys a p pr o pri at e b ot h f or c hil dr e n a n d t h e pr o c ess ( Dr ui n, 2 0 0 2). I v ers e n et al. ( 2 0 1 7) s u g g est t o d e e p e n t h e u n d erst a n di n g o n h o w c hil dr e n m a y b e e m p o w er e d t hr o u g h d esi g n. T h e g o al is t o gi v e c hil dr e n a v oi c e i n t h e d esi g n pr o c ess a n d t o r efl e ct t h e r ol e of t e c h n ol o g y i n t h eir pr a ctis es. I n t his t h esis w or k, t h e c hil dr e n a ct e d as d esi g n p art n ers, c o- d esi g n ers s o t o s p e a k, pr o vi d e d t h eir i d e as a n d c o ntri b uti o ns b y c ust o mi zi n g a n d d esi g ni n g g a m e el e m e nts: t h e a v at ar, c oll e ct a bl es, s c e n er y, a n d t h e n arr ati v e.
Dr ui n ( 2 0 0 2) h as als o r e c o g ni z e d t h at t h e r ol es c hil dr e n pl a y i n t h e d esi g n pr o c ess c a n n ot o nl y aff e ct t h e t e c h n ol o g y d esi g n pr o c ess, b ut it m a y als o h a v e a n i m p a ct o n w h at ki n d of t e c h n ol o gi es ar e b ei n g cr e at e d (s e e e. g T a x e n et al., 2 0 1 0).
It is w ort h c o nsi d eri n g, w h at ar e t h e b e n efits f or c hil dr e n t o p arti ci p at e
i n s u c h a cti viti es. M c N all y et al. ( 2 0 1 7) h a v e i d e ntifi e d, t hr o u g h t h eir r es e ar c h
a n d lit er at ur e, t h at s o m e of t h e m ost n ot a bl e g ai ns f or t h e c hil dr e n al u m ni h as
b e e n r e g ar di n g f or e x a m pl e c oll a b or ati o n, c o m m u ni c ati o n, c o nfi d e n c e a n d
l e ar ni n g v ari o us d esi g n t e c h ni q u es. D es pit e s e v er al p u blis h e d w or ks o n
c hil dr e n wit h A D H D a n d g a mi n g ( e. g. F ar c as et al., 2 0 1 6; Str a hl er Ri v er o et al.,
2 0 1 5), t h er e is a r es e ar c h g a p i n u n d erst a n di n g h o w t o pr a cti c all y or g a ni z e
g a m e d esi g n w or ks h o ps f or A D H D c hil dr e n. N or ar e t h er e g ui d eli n es o n h o w
t o i n v ol v e A D H D c hil dr e n as g a m e c o- d esi g n ers at e arl y st a g es of g a m e d e v el o p m e nt.
T h e C hil d B ar o m et er ( T u u k k a n e n et al., 2 0 1 8) f o c us es o n g at h eri n g e x p eri e nt al d at a fr o m y o u n g c hil dr e n. It hi g hli g hts t h e i m p ort a n c e of c hil dr e n's ri g hts a n d h e ari n g t h eir v oi c e n ot o nl y as a b asis f or b ett er p oliti c al d e cisi o n m a ki n g b ut als o fr o m c hil dr e n's p oi nt of vi e w t o pr o vi d e a c h a n n el f or t h e m t o p arti ci p at e wit h t h e p ossi bilit y t o i nfl u e n c e d e cisi o ns aff e cti n g t h e m. H o w e v er, t h er e is cl e arl y a l a c k of r es e ar c h a n d a v ail a bilit y of e n o u g h s uit a bl e m et h o ds t o g at h er c hil dr e n's e x p eri e n c es. F or e x a m pl e, i n t h e st u d y it w as r e v e al e d t h at t h er e is a diff er e n c e b et w e e n d at a c oll e ct e d vi a diff er e nt i nt er vi e w m et h o ds wit h c hil dr e n. C o m p ar e d t o p h o n e i nt er vi e ws, t h e c hil dr e n w er e c h atti n g m or e a n d gi vi n g m or e p ositi v e r es p o ns es w h e n i nt er vi e w e d f a c e-t o-f a c e ( T u u k k a n e n et al., 2 0 1 8.). G etti n g f e e d b a c k fr o m t h e p arti ci p a nts is v al u a bl e n ot o nl y f or f ut ur e it er ati o ns of s u c h w or ks h o ps b ut als o t o e x a mi n e p ossi bl e g ai ns t h e p arti ci p a nts mi g ht p er c ei v e fr o m t a ki n g p art i n s u c h a cti viti es. H o w e v er, g etti n g v ali d f e e d b a c k fr o m c hil dr e n r e g ar di n g t h eir e x p eri e n c es c a n b e pr o bl e m ati c si n c e c hil dr e n m a y h a v e diffi c ulti es i n e x pr essi n g t h eir o pi ni o ns or ot h er f a ct ors, s u c h as t h e e n vir o n m e nt or t h e m et h o d i n w hi c h t h e d at a is c oll e ct e d, mi g ht aff e ct t h eir a ns w ers. I n a d diti o n, t h e a ns w ers mi g ht n ot al w a ys pr o vi d e cl e ar a n d c o n cis e i nf or m ati o n. T his c a n b e t h e c as e es p e ci all y wit h c hil dr e n wit h s p e ci al n e e ds w h o m a y b e i m p air e d wit h t h eir c o m m u ni c ati o n or cr e ati v e s kills (s e e Fr a u e n b er g er et al., 2 0 1 1). O n e w a y t o o v er c o m e t h es e li mit ati o ns w o ul d b e t o e x pl or e g a mifi c ati o n m et h o ds als o f or eli citi n g f e e d b a c k, as w as e x pl or e d i n t his t h esis w or k.
2. 2 G a mifi c ati o n a n d T h er a p e uti c G a m e s f or A D H D
T h e us e of vi d e o g a m es, or g a mifi c ati o n, i n h e alt h c ar e a n d t h er a p e uti c
a p pli c ati o ns is wi d el y a c k n o wl e d g e d as g a mifi c ati o n is k n o w n t o f ost er
m oti v ati o n t o c o m pl et e t as ks ( S ail er et al., 2 0 1 4). T h e a p pli c ati o ns c a n v ar y fr o m
p h ysi ot h er a p y (s e e e. g. C ar y et al., 2 0 1 4) t o tr ai ni n g c o g niti v e c o ntr ol i n a d ults
(s e e e. g. A n g u er a et al., 2 0 1 3), a n d s u p p orti n g c hil dr e n's e m oti o n al
d e v el o p m e nt ( F a n et al., 2 0 1 8). H o w e v er, w h e n t al ki n g a b o ut g a m es us e d i n t h er a p y, t h e c o n c e pt of seri o us g a mes s h o ul d b e disti n g uis h e d fr o m g a mifi c ati o n.
W h er e g a mifi c ati o n r ef ers t o e x pli cit us e of g a m e el e m e nts i n n o n- g a m e c o nt e xt, s eri o us g a m es ar e f ull-fl e d g e d g a m es d e v el o p e d f or ot h er p ur p os es t h a n e nt ert ai n m e nt ( S ail er et al., 2 0 1 4). S o m e t y pi c al el e m e nts of g a m es t h at g a mifi c ati o n e m pl o y es ar e a v at ars, p oi nts, b a d g es, pr o gr ess b ars, a n d l e a d er b o ar ds. A v at ars ar e a m ai n c o m p o n e nt of r ol e- pl a yi n g g a m es a n d ar e disti n g uis h e d fr o m c h ar a ct ers b y t h eir f or m of r e pr es e nt ati o n. A c h ar a ct er is a n a g e nt t hr o u g h w hi c h a st or y is t ol d ( F ull ert o n 2 0 1 4, 9 6) a n d r ef ers t o t h e p ortr a y al of a p ers o n, w h er e as a n a v at ar is o nl y t h e vis u al r e pr es e nt ati o n of t h e pl a y er. T h er e h a v e b e e n m a n y d efi niti o ns of a v at ars i n vi d e o g a m es ( W a g g o n er, 2 0 0 9) b ut i n t his c o nt e xt, a n a v at ar m e a ns a virt u al r e pr es e nt ati o n of t h e us er i n a vi d e o g a m e. T o b e a bl e t o cr e at e or c h o os e y o ur o w n a v at ar c a n c o ntri b ut e t o a m or e e nj o y a bl e pl a y e x p eri e n c e ( Li m & R e e v es, 2 0 1 0; Ki n z er, 2 0 1 4) a n d i n cr e as e m oti v ati o n ( S ail er et al., 2 0 1 4). Ot h er m oti v ati o n al el e m e nts i n cl u d e p oi nts t h at c a n b e c oll e ct e d, b a d g es as vis u al r e pr es e nt ati o ns of a c hi e v e m e nts, pr o gr ess b ar s h o wi n g t h e pl a y er ́ s pr o gr ess t o w ar ds a g o al, a n d l e a d er b o ar ds w h er e t h e pl a y er c a n c o m p ar e t h eir r es ults wit h ot h ers ( S ail er et al ., 2 0 1 4).
T h er e ar e st u di es wit h pr o misi n g r es ults r e g ar di n g i m pr o v e d t h er a p y
r el at e d h e alt h o ut c o m es b y pl a yi n g a cti v e vi d e o g a m es ( St ai a n o & Fl y n n, 2 0 1 4)
a n d c o ns e q u e ntl y, t h er e h as b e e n i n cr e as e d i nt er est i n usi n g s eri o us g a m es i n
r e h a bilit ati o n of c hil dr e n wit h v ari o us c o n diti o ns. A r e c e nt pr o of- of- c o n c e pt
st u d y ( D a vis et al., 2 0 1 8) pr o vi d es pr eli mi n ar y s u p p ort t h at a vi d e o- g a m e li k e
i nt er a cti v e pr o gr a m c o ul d b e eff e cti v e i n i m pr o vi n g att e nti o n, w or ki n g m e m or y
a n d i n hi biti o n i n A D H D c hil dr e n. B ull et al. ( 2 0 1 8) c o n d u ct e d a st u d y w hi c h
ai m e d t o u n d erst a n d w hi c h gr o u ps of A D H D c hil dr e n w o ul d b e n efit t h e m ost
i n pl a yi n g s eri o us g a m es. T h e p arti ci p a nts w er e i nstr u ct e d t o pl a y a s eri o us
o nli n e g a m e ( d e v el o p e d f or t his p ur p os e) t h at ai ms t o i m pr o v e f u n cti o n al
o ut c o m es i n d ail y lif e s u c h as ti m e m a n a g e m e nt a n d c o o p er ati o n s kills. As t h er e
w as a diff er e n c e i n eff e cts b et w e e n t h es e gr o u ps, t h e y f o u n d t h at t h e t w o t y p es
of p arti ci p a nts w h o b e n efit e d t h e m ost fr o m t his ki n d of tr ai ni n g w er e girls
wit h A D H D i n g e n er al a n d b o ys wit h l o w er l e v els of b ot h h y p er a cti vit y a n d
c o n d u ct dis or d er. I n t his t h esis t h e ai m w as t o c ust o mi z e / p ers o n ali z e a t h er a p e uti c Ki n e ct- b as e d g a m e f or c hil dr e n wit h A D H D t hr o u g h P D w or ks h o p s essi o ns wit h n e ur o di v ers e c hil dr e n.
2. 3 R e h a bilit ati o n of E x e c uti v e F u n cti o n a n d Att e nti o n ( E X A T)
T h e g o al of t h e C o g nir e m pr oj e ct is t o cr e at e i nt er a cti v e a n d s kill- b uil di n g g a m e-li k e tr ai ni n g a p pli c ati o ns, w hi c h will ai d c hil dr e n wit h A D H D t o o v er c o m e c ert ai n d efi cits of A D H D: i n atte nti o n, h y per acti vit y a n d i m p ulsi vit y.
T h e w or ks h o ps w er e d esi g n e d f oll o wi n g t h e ori es a n d g ui d eli n es fr o m E X A T (r e h a bilit ati o n of E X e c uti v e f u n cti o n a n d A Tt e nti o n), w hi c h is a str u ct ur e d n e ur o ps y c h ol o gi c al m ultil e v el gr o u p i nt er v e nti o n d e v el o p e d f or c hil dr e n wit h e x e c uti v e f u n cti o n d efi cits at t h e Ps y c h ol o g y Cli ni c of T a m p er e U ni v ersit y ( P S Y K E) ( R a nt a n e n et al., 2 0 1 8). E X A T is a f or m of m e di c al r e h a bilit ati o n b as e d o n pri n ci pl es of n e ur o ps y c h ol o gi c al r e h a bilit ati o n, i nt e gr at e d wit h a n e vi d e n c e- b as e d b e h a vi or al m o difi c ati o n a p pr o a c h. E X A T c o m bi n es s e v er al ps y c h os o ci al tr e at m e nts: c hil d gr o u p tr ai ni n g, p ar e nt tr ai ni n g, a n d t e a c h er c o ns ult ati o ns. E X A T h as a l o n g hist or y i n cli ni c al pr a cti c e, ai mi n g t o r ei nf or c e e x e c uti v e f u n cti o ns a n d s elf- c o ntr ol, i m pr o v e s o ci al c o m p et e n c e a n d f ost er t h e c hil dr e n’s p ositi v e s elf- est e e m. E vi d e n c e s h o ws t h at E X A T h as p ositi v e eff e cts o n c hil dr e n’s b e h a vi or r e g ul ati o n s kills b y d e cr e asi n g i m p ulsi vit y a n d r estl ess b e h a vi or ( R a nt a n e n et al., 2 0 1 8). Of i nt er est f or t h e c urr e nt w or ks h o p ar e t h e f oll o wi n g m o d els a n d t h e ori es t h at E X A T is b as e d u p o n.
B ar kl e y ( 1 9 9 7) s u g g ests t h at att e nti o n d efi cits ar e r at h er a l a c k of i m p uls e
c o ntr ol, w hi c h gi v es ris e t o b e h a vi ors li k e fi d g eti n g. H e b as es t his as t h e c or e
d efi cit i n c hil dr e n wit h A D H D. Fr o m his m o d el of i n hi biti o n, e m er g es t h e n e e d
f or a str u ct ur e d pr o gr a m t h at h as fi x e d a n d a c hi e v a bl e g o als a n d us es vis u al
ai ds. T h e m o d el ai ms t o s u p p ort a n d d e v el o p e x e c uti v e f u n cti o ni n g, i n cl u di n g
t h os e p ert ai ni n g t o att e nti o n a n d m e m or y, t hr o u g h g ui d a n c e o n t as ks usi n g
si m pl e v er b al i nstr u cti o ns. Fr o m t his m o d el, t h e n e e d f or a hi g hl y str u ct ur e d
pr o gr a m wit h vis u al ai ds w as d et er mi n e d.
E n er g eti c a n d vi gil a n c e m o d el ( S er g e a nt, 2 0 0 0; 2 0 0 5; v a n d er M e er e, 1 9 9 6; v a n d er M e er e et al., 2 0 1 0) w as t h e first t o s u g g est t h at t h e c h all e n g es ass o ci at e d wit h A D H D mi g ht b e d u e t o u n d er ( n ot o v er) a cti v ati o n. F or b est or o pti m u m p erf or m a n c e, c hil dr e n n e e d t o b e ar o us e d or e x cit e d. T h er ef or e, if a c hil d is u n d er a cti v at e d b y t h eir e n vir o n m e nt or t as k, t h e y n e e d t o m o v e, or g et e n er g y i n s o m e ot h er w a y t o g et b a c k t o t h e o pti m u m or d esir e d a cti v ati o n l e v el. I n t his w a y, t h e c h all e n g es br o u g ht o ut b y A D H D ar e r e d u c e d w h e n t h e c hil d a c hi e v es t h e ri g ht a cti v ati o n l e v el, w hi c h is a c hi e v e d b y m o v e m e nt.
T h er ef or e, c hil dr e n c o m p e ns at e f or t h e l o w a cti v ati o n b y m o v e m e nt. Fr o m t his m o d el, t h e n e e d t o all o w m o v e m e nt wit hi n t h e s essi o ns a n d t o h a v e a diff er e nt e n vir o n m e nt f or diff er e nt a cti vit y w as d eri v e d.
C hil dr e n n e e d m or e i m m e di at e f e e d b a c k t o st a y f o c us e d i n a b us y e n vir o n m e nt. M or e o v er, t h er e s h o ul d b e a f o c us o n p ositi v e r ei nf or c e m e nt, t h us, i g n ori n g b a d b e h a vi ors. F e e d b a c k or r ei nf or c e m e nt n e e d n ot o nl y b e v er b al a n d c a n i n cl u d e n o n- v er b al g est ur es ( e. g. t h u m bs u p, n o d di n g a n d s mili n g). I n s c h o ols i n Fi nl a n d, t e a c h ers us e t h e re d, yell o w, a n d gree n c ar ds ( b as e d o n tr affi c li g hts), w h er e r e d or y ell o w c ar ds ar e us e d l ess t h a n t h e gr e e n c ar d. T h e tr affi c li g ht m o d el is us u all y f a mili ar t o t h e c hil dr e n. Ti m e o uts ar e als o us e d s o m eti m es t o c al m d o w n a n o v er w h el m e d or o v ersti m ul at e d c hil d, f or i nst a n c e, as ki n g t h e m t o t a k e a w al k or g o t o t h e ot h er r o o m ( b ut n ot s e nt t o a c or n er). Fr o m t h es e m oti v ati o n al t h e ori es ( S o n u g a- B ar k e et al., 1 9 9 2), t h e w or ks h o ps i n c or p or at e d p ositi v e r ei nf or c e m e nts a n d ti m el y f e e d b a c k.
I n t his t h esis, t h e ai m w as t o a p pl y E X A T - b as e d str at e gi es i nt o t h e P D w or ks h o p f or A D H D- di a g n os e d a n d n e ur o di v ers e c hil dr e n.
2. 4 O bj e cti v e s a n d R e s e ar c h Q u e sti o n s
T h e w or ks h o p h a d a c o m bi n ati o n of g a m e d esi g n g o als a n d f a cilit ati o n g o als.
Firstl y, t h er e w er e g a m e d esi g n g o als t o v ali d at e t h e i niti al g a m e i d e a a n d a d v a n c e a n e arl y g a m e pr ot ot y p e wit h a v at ar c ust o mi z ati o n, n arr ati v e, e n vir o n m e nt, a n d c oll e ct a bl e el e m e nts b as e d o n i n p ut b y t h e c hil d p arti ci p a nts.
T h e w or ks h o p w as ai m e d t o pr o d u c e a f u n cti o n al a n d a p p e ali n g g a m e t o b e
us e d b y c hil dr e n wit h A D H D d uri n g a f ort h c o mi n g cli ni c al tri al. Ess e nti all y, t h e p arti ci p a nts w er e e x p e ct e d t o w or k as c o- d esi g n ers t o g et h er wit h ot h er g a m e d e v el o p ers t hr o u g h p arti ci p at or y a cti viti es. T h us, t h eir m ai n c o ntri b uti o n w as i n cr e ati n g t h e vis u als a n d b a c kst or y f or t h e g a m e. T h e p arti ci p a nts w o ul d als o t est p arts of t h e r es ulti n g g a m e a n d v erif y t h e f u n cti o n alit y of m oti o n- b as e d c o ntr olli n g m et h o ds, g a m e m e c h a ni cs a n d t h e vis u al a p p e al of t h e g a m e.
T h e w or ks h o p als o ai m e d t o pr o vi d e a n i n cl usi v e, p ositi v e e x p eri e n c e f or t h e p arti ci p a nts a n d i ntr o d u c e t h e m t o s o m e f e at ur es of g a m e d e v el o p m e nt.
T h er ef or e, it w as pl a n n e d t o pr es e nt t h e pr o c ess of g a m e d e v el o p m e nt t o t h e
c hil dr e n, st arti n g fr o m c ust o mi zi n g t h e a v at ars a n d t h e e n vir o n m e nt t o cr e ati n g
n arr ati v es. T his w as als o a c hi e v e d b y pr o m ptl y i m pl e m e nti n g c hil dr e n's w or k
s o t h at t h e y w o ul d s e e h o w t h eir i d e as ar e i n c or p or at e d i nt o t h e g a m e
pr ot ot y p e t hr o u g h o ut t h e s essi o ns. C hil dr e n w o ul d als o e x p eri e n c e s o m e
c h all e n g es of t h e d esi g n pr o c ess, s u c h as b u gs (i n- g a m e t e c h ni c al c o m pli c ati o ns)
i n t h e s oft w ar e, ti m e c o nstr ai nts a n d t e a m c o m m u ni c ati o n. C o m m u ni c ati o n i n
t h e t e a m c a n s o m eti m es b e diffi c ult, f or e x a m pl e a gr e ei n g o n a n i d e a t o b e
i m pl e m e nt e d i n t h e g a m e, or w h e n pr o vi di n g (s o m eti m es n e g ati v e) f e e d b a c k t o
t e a m m at es. T his c a n b e c h all e n gi n g f or c hil dr e n i n g e n er al, a n d m or e s o f or
c hil dr e n wit h A D H D. T h er ef or e, t h e w or ks h o p h a d f a cilit ati o n g o als t o
i n c or p or at e str at e gi es b as e d o n E X A T - pri n ci pl es. T h e str at e gi es i n cl u d e d
a d o pti o n of a hi g hl y str u ct ur e d pr o gr a m f or t h e s essi o ns wit h a pr e di ct a bl e
s c h e d ul e, e n vir o n m e nt m o difi c ati o n as w ell as p ositi v e r ei nf or c e m e nt a n d
m o d elli n g of s o ci all y a c c e pt a bl e b e h a vi ors. K n o wi n g t h e diffi c ulti es t h at A D H D
c hil dr e n f a c e, s essi o ns w er e d esi g n e d t o i m pli citl y s u p p ort t h e c hil dr e n i n t h e
g a m e d esi g n t as ks, t h us, h el pi n g t o a c hi e v e g a m e d esi g n g o als. A d diti o n all y,
t h e s essi o ns w er e als o d esi g n e d t o e x pli citl y t e a c h c hil dr e n t h e s kills of s o ci al
i nt er a cti o n a n d s elf- or g a ni z ati o n t h at ar e r e q uir e d i n t e a m w or k. T h es e s kills
w er e f or m ul at e d as t h e 4 “I ” - st at e m e nts: I p artici p ate, I a m a te a m me m ber, I a m a
ti me kee per a n d I p a y atte nti o n. T h e y w er e b as e d o n a r e h a bilit ati o n pr o gr a m fr o m
t h e ps y c h ol o gists i n v ol v e d i n t h e pr oj e ct. T h e y w er e e m p h asi z e d a n d pr a ctis e d
i n a r el a x e d at m os p h er e t hr o u g h o ut t h e s essi o ns a n d t h e y will b e d es cri b e d i n
d et ail i n s e cti o n 3. 3. 1. A bri ef a n al ysis of t h e A D H D c hil dr e n's b e h a vi o ur, w h e n
r el e v a nt, d uri n g t h e s essi o ns is i n cl u d e d i n t h e s essi o n d es cri pti o ns i n s e cti o n 4.
T o i n cr e as e m oti v ati o n i n c hil dr e n t o c o m pl et e all t h e w or ks h o p s essi o ns, t h e a cti viti es i n t h e m, a n d pr a ctisi n g t h e s kills, g a mifi c ati o n w as us e d i n b ot h d esi g ni n g t h e s essi o n a cti viti es a n d e n h a n ci n g t h e s o ci al s kill tr ai ni n g.
As t his pr oj e ct w as d o n e i n c oll a b or ati o n wit h ot h er r es e ar c h ers, b ot h t h eir a n d m y r ol e i n t h e w or ks h o ps ar e d es cri b e d i n s e cti o n 3. 2. M y r es e ar c h w as b ot h c o nstr u cti v e a n d e x p eri m e nt al i n its n at ur e, wit h t h e f oll o wi n g o bj e cti v es:
● B as e d o n a pr eli mi n ar y o utli n e f or t h e w or ks h o ps pr o vi d e d b y t h e pr oj e ct l e a d, o bj e cti v e 1 w as t o pl a n i n d et ail t h e t h e m es f or e a c h s essi o n, t h eir c hr o n ol o gi c al s e q u e n c e t h at w o ul d cr e at e a s e ns e of c o nti n u ati o n b et w e e n t h e s essi o ns f or p arti ci p a nts, a n d pl a n ni n g t h e pr a cti c al g a m e d esi g n t as ks f or e a c h s essi o n.
● W or ki n g i n c oll a b or ati o n wit h ot h er r es e ar c h ers, o bj e cti v e 2 w as t o i n c or p or at e el e m e nts of E X A T r e h a bilit ati o n i nt er v e nti o n i nt o t h e w or ks h o p. T h e i d e a w as t o m a k e t h e w or ks h o p p arti c ul arl y s uit e d f or A D H D c hil d p arti ci p a nts, t h us, c h all e n g es a n d w a ys t o a c c o m m o d at e A D H D c hil dr e n n e e d e d t o b e st u di e d a n d a s et of f a cilit ati o n str at e gi es w er e i m pl e m e nt e d i nt o t h e w or ks h o p str u ct ur e a n d a cti viti es.
● O bj e cti v e 3 w as t o cr e at e a n d i n cl u d e el e m e nts of g a mifi c ati o n i nt o t h e w or ks h o p t o i n cr e as e c hil dr e n's m oti v ati o n t o c o p e wit h t h e w or ks h o p a cti viti es a n d c oll e ct c hil dr e n's i m pr essi o ns of t h e w or ks h o p.
● B as e d o n m y e x p ertis e as a gr a p hi c d esi g n er, o bj e cti v e 4 w as t o
r a pi dl y cr e at e c o m m er ci all y l o o ki n g g a m e gr a p hi cs b as e d o n
c hil dr e n's c o ntri b uti o ns i n a w a y t h at t h e y c o ul d f oll o w h o w t h eir
i d e as w er e i m pl e m e nt e d t o t h e s oft w ar e pr ot ot y p e d uri n g t h e
w or ks h o p. S e ei n g t h eir w or k, it w as a nti ci p at e d t o i n cr e as e c hil dr e n's m oti v ati o n a n d e m p o w er m e nt i n t h e d esi g n pr o c ess.
● T h e c o m bi n ati o n of t h e g a m e d esi g n g o als a n d f a cilit ati o n g o als r e q uir e d n ot o nl y c ar ef ul pl a n ni n g b ut als o r a pi d b et w e e n-s essi o n it er ati o ns t o t h e pl a ns s o t h at t h os e g o als c o ul d b e r e ali z e d.
O bj e cti v e 5 w as t o or g a ni z e bri efi n g m e eti n gs wit h ot h er r es e ar c h ers aft er e a c h s essi o n a n d u p d at e t h e t e a m a b o ut pr o gr ess i n d esi g n a n d h o w t h e s essi o n a n d a cti viti es w er e r e c ei v e d b y t h e c hil dr e n, a n d d efi n e w h at is i m pl e m e nt e d f or t h e n e xt s essi o n a n d m o dif y it if n e e d e d.
T h es e o bj e cti v es w er e m et s u c c essf ull y a n d will b e dis c uss e d i n t h e f oll o wi n g s e cti o ns: o bj e cti v e 1 i n s e cti o n 3. 3, o bj e cti v e 2 i n s e cti o n 3. 3. 1, o bj e cti v e 3 i n s e cti o n 3. 5, o bj e cti v e 4 i n s e cti o n 3. 3 a n d 4, a n d o bj e cti v e 5 i n s e cti o n 3. 3. 2.
T o a c c o m m o d at e t h es e o bj e cti v es, t w o r es e ar c h q u esti o ns w er e f o r m ul at e d:
R Q 1: H o w c a n c hil dr e n f oll o w t h e pr o p os e d w or ks h o p str u ct ur e a n d a cti viti es ? D o E X A T - b as e d f a cilit ati o n str at e gi es ai d A D H D p arti ci p a nts i n g etti n g i n v ol v e d i nt o t h e d esi g n pr o c ess a n d e n h a n c e t h eir s o ci al s kills ?
R Q 2: W h et h er a n d h o w i m pl e m e nti n g g a mifi c ati o n el e m e nts t o t h e w or ks h o p str u ct ur e a n d a cti viti es aff e ct c hil dr e n's m oti v ati o n t o c o p e wit h w or ks h o p a cti viti es a n d pr o vi di n g t h eir i m pr essi o ns of t h e w or ks h o p ?
T h es e r es e ar c h q u esti o ns ar e a ns w er e d i n s e cti o n 6.
T his s e cti o n st art e d wit h a lit er at ur e r e vi e w o n pr e vi o us w or k r e g ar di n g p arti ci p at or y d esi g n wit h c hil dr e n wit h s p e ci al n e e ds, g a mifi c ati o n a n d t h er a p e uti c g a m es f or A D H D c hil dr e n. T h e E X A T- pri n ci pl es w er e i ntr o d u c e d a n d t h e o bj e cti v es a n d r es e ar c h q u esti o ns of t his w or k w er e pr e s e nt e d.
3 P A R TI CI P A T O R Y D E SI G N A N D G A MI FI C A TI O N M E T H O D S
T his s e cti o n d es cri b es t h e p arti ci p at or y d esi g n a n d g a mifi c ati o n m et h o ds st arti n g wit h a bri ef m e nti o n of t h e et hi cs p er missi o n. T h e n, it will b e c o nti n u e d wit h d es cri pti o ns of t h e w or ks h o p p arti ci p a nts a n d t h e r es e ar c h t e a m f oll o w e d b y t h e E X A T- b as e d f a cilit ati o n str at e gi es, t h e w or ks h o p pl a n ni n g, t h e g a m e pr ot ot y p e a n d h o w g a mifi c ati o n w as us e d i n t h e w or ks h o p.
3. 1 Et hi c s
H u m a niti es Et hi cs C o m mitt e e of t h e T a m p er e r e gi o n, T a m p er e U ni v ersit y g a v e a p ositi v e st at e m e nt t o t h e r es e ar c h (s e e st at e m e nt 3 6 / 2 0 1 8 “ E m b o di e d g a m es f or c o g niti v e a n d b e h a vi or al r e h a bilit ati o n of att e nti o n d efi cit / h y p er a cti vit y dis or d er ”). T h e r es e ar c h w as s u p p ort e d b y t h e A c a d e m y of Fi nl a n d ( d e cisi o n n u m b er 3 0 8 9 2 9) a n d T a m p er e U ni v ersit y . T h us, it all o w e d t o c o n d u ct a st u d y
1wit h n e ur o di v ers e c hil dr e n t o e x pl or e P D.
Writt e n i nf or m e d c o ns e nt t o p arti ci p at e w as o bt ai n e d fr o m t h e p arti ci p a nts ́ p ar e nts. T h e c hil d p arti ci p a nts si g n e d t h e i nf or m e d c o ns e nt as w ell aft er b ei n g v er b all y e x pl ai n e d t h e d et ails, h o w t h e d at a is b ei n g us e d, a n d t h e c o m p e ns ati o n t h e y w o ul d r e c ei v e. T h e c o m p e ns ati o n w as t w o m o vi e ti c k ets p er c hil d if t h e y p arti ci p at e d i n all of t h e s essi o ns a n d o n e m o vi e ti c k et if t h e y att e n d e d t hr e e s essi o ns.
3. 2 T e a m M e m b er s
C hil dr e n R e s e ar c h A d vi s or y Gr o u p: T h e r ol e of t h e c hil d p arti ci p a nts w as t o a ct as d esi g n p art n ers; d esi g n c oll a b or ati v el y, pr o vi d e f e e d b a c k t o ot h ers ́ d esi g ns a n d t o t est t h e fi n al d esi g ns ( Dr ui n, 2 0 0 2). C hil d p arti ci p a nt pr ofil es ar e m e nti o n e d i n T a bl e 1.
1 Pr oj e ct F u n di n g:
htt p: / / w e bf o c us. a k a.fi /i bi _ a p ps / W F S er vl et ?I BI F _ e x = x _ H a k K u v a us 2 & C LI C K E D _ O N = & H A K N R O 1 = 3 0 8
T a bl e 1. C hil d p arti ci p a nts pr ofil e. T D = T y pi c all y d e v el o p e d, A D H D = C hil d wit h a n A D H D di a g n osis
C o d e G e n d er A g e N ati v e L a n g u a g e
P 1 ( A D H D) m al e 1 2 y e ars Fi n nis h
P 2 ( A D H D) f e m al e 1 2 y e ars E n glis h
P 3 ( T D) m al e 1 0 y e ars Fi n nis h
P 4 ( T D) m al e 1 0 y e ars Fi n nis h
R ol e s of t h e r e s e ar c h t e a m a n d s oft w ar e d e v el o p er s: T h e t e a m i n cl u d e d r es e ar c h ers a n d s oft w ar e d e v el o p ers. T h eir r ol es ar e m e nti o n e d i n T a bl e 2.
T a bl e 2. R es e ar c h t e a m a n d s oft w ar e d e v el o p er pr ofil e.
