ADHD Remote Technology and ADHD Transition: Predicting and Preventing Negative Outcomes (ART-transition)

Attention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental condition affecting 5.9% of young people. Late adolescence can be a particularly challenging period for young people with ADHD, with major life transitions, new demands and increased expectations. This vulnerable phase also coincides with the transition from child and adolescent mental health care to adult ADHD services, where new UK data show that most young people with ADHD do not successfully transfer to adult services. Therefore, many young people with ADHD do not receive appropriate interventions at a time when they may need them most. Opportunities for intervention are currently not fully realised due to both the young people's disengagement from clinical services and our limited understanding of real-world targets for more holistic interventions. The current study seeks to address these needs using remote (not in-person) measurement technology (RMT). The MRC-funded project, ART-transition, will use the ADHD Remote Technology ('ART') assessment and monitoring assessments with young people with a diagnosis of ADHD aged 16-17 and the RADAR-base mobile-health platform to which it is linked. ART consists of active (e.g. questionnaires) and passive (e.g. sleep) smartphone app monitoring. In the study, the investigators will address three questions on the transition to adulthood for individuals with ADHD: what changes take place, what predicts them, and how can the investigators prevent negative outcomes and support healthy lifestyles? The investigators will remotely monitor 250 young people with ADHD over two years. The investigators will then co-design, with young people with ADHD, a prototype for a new ADHD-transition smartphone app. Our approach focuses on giving young people with ADHD greater autonomy in how they manage their ADHD, in collaboration with their clinician, and places the emphasis on modifiable environmental factors and the prevention of negative outcomes.

Study Overview

• Status: Recruiting
• Conditions: Attention Deficit Hyerpactivity Disorder

• Study Type: Observational
• Enrollment (Estimated): 500

Contacts and Locations

• Study Contact: Name: Aislinn Bowler, PhD; Phone Number: 07503926683; Email: art-transition@kcl.ac.uk

Study Locations

• United Kingdom
  • London, United Kingdom
    • Recruiting
    • King's College London
    • Principal Investigator: Jonna Kuntsi, PhD
    • Contact: Aislinn Bowler, PhD; Phone Number: 07503926683; Email: art-transition@kcl.ac.uk
    • Contact: Email: aislinnbowler@gmail.com

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

• Sampling Method: Non-Probability Sample

Study Population

Community and secondary care clinics

Description

Inclusion Criteria:

• Diagnosis of DSM-5 ADHD
• Aged 16-17
• Able to give informed consent for participation
• Willing and able to complete self-reported assessments via smartphone
• Willing to use either their own compatible Android phone or a study Android - phone as their only smartphone during the data collection period
• Willing to wear the wearable device during the data collection period

Exclusion criteria

• Psychosis, currently experiencing a major depressive episode, mania, drug dependence in the last six months, or a major neurological disorder.
• Recent contact with psychiatric acute care (admission, crisis team or liaison team (A&E) in the last six months
• Any other major medical disease which might impact upon the patient's ability to participate in normal daily activities (e.g., due to hospitalisations)
• Pregnancy
• IQ < 70

Informant Inclusion Criteria:

• A parent or guardian, as chosen by the participant with ADHD
• Aged 18 or over
• Willing and able to complete web-based questionnaires regarding the participant with ADHD

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Adolescents with ADHD
Informant; Parent or guardian of the individuals with ADHD

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
ADHD symptoms and functional impairment	Barkley Adult ADHD Rating scale on symptoms and functional impairment (BAARS-IV)- Self Report. 29 items. For 18 items, individuals report the frequency with which they have experienced ADHD symptoms over the past two weeks on a four-point Likert Scale (0 = 'Never' or 'Rarely', 1 = 'Sometimes', 2 = 'Often', 3 = 'Very Often'). One item asks individuals to indicate the ages at which they first experienced symptoms. For the final 10 items, individuals report the extent to which their symptoms have interfered with their ability to function in various domains (e.g., home life or at work) on a four-point Likert Scale (0 = 'Never or Rarely', 1 = 'Sometimes', 2 = 'Often', 3 = 'Very Often').	Baseline and every 4 weeks up to month 24
ADHD symptoms	Non-validated daily ADHD symptom question. 1 item. Individuals report the extent to which ADHD symptoms affected their daily activities on a Likert Scale (1 = Not at all, 2 = Slightly, 3 = Somewhat, 4 = Quite a lot, 5 = A lot).	Baseline and every day up to month 24
Anxiety (General Anxiety Disorder-7, GAD-7)	7-items. 4-point Likert scale indicating the frequency of experiencing items in the past two weeks (0 = 'Not at all', 1 = 'Several days', 2 = 'More than half the days', 3 = 'Nearly every day'). Higher scores indicate higher severity of anxiety symptoms.	Baseline and every 4 weeks up to month 24
Depression (Patient Health Questionnaire -8, PHQ-8, adapted)	8-items. 4-point Likert scale indicating the frequency of experiencing items in the past two weeks (0 = 'Not at all', 1 = 'Several days', 2 = 'More than half the days, 3 = 'Nearly every day'). Higher scores indicate higher severity of depression symptoms.	Baseline and every 4 weeks up to month 24
Aggression (Reactive-Proactive Aggression Questionnaire for Adults. RPQ-A, adapted)	23 items, 3-point Likert scale rated from 0 to 2 (0 = 'Never', 1 = 'Sometimes', 2 = 'Often'), indicating the frequency of experiencing items in the past two weeks. Higher scores indicate increased aggression.	Baseline and every 4 weeks up to month 24
Irritability - (Affective Reactivity Index self-report, ARI-s, adapted)	7-item, 3-point Likert Scale rated from 0 to 3 (0 = 'Not True', 1 = 'Somewhat True', 2 = 'Certainly True') indicating frequency of experiencing symptoms in the past two weeks.	Baseline and every 4 weeks up to month 24
Nicotine Dependence - The Fagerstrom Test for Nicotine Dependence	6-items. Four items are yes/no questions rated from 0 to 1, and two are multiple-choice questions rated from 0 to 3 on a 4-point Likert scale. A higher score is associated with more nicotine dependence.	Baseline and every 4 weeks up to month 24
Alcohol Use (Alcohol Use Disorders Identification Test questionnaire, AUDIT)	10 items, with a 4-point Likert scale rated from 0 to 3. A higher score is associated with more harmful or hazardous drinking.	Baseline and every 4 weeks up to month 24
Eating Disorders (Short Form of the Eating Disorder Examination Questionnaire, EDE-QS)	12 items. 10 items are questions about behaviours in the past seven days, rated on a scale from 0 to 3 for frequency (0 = 0 days, 1 = 1-2 days, 2 = 3-5 days, 3 = 6-7 days). 2 items are about self-perception over the past seven days, rated on a scale from 0 to 3 for extent (0 = Not at all, 1 = Slightly, 2 = Moderately, 3 = Markedly). A higher score is associated with more eating disorder behaviours.	Baseline and every 6 months up to month 24
Self-esteem (Rosenberg Self-Esteem Scale, RSES)	10 items. 4-point Likert scale format ('Strongly Agree', 'Agree', 'Disagree, 'Strongly Disagree'). Responses are assigned 1-4 points. Higher scores indicate higher self-esteem.	Baseline and every 6 months up to month 24
Social support and engagement with work/studies	Non-validated questionnaire	Baseline and every 4 weeks up to month 24]
Healthy lifestyle behaviours and digital signals associated with changes in clinical symptoms	Passive monitoring using the RADAR-BASE smartphone "Passive App" measuring digital signals of behaviour.	Continuously across a 24-month time period
Healthy lifestyle behaviours and digital signals associated with changes in clinical symptoms	Passive monitoring using a Fitbit wearable device measuring sleep. Device sensors, including an accelerometer and a photoplethysmographic pulse oximeter, will be combined to calculate sleep duration.	Continuously across a 24-month time period
Healthy lifestyle behaviours and digital signals associated with changes in clinical symptoms	Passive monitoring using a Fitbit wearable device measuring physical activity. Device sensors, including a gyroscope and an accelerometer, will be combined to calculate step count.	Continuously across a 24-month time period
Markers associated with clinical symptoms - cognitive measures	Continuous Performance Test/Go No-Go Task (Combined Task)	Baseline and every 6 months up to month 24
Markers associated with clinical symptoms - cognitive measures	Fast Task	Baseline and every 6 months up to month 24

Collaborators and Investigators

• Sponsor: King's College London
• Collaborators: South London and Maudsley NHS Foundation Trust; Northamptonshire Healthcare NHS Foundation Trust; South West London and St George's Mental Health NHS Trust
• Investigators: Principal Investigator: Jonna Kuntsi, PhD, Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London

Publications and helpful links

Helpful Links

• RADAR-base mobile-health platform developed by Dobson et al.
• ADHD Remote Technology ('ART') assessment and monitoring assessments developed by Kuntsi, Dobson, et al.

Study record dates

Study Major Dates

• Study Start (Actual): February 17, 2025
• Primary Completion (Estimated): April 1, 2028
• Study Completion (Estimated): April 1, 2028

Study Registration Dates

• First Submitted: January 23, 2025
• First Submitted That Met QC Criteria: November 13, 2025
• First Posted (Estimated): November 14, 2025

Study Record Updates

• Last Update Posted (Actual): November 26, 2025
• Last Update Submitted That Met QC Criteria: November 20, 2025
• Last Verified: January 1, 2025

More Information

Terms related to this study

• Keywords: ADHD; mHealth; Longitudinal; Adolescence; medication adherence; attention-deficit/hyperactivity disorder; remote measurement technology
• Additional Relevant MeSH Terms: Mental Disorders; Neurodevelopmental Disorders; Attention Deficit and Disruptive Behavior Disorders; Behavior; Treatment Adherence and Compliance; Health Behavior; Patient Compliance; Patient Acceptance of Health Care; Attention Deficit Disorder with Hyperactivity; Medication Adherence
• Other Study ID Numbers: 334427

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Not relevant

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No