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Photography-Based Intervention for Children With Attention Deficit Hyperactivity Disorder
Photography-Based Intervention to Improve Emotion Wellbeing and Symptoms in Children With Attention Deficit Hyperactivity Disorder
Studie Overzicht
Toestand
Interventie / Behandeling
Gedetailleerde beschrijving
Attention-Deficit/Hyperactivity Disorder (ADHD) remains one of the most prevalent neurodevelopmental disorders, affecting a significant percentage of school-aged children across the globe. While the condition is primarily characterized by symptoms of inattention and impulsivity, there is a growing consensus that ADHD is fundamentally underpinned by profound impairments in emotional functioning. This emotional dysregulation is considered a transdiagnostic feature that significantly predicts long-term functional impairment in daily life. Specifically, children with ADHD exhibit marked deficits in emotion recognition and emotional awareness, which often manifests as an inability to accurately differentiate between various internal affective states. This socio-emotional dysregulation creates a cascading negative impact, not only exacerbating behavioral symptoms but also undermining subjective well-being, particularly within high-pressure educational ecologies such as Hong Kong.
Currently, the clinical landscape for ADHD emotional intervention is dominated by pharmacological treatments and behavioral modalities, including Cognitive Behavioral Therapy and Social Skills Training. While research supports the efficacy of these traditional approaches in reducing overt behavioral disruptions, their impact on the core neurocognitive processing of emotions remains inconsistent. Meta-analytic evidence indicates that individuals with ADHD exhibit pervasive deficits in underlying emotional regulation and specific impairments in non-verbal emotional decoding-areas that standard interventions often fail to significantly improve, even when outward compliance is achieved. Furthermore, while creative arts therapies like art or play therapy have emerged as helpful adjunctive tools, much of the existing literature is constrained by methodological limitations, such as small sample sizes, a lack of rigorous control designs, and a reliance on unblinded informant reports. To date, there is no standardized psychoeducational modality that specifically targets the cognitive architecture of emotional processing in ADHD through a visual medium.
The practical implementation of traditional psychoeducation faces a critical theoretical bottleneck: the high cognitive load placed on participants. According to Cognitive Load Theory, human working memory has a strictly finite capacity. Traditional programs rely heavily on dense textual materials and didactic verbal instruction. For children with ADHD, whose neurocognitive profile is inherently compromised by deficits in executive functioning and sustained attention, this text-centric design imposes an overwhelming extraneous cognitive load. When a child's cognitive resources are exhausted by the effort of processing complex linguistic instructions, the available capacity for internalizing actual emotional regulation strategies is depleted. This leads to premature disengagement and poor adherence to the therapeutic process. Therefore, there is an urgent clinical need for innovative modalities that optimize cognitive load by bypassing heavy linguistic processing in favor of more accessible formats.
Studietype
Inschrijving (Werkelijk)
Fase
- Niet toepasbaar
Contacten en locaties
Studie Locaties
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Hong Kong
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Hong Kong, Hong Kong, Hongkong
- Ka Po Wong
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Deelname Criteria
Geschiktheidscriteria
Leeftijden die in aanmerking komen voor studie
- Kind
Accepteert gezonde vrijwilligers
Beschrijving
Inclusion Criteria:
- ethnic Chinese aged between 8-12 years old
- documented diagnosis of ADHD by a psychiatrist according to the ICD-10 HKD or DSM-5 criteria
- stable on current treatment for ADHD eight weeks before baseline
- ability to read Chinese and listen to Cantonese
- able to operate a camera; 8) willingness of
- their guardians to provide informed consent
Exclusion Criteria:
- general intellectual functioning below the low-average range (estimated IQ < 80)
- unstable screened via parental declaration and medication review
- comorbid psychiatric disorder, severe physical or learning disability that prevents functional participation in photography tasks
Studie plan
Hoe is de studie opgezet?
Ontwerpdetails
- Primair doel: Ondersteunende zorg
- Toewijzing: Gerandomiseerd
- Interventioneel model: Parallelle opdracht
- Masker: Dubbele
Wapens en interventies
Deelnemersgroep / Arm |
Interventie / Behandeling |
|---|---|
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Experimenteel: Photography-based intervention group
The participants in this group will have a six-weekly photography course.
Each session is about 60 minutes.
Four participants will be arranged together to conduct one session.
In each session, a photographer will teach the participants basic photography skills and give a theme for the participants to take photos which will be used for sharing in the next session.
Themes mainly are emotions and objects.
In the sharing, the photographer will ask the participants to explain the reasons why take these photos and the photographer will explain the different types of emotions to the participants based on the themes.
The participants can express their views and feelings regarding their photos.
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The programme follows a structured progression across six sessions, each building upon previous learning whilst introducing new skills and concepts. For the first session, participants build rapport and introduce photography techniques (composition, lighting) alongside emotional awareness to capture basic emotional states. For the second and third sessions, they explore personal emotions and triggers through self-portraits and visual documentation. For the fourth and fifth sessions, they focus on the ADHD journey via strength-based photo narratives and collaborative projects to enhance peer support and social learning. In the last session, they consolidated skills into personal visual toolkits for ongoing regulation, concluding with a final project presentation and maintenance planning. |
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Geen tussenkomst: Waitlist control group
The participants maintained their Treatment-as-Usual (TAU).
Participants in the waitlist group received the identical photography-based psychoeducation program immediately after the post-intervention assessment.
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Wat meet het onderzoek?
Primaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Emotional Awareness
Tijdsspanne: From enrollment to the end of treatment at 6 weeks and 3-month follow-up
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Participants' emotional functioning was evaluated by a licensed clinical psychologist using an adapted version of the Emotion Awareness Questionnaire (EAQ).
To fit the clinical evaluation context and focus specifically on the core processing stages of emotion identification and expression, the questionnaire was adapted into an informant-report format consisting of two selected subscales (10 items in total): Verbal Sharing of Emotions (3 items) and Differentiating Emotions (7 items).
Items in this adapted version were rated on a 4-point Likert scale ranging from 1 (never) to 4 (always).
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From enrollment to the end of treatment at 6 weeks and 3-month follow-up
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Secundaire uitkomstmaten
Uitkomstmaat |
Maatregel Beschrijving |
Tijdsspanne |
|---|---|---|
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Emotion Recognition
Tijdsspanne: From enrollment to the end of treatment at 6 weeks and 3-month follow up
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Participants' ability to accurately identify emotional states from non-verbal cues was evaluated using a customized, 7-item Facial Emotion Recognition Task (FERT) based on the universal emotional categories.
Children were presented with seven distinct facial-expression stimuli, each representing a specific emotion category: happiness, surprise, anger, contempt, disgust, fear, and sadness.
The facial stimuli were presented on a computer screen by a licensed clinical psychologist.
For each item, participants were instructed to identify or label the displayed emotion.
The performance was scored based on overall accuracy (total correct answers out of 7), with higher scores indicating a better capacity for facial emotion recognition.
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From enrollment to the end of treatment at 6 weeks and 3-month follow up
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Subjective well-being
Tijdsspanne: From enrollment to the end of treatment at 6 weeks and 3-month follow-up
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The 4-item Subjective Happiness Scale (SHS) was utilized to measure subjective happiness.
Respondents rated items on a 7-point Likert scale (1 = strongly disagree 1=strongly disagree, 7 = strongly agree 7=strongly agree).
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From enrollment to the end of treatment at 6 weeks and 3-month follow-up
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ADHD symptoms
Tijdsspanne: From enrollment to the end of treatment at 6 weeks and 3-month follow up
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The teacher-rated Chinese version of the Swanson, Nolan, and Pelham, Version IV (SNAP-IV-18) 18-item scale, which assesses inattention (9 items) and hyperactivity/ impulsivity (9 items).
A 4-point Likert scale will be used, ranging from 0 (not at all) to 3 (very much).
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From enrollment to the end of treatment at 6 weeks and 3-month follow up
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Satisfaction of the intervention
Tijdsspanne: At 6 weeks (post-intervention)
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Evaluated using a child-friendly, single-item 7-point visual facial Likert scale.
Children were directly asked to rate their overall satisfaction with the photography-based program by selecting one of seven standardized facial expressions, ranging from 1 (a very unhappy/dissatisfied face) to 7 (a very happy/satisfied face).
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At 6 weeks (post-intervention)
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Feasibility of the study
Tijdsspanne: From enrollment to the end of treatment at 6 weeks and 3-month follow up
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Operationalized through intervention attendance, completion rates, and protocol adherence.
Attendance was tracked weekly by group facilitators, with successful feasibility defined a priori as an overall session attendance rate of ≥ 80 % and a study completion/retention rate of ≥ 85 % across the 6-week intervention period.
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From enrollment to the end of treatment at 6 weeks and 3-month follow up
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Medewerkers en onderzoekers
Onderzoekers
- Hoofdonderzoeker: Ka Po Wong, PhD, The Hong Kong Polytechnic University
Publicaties en nuttige links
Nuttige links
Studie record data
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Studie start (Werkelijk)
Primaire voltooiing (Geschat)
Studie voltooiing (Geschat)
Studieregistratiedata
Eerst ingediend
Eerst ingediend dat voldeed aan de QC-criteria
Eerst geplaatst (Werkelijk)
Updates van studierecords
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Meer informatie
Termen gerelateerd aan deze studie
Trefwoorden
Aanvullende relevante MeSH-voorwaarden
Andere studie-ID-nummers
- HSEARS20230714001
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