An evidence-based AI Virtual Assistant for young people with ADHD: Co-design and prototype development (Preprint)

BACKGROUND: Though attention deficit hyperactivity disorder (ADHD) is thought to be the most prevalent neurodevelopmental disorder in young people worldwide, there are inequalities in access to psychoeducation and health care support. One way to improve access, potentially increase engagement, reduce health care inequalities, and enhance care is by co-developing digital responsive interventions. These have the potential to support long-term condition management and to act as an adjunct to usual care. Virtual assistants that use large language models can provide information in response to questions and learn to tailor communication to suit an individual user's needs. This can be especially valuable for people with ADHD who often struggle to regulate attention and can experience communication challenges. Involving people with lived experience in the co-design process is crucial for the development of effective digital interventions. Therefore, this article explores the views and preferences of young people with ADHD and their supporters from the United Kingdom who collaborated with researchers to co-design a prototype chatbot. OBJECTIVE: This study aimed to co-develop an evidence-based chatbot prototype, intended to help young people with ADHD thrive through improved access to health care information, psychoeducation, and self-management strategies. METHODS: An interdisciplinary team was established, including researchers, software developers, clinicians, and lived experience collaborators. Research advisory and working groups were set up in ways that facilitated flexible involvement. Following the person-based approach, guiding principles were established, and workshops were held with young people with ADHD and supporters of young people with ADHD to co-develop an early prototype. Feedback was sought via think-aloud interviews with lived experience collaborators. RESULTS: In total, 9 experts by lived experience and 3 health care professionals chose to engage in workshops, and this feedback informed the development of a SmartADHD chatbot prototype. An off-the-shelf chatbot (GPT-4o hosted on Convai) was trained using resources from the National Health Service (NHS). Overall, 6 experts by lived experience engaged with think-aloud interviews, providing feedback on the prototype conversational flow and feel, the avatar, the text-to-speech, the chatbox feature, and the content of the messages. Seven recommendations are made for future development, which will inform the SmartADHD program of work. CONCLUSIONS: These findings provide rich data on the preferences of people with ADHD. Specific recommendations for a chatbot for young adults with ADHD have not been investigated before with young people, making this study a novel contribution to the field. These findings provide an excellent foundation for chatbot development for this group and may be relevant for those developing digital tools for people with ADHD across the lifespan and other neurodevelopmental conditions. Further work is required to elucidate the views of health care professionals and identify the limits of the technology before subsequent evaluation.

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