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The aims are to evaluate the feasibility and acceptability of the photography-based intervention in children with ADHD and to provide preliminary evidence of its effectiveness in alleviating emotion recognition, attention, and impulsivity in this population. Photo-taking is a common daily activity that significantly impacts people's lives. Given the effectiveness of photography in addressing social skills, communication, and emotional well-being, and its ease of use, a photography-based intervention is proposed as an adjunct tool to teach children with ADHD emotional recognition and improve their ADHD symptoms. To the best of my knowledge, no previous study has adopted photography to teach emotional recognition in children with ADHD. This photography-based intervention not only teaches children with ADHD photography skills but also improves their ability to recognize and express emotions. Appropriate emotional processing and expression may have a positive impact on these children's confidence and ability to develop and maintain positive relationships with their peers, leading to better overall well-being and social integration.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Photography-based intervention group | Experimental | 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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| Waitlist control group | No Intervention | 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. |
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Photography-based psychoedication | Behavioral | 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. |
| Measure | Description | Time Frame |
|---|---|---|
| Emotional Awareness | Participants' emotional functioning was evaluated by a licensed clinical psychologist using an adapted version of the Emotion Awareness Questionnaire (EAQ; Rieffe et al., 2007). 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). | From enrollment to the end of treatment at 8 weeks and 3-month follow-up |
| Measure | Description | Time Frame |
|---|---|---|
| Emotion Recognition | 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 established by Ekman and Friesen (1975). 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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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ka Po Wong | Hong Kong | Hong Kong | Hong Kong |
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| ID | Term |
|---|---|
| D001289 | Attention Deficit Disorder with Hyperactivity |
| D007175 | Impulsive Behavior |
| ID | Term |
|---|---|
| D019958 | Attention Deficit and Disruptive Behavior Disorders |
| D065886 | Neurodevelopmental Disorders |
| D001523 | Mental Disorders |
| D001519 | Behavior |
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| From enrollment to the end of treatment at 8 weeks and 3-month follow up |
| Happiness | The 4-item Subjective Happiness Scale (SHS; Lyubomirsky & Lepper, 1999) 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). | From enrollment to the end of treatment at 8 weeks and 3-month follow-up |
| ADHD symptoms | The teacher-rated Chinese version of the Swanson, Nolan, and Pelham, Version IV (SNAP-IV-18) 18-item scale (Swanson, 1992), 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). | From enrollment to the end of treatment at 8 weeks and 3-month follow up |