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General rightsThis document is made available in accordance with publisher policies. Please cite only the published version using the reference above. Full terms of use are available: http://www.bristol.ac.uk/pure/about/ebr-terms ABSTRACTDigital self-tracking technologies offer many potential benefits over self-tracking with paper notebooks. However, they are often too rigid to support people's practical and emotional needs in everyday settings. To inform the design of more flexible self-tracking tools, we examine bullet journaling: an analogue and customisable approach for logging and reflecting on everyday life. Analysing a corpus of paper bullet journal photos and related conversations on Instagram, we found that individuals extended and adapted bullet journaling systems to their changing practical and emotional needs through: (1) creating and combining personally meaningful visualisations of different types of trackers, such as habit, mood, and symptom trackers; (2) engaging in mindful reflective thinking through design practices and self-reflective strategies; and (3) posting photos of paper journals online to become part of a selftracking culture of sharing and learning. We outline two interrelated design directions for flexible and mindful selftracking: digitally extending analogue self-tracking and supporting digital self-tracking as a mindful design practice.

Families of children with Attention Deficit Hyperactivity Disorder (ADHD) often report morning and bedtime routines to be stressful and frustrating. Through a design process involving domain professionals and families we designed MOBERO, a smartphone-based system that assists families in establishing healthy morning and bedtime routines with the aim to assist the child in becoming independent and lowering the parents' frustration levels. In a two-week intervention with 13 children with ADHD and their families, MOBERO significantly improved children's independence and reduced parents' frustration levels. Additionally, use of MOBERO was associated with a 16.5% reduction in core ADHD symptoms and an 8.3% improvement in the child's sleep habits, both measured by standardized questionnaires. Our study highlights the potential of assistive technologies to change the everyday practices of families of children with ADHD.

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Breathing exercises can help children with ADHD control their stress level, but it can be hard for a child to sustain attention throughout such an exercise. In this paper, we present ChillFish, a breath-controlled biofeedback game designed in collaboration with ADHD professionals to investigate the possibilities of combining breathing exercises and game design. Based on a pilot study with 16 adults, we found that playing ChillFish had a positive effect, helping the participants to reach a relaxed state similar to the one offered by traditional breathing exercises. Further, we analyze the opportunities and challenges of creating a tangible respiration-based controller and use it as a core game mechanic. Finally, we discuss the challenge of balancing engagement and relaxation in physically controlled games for children with ADHD in order to make a game that can be calming and still sustain their attention.

No research on assistive technologies for families of children with attention deficit hyperactivity disorder (ADHD) has investigated the long-term impact after the assistive technology is returned to the researchers. In this paper, we report the outcomes of a follow-up study, conducted four-weeks after a field study of 13 children with ADHD and their families who used an assistive technology designed to help establish and change family practices. We show that some of the positive effects on parent frustration level and conflict level around morning and bedtime routines that we observed in the first phase of the study, continued even after the technology was taken away from the families. We furthermore present insights into family practices in families of children with ADHD and how these can lead to unexpected challenges and implications related to the adoption, use, and outcome of the assistive technology.

In this paper, we present a design framework for ADHD assistive technologies that aims to give researchers grounding in the background research on the condition, to provide a lingua franca, and to highlight potential research directions for HCI researchers within assistive technology. The design framework couples ADHD patient challenge areas to technological opportunities and it provides a set of practical design strategies for developing successful assistive technologies for people with ADHD. The framework is based on empirical studies, ADHD research, and related work on assistive technologies. We map existing assistive technologies and potential new research efforts to the framework concepts. This way we show how it is used to support and advance the research and development of novel assistive technologies for the ADHD domain.

Blood sampling is a common and necessary procedure in the treatment and diagnosis of a variety of diseases. However, it often results in painful and stressful experiences for children. Designed together with domain experts, Pufferfish is a breath-controlled biofeedback game technology with bespoke airflow sensor that aims to calm children during blood sampling procedures. An initial randomized controlled trial was conducted in which 20 children aged 6-11 were assigned to one of two conditions involving either passive distraction (watching a video) or active distraction using the Pufferfish prototype. Medical staff rated Pufferfish significantly more useful in facilitating the blood sampling procedure compared to passive distraction. Qualitative feedback from patients, parents, and medical staff identified aspects that impact the acceptance of breath-based active distraction. Our study highlights the potential of non-pharmacological assistive technology tools to reduce fear and pain for children undergoing painful or stressful medical treatment.