Design of Deep Breathing Exercise Facilitation Technology as a Digital Cognitive Behavioral Therapeutic Intervention for Children with Attention Deficit Hyperactivity Disorder

This study developed an ICT-integrated wearable deep breathing facilitation technology to address key challenges in implementing and managing deep breathing exercises—one of the most widely used cognitive behavioral therapy (CBT) techniques for children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD). These challenges include low adherence, difficulty in systematic administration, and lack of objective clinical data collection [1–3]. The proposed system consists of two main components: a belt-type wearable device that monitors the child’s real-time respiratory activity, and a dual mobile app package designed respectively for children with ADHD and their caregivers. The wearable device detects abdominal expansion during breathing and transmits the data wirelessly via Bluetooth Low Energy to the mobile application.

The child-facing app delivers personalized deep breathing training in the form of an engaging fishing game. It incorporates both visual and auditory feedback to help children intuitively follow the breathing guidance. The caregiver-facing app (for parents, clinicians, or special education teachers) provides functionality for (1) customizing the training content and schedule, (2) reviewing training results, and (3) sending notifications and encouragement. Specifically, caregivers can prescribe breathing exercises tailored to the child’s daily routine and skill level, and evaluate adherence by comparing the recorded breathing patterns with the prescribed patterns using visual graphs. Furthermore, based on Parent-Child Interaction Therapy (PCIT), caregivers can enhance engagement by sending motivational messages, thereby encouraging consistent participation in CBT.

This system is expected to serve as a more effective digital support tool for ADHD cognitive behavioral therapy than traditional methods. Future work will focus on miniaturizing the wearable device and refining the UX/UI of the mobile applications, followed by pilot distribution to target users and professionals to evaluate usability and therapeutic effectiveness.