Prevalence
Estimated ADHD diagnoses in USA (2023)
- 7‑18% all children
- 4‑4.5% all adults
However,
- ADHD is a lifespan neurological disorder
- Not simply outgrown with age
- 60‑80% of ADHD symptoms continue into adulthood
UX Research Case Study
Adults with ADHD Engaging with
Online Learning Platforms
How does the design of online learning platforms shape the experience of adult learners with attention‑deficit/hyperactivity disorder?
Goals
- Fill the UX research gap on adults with ADHD and online learning
- Investigate experiences engaging with online learning platforms
- Translate into inclusive design considerations for online learning platforms
Background
ADHD Symptoms
- Inattention, impulsivity, hyperactivity
In adults, this looks like:
- Disorganization and problems prioritizing
- Poor time management skills
- Problems focusing on a task
- Trouble multitasking
- Excessive activity or restlessness
- Poor planning
- Low frustration tolerance
- Frequent mood swings/hot temper
- Problems following through/completing tasks
- Trouble coping with stress
Online Learning
- Growing in popularity since 2010, but especially due to the COVID‑19 pandemic
- Over 10 million online college students (NCES 2022)
- 90% of companies offer employee's online learning/training (LinkedIn 2018)
- 22 million American Coursera users (2023)
Methodology
The project moved through four stages, each one feeding the next.
Step 01
Literature Review
To start my research, I looked to existing publications that might offer insight into my research question. Below is a recap of some of the most relevant work to my project, however, I failed to find a resource that studied the same intersectionality of adult ADHD and online learning.
Step 02
User Interviews
Semi-Structured Interview Protocol
Call opening
- Greet and thank participant for joining
- Request permission to record
- Review purpose of research
- Provide housekeeping reminders (informed consent/research participant rights)
- Ask participant if they have any questions and answer accordingly
Interview questions
- I'd like you to begin by telling me a little about yourself as a student and how you used online learning platforms?
- Could you describe your current relationship with education?
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Can you talk about the online learning platform you are currently/recently using and your experience with that?
- How does that compare to a course you had that did not use a learning platform or that was different in some meaningful way?
- Which features of [the online learning platform] have had a positive impact on your learning?
- Conversely, which features of [the online learning platform] had a negative impact on your learning?
- What could or should online learning platforms do differently in the future to make online learning work better for adults with ADHD?
- What haven't I asked you today that you think would be valuable for me to know?
Recruitment
-
Requirements:
- 18 years or older
- Has ADHD/ADD
- Uses/used an online learning platform
- Resides in the USA
- Recruited via personal Facebook, Instagram, LinkedIn, Reddit accounts.
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Participants filled out a Research Participant Interest Form virtually, confirming they:
- Meet the above requirements
- Reviewed the informed consent and wish to continue
- Have availability to meet during timeframe interviews were being conducted
- 7 total interviews were scheduled and conducted via Zoom on a rolling basis
Participant Overview
Step 03
Affinity Mapping
Using Dovetail, transcripts were reduced to notes, then clustered bottom‑up across five passes until stable themes emerged.
-
1
Transcribe
Every session transcribed in full and stripped of identifying detail.
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2
Extract
Individual observations pulled onto discrete notes, one idea per note.
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3
Cluster
Notes grouped by similarity without predetermined categories.
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4
Label
Each cluster named, split or merged as the grouping settled.
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5
Synthesise
Themes translated into the design considerations below.
Final Categories
Seven categories emerged from the clustering, each holding its own set of sub‑categories.
Step 04
Design Considerations
Eight considerations for teams building and or researching learning products, based on participant insight.
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Provide Insights to Students
Participant insight
Helpful to be able to calibrate where they are in the course/content in terms of what they have already completed and what still remains open.
Reduces feeling overwhelmed with outstanding assignments and due dates.
Clear tracking of individual grades and their weights towards the final grade helps them see their success in the course and or where effort needs to be allocated.
Easy to hyperfixate on low-value add work when there is time-extensive work waiting to be completed.
What this might look like
- Progress bars: visualize (and link to) what is completed / remains for a course or specific content.
- Grades: display assignment weights and clear breakdown of success or where improvement is needed.
- Time spent: inform user of elapsed time spent on item to help prioritize time / effort on other activities.
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Gamify Interactions
Participant insight
Easy to lose interest in things and thus lose motivation to do said uninteresting things.
For example, Participant 9 described the relationship between grades and interest level as directly related: “if it's something I'm not super interested in, I'd say that's less favorable for my grades. And then, if it's something I'm interested in, that tends to be better in terms of the grades.” Similarly, they described that it felt “kind of a chore like a chore to study because if it wasn't something I felt like I was interested in, then there was no like spark to try, in a sense.”
Need something to maintain interest and motivation; for many it is the threat of failing.
What this might look like
- Screen effects: instantly reward the student for completing a learning / submitting assignments with celebratory design, such as confetti momentarily popping on the screen.
- Leaderboard: create incentive for specific actions by highlighting user metrics in relation to that of their peers.
- Learning achievements: creative incentive for specific actions by defining points of achievement and awarding user with a fun designation/collectible reflecting their status.
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Help Time Management
Participant insight
Due dates for deliverables need to be apparent, clear, and easy to find. If this information is mixed in with other details or not in the place they would expect it to be, they will lose track.
Even if a due date is clear, automated reminders and notifications help combat time blindness and forgetfulness.
Participant 3 attributes a positive impact to their online learning to “just knowing when an assignment is due and then also, you know, just getting the email reminders like you have an assignment due in two days or whatever is helpful to stay on top of things.”
What this might look like
- Reminders: automatically send reminders pertaining to upcoming/late due dates for work not yet submitted.
- Calendar feature: automatically add all course(s) deliverables to a single calendar.
- Highlight important information: visually bring attention to important information through the use of color, size, or bold fonts.
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Provide Access to Materials
Participant insight
The online platform serving as a “one stop shop” for all course materials and documents helps provide security as it removes the possibility of them losing a paper copy like in traditional settings.
Having a source of truth updated directly by the instructor eases concerns about missing critical notes about due dates / details jotted down somewhere or having outdated/incorrect information without realizing.
Searchability for and within documents is important. If the information cannot be found due to disorganization or no search feature, then its utility is partially lost by the manual effort to find it.
Knowing that a lecture is going to be recorded and be available online allows for active listening during the lecture and eliminates hectic/distracting notetaking practices, both allowing for more effective learning.
What this might look like
- Video recordings: exist in a repository or location relevant to course organization, should be available 24/7 with ability to pause/rewind/fast forward/adjust speed and dialogue transcriptions.
- Mobile version: enable mobile devices to have the same access to content on the go to increase flexibility and convenience for users.
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Create Manageable Structure
Participant insight
Task paralysis / difficulty breaking down steps to tackle time/effort intensive work.
For example, Participant 5 described how “When there's a lot of things in front of me that I have to do, I can't like focus on just the one I see. Like if I have 4 assignments due it like stresses me out to the point of where I can't even do one at a time. That still bothers me today […] like right now, I have 4 different papers on my desk, and for the last hour I was refreshing Google's homepage.”
Without any enforced structure, they will put off the work until the last minute.
For example, Participant 10 said: “if you just give me every single lecture, and it's like watch one a week, I will not be doing that. I will be waiting until the last week. I will watch them all, and then I will finish the project. I cannot do it; I do not have the kind of discipline to do things incrementally.”
What this might look like
- Incremental submissions: provide due dates for different project milestones that need to be submitted between its assignment date and final due date.
- Bite size learning: create materials or short videos with summaries/key points per concept.
- Section reinforcement: offer low-stakes/optional quizzes or modules after each section.
- Practice/study content: generate practice materials or study guides that pull from each section's key concepts.
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Offer Diverse Modes/Activities
Participant insight
Types of activities and assignments vary by professor or area of study; some learn / perform better with one type versus another.
For example, Participant 8 reported easily getting bored and distracted due to the learning format but wished that professors “diversified the type of exam style instead of it just being reading and answering questions, or like essay writing. I think in higher academia that's really the only way that they gauge learners. I feel like when you're younger, they give other ways of presentation […] like, write a rap song, or like make a movie, or something like that, whereas in law school, because of the time constraint and the content that they have to teach in such limited time, the professors don't really care to focus so much on the pedagogy.”
What this might look like
- Different modes: ability to activate a mode based on type of learner (visual/auditorial/etc) to engage with content in a format best suited to learning style.
- Various activities: provide options on how to be evaluated on material since some students might apply their knowledge better in a multiple-choice quiz versus an essay versus a creative project, etc.
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Enable Connection
Participant insight
Harder to ask questions about the course and its materials in a virtual setting than in a traditional setting.
May not know if the professor would answer in time/at all or understand/answer the question over written communication effectively.
Difficult to connect with classmates like they would in-person to form study groups or work together.
Participant 6 described working asynchronously and in isolation as feeling “very detached, so there was just no incentive to keep going.”
Discussion board post requirements, however, feel forced / unnatural and are not helpful in connecting with classmates.
What this might look like
- Virtual office hours: instructor defines days/times and virtual meeting place (e.g. Zoom) in which students can reach them in a live setting to real-time address questions/ concerns/ comments.
- Low-stakes / semi-structured connections between classmates: pair students intentionally and provide general guidelines as to what they need to discuss together that is relevant and will help them with the course.
- Class list availability: students can opt-in to have their name / contact information / topics open to discussing visible for others in the class to see to drive natural connections.
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Reduce Distractions
Participant insight
Easy to wander away from learning platform to find something more engaging on the internet/device, especially without authority present.
For example, Participant 7 said that “if you have an assignment on BlackBoard [it's been normalized] to be clicking around on Google or on social media. I mean, yeah, it's much harder like online, since you're not forced in a classroom with the professor that can easily see what you're doing.”
The organization of the online course and its materials are highly dependent on the instructor, causing them to relearn and adjust to where content is with new instructors.
When they don't know where to look, they're more likely to lose their momentum or stumble upon something else and get carried away.
What this might look like
- Consistent organization and navigation: instill platform-wide shell course organization layout and best-practices to instructors that need to customize to their course content's needs.
- Window blocker: option to activate a window blocker that will prevent clicks outside of the window to help prevent deviation from course work.
- Cross-application integration: provide direct links to non-platform material or tools or embed directly into the tool where possible.
- Incorporate focus awareness: alert the user of behaviors that suggest they are not paying attention to the task at hand.
Discussion
Limitations
- Only 7 participants
- Did not collect demographic information
- Did not collect medical information (besides diagnosis)
- Use of online learning platforms varied from fully‑dependent (fully virtual) to augmented use (in person but used for submitting assignments)
Takeaways
- Additional research and methods are needed to make design considerations more concrete.
- Many of these design considerations would be helpful for online students beyond the adult ADHD audience.
- Generative AI could help make a lot of these “modalities” / customizations possible.
- Improving the accessibility design of online learning platforms to include adults with ADHD will help reduce potential hesitations towards enrolling by providing a more equitable educational environment which will hopefully lead to more completed programs and success stories for this population.
References
- Cretu, Daniela-Maria. “Learning to Teach Students With Attention Deficit Hyperactivity Disorder: Training Experiences for Teachers.” Handbook of Research on Student-Centered Strategies in Online Adult Learning Environments, IGI Global, 2018, pp. 319–38, https://doi.org/10.4018/978-1-5225-5085-3.ch015.
- Daley, D., and Birchwood, J. (2010). ADHD and academic performance: why does ADHD impact on academic performance and what can be done to support ADHD children in the classroom? Child: Care, Health and Development, 36: 455–464. https://doi.org/10.1111/j.1365-2214.2009.01046.x.
- Fitzgerald, Carlton J., et al. Handbook of Research on Student-Centered Strategies in Online Adult Learning Environments. IGI Global, 2018, https://doi.org/10.4018/978-1-5225-5085-3.
- Husain, Fatemah. Investigating Current State-of-The-Art Applications of Supportive Technologies for Individuals with ADHD. 2020, https://doi.org/10.48550/arxiv.2005.09993.
- Kim, Junghwan, Heh Youn Shin, Kim L. Smith, and Jihee Hwang. “Online Higher Education for Nontraditional Adult Students: Best Cases of Public Universities.” Handbook of Research on Student-Centered Strategies in Online Adult Learning Environments, IGI Global, 2018, pp. 221–40, https://doi.org/10.4018/978-1-5225-5085-3.ch011.
- Majarwitz, Daniel J., and Parvathi Perumareddi. “Attention-Deficit/Hyperactivity Disorder Across the Spectrum: From Childhood to Adulthood.” Primary Care, vol. 50, no. 1, 2023, pp. 21–36, https://doi.org/10.1016/j.pop.2022.10.004.
- National Center for Education Statistics. (2022). Undergraduate Enrollment. Condition of Education. U.S. Department of Education, Institute of Education Sciences. Retrieved May 31, 2022, from https://nces.ed.gov/programs/coe/indicator/cha.
- Nielsen, Jakob. “Enhancing the Explanatory Power of Usability Heuristics.” Proceedings of the SIGCHI Conference on Human Factors in Computing Systems, ACM, 1994, pp. 152–58, https://doi.org/10.1145/191666.191729.
- Sonne, T., Marshall, P., Obel, C., Thomsen, P. H., and Gronbaek, K. (2016). An assistive technology design framework for ADHD. In Proceedings of the 28th Australian Conference on Computer-Human Interaction (OzCHI ’16), 60–70. https://doi.org/10.1145/3010915.3010925.
- Ulberstad, Fredrik, et al. “Objective Measurement of Attention Deficit Hyperactivity Disorder Symptoms Outside the Clinic Using the QbCheck: Reliability and Validity.” International Journal of Methods in Psychiatric Research, vol. 29, no. 2, 2020, p. e1822–n/a, https://doi.org/10.1002/mpr.1822.
- U.S. Department of Education, National Center for Education Statistics (2022). Impact of the Coronavirus (COVID-19) Pandemic on Public and Private Elementary and Secondary Education in the United States (Preliminary Data): Results from the 2020–21 National Teacher and Principal Survey (NTPS).
- Wood, Johnny. “These 3 Charts Show the Global Growth in Online Learning.” World Economic Forum, 27 Jan. 2022, weforum.org/agenda/2022/01/online-learning-courses-reskill-skills-gap.