Development of an application with a playful interface for the practice of controlled ventilation, based on biofeedback of cardiorespiratory signals, and a web platform for the treatment and monitoring of children with ADHD

Abstract

Attention Deficit/Hyperactivity Disorder (ADHD) is one of the most common neuropsychiatric disorders in childhood, affecting between 5 and 9% of children worldwide. It is characterized by inattention and/or hyperactivity behaviors (DSM-5). Clinical studies have already shown that behavioral changes in ADHD are associated with autonomic control dysfunction, with increased sympathetic tone and reduced vagal tone, in addition to changes in breathing pattern. With regard to treatment, 20% to 25% of ADHD patients do not respond to medication and some side effects can be observed, leading to treatment discontinuation. Multidisciplinary treatment is considered the gold standard for symptoms improvement, but it is still a challenge due to some aspects, including the demand for face-to-face monitoring in clinics, which often do not have specialists from different areas. In addition, it requires great dedication and interaction of the team, parents and professionals. The aim of this project is the development and implementation of an interactive platform for mobile devices, to help ADHD children to perform controlled breathing exercises and induce autonomic balance. The platform will have a suitable interface for children (games) and through breathing exercises, it will stimulate the autonomic balance, usually altered in these patients. Feedback based on extracted parameters from heart rate variability and respiratory rate, obtained during therapeutic sessions, will act as the game control mechanism and achieve self-awareness. These methods are proposed as a complementary solution to the cognitive therapies and pharmacological interventions currently used, and will also allow real time patient monitoring, by different professionals, through a web platform. Combining methods based on scientific research and clinical knowledge, treatments will be conducted in a personalized way, considering the evolution and response to therapy. The tests with patients in the last phase of our schedule, will be guided and supported of by the neuropsychopedagogue Renata Casali, partner of the company, validating the child's interaction with the game based on controlled breathing exercise. The product will be developed by Self, a company of software development and commercialization service, to assist online and automatic treatment. Monetization will be given by the sale of the service, in which the clinic rents monthly packages for the use of the tools, incorporating intelligence and technology in its treatment. Marketing and dissemination will occur predominantly on the internet and exhibition at events, whose target audience are professionals from psychology, neuropsychopedagogy, psychiatry, etc., congresses and fairs, visits to hospitals, clinics and schools, in addition to the network of leaders involved in this project. SELF's market is comprehensive and profitable. According to the Pan American Health Organization, half of the planet's population lives in places with less than one psychiatrist per 100,000 population. With the acquisition of services, professionals will be able to reach a larger number of patients and remotely monitor the treatment. The product's market potential is based on the number of children affected by ADHD in Brazil, around 2.8 million. In a plausible projection, it is estimated to reach 5% of this audience in five years, estimated gross revenue is approximately R$ 7,000,000.00 monthly. The flexibility of carrying out the therapy at home, remotely assisted by involved professionals, enhances the possibility to achieve desired outcomes and to improve patient's engagement and management. The long tail product model will allow additional services implementation for cognitive diseases and incorporation in the platform, reaching other needs and niches of market. (AU)