Creating the Focus Score: A Breakthrough in Measuring Attention for ADHD Treatment
The Need for Objective Attention Metrics
In this UX case study, we explore the design and implementation of the Focus Score, a game-play derived metric intended to correlate with improved attention function in players of a video game treatment for ADHD.
The main objective is to give the player meaningful feedback about their progress and encourage consistent use of the treatment.
My role: lead UX/UI designer
Akili’s Video Game-Based ADHD Treatment
To provide a non-pharmacological treatment for ADHD, Akili developed a video game-based treatment targeting improved attention and focus in 8-12-year-olds that has been available with a prescription since 2020. More recently, Akili made the same treatment product available for adults.
Through early feedback, we got a clear signal that this new user base felt they were missing a way to measure their progress and help them understand if the treatment was making an impact.
70% of users requested that we “Add a way to track progress in Attention and Focus”.
“Seeing improved focus would be a huge benefit... like a graph or number that shows focus level, which is different than game scores”
“It can give a reinforcement that this is helping you and that it’s okay if you’re struggling because you can see how much progress you’ve made over time... It’s cool to see that you’re improving and sometimes that’s hard with games like this because you can feel kind of defeated when you’re not doing well. Having results can help.” - User research participant
In addition to user feedback, there is a lot of health industry evidence that suggests providing individuals with real-time feedback on their performance can significantly increase their engagement with a task; see Measurement-Based Care. The Focus Score aims to leverage this principle by providing them with a way proactively manage their focus.
“What you can measure you can manage.”
Designing a Meaningful Metric
Design a game-play-derived metric that quantifies a player's attention and focus during gameplay.
Ensure the metric positively correlates with improved attention function in ADHD patients.
Design an intuitive and visually appealing UI to display the metric and related information.
Incorporate gamification elements into the design to improve it’s effectiveness.
Incorporate this metric into a free-trial experience that increases subscriptions and perceived product value.
Ideation & Design: Crafting the Experience
The Focus Score metric was developed by the Cognitive Data Science team at Akili. Game-derived cognitive performance metrics were mapped onto cognitive processes (Focus/Sustained Attention, Distractibility, Impulsivity, etc) to develop the metric.
To design how the data would be presented to the users, I performed a competitive analysis and collected external inspiration from other relevant offerings to help guide our creative collaboration.
Next, we held a cross-functional ideation workshop where all stakeholders could sketch low-fidelity ideas and think visually about how we might convey this information.
A Functional Prototype Validated Our Approach
To validate our direction we created a functional prototype that simulated a 7-day free trial of the treatment with the Focus Score concept included and conducted usability testing sessions to collect feedback on the game mechanics, Focus Score comprehension, and value.
Bringing Focus Score to Life
Informed by the findings from our research, we created high-fidelity mockups and functional specifications for the final list of features that were to be included in the release. We collaborated with developers to integrate the Focus Score into the game's codebase and existing game flows.
In parallel, our data science team conducted thorough testing to ensure the accuracy and reliability of the Focus Score calculation. Across 3 clinical studies (pediatric, adolescent, adult ADHD), we found that improvement in Focus Score is significantly correlated to improved ADHD symptoms, validating that this was a meaningful measurement for our users.
Early Success Indicators and Ongoing Analysis
User feedback indicated high satisfaction with the Focus Score - it was rated as 2nd most important (after clinical validity) on a list of what people liked most about the product.
Continuous Improvement and Patient Outcomes
By providing players with a meaningful and engaging metric that correlates with improved attention function, the game will motivate players to manage their ADHD symptoms actively. The project demonstrates the potential of gamification and UX design in contributing to digital therapeutic treatment compliance. Continuous monitoring and user feedback will remain essential for ongoing improvements and refinements to ensure the best possible outcomes for patients.
Bonus: Gamification Insights
The Octalysis Framework for Gamification & Behavioral Design, developed by Yu-kai Chou, is a gamification framework that identifies eight core drives that motivate human behavior. Each core drive represents a different aspect of motivation and engagement. The Focus Score addresses multiple core drives from the Octalysis framework, including:
Core Drive 2: Development & Accomplishment - The Focus Score provides players with a sense of accomplishment and progress as they strive to improve their attention and focus during gameplay. By earning higher focus scores, players feel a sense of development and achievement in managing their ADHD symptoms effectively.
Core Drive 4: Ownership & Possession - As players see their Focus Score improve over time, they develop a sense of ownership over their progress. They become more attached to their achievements, further motivating them to continue using the treatment video game and aiming for higher scores.
Core Drive 6: Scarcity & Impatience - The Focus Score introduces a time-sensitive element to gameplay, as players must play 15 missions to unlock their next score. This scarcity creates a sense of urgency and impatience, pushing players to remain engaged and committed to improving their performance.
Core Drive 8: Loss & Avoidance - As players become invested in their Focus Score and its relationship to their attention function, they become driven to avoid distractions and lapses in focus during gameplay. The fear of losing progress and potential rewards encourages players to remain focused and committed to the treatment.
Leveraging these core drives, we believe creates a compelling and motivating user experience.