ADHD Remote Technology and ADHD Transition:Predicting and Preventing Negative Outcomes (ART-transition) - An Adolescent Prospective Cohort Study Protocol

Background: Late adolescence is a highly challenging and potentially critical period for young people with attention deficit hyperactivity disorder (ADHD). Many of the conditions that frequently co-occur with ADHD, such as depression, often first emerge in adolescence. Major life transitions, such as moving out of the parental home, lead to multiple new demands and changes in available support networks, further increasing the vulnerability. Additionally, UK data show that most young people with ADHD do not successfully transfer to adult services and thus do not receive appropriate interventions at a time when they may need them most. The lack of well-defined targets for holistic interventions limits opportunities for intervention. Our project on ADHD transition - ADHD Remote Technology and ADHD Transition: predicting and preventing negative outcomes (ART-transition) - uses remote measurement technology (RMT), which offers the potential to obtain ongoing, long-term, real-world data. We aim to identify the nature and timing of real-world changes in the transition to adulthood and what predicts such changes. We will further use these timeframes and intervention targets to co-design, with young people with ADHD, a prototype for an ADHD transition interactive smartphone app.<br/>Methods: ART-transition is a prospective cohort study that will recruit 250 16-17-year-olds with ADHD. The participants will complete baseline assessments, including an ADHD clinical interview, questionnaires, and cognitive tasks. Participants will then be monitored remotely over 24 months. Passive monitoring, which involves the participants wearing a wrist-worn device (Fitbit Charge 6) and downloading the study Passive App on their smartphone, will provide ongoing data collection on a range of variables, such as physical activity, sleep, heart rate, smartphone usage including social connectivity, and the environment (e.g. ambient noise, relative location). Active remote monitoring involves the participant downloading the study Active App to complete tasks (such as clinical questionnaires and speech tasks) and using a PC/laptop to complete cognitive tasks. The ADHD Remote Technology (ART) system is built on the RADAR-base mobile-health platform.<br/>Discussion: ART-transition will use RMT to identify fluctuations in ADHD symptoms and the wider phenotype at a level of detail not previously possible and to identify real-world targets for intervention.