This thesis investigates how game design may create conditions for social interaction to emerge naturally between children with Attention Deficit Hyperactivity Disorder (ADHD) and their neurotypical peers, without relying on prescriptive instruction, predefined roles, or performance-based evaluation. Contemporary approaches to inclusion in game-based and therapeutic contexts often position children with ADHD as subjects who must learn, adapt, or be corrected within existing social frameworks, an approach that risks reproducing the same performance pressures it seeks to reduce. This study proposes an alternative: rather than treating interaction as a skill to be taught, it treats interaction as an environmental, emergent, and relational process, one that can be supported through deliberate design rather than directed through instruction. Grounded in a review of childhood peer dynamics, digital communication patterns, ADHD-specific interaction characteristics, and existing game-based approaches to social engagement, the study develops a design framework of twelve environmental and interaction parameters, informed further by a semi-structured interview with a professional working directly with children with ADHD. This framework is translated into Echo, a shared forest world for two players built around a distributed signal mechanic, with no score, assigned roles, or evaluative objectives. A working prototype was developed using Unity and Netcode for GameObjects, and evaluated through two exploratory observation sessions, each involving a different dyad of one neurotypical child and one child with ADHD. Findings suggest that uninstructed, spontaneous interaction may emerge under these conditions, most clearly in a six-minute episode of coordinated, wordless movement between two children with no prior relationship. The evaluation also surfaced a variable not fully anticipated by the original framework: mechanical legibility, the degree to which an environment’s responses are understandable to a child without external explanation. In the observed sessions, this appeared to be as consequential to engagement as the absence of instruction itself. A technical defect encountered during testing produced disengagement that functioned similarly to a designed failure state, suggesting that environmental reliability is inseparable from the design philosophy this thesis advances. Based on this preliminary evidence, the thesis argues that inclusive interaction design requires attention not only to openness and non-judgement, but also to the legibility and reliability of the shared environment itself. Echo therefore does not reject structure altogether; rather, it explores a non-prescriptive, non-evaluative, and mechanically legible form of structure. Given the limited scale of the evaluation, two dyads across two sessions, these findings are presented as indicative and hypothesis-generating rather than conclusive, with directions for further testing, refinement, and validation outlined for future research.
Questa tesi indaga come il game design possa contribuire a creare le condizioni affinché l’interazione sociale emerga in modo naturale tra bambini con Disturbo da Deficit di Attenzione e Iperattività (ADHD) e i loro coetanei neurotipici, senza fare ricorso a istruzioni prescrittive, ruoli predefiniti o valutazioni basate sulla prestazione. Gli approcci contemporanei all’inclusione in contesti ludici e terapeutici tendono spesso a posizionare i bambini con ADHD come soggetti che devono imparare, adattarsi o essere corretti all’interno di sistemi sociali esistenti, un approccio che rischia di riprodurre proprio le pressioni prestazionali che intende ridurre. Questo studio propone un’alternativa: anziché considerare l’interazione come un’abilità da insegnare, la tratta come un processo ambientale, emergente e relazionale, che può essere sostenuto attraverso scelte progettuali deliberate piuttosto che diretto attraverso l’istruzione. Sulla base di una revisione della letteratura sulle dinamiche tra pari nell’infanzia, sui modelli di comunicazione digitale, sulle caratteristiche interazionali specifiche dell’ADHD e sugli approcci ludici esistenti all’inclusione sociale, lo studio sviluppa un framework progettuale composto da dodici parametri ambientali e interazionali, ulteriormente informato da un’intervista semi-strutturata con una professionista che lavora direttamente con bambini con ADHD. Questo framework è tradotto in Echo, un mondo-foresta condiviso per due giocatori, costruito attorno a una meccanica di segnale distribuito, privo di punteggio, ruoli assegnati o obiettivi valutativi. È stato sviluppato un prototipo funzionante utilizzando Unity e Netcode for GameObjects, valutato attraverso due sessioni osservative esplorative, ciascuna con una coppia diversa composta da un bambino neurotipico e un bambino con ADHD. I risultati suggeriscono che un’interazione spontanea e non istruita possa emergere in queste condizioni, in modo particolarmente evidente in un episodio di sei minuti di movimento coordinato e privo di comunicazione verbale tra due bambini privi di qualsiasi relazione pregressa. La valutazione ha inoltre messo in luce una variabile non pienamente anticipata dal framework originario: la leggibilità meccanica, ovvero il grado in cui le risposte di un ambiente risultano comprensibili a un bambino senza bisogno di una spiegazione esterna. Nelle sessioni osservate, questa variabile è apparsa tanto rilevante per il coinvolgimento quanto l’assenza di istruzioni stessa. Un difetto tecnico riscontrato durante i test ha prodotto un disimpegno che ha funzionato in modo simile a uno stato di fallimento progettato, suggerendo che l’affidabilità ambientale sia inseparabile dalla filosofia progettuale sostenuta da questa tesi. Sulla base di queste evidenze preliminari, la tesi sostiene che il design dell’interazione inclusiva richieda attenzione non solo all’apertura e all’assenza di giudizio, ma anche alla leggibilità e all’affidabilità dell’ambiente condiviso stesso. Echo, quindi, non rifiuta del tutto la struttura; esplora piuttosto una forma di struttura non prescrittiva, non valutativa e meccanicamente leggibile. Data la scala limitata della valutazione, due coppie in due sessioni, questi risultati vengono presentati come indicativi e generatori di ipotesi piuttosto che conclusivi, con indicazioni per ulteriori test, affinamenti e validazioni delineate per la ricerca futura.
Designing echo: an environment-mediated approach to emergent social interaction between children with ADHD and neurotypical peers
Turkoz, Iklima Ikbal
2025/2026
Abstract
This thesis investigates how game design may create conditions for social interaction to emerge naturally between children with Attention Deficit Hyperactivity Disorder (ADHD) and their neurotypical peers, without relying on prescriptive instruction, predefined roles, or performance-based evaluation. Contemporary approaches to inclusion in game-based and therapeutic contexts often position children with ADHD as subjects who must learn, adapt, or be corrected within existing social frameworks, an approach that risks reproducing the same performance pressures it seeks to reduce. This study proposes an alternative: rather than treating interaction as a skill to be taught, it treats interaction as an environmental, emergent, and relational process, one that can be supported through deliberate design rather than directed through instruction. Grounded in a review of childhood peer dynamics, digital communication patterns, ADHD-specific interaction characteristics, and existing game-based approaches to social engagement, the study develops a design framework of twelve environmental and interaction parameters, informed further by a semi-structured interview with a professional working directly with children with ADHD. This framework is translated into Echo, a shared forest world for two players built around a distributed signal mechanic, with no score, assigned roles, or evaluative objectives. A working prototype was developed using Unity and Netcode for GameObjects, and evaluated through two exploratory observation sessions, each involving a different dyad of one neurotypical child and one child with ADHD. Findings suggest that uninstructed, spontaneous interaction may emerge under these conditions, most clearly in a six-minute episode of coordinated, wordless movement between two children with no prior relationship. The evaluation also surfaced a variable not fully anticipated by the original framework: mechanical legibility, the degree to which an environment’s responses are understandable to a child without external explanation. In the observed sessions, this appeared to be as consequential to engagement as the absence of instruction itself. A technical defect encountered during testing produced disengagement that functioned similarly to a designed failure state, suggesting that environmental reliability is inseparable from the design philosophy this thesis advances. Based on this preliminary evidence, the thesis argues that inclusive interaction design requires attention not only to openness and non-judgement, but also to the legibility and reliability of the shared environment itself. Echo therefore does not reject structure altogether; rather, it explores a non-prescriptive, non-evaluative, and mechanically legible form of structure. Given the limited scale of the evaluation, two dyads across two sessions, these findings are presented as indicative and hypothesis-generating rather than conclusive, with directions for further testing, refinement, and validation outlined for future research.| File | Dimensione | Formato | |
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https://hdl.handle.net/10589/260567