An interventional study of Photography-based psychoedication in Attention Deficit Hyperactivity Disorder, sponsored by The Hong Kong Polytechnic University. Active, not recruiting at 1 site in Hong Kong. Open to participants aged 8 Years to 12 Years. Per ClinicalTrials.gov, last updated 2026-09-08.
Sponsored by The Hong Kong Polytechnic University · Not applicable, Interventional, and Supportive care
The aims are to evaluate the feasibility and acceptability of the photography-based intervention in children with Attention Deficit Hyperactivity Disorder (ADHD) and to provide preliminary evidence of its effectiveness in alleviating emotion recognition, attention, and impulsivity in this population. Photo-taking is a common daily activity that significantly impacts people's lives. Given the effectiveness of photography in addressing social skills, communication, and emotional well-being, and its ease of use, a photography-based intervention is proposed as an adjunct tool to teach children with ADHD emotional recognition and improve their ADHD symptoms. To the best of my knowledge, no previous study has adopted photography to teach emotional recognition in children with ADHD. This photography-based intervention not only teaches children with ADHD photography skills but also improves their ability to recognize and express emotions. Appropriate emotional processing and expression may have a positive impact on these children's confidence and ability to develop and maintain positive relationships with their peers, leading to better overall well-being and social integration.
Attention-Deficit/Hyperactivity Disorder (ADHD) remains one of the most prevalent neurodevelopmental disorders, affecting a significant percentage of school-aged children across the globe. While the condition is primarily characterized by symptoms of inattention and impulsivity, there is a growing consensus that ADHD is fundamentally underpinned by profound impairments in emotional functioning. This emotional dysregulation is considered a transdiagnostic feature that significantly predicts long-term functional impairment in daily life. Specifically, children with ADHD exhibit marked deficits in emotion recognition and emotional awareness, which often manifests as an inability to accurately differentiate between various internal affective states. This socio-emotional dysregulation creates a cascading negative impact, not only exacerbating behavioral symptoms but also undermining subjective well-being, particularly within high-pressure educational ecologies such as Hong Kong.
Currently, the clinical landscape for ADHD emotional intervention is dominated by pharmacological treatments and behavioral modalities, including Cognitive Behavioral Therapy and Social Skills Training. While research supports the efficacy of these traditional approaches in reducing overt behavioral disruptions, their impact on the core neurocognitive processing of emotions remains inconsistent. Meta-analytic evidence indicates that individuals with ADHD exhibit pervasive deficits in underlying emotional regulation and specific impairments in non-verbal emotional decoding-areas that standard interventions often fail to significantly improve, even when outward compliance is achieved. Furthermore, while creative arts therapies like art or play therapy have emerged as helpful adjunctive tools, much of the existing literature is constrained by methodological limitations, such as small sample sizes, a lack of rigorous control designs, and a reliance on unblinded informant reports. To date, there is no standardized psychoeducational modality that specifically targets the cognitive architecture of emotional processing in ADHD through a visual medium.
The practical implementation of traditional psychoeducation faces a critical theoretical bottleneck: the high cognitive load placed on participants. According to Cognitive Load Theory, human working memory has a strictly finite capacity. Traditional programs rely heavily on dense textual materials and didactic verbal instruction. For children with ADHD, whose neurocognitive profile is inherently compromised by deficits in executive functioning and sustained attention, this text-centric design imposes an overwhelming extraneous cognitive load. When a child's cognitive resources are exhausted by the effort of processing complex linguistic instructions, the available capacity for internalizing actual emotional regulation strategies is depleted. This leads to premature disengagement and poor adherence to the therapeutic process. Therefore, there is an urgent clinical need for innovative modalities that optimize cognitive load by bypassing heavy linguistic processing in favor of more accessible formats.
1,817 studies on the registry are indexed under Attention Deficit Disorder with Hyperactivity; 296 are open to participants now.
This study's enrollment of 60 is below the median of 71 across 1,437 interventional studies indexed under Attention Deficit Disorder with Hyperactivity.
Browse Attention Deficit Disorder with Hyperactivity studies →The Hong Kong Polytechnic University is the lead sponsor of 679 studies on the registry; 257 are open to participants now.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
DSM diagnostic criteria
The American Psychiatric Association’s manual of mental health diagnoses. DSM-5 (2013, revised as DSM-5-TR in 2022) replaced DSM-IV, and some studies still name the older edition. “Meets DSM criteria for …” means diagnosed by that edition’s diagnostic criteria, usually by a clinician in an interview.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Informed consent
Before you join, the study team explains what taking part involves — its purpose, what happens, the risks and possible benefits — and answers your questions, so you can decide freely. Consent is usually recorded on a form (the informed consent form, ICF) signed by you or, where the law allows, by someone legally authorised to decide for you.
You can keep asking questions during the study, you are told of new information that matters, and you can choose to leave at any time.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The participants in this group will have a six-weekly photography course. Each session is about 60 minutes. Four participants will be arranged together to conduct one session. In each session, a photographer will teach the participants basic photography skills and give a theme for the participants to take photos which will be used for sharing in the next session. Themes mainly are emotions and objects. In the sharing, the photographer will ask the participants to explain the reasons why take these photos and the photographer will explain the different types of emotions to the participants based on the themes. The participants can express their views and feelings regarding their photos.
Behavioral: Photography-based psychoedication
The participants maintained their Treatment-as-Usual (TAU). Participants in the waitlist group received the identical photography-based psychoeducation program immediately after the post-intervention assessment.
The programme follows a structured progression across six sessions, each building upon previous learning whilst introducing new skills and concepts. For the first session, participants build rapport and introduce photography techniques (composition, lighting) alongside emotional awareness to capture basic emotional states. For the second and third sessions, they explore personal emotions and triggers through self-portraits and visual documentation. For the fourth and fifth sessions, they focus on the ADHD journey via strength-based photo narratives and collaborative projects to enhance peer support and social learning. In the last session, they consolidated skills into personal visual toolkits for ongoing regulation, concluding with a final project presentation and maintenance planning.
Emotional Awareness
Participants' emotional functioning was evaluated by a licensed clinical psychologist using an adapted version of the Emotion Awareness Questionnaire (EAQ). To fit the clinical evaluation context and focus specifically on the core processing stages of emotion identification and expression, the questionnaire was adapted into an informant-report format consisting of two selected subscales (10 items in total): Verbal Sharing of Emotions (3 items) and Differentiating Emotions (7 items). Items in this adapted version were rated on a 4-point Likert scale ranging from 1 (never) to 4 (always).
Time frame: From enrollment to the end of treatment at 6 weeks and 3-month follow-up
Emotion Recognition
Participants' ability to accurately identify emotional states from non-verbal cues was evaluated using a customized, 7-item Facial Emotion Recognition Task (FERT) based on the universal emotional categories. Children were presented with seven distinct facial-expression stimuli, each representing a specific emotion category: happiness, surprise, anger, contempt, disgust, fear, and sadness. The facial stimuli were presented on a computer screen by a licensed clinical psychologist. For each item, participants were instructed to identify or label the displayed emotion. The performance was scored based on overall accuracy (total correct answers out of 7), with higher scores indicating a better capacity for facial emotion recognition.
Time frame: From enrollment to the end of treatment at 6 weeks and 3-month follow up
Subjective well-being
The 4-item Subjective Happiness Scale (SHS) was utilized to measure subjective happiness. Respondents rated items on a 7-point Likert scale (1 = strongly disagree 1=strongly disagree, 7 = strongly agree 7=strongly agree).
Time frame: From enrollment to the end of treatment at 6 weeks and 3-month follow-up
ADHD symptoms
The teacher-rated Chinese version of the Swanson, Nolan, and Pelham, Version IV (SNAP-IV-18) 18-item scale, which assesses inattention (9 items) and hyperactivity/ impulsivity (9 items). A 4-point Likert scale will be used, ranging from 0 (not at all) to 3 (very much).
Time frame: From enrollment to the end of treatment at 6 weeks and 3-month follow up
Satisfaction of the intervention
Evaluated using a child-friendly, single-item 7-point visual facial Likert scale. Children were directly asked to rate their overall satisfaction with the photography-based program by selecting one of seven standardized facial expressions, ranging from 1 (a very unhappy/dissatisfied face) to 7 (a very happy/satisfied face).
Time frame: At 6 weeks (post-intervention)
Feasibility of the study
Operationalized through intervention attendance, completion rates, and protocol adherence. Attendance was tracked weekly by group facilitators, with successful feasibility defined a priori as an overall session attendance rate of ≥ 80 % and a study completion/retention rate of ≥ 85 % across the 6-week intervention period.
Time frame: From enrollment to the end of treatment at 6 weeks and 3-month follow up
Plan to share: No
This study is active, not recruiting, as verified in Jan 2026. You cannot join it, but the record below documents what was studied.
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