The “Extra Layer of Things”: Everyday Information Management Strategies and Unmet Needs of Moms with ADHD

Sheila Walsh (she/her)�M.S., Human-Computer Interaction

University of Maryland�

Meet “Octavia”��ER Doctor�Mom to 3 year old�Diagnosed with ADHD last year

“Having to care for another living being that was completely dependent on me completely threw every coping mechanism that I had apparently built over the years into a tailspin.”

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Image source: Storyset

Related Work

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Related work�What is ADHD?

• An “ongoing pattern of inattention and/or hyperactivity/impulsivity that interferes with functioning or development” (NIMH)

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• “Variable attention stimulus trait”: People with ADHD “do not have a disease, nor do they have a deficit of attention; in fact, what they have is an abundance of attention. The challenge is controlling it.” (Hallowell, 2024)

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• Runs in families (Hinshaw, 2022)

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• Shaped by context and systems - Symptoms vary with environment, support, and social factors. Diagnosis and care are influenced by gender, race, and roles.

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Related work�ADHD in Women

• Undertreated and under-researched (Chronis-Tuscano, 2022; Hayashi et al., 2019; Hinshaw, 2022; Young et al., 2020).

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• Hyperactive presentation more common in boys/men and inattentive presentation more common in girls/women (Hinshaw, 2022)

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• Obscured by comorbidities (including anxiety and depression) and the tendency to mask and overcompensate (Antoniou et al., 2021; Young et al., 2020).

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• Heightened risk of serious impairments including problems in close relationships, trauma, and self-harm (Hinshaw et al., 2022, p. 1).

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• Late diagnosis is common, often follows “years of difficulty and demoralization.” Chronis-Tuscano (2022)
• Need routine screening and prompt referral for treatment

Related work�Moms with ADHD

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• New moms: Establishing routines, socializing with peers, and attending to self-care (Curtin-McKenna, 2013)

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• Challenges of inattentive ADHD (NIMH, 2021):
• Overlook or miss details
• Find it harder to follow through on instructions and chores
• Lose things
• Have difficulty making realistic plans and staying organized

• Top challenges include managing the household and organizing/completing daily responsibilities (Chronis-Tuscano et al., 2016)

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Related work�The Promise of Technology

• Health and psychology experts recommend non-pharmacological supports include guidance on time and task management and prioritization and digital apps (Chronis-Tuscano, 2022; Young et al., 2020).

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• Technology can be helpful because it allows people to “offload” certain cognitive functions, allowing them to be carried by technology. Common example: Grocery list. (Dawson & Guare, 2015).

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Related work�Technology Research

• Technology usage and needs of adults with ADHD is under-researched (Spiel et al. (2022)

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• An “assistive technology framework” for ADHD is based on studies of technology designed to benefit children, not adults (Sonne et al., 2016).

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• Lower satisfaction with technology for time management than people without ADHD. More likely to use timers and digital devices (Desrochers et al., 2019).

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• Common personal knowledge management strategy of adults with ADHD: “Externalizing” information - “making ideas and thoughts metaphorically or literally physical” (Hoffman, 2023).

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Study Design

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Research Overview

• Institutional Review Board approval, May 2024.

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• 5 moms interviewed May-June 2024 (average 48 minutes)
• Diagnosed with ADHD by a healthcare professional
• At least one child under age 18 living at home.

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• Survey distributed via listservs (ex. University of Maryland/Michigan, Silver Spring Parents, etc.)
• Snowball sampling

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• Thematic analysis of data

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Research Questions

For which tasks do moms with ADHD indicate that they need additional support, whether through technology or other means?

How do moms with ADHD describe their current use of technology and other tools to manage their everyday lives?

How do moms with ADHD describe their diagnosis and the impact of ADHD on their everyday lives?

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Interview Participants

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Findings: 5 Themes

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Theme 1�Past a Tipping point

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Overwhelm

“I have enough trouble keeping track of everything for myself, and [now] I also have to keep track of everything for everybody else.” - I04

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Previous strategies no longer worked

“I have certainly struggled more with my ADHD since becoming a mother … It’s almost like I stopped being able to mask and compensate, all of a sudden and out of nowhere.” - I01

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Diagnosis was a game-changer

“It helps explain why some things are hard that I wouldn't think should be hard, and then it also allows for interventions such as medication to help.” - I04�

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Theme 2�Tasks Needing More Support

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Updating CV, putting work tasks behind family needs, uninterrupted time for writing or furniture restoration

Career/hobby

Medical appointments, remote caregiving, family meeting/schedule

Planning/coordination

- Cleaning, meal planning, organizing�- “It can be difficult to force myself [to clean], especially when I have competing things like exhaustion.” (I01)

Household tasks

Exercise, going to the gym, hygiene.

Physical self-care

Theme 3�Abandoning and Adapting Tools��

• Switching task and time management systems after marriage and parenthood
• Toggling between paper and digital tools

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Strong Need to “Externalize” Information

Making information physical (Hoffman, 2023)

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“If I see the piece of paper, it’s there. It’s like it says ‘Hello!’ – IO4

“I like the physicality (of paper), and I feel like having more stuff visible like in my line of sight helps me with remembering it. Things that go into apps are like my refrigerator drawers. I don't know what's in there, and I'm probably not gonna open it to find out until it's too late.”- I02

Tactile: “That Good Feeling” �

“I had put like a screen cover on my iPad that was to make it paper-like. So it felt more like you were writing on paper. But it's still like it just wasn't quite right…’

• I05

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“A big part of [my bullet journal] is the tactileness of it. Having it in my hands, and being able to write in it. I've always really loved like the physical aspect of writing things, and that definitely helps my brain hold on to that information … I love a good notebook… it just gives me that good feeling.”

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Theme 4:�System Failure: Task lists

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“The lists that I used to keep got too depressing because they would get so long with undone things … They would [include] everything … long-term, short-term, multi-step, single-step, and they weren't helping anymore.” - 102

“Anytime I try to do a to do list on my phone or digitally, I can never keep up with it. I just move on from it. I get bored of it really easily. - 101

Theme 5�Successful Strategies (Mostly)

Successful strategies for several participants:

• Digital calendars - integrating multiple calendars challenging
• Timers and reminders - used sparingly (too many causes “signal fatigue”)
• Voice input on phone/watch to avoid temptation of seeing distracting apps
• Airtags, Find my phone

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“ I don't miss appointments or anything, because if it's in my calendar it'll happen. But with little things I worry… like, did I forget about it being ‘Wear your favorite hat day at school’ … and how that that absent-mindedness, if you will, is perceived by my children's teachers or other parents.” - I05

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I03: Still Looking for Solutions…

Paper helps her remember…

“For me, [paper] cements things. It makes it more real than when it's in it's in my phone or in my laptop [where] it's not as tangible.”

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But it is easily lost…

“I will write a list. And these days, I will lose, said list, because I will put it down because the toddler needs something, and then it's gone. So when I get to the grocery store, the list is gone.”

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And perfectionism can kick in…

“... If I write a list. and then I do something on that list and, say .. the thing I did is in the middle of the list, I will then rewrite that list.”

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Photo by Ketut Subiyanto

Recommendations

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Design Considerations

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• Integrate paper and digital tools to allow users to benefit from both.

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• Easy externalizing of information in both physical and digital formats

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• Engage multiple senses - Auditory, tactile, visual, haptic

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• Smart reminders - Automated, customizable, sparing, and varied

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• Hide information not needed at a particular time, without worry it will be forgotten

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• Facilitate social support and breaks from technology

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Promising Technology

Vary intensity and method of notifications, starting with ambient (subtle). Use disruptive notifications only if needed (Lee et al. , 2023)

Ambrumptive notifications

“less constraining interaction styles [that allow physical movement] are likely to help users think and communicate” (Klemmer et al., 2006, p. 141).

Embodied computing

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AI/Machine learning

Supporting task intake, prioritization, and smart display to prevent overwhelm

Future Research

Systems that support family coordination, integrate multiple senses, allow switching between digital and non-digital tools, support externalization

Family information management

Design technology *with* moms with ADHD rather than *for* them, focusing on tasks needing greatest support

Participatory design

More and larger studies. Examine current uses of technology and ways to bolster executive functioning for self-defined priorities.

Larger HCI studies of adults with ADHD

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Summary

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Summary

• First study of its kind that focused on technology design for moms with ADHD

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• Moms with ADHD need more support with
• Externalizing and sharing everyday information with family members
• Task intake and management systems
• Integrating digital and non-digital tools
• Technology that engages multiple senses especially tactile

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• The moms in this study are not failing – they’re navigating systems that were never designed with them in mind. We have the opportunity to do better.

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Thank you!

Conference Organizers and Attendees

Dr. Beth St. Jean, Thesis Advisor

Research Study Participants

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Sheila Walsh

swalsh@umd.edu

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CREDITS: This presentation template was created by Slidesgo, and includes icons by Flaticon, and infographics & images by Freepik

References

Antoniou, E., Rigas, N., Orovou, E., Papatrechas, A., & Sarella, A. (2021). ADHD Symptoms in Females of Childhood, Adolescent, Reproductive and Menopause Period. Materia Socio-Medica, 33(2), 114–118. https://doi.org/10.5455/msm.2021.33.114-118

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Ashinoff, B. K., & Abu-Akel, A. (2021). Hyperfocus: The forgotten frontier of attention. Psychological Research, 85(1), 1–19. https://doi.org/10.1007/s00426-019-01245-8

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Chronis-Tuscano, A. (2022). ADHD in girls and women: A call to action – reflections on Hinshaw et al. (2021). Journal of Child Psychology and Psychiatry, 63(4), 497–499. https://doi.org/10.1111/jcpp.13574

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Chronis-Tuscano, A., Wang, C. H., Strickland, J., Almirall, D., & Stein, M. A. (2016). Personalized Treatment of Mothers With ADHD and Their Young At-Risk Children: A SMART Pilot. Journal of Clinical Child & Adolescent Psychology, 45(4), 510–521. https://doi.org/10.1080/15374416.2015.1102069

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Curtin-McKenna, M. T. (2013). Mothers with attention-deficit/hyperactivity disorder (ADHD) in the first twelve months postpartum: Challenges, coping supports, strengths, and resilience: A two-part project based upon an investigation at MotherWoman, Hadley Massachusetts [Smith College]. https://scholarworks.smith.edu/theses/1078

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Bibliography, continued

Dawson, P., & Guare, R. (2015). The Smart but Scattered Guide to Success: How to Use Your Brain’s Executive Skills to Keep Up, Stay Calm, and Get Organized at Work and at Home. Guilford Publications.

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Desrochers, B., Tuson, E., & Magee, J. (2019). Evaluation of Why Individuals with ADHD Struggle to Find Effective Digital Time Management Tools. The 21st International ACM SIGACCESS Conference on Computers and Accessibility, 603–605. https://doi.org/10.1145/3308561.3354622

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Hallowell, E. (2024, November 1). ADHD Needs a Better Name. We Have One. Additude Magazine. https://www.additudemag.com/attention-deficit-disorder-vast/

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Hayashi, W., Suzuki, H., Saga, N., Arai, G., Igarashi, R., Tokumasu, T., Ota, H., Yamada, H., Takashio, O., & Iwanami, A. (2019). Clinical Characteristics of Women with ADHD in Japan>. Neuropsychiatric Disease and Treatment, 15, 3367–3374. https://doi.org/10.2147/NDT.S232565

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Hinshaw, S. P., Nguyen, P. T., O’Grady, S. M., & Rosenthal, E. A. (2022). Annual Research Review: Attention-deficit/hyperactivity disorder in girls and women: underrepresentation, longitudinal processes, and key directions. Journal of Child Psychology and Psychiatry, 63(4), 484–496. https://doi.org/10.1111/jcpp.13480

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Bibliography, continued

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Hoffman, K. M. (2023). Library And Information Science Research And Neurodiversity: So Much Potential If We’d Just Apply Ourselves [Doctoral Dissertation, University of Maryland]. Digital Repository at the University of Maryland (DRUM). https://doi.org/10.13016/dspace/vleg-qb2h

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Huh, J., & Ackerman, M. S. (2010). Exploring social dimensions of personal information management with adults with AD/HD. CHI ’10 Extended Abstracts on Human Factors in Computing Systems, 3715–3720. https://doi.org/10.1145/1753846.1754044

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National Institute of Mental Health/National Institutes of Health. (2021, Revised). Attention-Deficit/Hyperactivity Disorder in Adults: What You Need to Know. https://infocenter.nimh.nih.gov/sites/default/files/2021-12/attention-deficit-hyperactivity-disorder-in-adults-what-you-need-to-know_0.pdf

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Sannon, S., Vorvoreanu, M., Walker, K., & Fourney, A. (2020). “Am I doing this all wrong?”: Challenges and Opportunities in Family Information Management. Proceedings of the ACM on Human-Computer Interaction, 4(CSCW2), 138:1-138:28. https://doi.org/10.1145/3415209

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Bibliography, continued

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Spiel, K., Hornecker, E., Williams, R. M., & Good, J. (2022). ADHD and Technology Research – Investigated by Neurodivergent Readers. Proceedings of the 2022 CHI Conference on Human Factors in Computing Systems, 1–21. https://doi.org/10.1145/3491102.3517592

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Young, S., Adamo, N., Ásgeirsdóttir, B. B., Branney, P., Beckett, M., Colley, W., Cubbin, S., Deeley, Q., Farrag, E., Gudjonsson, G., Hill, P., Hollingdale, J., Kilic, O., Lloyd, T., Mason, P., Paliokosta, E., Perecherla, S., Sedgwick, J., Skirrow, C., … Woodhouse, E. (2020). Females with ADHD: An expert consensus statement taking a lifespan approach providing guidance for the identification and treatment of attention-deficit/ hyperactivity disorder in girls and women. BMC Psychiatry, 20(1), 404. https://doi.org/10.1186/s12888-020-02707-9

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Supplementary Slides

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Nuanced views of ADHD

“We [people with ADHD] can have a lot of interests, and I can share them with people. It’s like there's always more ideas. Internally, I like it when I just can have a little space and can just let myself free associate. It may be a little unfocused, but it's also more creative.” - I02

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“I can come up with fun ways to do different things. I always want to be active and doing something.” - I05

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“As I've grown, and as I've struggled with it a lot more, it's really become apparent that [ADHD] is a disability. It is something that affects every aspect of my life.” - I02

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“I know there's there's this whole

movement that ‘there's nothing wrong [with ADHD]. It's just different.’ But [ADHD] gets in the way … whether it's wrong or not, bad or not bad, It's annoying.” - I04

Disability

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Methods�Design

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• Exploratory study to guide future research
• Qualitative research method to gain a deep understanding of lived experiences and most important issues for further research (also recommended by Chronis-Tuscano, 2022)

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• Scope:
• Excluded information management related to paid employment
• Broad definition of technology

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Methods�Miro Activity

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• Tasks interviewees spent time on in recent days - and tasks they wanted or needed to do but didn’t.
• Participant-directed

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Methods�Data Analysis

Method: Thematic analysis (Braun & Clarke, 2006)

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Limitations

Results cannot be generalized to all mothers with ADHD in the U.S.

Recruitment through university listservs likely not representative

Participant reactivity

Sample size

Selection bias

Self-reported data can be inaccurate or incomplete.

Participants might have changed their behavior or responses to appear more acceptable.

Self-reporting bias

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“Magic wand” wishes

“I need a tool that makes it feel like my other **** is being handled…If [I’m writing], I need to feel like there aren’t 16 crises happening.”�“Something, somehow reminding me ‘don’t do that thing you thought of just now.”

Reduce overwhelm by help creating/refining a routine for household tasks, with integration into calendar and notifications. Hide tasks not relevant in the current time or place.

“The part that I would like to ‘magic wand’ would be for [a virtual assistant] to understand my life without me having to train them … so they could do the little things I need … I need a wife…Or I need a mom, someone to help me stay on top of everything.”

102: No interruptions

I03: Curated display

I05: “Understand my life”

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Related work�Family Information Management

• More research is needed on social and collective aspects of personal knowledge management, including
• how people with ADHD gather information and share strategies (Huh & Ackerman, 2010)
• how information is managed within families (Sannon et al., 2020).

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