The proposed research is for the field testing of an innovative approach to behavior change—“behavioral pay-per-view”—in which individuals are required to pay for their use of TV, Internet, cell phone, electronic gaming, etc. with points earned for engaging in targeted behaviors. The general approach is shown in Figure 1A. The technology takes advantage of wireless mobile ad hoc networks (MANETs) and embedded sensors for the detection and measurement of behaviors and the creation of a media economy in the home. Importantly, the individual need not be tethered to the media device while engaging in the targeted behavior; but rather, credits can be earned anytime and anyplace and spent by the individual on the media of their choosing (with certain other restrictions at the option of the parent). Furthermore, the rules for earning points can be modified in order to ‘shape’ the individual’s behavior toward a particular goal. The MANET also allows other cognitive support in the form of praise, goals, and performance metrics to be displayed on any device in the network having graphics capabilities. These cognitive supports are combined with the behavioral modification program to build behaviors that last after the supports are removed. The technology further helps the family achieve balance between media use and the behaviors necessary for human development.

Two of the most pressing challenges facing children and families today are obesity and attention deficit hyperactivity disorder (ADHD). Obesity is the second leading cause of preventable death in the U.S. and is associated with greater risk for cardiopulmonary disease, diabetes mellitus, and several forms of cancer. The epidemic increase in obesity rates is well-documented and has received considerable attention in the national press. ADHD is the most commonly diagnosed psychiatric disorder of children, effecting between 5-10% of U.S. children. In addition to the challenges placed on the child, ADHD is deleterious to family life and the education of all children. Treatments for ADHD are often expensive and not covered by insurance, thereby placing even greater strains on these families.