Scientific background — what Kikidori is built on

Last updated: May 2026 · Continuously updated.

Kikidori is an app that helps families find more structure and less conflict in everyday life. We operationalize methods that have been clinically well established for decades and make them available as a practical everyday tool for parents and children. We are not a digital health application (DiGA), not a medical device, not a therapy and not a certified training manual. What we document here are the principles Kikidori's design is built on — and what we deliberately do not claim.

The three core mechanics with evidence

1. Contingency management (internationally: Token Economy)

Systematically reinforcing desired behavior with tokens (points, stickers, coins) that are later exchanged for rewards is one of the best-studied behavioral methods. In the largest current evidence-based-practice synthesis for autism (Steinbrenner et al. 2020, National Clearinghouse on Autism Evidence and Practice [NCAEP], University of North Carolina), reinforcement — explicitly including Token Economy — is classified, based on 106 international studies, as an evidence-based practice. The German S3 guideline on ADHD v2.0 of the Association of the Scientific Medical Societies (AWMF; Banaschewski et al. 2026) uses the term "contingency management" as an umbrella concept and names it as a component of recommended psychosocial interventions, both in school (recommendation 1.3.3.3 A) and in parent and educator training.

2. Visual structuring and weekly plans

Visual daily/weekly/activity schedules are classified in the same NCAEP 2020 synthesis as a separate evidence-based practice ("Visual Supports") — supported by 65 studies. Specifically for visual activity schedules, Knight, Sartini & Spriggs (2015, Journal of Autism and Developmental Disorders) evaluated and confirmed the EBP status separately. Most of the evidence for visual structuring comes from autism education (the TEACCH tradition of Schopler & Mesibov, Univ. of North Carolina since 1972); for ADHD the direct body of studies is thinner. The German S3 guideline on ADHD v2.0 does, however, recommend "structure-providing interventions (rules, routines)" as a classroom-management component, and executive difficulties overlap in both profiles.

3. Daily feedback in the school-home context (Daily Report Card)

The Daily Report Card tradition goes back to the 1960s (Jon Bailey/Kansas; Sue & Dan O'Leary with Bill Pelham/Stony Brook) and is today advanced most prominently by Gregory Fabiano (Florida State University). A meta-analysis by Pyle & Fabiano (2017, Remedial and Special Education) confirms four effective core building blocks that have remained constant for 50+ years: clearly specified behavioral goals with objective criteria, progress feedback during the day, daily communication between caregivers and child, and contingent rewards. These four building blocks also appear in Kikidori's design: quests as behavioral goals, real-time points as daily feedback, parent sync as communication, the reward shop and wish list as contingent rewards. A clinically applied DRC with school involvement and professional supervision is not replaced by this, however — Kikidori makes the principle available in everyday family life, not the entire setting.

What research does not answer

Even a very well-studied method is no promise for any individual child.

Every child is unique. Whether a method works for you is best tested in everyday life — ideally in coordination with your pediatric or child-and-adolescent mental-health services, or your child's therapist. We see Kikidori as a tool you can try without losing anything: no contracts, no point losses, no guilty conscience when a week passes without the app.

Three points known in the research as open questions:

  • Generalization. A routine that works reliably with points does not automatically work without them. The transition from "with the app" to "works without it too" is the real art — and a well-described problem in the literature.
  • Consistency. Token systems thrive on reliability. If adults award points sometimes and not others, trust erodes quickly. An app can help, but it doesn't take the relationship work off your hands.
  • Transferability between settings. Clinic, school and family are three very different places. What works in a therapeutic setting need not work 1:1 at home — and vice versa.

International guidelines — how different countries categorize it

Four authoritative guideline bodies for the treatment of ADHD in children and adolescents, all recommending behaviorally oriented interventions — each with somewhat different language:

  • NICE NG87 (National Institute for Health and Care Excellence, UK, 2018/2019): recommendation 1.5.7 recommends an ADHD-focused parent-training program as "first-line treatment" for children under 5. Reminder apps for medication adherence are explicitly named in recommendation 1.9.4.
  • AAP Clinical Practice Guideline (American Academy of Pediatrics, USA, Wolraich et al. 2019, Pediatrics 144(4):e20192528): recommends evidence-based parent training as first-line for children under 6, with "positively framed instructions within Behavioral Parent Training".
  • CADDRA 4.1 (Canadian ADHD Resource Alliance, Canada, 2021): verbatim — "Children with an ADHD diagnosis may benefit most from immediate reward and need more frequent and consistent reinforcement than typically developing children for reward to be effective." This is the most direct international evidence for Kikidori's design decision in favor of immediate real-time feedback.
  • AWMF S3 guideline on ADHD v2.0 (Germany, Banaschewski et al. 2026, AWMF register 028-045): uses "contingency management" as an umbrella term for token-based reinforcement plans. Recommendation 1.3.2.1 A (preschool age) classifies parent training as a strong recommendation (grade A, 100% consensus). The new chapter 1.4.1 (2026 for the first time) explicitly recognizes web-/app-based parent and teacher training as legitimate complementary interventions.

DACH anchoring: Döpfner's THOP manual

In the German-speaking world, THOP ("Therapieprogramm für Kinder mit hyperkinetischem und oppositionellem Problemverhalten", Döpfner, Schürmann & Frölich, Beltz 5th ed. 2013) is the most widely used clinical parent manual. Manfred Döpfner is a steering-group member of the AWMF S3 v2.0 and co-developer of the first DiGA for children with ADHD approved by the German Federal Institute for Drugs and Medical Devices (BfArM) (hiToco). THOP operationalizes the point system in four variants:

  • Point plan — a point for each rule followed, no deductions. Point accumulation → reward. Kikidori matches this 1:1.
  • Point snake — a visualization variant for younger children who can't yet handle numbers well. Stickers on a pre-printed snake. Structurally comparable to Kikidori's streak and progress visualization.
  • Wish list for special rewards — the child creates their own wish list, from which rewards are selected. Already implemented as a feature in Kikidori.
  • "Competition for smiling faces" (smiley plan) — point deduction for problem behavior ("response cost"). We deliberately do not implement this building block; see the next section.

What we deliberately do not do — and why

Some components of established programs do not fit Kikidori's target group and use context for clinical, ethical or values-based reasons. We make these decisions transparently:

  • No point deductions (response cost). We do not follow the THOP "smiley plan" variant here. The evidence on it is mixed (Carlson, Mann & Alexander 2000; McGoey & DuPaul 2000), but Sullivan & O'Leary (1989) show that reward-only programs hold up better in maintenance — i.e. after training ends. In the autistic context, fairness concerns are added (loss is experienced as "punishment despite effort"), in children with oppositional behavior response cost increases the escalation risk in parent-child power struggles, and there is the general risk of motivation erosion.
  • No leaderboards between siblings or families. Hanus & Fox (2015, Computers & Education 80:152–161) showed in a 16-week comparison that gamification with leaderboards lowers motivation, satisfaction and even exam results rather than raising them. In children whose self-worth is already impaired (Hopkins, Sims-Schouten et al. 2024), social-comparison mechanics are particularly risky.
  • No diagnosis data in our database. Diagnoses are recorded in the wizard only situationally, to make fitting suggestions — they never leave the device. This is a consequence of Art. 9 of the General Data Protection Regulation (GDPR; special categories of data) and a promise of trust to our target group.
  • No US data processors. All services run on netcup in Germany; there are no third-country transfers. This too is a values-based decision beyond the GDPR minimum requirement.

What we do not claim

Credibility also comes from clearly naming what an app is not or does not do:

  • Kikidori is not a DiGA and is not approved by the BfArM. A DiGA path is a separate option for the future, not a current claim.
  • Kikidori has no own proof of efficacy as an app to date. The cited guidelines and studies validate principles, not products. An accompanying scientific study is planned; we are seeking a collaboration with an academic institution focused on neurodivergence.
  • Kikidori is not officially recommended by NCAEP, NICE, CADDRA or AWMF. These bodies recommend methods and care structures, not specific consumer products.
  • Kikidori does not replace therapy, medication or parent training — which the guidelines recommend for moderate to severe ADHD. We see ourselves as a practical everyday complement, not a substitute.

Sources

We keep full references and detailed analyses internally in research notes; the central sources for this page:

  • Steinbrenner, J. R., Hume, K., Odom, S. L. et al. (2020). Evidence-Based Practices for Children, Youth, and Young Adults with Autism. NCAEP/UNC. ERIC ED609029.
  • Wong, C., Odom, S. L. et al. (2015). Evidence-Based Practices for Children, Youth, and Young Adults with ASD: A Comprehensive Review. Journal of Autism and Developmental Disorders 45(7):1951–1966.
  • Banaschewski, T. et al. (2026). S3 Guideline ADHD in childhood, adolescence and adulthood Version 2.0. AWMF register 028-045.
  • National Institute for Health and Care Excellence (2018, updated 2019). NG87: Attention deficit hyperactivity disorder: diagnosis and management.
  • Wolraich, M. L., Hagan, J. F., Allan, C. et al. (2019). Clinical Practice Guideline for the Diagnosis, Evaluation, and Treatment of ADHD in Children and Adolescents. Pediatrics 144(4):e20192528.
  • Canadian ADHD Resource Alliance (2021). Canadian ADHD Practice Guidelines 4.1.
  • Döpfner, M., Schürmann, S., & Frölich, J. (2013). Therapieprogramm für Kinder mit hyperkinetischem und oppositionellem Problemverhalten (THOP), 5th ed., Beltz.
  • Knight, V. F., Sartini, E., & Spriggs, A. D. (2015). Evaluating Visual Activity Schedules as Evidence-Based Practice for Individuals with Autism Spectrum Disorders. Journal of Autism and Developmental Disorders 45(1):157–178.
  • Pyle, K., & Fabiano, G. A. (2017). Daily Report Card Intervention and ADHD: A Meta-Analysis of Single-Case Studies. Remedial and Special Education.
  • Hanus, M. D., & Fox, J. (2015). Assessing the Effects of Gamification in the Classroom. Computers & Education 80:152–161.
  • Sullivan, M. A., & O'Leary, S. G. (1989). Differential maintenance following reward and cost token programs with children. Behavior Therapy 21:139–151.
  • Marx, I., Hacker, T., Yu, X., Cortese, S., & Sonuga-Barke, E. (2021). ADHD and the Choice of Small Immediate Over Larger Delayed Rewards: A Comparative Meta-Analysis. Journal of Attention Disorders 25(2):171–187.