Characterizing Collective Efforts in Content Sharing and Quality Control for ADHD-relevant Content on Video-sharing Platforms
Hanxiu Hazel Zhu, Avanthika Senthil Kumar, Sihang Zhao, Ru Wang, Xin Tong, Yuhang Zhao · 2025 · ASSETS 2025: 27th International ACM SIGACCESS Conference on Computers and Accessibility · doi:10.1145/3663547.3746387
Summary
This paper presents the first in-depth characterization and analysis of ADHD-relevant video content across YouTube and TikTok, examining content quality, accessibility challenges, and the collective efforts of creators and viewers in quality control. The researchers systematically collected 373 ADHD-relevant videos (189 YouTube, 184 TikTok) along with their top comments, analyzing the data using a mixed-methods approach combining quantitative comparison via Chi-square tests and qualitative thematic analysis. The study addresses a significant gap: while video-sharing platforms have become crucial resources for people with ADHD to recognize symptoms, acquire knowledge, and find community support—with over 3 million TikTok posts under the hashtag #adhd garnering 25 billion views—little prior work had thoroughly examined content quality and accessibility issues specific to ADHD viewers. The research reveals stark differences between the two platforms. TikTok fosters close-knit communities of individuals sharing personal ADHD experiences (69.6% of creators self-identified as having ADHD), while YouTube conveys more authoritative information from health professionals and organizations. The study identified nine types of content creators, 12 content types spanning clinical knowledge and pragmatic experiences, and 13 video presentation forms. Critically, the researchers examined how creators establish authority and trust (through identity disclosure, references, and disclaimers) and how viewers actively participate in quality control through comments—questioning claims, providing alternative perspectives, supplementing content with personal experiences, and even creating community-driven video breakdowns with timestamps.
Key findings
The study uncovered several critical findings about ADHD content ecosystems on video platforms. On quality control, creators used identity disclosure (55.6-69.5% via profiles), references to health publications (13.2% on YouTube, 2.2% on TikTok), and disclaimers (15.3% on YouTube, 3.8% on TikTok) to build credibility—but these efforts faced challenges including vague credentials, irrelevant references used to appear credible, and low visibility of disclaimers. YouTube health expert recognition covered only 47.4% of self-disclosed health professionals. Viewers actively assessed quality through comments, with remarks under 41 videos highlighting how content differed from their lived experience, and comments under 9 videos identifying factual mistakes. On accessibility, four primary barriers emerged for ADHD viewers: (1) excessive video length—YouTube videos averaged 13.4 minutes, with 40% of comments on a 2-hour medical video complaining about length; (2) slow pacing that caused attention drift; (3) distracting sounds and visual overlays described as "maddening"; and (4) missing or low-quality auto-generated captions. Notably, ADHD viewers perceived "fast" differently from neurotypical people, and speeding up videos created unintended visual distraction. Viewers also expressed desire for an "ADHD mode" with clean screens and no recommended videos. Self-diagnosis was a particularly controversial topic, with some viewers advocating for it due to lack of accessible clinical resources while others criticized it as harmful.
Relevance
This research has significant implications for both platform designers and accessibility practitioners. It demonstrates that cognitive accessibility extends well beyond traditional screen reader and motor impairment considerations—ADHD affects 7.6% of children and 6.8% of adults, and these users face distinct accessibility barriers when consuming video content. The finding that professional health content is often the least accessible to ADHD viewers (long talks and presentations) highlights a critical irony in health information design. For platform designers, the study offers concrete design implications: facilitate video customization for ADHD (chapter markers, simplified visual layouts, adjustable pacing), leverage community-driven quality control through AI-assisted comment summarization and collective quality review features, and reduce creative burden for ADHD content creators through automated chapter generation and disclaimer templates. The research also raises important tensions around content quality standards in neurodivergent communities—traditional authority-based quality metrics may conflict with neurodiversity movement values that privilege lived experience over clinical framing. Limitations include reliance on comment analysis rather than direct user interviews and the absence of health expert perspectives on information quality.
Tags: ADHD · video-sharing platforms · information quality · online communities · content accessibility · neurodivergent · misinformation · social media · cognitive accessibility · TikTok · YouTube