August 16, 2017

Developer discusses how app builds empathy, research behind it

Megan A. Moreno, M.D., M.S.Ed., M.P.H., FAAP

  • Mastering the Media

Parents often ask us to recommend apps for a variety of reasons such as helping with potty training or remembering to take medications. As child health experts and advocates, many of us wish we also knew more about apps focused on health and prevention that we could integrate into anticipatory guidance.

With millions of apps available, it can be overwhelming to find evidence-based ones that can help our patients. Thus, when an app has been scientifically developed, tested and found to be effective, it is worth having on our collective radar.

Random App of Kindness is one such app. Using games designed for smartphones, the app aims to increase empathy in teens.

Following is a Q&A with app developer Sara Konrath, Ph.D., who discusses how pediatricians can use Random App of Kindness to promote child health and wellness. Dr. Konrath is an assistant professor of philanthropic studies at the Indiana University Lilly Family School of Philanthropy and director of the Interdisciplinary Program on Empathy and Altruism Research.

Q: Why did you develop an app focused on empathy?

A: Research has found that empathy acts like a “social glue” that enhances our close relationships and makes us want to help others, even those who are different from us. It also makes us less likely to bully or harm others. We chose to focus on empathy because it is a critical capacity that has implications for positive youth development and for addressing larger societal issues like bullying, aggression and prejudice.

Unfortunately, our research has found that empathy has been declining among young Americans in recent generations. Many argue that mobile phones can impair people’s empathy. But our team believes that mobile phones present an opportunity to teach empathy in new ways to young people, who spend over nine hours per day on their phones.

Ultimately, our game is designed to help address the declines in empathy among young people and help promote a more caring and compassionate society.

Q: Isn’t empathy an inherent trait within a child?

A: Research has found that empathy is heritable, but there also are environmental influences on empathy. For example, certain parenting styles are associated with greater empathy in children. Other potential influences include teachers, school cultures, media and economic factors. Dozens of studies show that empathy is teachable, and people of any age, including children, can learn to be more empathic.

Q: How is empathy related to health and wellness?

A: Research has found that feelings of care and concern for others are associated with positive psychological outcomes such as lower depression and lower physiological stress responses. For example, we found that more empathic women have lower stress hormones (cortisol) when they are giving a videotaped speech. Most research, however, is focused on adults. We need more research to see how empathy is related to health and wellness among children.

Q: How did you develop and test the Random App of Kindness?

A: Most empathy training programs take place in face-to-face interactions, e.g., in a classroom or small group setting. Although these programs have been shown to be effective, they are expensive and can’t reach many people. Our team of scientists and technology developers decided to translate some of these high-impact, empathy-building practices into a mobile phone application. Our goal was to design interactive mini-games based on the latest science of building empathy and were fun and immersive on their own.

We did extensive user testing on children ages 10 to 17 to get their feedback, and made changes based on what they liked and didn’t like.

The Random App of Kindness (RAKi) has nine mini-games that cover emotion recognition, caring for vulnerable animals and babies, control and management of cognitive processes, perspective taking, motor mimicry, conflict resolution skills, helping and cooperation, and self-affirmation.

Our scientists conducted a study of 106 preteens and teens (ages 10-17) examining the effect of playing Random App of Kindness compared to a different app. After two months, we found that children who played Random App of Kindness were more likely to feel compassion for and help someone in distress. We also found that using our app was associated with a reduction in aggressive behavior. Overall, there is evidence that RAKi can increase empathy among children ages 10-17.

Q: How can pediatricians use the app in a clinical setting?

A: We are working on developing guides for parents, teachers, pediatricians and youth workers. Until then, we recommend that pediatricians include this evidence-based app on handouts of healthy media choices or discuss it informally with parents when it comes to issues around socioemotional development or media use.

We have found that children in the app’s targeted age range (10-17) can easily figure out how to use it at home. If parents have questions about why empathy is important, what kinds of skills we are aiming for in these games and how to play, they can go to our website,, for information and resource guides.

Q: Can you address reviews of the game that indicate it has some violence. For example, one mini-game has players help grandma across a street. If they fail, she is hit by a car. Another includes the option to give a crying baby poison instead of a diaper or bottle.

A: Some parents have been surprised at some of the content. Unlike violent games that promote intentional harm to others, the main goal of our game is to help others by keeping them safe from harm. Some players may find it funny to try to hurt the baby or grandma, but if so, they will lose points and not advance to the next level.

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