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
Why did you develop an app focused
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.
Isn’t empathy an inherent trait within
Research has found that empathy is
heritable, but there also are environ-
mental influences on empathy. For example, cer-
tain parenting styles are associated with greater
empathy in children.
Other potential influ-
ences 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.
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.
How did you develop and test the Ran-
dom App of Kindness?
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-build-ing 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.
How can pediatricians use the app in 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, www.rakigame.com, for information
and resource guides.
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.
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
Dr. Moreno is a member of the AAP
Council on Communications and Media Executive Committee.
Mastering the Media
The Random App of Kindness, for youths ages 10-17, addresses the declines in
empathy among young people and helps promote a more caring and compassionate
society, according to its developer. It includes nine 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.
Developer discusses how app builds empathy, research behind it
by Megan A. Moreno, M.D., M.S.Ed., M.P.H., FAAP
• For more information on the Random App of Kindness
and a video to teach health care providers, educators,
youth workers and families about the app, visit www.
• For a video on the research behind the app, visit https://