-->PONE-D-25-54718-->-->Evaluating Large Language Models for ADHD Education: A Comparative Study of ChatGPT 5, DeepSeek V3, and Grok 4-->-->PLOS One

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Academic Editor

PLOS One

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Reviewer's Responses to Questions

-->Comments to the Author

1. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. -->

Reviewer #1: Yes

Reviewer #2: Yes

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-->2. Has the statistical analysis been performed appropriately and rigorously? -->

Reviewer #1: Yes

Reviewer #2: Yes

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-->3. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: Yes

Reviewer #2: Yes

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-->4. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.-->

Reviewer #1: Yes

Reviewer #2: No

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-->5. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #1: Interesting and provocative paper.

Some issues.

Abstract: primary end point should be added

Abstract: definition of high reading level should be added

Introduction for a paper like this should be shortened to 1 page

Stat methods: normal distributriuon shiuld be checkef for

methods: it is not clear who reviewed the models

Methiods: do these results of LLM predicted also response to therapies?

Reviewer #2: The study is promising, but clearer methodological rigor, stronger grounding in ADHD education literature, and deeper comparative analysis are needed.

1) Provide the exact prompt set, prompt order, temperature or generation settings, and session controls to ensure reproducibility and fairness across models.

2) Clarify how “content accuracy” was evaluated—who rated it, using which rubric, and whether inter-rater agreement was measured.

3) Expand the literature review on ADHD inclusion in physical education and coaching contexts, including established accessibility and universal design frameworks.

4) While the study provides a useful comparison of LLM-generated ADHD educational material, the related work would benefit from referencing existing research on AI-based clinical decision support and automated interpretation of physiological data. This will provide relevant insights into the challenges of accuracy, stability, and accessibility when AI systems are used to communicate health-related information to non-expert users. I suggest authors consider citing; 'Spirometer and sEMG respiratory patterns for clinical decision support system'. ( doi: 10.1109/I2MTC53148.2023.10175925 )

5) Include statistical testing (e.g., variance analysis, confidence intervals, or effect sizes) to support claims about stability and differences between models.

6) Address potential model bias and temporal variability (responses may change across sessions or updates).

7) Strengthen the practical implication section by translating findings into concrete guidance for non-specialist educators (e.g., recommended prompt templates or readability calibration strategies).

8) Justify the choice of readability metrics and discuss their known limitations for health education materials.

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Reviewer #1: Yes: Fabrizio d'ascenzo

Reviewer #2: No

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Evaluating large language models for ADHD education: a comparative study of ChatGPT 5, DeepSeek V3, and Grok 4

PONE-D-25-54718R1

Dear Dr. Han,

We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements.

Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication.

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Kind regards,

Thiago P. Fernandes, PhD

Academic Editor

PLOS One

Additional Editor Comments (optional):

Reviewers' comments:

Reviewer's Responses to Questions

-->Comments to the Author

1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation.-->

Reviewer #1: All comments have been addressed

Reviewer #2: All comments have been addressed

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-->2. Is the manuscript technically sound, and do the data support the conclusions?

The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. -->

Reviewer #1: (No Response)

Reviewer #2: Yes

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-->3. Has the statistical analysis been performed appropriately and rigorously? -->

Reviewer #1: (No Response)

Reviewer #2: Yes

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-->4. Have the authors made all data underlying the findings in their manuscript fully available?

The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified.-->

Reviewer #1: (No Response)

Reviewer #2: Yes

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-->5. Is the manuscript presented in an intelligible fashion and written in standard English?

PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here.-->

Reviewer #1: (No Response)

Reviewer #2: Yes

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-->6. Review Comments to the Author

Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters)-->

Reviewer #1: (No Response)

Reviewer #2: (No Response)

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-->7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files.

If you choose “no”, your identity will remain anonymous but your review may still be made public.

Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy.-->

Reviewer #1: Yes: fabrizio d'ascenzo

Reviewer #2: No

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