Wearables: Tracking Behavioral Patterns in Special Needs Kids



  • Data-driven insights can help medical professionals better understand their special needs children’s behavioral triggers
  • Experts from the Sheppard Pratt-Lieber Research Institute describe future uses for healthcare wearables beyond psychiatric care

How real-time biometric data can predict and prevent behavioral issues

It is heartbreaking to see a special needs child having a psychiatric meltdown and being unable to explain what is wrong. It breaks their parents’ heart, perplexes the caregivers who want to help and it stresses and exhausts the child.

Figuring out what sets off a reaction or triggers a downhill spiral has long been a guessing game for medical professionals. Did the child not get enough sleep? Is it too loud in the room? Sometimes the child can provide some insight, but often a cognitive or expressive disorder makes this impossible. Other times the kid is simply too overwhelmed at that point to communicate.

Researchers at the Sheppard Pratt-Lieber Research Institute are in the final testing stage of a pilot program that they hope will give clinicians and families the answers they need to help patients and loved ones.

“We often hear from their teachers and clinicians who work with kids with developmental and/or psychiatric disorders that behaviors seem to appear out of nowhere and the triggers are often elusive,” says Tom Flis, MS, BCBA, LBA, LCPC, senior behavior specialist, Sheppard Pratt Health System. “We frequently can’t determine what exactly leads to their stress or what triggers them. This makes it really difficult to determine how to treat the patient.”

Wearables collect biometric data

In the pilot program, patients hospitalized at the health system’s short-term child and adolescent neuropsychiatry inpatient unit wear an Empatica E4 device on their wrists, which looks like a watch without a face. The patients, who stay an average of 17 days, have a wide range of conditions from autism spectrum disorders, developmental disabilities and genetic disorders to traumatic brain injuries. The wearable device has 60 hours of data storage and collects biometric data such as blood volume pulse (BVP), motion-based activity, skin temperature and electrodermal activity. Flis says clinicians will then compare data to reports of any meltdowns or behaviors so clinicians can figure out if the patient was stressed, aroused, excited or asleep.

“We’re trying to correlate data from the sensors with other information that tells us something about the behavioral function of patients. This would potentially allow us to predict the onset of crisis, mania or aggressive behavior to make early intervention possible,” says Robert Schloesser, M.D., executive director of the Sheppard Pratt-Lieber Research Institute.

Schloesser says sleep is an especially important factor in their patients since sleep patterns often change during episodes of mood disorders such as bipolar, mania or depression. Sleep patterns can also change in patients with autism or neurodevelopmental disorders. “We know that a change in sleep patterns can help predict a change in current symptoms, so the devices help measure sleep as well,” says Schloesser.

Using data to prevent behavioral issues

The device sends patient data using Bluetooth technology from the patient’s wrist to a secure cloud platform. Flis says that the data can be viewed in real time through an app on a smartphone or tablet as well as from a laptop or desktop. Since patient privacy is of the utmost importance, the server is secure and all data is encrypted. As an added layer, no patient identifiers are included with the data. Clinicians will also use a data analytics tool on the information for a time/frequency analysis.

Flis says clinicians can compare the data with the environment in the room at the time (i.e., the room is very noisy) to make environmental changes for the patient. “A lot of our patients are probably stressed but they don’t appear so on the outside, and then out of nowhere, this explosive behavior occurs,” says Flis. “By having this biometric data, we can know what is going on and create some kind of intervention plan, whether it is through medicine or behavioral intervention, most likely a combination of both. We will then continue to monitor patient data from the device to see if the interventions work.”

The future of healthcare: biometric wearables

Psychiatric care tends to be fairly subjective. “It’s more than an art, and it’s difficult; there are a million different variables that can affect an individual and it’s hard to determine exactly why something happens,” says Flis. “The biometric data in our new program is very hard to lie about and is not subjective at all—it is objective, concrete data. The hope is this will lead to better treatment because we can approach care more objectively.”

Although his team is working on using this technology for psychiatric care, Empatica works with other researchers using similar technology for a variety of issues, including mood disorders, epilepsy and communication disorders.

“I honestly think this is going to be the future of healthcare,” says Flis. “I know this is a big statement, but I believe technology is going to improve exponentially over the next decade to the point where gathering data through wearables is a major part of the healthcare system. And the hope is that this helps us provide better care to each patient and help each person live the best life possible.”

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