Objective: Internalizing disorders, such as anxiety and depression, in pre-school aged children are common and often go undiagnosed into adulthood. To augment traditional parental-reports, we have previously presented an objective assessment for early childhood anxiety and depression which leverages movement and vocal biomarkers measured via wearable sensors during brief mood induction tasks that achieves good accuracy (75%-81%). However, these methods required specialized equipment and expertise in data and sensor engineering to administer and analyze. Method: To address this challenge, we have developed the ChAMP (Childhood Assessment and Management of digital Phenotypes) System, which includes an Android mobile application for collecting movement and audio data during mood induction tasks and an open-source data analysis platform for extracting digital biomarkers and discovering digital phenotypes. As proof of principle, we present data collected using the ChAMP System from 50 children ages 5-8, with and without anxiety or depressive disorders. Results: Movement and vocal features derived from the ChAMP System support the consideration of theory-driven temporal phases within mood induction tasks, and the use of an assessment battery for characterizing childhood internalizing disorders. Results also demonstrate that features significantly differ between diagnostic groups and correlate with symptom severity implying their potential use as digital biomarkers. Conclusions: The ChAMP System provides clinically relevant digital biomarkers of childhood anxiety and depression. This new open-source tool lowers the barrier to entry for those interested in exploring digital phenotyping of childhood mental health.
Childhood mental health disorders such as anxiety, depression, and ADHD are commonly-occurring and often go undetected into adolescence or adulthood. This can lead to detrimental impacts on long-term wellbeing and quality of life. Current parent-report assessments for pre-school aged children are often biased, and thus increase the need for objective mental health screening tools. Leveraging digital tools to identify the behavioral signature of childhood mental disorders may enable increased intervention at the time with the highest chance of long-term impact. We present data from 84 participants (4-8 years old, 50% diagnosed with anxiety, depression, and/or ADHD) collected during a battery of mood induction tasks using the ChAMP System. Unsupervised Kohonen Self-Organizing Maps (SOM) constructed from movement and audio features indicate that age did not tend to explain clusters as consistently as gender within task-specific and cross-task SOMs. Symptom prevalence and diagnostic status also showed some evidence of clustering. Case studies suggest that high impairment (>80th percentile symptom counts) and diagnostic subtypes (ADHD-Combined) may account for most behaviorally distinct children. Based on this same dataset, we also present results from supervised modeling for the binary classification of diagnoses. Our top performing models yield moderate but promising results (ROC AUC .6-.82, TPR .36-.71, Accuracy .62-.86) on par with our previous efforts for isolated behavioral tasks. Enhancing features, tuning model parameters, and incorporating additional wearable sensor data will continue to enable the rapid progression towards the discovery of digital phenotypes of childhood mental health.
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