An Integrated Approach for the Monitoring of Brain and Autonomic Response of Children with Autism Spectrum Disorders during Treatment by Wearable Technologies

Abstract

Autism Spectrum Disorders (ASD) are associated with physiological abnormalities, which are likely to contribute to the core symptoms of the condition. Wearable technologies can provide data in a semi-naturalistic setting, overcoming the limitations given by the constrained situations in which physiological signals are usually acquired. In this study an integrated system based on wearable technologies for the acquisition and analysis of neurophysiological and autonomic parameters during treatment is proposed and an application on five children with ASD is presented. Signals were acquired during a therapeutic session based on an imitation protocol in ASD children. Data were analyzed with the aim of extracting quantitative EEG (QEEG) features from EEG signals as well as heart rate and heart rate variability (HRV) from ECG. The system allowed evidencing changes in neurophysiological and autonomic response from the state of disengagement to the state of engagement of the children, evidencing a cognitive involvement in the children in the tasks proposed. The high grade of acceptability of the monitoring platform is promising for further development and implementation of the tool. In particular if the results of this feasibility study would be confirmed in a larger sample of subjects, the system proposed could be adopted in more naturalistic paradigms that allow real world stimuli to be incorporated into EEG/psychophysiological studies for the monitoring of the effect of the treatment and for the implementation of more individualized therapeutic programs.

Heart Rate Variability During a Joint Attention Task in Toddlers With Autism Spectrum Disorders

“…This could be particularly important in young age as it could provide important physiological markers of social functioning in toddlers with ASD, thus contributing to the diagnosis and the identification of the best therapeutic approach. The system proposed was already successfully applied by our group in schoolers with ASD (Billeci et al, 2016b ; Di Palma et al, 2017 ), thus this study extends our previous results also to toddlers, therefore possibly representing the basis for future related investigations. Moreover, we showed the feasibility of simultaneous recording of eye-tracking and ECG during a social task, like JA, providing the possibility of measuring at the same time gaze pattern and physiological response.…”

JAKE® Multimodal Data Capture System: Insights from an Observational Study of Autism Spectrum Disorder

“…In contradistinction to the EU-AIMS and ABC-CT initiatives, which are exploring various tools administered by highly trained clinical research professionals in a laboratory setting, the aim of JAKE is to employ a mobile and web-based application coupled with biosensors that can be used by a community-based clinician and even by non-medical persons who can be trained to use them in a general clinical or clinical research setting. This has some similarities to an approach described by Billeci, also in the early stages of development (Billeci et al, 2016 ). The different components of JAKE, as described further below, are designed to capture sufficiently variable phenotypes and behaviors across all key domains of ASD, while providing a high level of utility—effectively making it simple for caregivers and other observers to record critical information on improvement or worsening of symptoms and behaviors.…”

Behavioral and Autonomic Responses in Treating Children with High-Functioning Autism Spectrum Disorder: Clinical and Phenomenological Insights from Two Case Reports

“…Fourth, the use of wearables, even if recently more frequent in the scientific literature dealing with ASD (see, for example, [40,41]), should take advantage of a wider, better grounded amount of data, which will be possible step-by-step in next few years when such methodologies, still relatively new in the neurophysiological monitoring of ASD, will fully enter scientific society.…”