Using Heart Rate and Behaviors to Predict Effective Intervention Strategies for Children on the Autism Spectrum: Validation of a Technology-Based Intervention.

Amarachi Emezie, Rima Kamel, Morgan Dunphy, Amanda Young, Heather J Nuske
Author Information
  1. Amarachi Emezie: Department of Psychology, University of Pennsylvania, Philadelphia, PA 19104, USA.
  2. Rima Kamel: Department of Psychiatry, Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
  3. Morgan Dunphy: Department of Psychiatry, Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. ORCID
  4. Amanda Young: Mayo Clinic, Mayo Eugenio Litta Children's Hospital, Rochester, MN 55902, USA.
  5. Heather J Nuske: Department of Psychiatry, Penn Center for Mental Health, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA. ORCID

Abstract

Many children on the Autism Spectrum engage in challenging behaviors, like aggression, due to difficulties communicating and regulating their stress. Identifying effective intervention strategies is often subjective and time-consuming. Utilizing unobservable internal physiological data to predict strategy effectiveness may help simplify this process for teachers and parents. This study examined whether heart rate data can predict strategy effectiveness. Teachers and coders from the research team recorded behavioral and heart rate data over three months for each participating student on the Autism Spectrum using the KeepCalm app, a platform that provides in-the-moment strategy suggestions based on heart rate and past behavioral data, across 226 instances of strategy interventions. A binary logistic regression was performed to assess whether heart rate reduction, time to return to heart rate baseline, and documented skills and challenging behaviors predicted strategy effectiveness. Results suggested that heart rate reduction may be a significant predictor, and supported the existing practice of using behavioral patterns as proxies for strategy effectiveness. Additional analyses indicate proactive strategies are more effective and are associated with greater reduction in heart rate, relative to reactive strategies. Further exploration of how internal physiological data can complement observable behaviors in assessing intervention strategy effectiveness is warranted given the novelty of our findings.

Keywords

References

  1. Eur Child Adolesc Psychiatry. 2024 Jun;33(6):1963-1976 [PMID: 37740093]
  2. Stress. 2019 May;22(3):303-311 [PMID: 30822219]
  3. Autism Res. 2022 Jan;15(1):117-130 [PMID: 34741438]
  4. Biol Psychol. 2010 Jul;84(3):394-421 [PMID: 20371374]
  5. Clin Child Fam Psychol Rev. 2021 Dec;24(4):684-706 [PMID: 34275057]
  6. J Autism Dev Disord. 2002 Oct;32(5):423-46 [PMID: 12463518]
  7. JMIR Res Protoc. 2023 Jun 26;12:e45852 [PMID: 37358908]
  8. Dev Neurorehabil. 2011;14(4):221-9 [PMID: 21732806]
  9. Behav Modif. 2013 Jul;37(4):543-67 [PMID: 23144173]
  10. J Pediatr Psychol. 2024 Oct 23;: [PMID: 39441712]
  11. Adm Policy Ment Health. 2022 Jul;49(4):575-586 [PMID: 34997368]
  12. Adm Policy Ment Health. 2016 Nov;43(6):1023-1028 [PMID: 27511103]
  13. Sensors (Basel). 2020 Jan 28;20(3): [PMID: 32012920]
  14. Curr Probl Pediatr Adolesc Health Care. 2018 Oct;48(10):234-249 [PMID: 30337149]
  15. Autism Res. 2019 Aug;12(8):1286-1296 [PMID: 31225952]
  16. Sensors (Basel). 2023 Sep 26;23(19): [PMID: 37836923]
  17. J Evid Based Soc Work. 2011 May;8(3):304-22 [PMID: 21660825]
  18. Child Adolesc Psychiatr Clin N Am. 2014 Jan;23(1):25-40 [PMID: 24231165]

Grants

  1. K01MH120509/NIMH NIH HHS

MeSH Term

Humans
Heart Rate
Child
Autism Spectrum Disorder
Male
Female
Mobile Applications

Word Cloud

Created with Highcharts 10.0.0strategyheartratedataeffectivenessbehaviorsbehavioralchallenginginterventionstrategiesinternalphysiologicalreductionautismspectrumeffectiveunobservablepredictmaywhethercanusingobservableInterventionManychildrenengagelikeaggressionduedifficultiescommunicatingregulatingstressIdentifyingoftensubjectivetime-consumingUtilizinghelpsimplifyprocessteachersparentsstudyexaminedTeacherscodersresearchteamrecordedthreemonthsparticipatingstudentKeepCalmappplatformprovidesin-the-momentsuggestionsbasedpastacross226instancesinterventionsbinarylogisticregressionperformedassesstimereturnbaselinedocumentedskillspredictedResultssuggestedsignificantpredictorsupportedexistingpracticepatternsproxiesAdditionalanalysesindicateproactiveassociatedgreaterrelativereactiveexplorationcomplementassessingwarrantedgivennoveltyfindingsUsingHeartRateBehaviorsPredictEffectiveStrategiesChildrenAutismSpectrum:ValidationTechnology-Baseddigitalmentalhealthtracking

Similar Articles

Cited By