An iPhone app, built on Apple’s ResearchKit platform, has been shown to be an effective means for conducting in-home screenings of young children for signs of autism.
Currently, autism screening in young children is conducted in clinical settings by highly trained medical professionals who administer the tests and analyze the results.
However, a new one-year study—published in the journal npj Digital Medicine—of 1,756 families with children ages one to six years demonstrated that the app is a novel, easy to use, and scalable method for collecting high-quality and scientifically valid data in a child's natural environment.
The Autism and Beyond app uses the smartphone’s camera to collect videos of children’s reactions while they watch movies designed to elicit autism risk behaviors—such as patterns of emotion and attention—on the device’s screen. Behavioral coding software then automatically tracks the movement of “video landmarks” on their faces and quantifies the data.
“We found that this app provided data consistent with what we see in a traditional clinical research setting,” says Helen Egger, MD, the Arnold Simon Professor of Child and Adolescent Psychiatry and chair of the Department of Child and Adolescent Psychiatry at NYU Langone Health. She co-led the study with colleagues at Duke University Medical Center and Duke’s Pratt School of Engineering.
“This demonstrates the feasibility of this approach,” said Geraldine Dawson, director of the Duke Center for Autism and Brain Development and co-leader of the study. “Many caregivers were willing to participate, the data were high quality, and the video analysis algorithms produced results consistent with the scoring we produce in our autism program here at Duke.”
Dawson points out that early detection and early intervention can have a “significant impact on long term outcomes for individuals with autism” and that this app—which is available for free from the Apple Store—can help families with children who, in many cases, typically don’t get diagnosed until they are about four years old.
In addition, an app-based approach can make this kind of technology more accessible to underserved areas, and it can help track a child's changes over time, according to Guillermo Sapiro, a professor at the Edmund T. Pratt, Jr. School of Electrical and Computer Engineering at Duke and a co-leader of the study.
“This technology has the potential to transform how we screen and monitor children's development," says Sapiro.
“This study lays the groundwork to create tools like this to evaluate other developmental and mental health challenges in early childhood in children’s homes,” adds Egger, who has established the WonderLab at NYU Langone Health to build a digital platform for assessing picky eating, tantrums, anxiety and sleep in children.
The goal is to create apps that provide parents with evidence-based knowledge about their children’s mental health and development, helping them to make the determination as to whether clinical help is then needed
“The shortage of child mental health experts is a global issue, and we need new and ambitious solutions to address it,” concludes Egger. “We seek to create apps that are feasible and scalable so that we can bring mental health resources into people’s homes and reach underserved children around the world.”
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