A Review of Wearable Solutions for Physiological and Emotional Monitoring for Use by People with Autism Spectrum Disorder and Their Caregivers
Abstract
:1. Introduction
2. Physiological Changes in ASD Population, Their Relevance in the Context of Anxiety, Stress, and Challenging Behavior Detection, and the Potential for Wearable Assistive Technology
2.1. Autism, and Prevelance of Anxiety in ASD Population
2.2. Physiological Signals for Emotional Monitoring
2.2.1. Heart Rate, Heart Rate Variability, and Heart Rate Reactivity
2.2.2. Respiration Rate
2.2.3. Electrodermal Activity
2.2.4. Skin and Body Temperature
2.2.5. Cortisol Level
2.2.6. Blood Pressure
2.2.7. Blood Volume Pulse
2.2.8. Blood Oxygen Saturation
2.2.9. Electromyography
2.2.10. Electroencephalogram
2.3. Physiological Changes Associated with Anxiety, Stress in ASD Population
2.4. Emotional Changes Assosciated with Challenging Behavior in Population with ASD
2.5. The Potential for Wearable Technology for Stress Detection in ASD in Daily Life
3. Related Work
4. Review of Physiological and Emotional Wearable Monitoring Solutions
4.1. Research Methodology
- Commercially available devices that can monitor physiological signals or emotional states.
- Research prototypes that can monitor physiological signals or emotional states.
- Forthcoming solutions that are still under development which can claim to be able to monitor physiological signals or emotional states.
4.2. Commercial Wearable Devices
4.3. Research Prototypes
4.4. Emerging Solutions
5. Discussion
6. Conclusions
Author Contributions
Funding
Acknowledgments
Conflicts of Interest
Abbreviations
BLE | Bluetooth Low-Energy |
HR | Heart Rate |
HRV | Heart Rate Variability |
RR | Respiration Rate |
RSA | Respiratory Sinus Arrhythmia |
ST | Skin Temperature |
EDA | Electrodermal Activity |
PPG | Photoplethysmogramy |
BVP | Blood Volume Pulse |
ECG | Electrocardiogramy |
EEG | Electroencephalogramy |
EMG | Electromyography |
FDA | Drug and Food Administration |
TENS | Transcutaneous electrical nerve stimulation |
tDCS | Transcranial direct current stimulation |
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Product, Producer | Purpose | Device Form Factor | Sensors/Parameters | Support for Wireless Technology | Clinical Validity | Suitability for Individual with ASD |
---|---|---|---|---|---|---|
Vivosmart 4, Garmin Inc., Olathe, KS, USA [64] | Monitoring stress score using HRV, sleep quality, and activity (step, distance, calories, floors) | Wristband | HR, HRV, accelerometer, oxygen saturation | Yes, Bluetooth Low Energy (BLE) and ANT+ | Not clinically validated | ☆☆☆ |
Rhythm24, Scosche Inc., Oxnard, CA, USA [65] | Monitoring heart rate data | Armband | HR, HRV | Yes, BLE/ANT+ Connection | Investigation showed reliable readings [66] | ☆☆☆ |
E4 wristband, Empatica Inc., Cambridge, MA, USA [67] | Collecting physiological and movement data only | Wristband | HR, HRV, EDA, ST, acceleration | Yes, BLE and data uploaded to cloud | Comparable readings to chest strap [66] | ☆☆☆☆ |
Embrace, Empatica Inc., Cambridge, MA, USA [68] | Alerts epileptics (or caregivers) when an attack occurs in ASD population | Watch | HR using PPG, EDA, ST, and activity | Yes, using BLE | Clinically validated and FDA approved [69] | ☆☆☆☆☆ |
PulseOn OHR, PulseOn, Espoo, Finland [70] | Monitoring physiological and movement data | Wristband | HR, HRV, acceleration | Yes, real-time transfer to application using BLE | HR/HRV are reliable only during resting condition [71] | ☆☆☆ |
ViSi Mobile, Sotera Wireless Inc., San Diego, CA [72] | Monitoring physiological data | Wristband | ECG, HR, pulse rate, BP, RR, SpO2, and ST | Yes, using WiFi | FDA approved for blood pressure monitoring [73] | ☆☆☆ |
BioHarness 3.0, Zephyr Technology, Annapolis, MD, USA [74] | Physiological and activity data collection | Chest strap | HR, HRV, EDA, body temperature, RR, activity, location | Yes, using BLE and LP–PAN [74] | Only reliable HR but HRV is not suitable for clinical evaluations [75] | ☆☆ |
EQ02 LifeMonitor, Equivital Inc., Cambridge, UK [76] | Physiological and activity data collection | Chest Belt | ECG; HR, HRV, RR, EDA, ST, acceleration | Yes, using Bluetooth 2.1 | EQ02 can accurately measure ECG and HRV [77] | ☆ |
Zephyr belt, Medtronic, Inc., Minneapolis, MN, USA [78] | Sports health monitoring | Belt | HR, HRV, RR | Yes, using BLE | Not clinically validated | ☆ |
Hexoskin Smart Shirt, Hexoskin, Inc., Montreal, QC, Canada [62] | Physiological and activity data collection and monitoring quality of sleep | Shirt | HR, HRV, Heart rate recovery, RR and volume, acceleration and power | Yes, using BLE and uploaded to cloud | Clinically validated to obtain reliable HR and RR [79] | ☆☆☆ |
Polar H7 & H10, Polar Electro Oy, Kempele, Finland [80] | Monitoring HR activity | Chest Strap | HR, HRV using ECG | Yes, BLE protocol | Clinically comparable data [81,82] | ☆ |
Polar V800, Polar Electro Oy, Kempele, Finland [83] | Monitoring HR activity | Watch | HR, HRV using light source sensor | Yes, BLE protocol | Clinically validated during rest [84] | ☆☆☆☆ |
Polar Vantage V, Polar Electro Oy, Kempele, Finland [85] | Monitoring HR and physical activity | Watch | HR, HRV, accelerometer | Yes, BLE protocol | Not clinically validated | ☆☆☆☆ |
QardioCore, Qardio, Inc., San Francisco, CA, USA [86] | Monitoring HR, ST, activity tracking | Can be mounted on chest | HR, HRV using ECG sensor, RR, ST, acceleration | Yes, BLE protocol | FDA (510) cleared [87] | ☆ |
Armour39® Module & Chest Strap, Under Armour, Inc., Baltimore, MD, USA [88] | Monitoring heart rate, calorie | Chest Strap | HR, HRV using ECG | Yes, BLE protocol | HR/HRV are reported to be accurate [89] | ☆ |
Wahoo TICKR X, Wahoo Fitness, Atlanta, GA, USA [90] | Monitoring HR, calorie tracking, insights of physical activity | Chest Strap | HR, HRV using ECG acceleration | Yes, using BLE and ANT+ | Bluetooth is HR/HRV accurate, ANT+ is just HR accurate [91] | ☆ |
Suunto 9, Suunto, Inc., Vantaa, Finland [92] | Monitoring HR activity | Watch | HR, HRV | Yes, using BLE | Not clinically validated | ☆☆☆☆ |
Suunto Smart Sensor, Suunto, Inc., Vantaa, Finland [93] | Monitoring HR activity | Chest Strap | HR, HRV | Yes, using BLE | Tests showed reliable HR and HRV [94] | ☆☆ |
Apple Watch Series 4, Apple, Inc. [95] | HR and physical activity | Watch | HR, HRV | Yes, using BLE and to cloud | FDA cleared, initial tests showed good HR and HRV data [96] | ☆☆☆ |
GoBe 2, Healbe, Corp., Moscow, Russia [97] | Emotional monitoring, calorie intake, sleep quality | Wristband | HR, EDA, impedance, BP, and acceleration sensor | Yes, using BLE | Not clinically validated | ☆☆☆ |
BioStamp nPoint, MC10, Inc., Cambridge, CA, USA [98] | Monitoring heart rate, activity and posture data, sleep quality | Patch | HR, HRV, respiration rate, acceleration | Yes, using BLE and uploaded to cloud | FDA (510) cleared [99] | ☆ |
VitalPatch, VitalConnect, San Jose, CA, USA [100] | HR, HRV, respiration rate, skin temperature, body posture, and activity | Patch | ECG for HR acceleration, thermistor for ST | Yes, data uploaded to the cloud | FDA (510) cleared, CE Marked, ISO 13485 certified. | ☆ |
Lief Smart Patch, Lief Therapeutics, Inc., San Francisco, CA, USA [101] | Monitoring heart rate, emotional state, activity | Patch | HR, HRV using ECG sensor, RR, acceleration | Yes, using BLE | Not clinically validated | ☆☆☆ |
AIO Sleeve, Komodo Technologies, Inc., Winnipeg, MB, Canada [102] | Physiological, activity data, monitoring stress level and sleep quality | Sleeve | HR and HRV using ECG, acceleration | Yes, using BLE protocol | Not clinically validated | ☆☆☆☆ |
Empower Me, Brain Power, LLC., Cambridge, MA, USA [103] | Recognizing others’ emotions for ASD people | Glass | Acceleration | Yes, using BLE protocol | Clinically validated | ☆☆☆☆ |
Reference, Institution, Year | Purpose | Device Form Factor | Sensors/Parameters | Support for Wireless Technology | Clinical Validity | Suitability for ASD |
---|---|---|---|---|---|---|
Imani et al. [105], University of California, San Diego, 2016 | Heart rate activity and sweat monitoring | Patch | HR from ECG sensor, concentrations of hydrogen and sodium ions, lactate in human sweat | Yes, using BLE protocol | Initial test on three subject and HR sensor comparable to commercial monitors | ☆☆ |
Yoon et al. [106], Advanced Institute of Science and Technology, 2016 | Stress Monitoring | Patch | EDA, ST, and pulsewave | No | No | ☆☆☆ |
Williams et al. [107], Microsoft, Inc., Redmond, WA, USA 2015 | Reflecting on user’ emotional state, recognizing other’s emotions and stress-relief system | Scarf | Heart rate (HR) | Yes, using BLE | Tested on small number of participants but not validated yet | ☆☆☆☆☆ |
Guo et al. [108], Purdue University, 2016 | Recognizing emotions, enhancing positive emotions and mitigating negative ones. | Scarf | HR, Electrodermal activity (EDA), and use color-changing and odor emitting tool to promote positive emotions | Yes, using Infrared technology | Not validated yet | ☆☆☆☆☆ |
Tang et al. [110], Wenzhou-Kean University, 2016 | Helping neuro-typical individuals recording emotional states of children with ASD | HR, perspiration, Pressure, and acceleration sensor | Yes, using WiFi to upload data to cloud | No | ☆☆ | |
Parlak et al. [16], Stanford University, 2018 | Measuring stress noninvasively | Patch | Cortisol using novel electrochemical sensor | No | Not validated yet | ☆☆☆☆ |
Notenboom [104], University of Twente, 2017 | Monitoring stress level for people with ASD | Watch | HR, EDA, ST, and oxygen sensor | No | Not validated yet | ☆☆☆☆☆ |
Torrado et al. [111], Autonomous University of Madrid, 2017 | Inferring outburst patterns and self-regulation | Watch | HR monitor, accelerometer and gyroscope | Yes, BLE protocol | Not validated yet | ☆☆☆☆ |
AlHanai et al. [112], Massachusetts Institute of Technology, 2017 | Predicting the mood using para-linguistic cues, linguistic content and the physiological state | Watch | ECG, PPG, accelerometer, gyroscope, bioimpedence, electric tissue impedance, EDA, ST, audio and text features | Yes, BLE protocol | Not validated yet | ☆☆☆☆☆ |
Northrup et al., [113], The Center for Discovery, USA, 2016 | Monitoring stress to coordinate emotional arousal with contexts in ASD population | wristband | Electrodermal Activity (EDA) | Yes, BLE protocol | Preliminary tests showed good results [113] | ☆☆☆☆ |
Simm et al. [114], Lancaster University, 2017 | Assessing anxiety | Wristband | HR, ST, and environmental sensing | No | Preliminary tests on adults with ASD [114] | ☆☆☆☆☆ |
Hui et al. [109], University of Reading, 2018 | Emotional monitoring and assessment | Glove | Blood volume pulse, EDA, ST | Yes, using BLE to phone and data uploaded to cloud using WiFi/Cellular | Not validated | ☆☆☆☆ |
Koo et al. [58], Konkuk University & University of California, Davis, 2018 | Monitoring Emotional states for people with ASD | Glove | EDA, HR and HRV using pulse oximeter | Yes, using BLE protocol | Not validated | ☆☆☆ |
Solution Name, Company | Purpose | Device Form Factor | Sensors/Parameters | Support for Wireless Technology | Clinical Validity | Suitability for Individuals with ASD |
---|---|---|---|---|---|---|
MyFeel wristband, Sentio Solutions Inc., Palo Alto, CA, USA [131] | Recognizing emotions | Wristband | HR, EDA, ST | Yes, using BLE | Preliminary study showed usefulness on 150 subjects | ☆☆☆☆ |
Reveal, Awake Labs, Toronto, ON, Canada [34] | Monitoring stress and anxiety in ASD | Wristband | HR, EDA, ST | Yes, using BLE | Undergoing clinical validation and pilot study [132] | ☆☆☆☆☆ |
Gaia Wearable, Gaia LLC., Las Vegas, NV, USA [118] | Monitoring stress, notifying individuals with ASD of meltdowns | Shirt | HR, EDA | Yes, using BLE | Not validated | ☆☆☆☆☆ |
Dymaxia Wearable, Dymaxia, Inc., Toronto, ON, Canada [133] | Analyzing anxiety trends in ASD | Wristband | HR | Yes, using BLE | Not validated | ☆☆☆ |
BioHug Vest, Bio Hug Technologies Ltd., [122] | Calming people with extreme levels of stress in people with ADHD, post-traumatic stress disorders (PTSD), ASD | Vest | Air pressure using Deep Pressure patent technology | Yes, using BLE | Not validated | ☆☆☆☆☆ |
MOXO Wearable, mPath, Broomfield, CO, USA [134] | Monitoring stress levels | Watch | Electrodermal activity | No known | Preliminary studies showed good results [119] | ☆ |
iBreve, iBreve, Ltd., Dublin, Ireland [135] | Monitoring breathing, stress, and activity for women | Clip | RR, HRV, and acceleration | Yes, using BLE | Initial tests to distinguish between different breathing [136] | ☆☆☆ |
KiddoWear band, Good Parents Inc., San Francisco, CA, USA [137] | Monitoring health, stress, activity, and sleep levels | Wristband for kids | HR, ST, EDA, and acceleration | Yes, using BLE | Not validated yet | ☆☆☆☆ |
Spire Health Tag, Spire, St. Louis, MO, USA [138] | Monitoring respiration and HR, sleep quality | Tag | HR, RR, and acceleration | Yes, using BLE | Undergoing clinical trial [139] | ☆☆☆☆☆ |
SKIIN Smart Clothing, Myant Inc., Toronto, ON, Canada [140] | Monitoring respiration heart rate, and sleep | Textile clothing | HR, ST, RR and acceleration | Yes, using BLE | Not validated yet | ☆☆☆☆☆ |
U-Check-It, Bedell Innovations, LLC., PA, USA [141] | Monitoring stress level, stress relief | Wristband | EDA, body temperature, acceleration | Yes, using BLE | Not validated yet | ☆☆☆☆ |
Moodmetric Smart Ring, Vigofere Oy, Tampere, Finland [142] | Monitoring stress level | Ring | Electrodermal activity | Yes, using BLE | Not validated yet | ☆☆☆☆ |
TouchPoints wristband, Touchpoint Solution™, [120] | Stress and anxiety relief | Wristband | Bi-lateral alternating stimulation –tactile (BLAST) | No | Patent-pending neuro-scientific technology | ☆☆☆☆ |
The Pip, Galvanic, Inc., Calgary, AB, Canada [143] | Monitoring and reducing stress level | Teardrop-shape | Electrodermal activity | Yes, using BLE | Not validated yet | ☆ |
Thync, Thync Global Inc., USA [126] | Improving mood (reduce stress, relax, and help in sleep) | Wearable on forehead | Neurostimulation (TENS and tDCS) | Yes, using BLE | Not validated yet | ☆ |
Muse, InteraXon [129] | Monitoring brain activity and stress-relief | Headband | EEG sensor | Yes, using BLE | Preliminary tests [144] and undergoing clinical trial [139] | ☆ |
HeartGuide, Omron Healthcare, Milton Keynes, UK [130] | Monitoring blood pressure, heart rate, sleep quality | Wristband | Optical blood pressure sensor | Yes, using BLE | Undergoing clinical validation but not validated yet. | ☆☆☆☆ |
Leaf Urban, Bellabeat, San Francisco, CA, USA [145] | Stress prediction, sleep monitoring | Bracelet, necklace | Monitor activity, sleep, and RR | Yes, using BLE | Not validated yet | ☆☆☆ |
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Taj-Eldin, M.; Ryan, C.; O’Flynn, B.; Galvin, P. A Review of Wearable Solutions for Physiological and Emotional Monitoring for Use by People with Autism Spectrum Disorder and Their Caregivers. Sensors 2018, 18, 4271. https://doi.org/10.3390/s18124271
Taj-Eldin M, Ryan C, O’Flynn B, Galvin P. A Review of Wearable Solutions for Physiological and Emotional Monitoring for Use by People with Autism Spectrum Disorder and Their Caregivers. Sensors. 2018; 18(12):4271. https://doi.org/10.3390/s18124271
Chicago/Turabian StyleTaj-Eldin, Mohammed, Christian Ryan, Brendan O’Flynn, and Paul Galvin. 2018. "A Review of Wearable Solutions for Physiological and Emotional Monitoring for Use by People with Autism Spectrum Disorder and Their Caregivers" Sensors 18, no. 12: 4271. https://doi.org/10.3390/s18124271