Public Health

Wearable tech supports home therapy for kids with autism


One of high tech’s most fabled consumer flops is showing significant promise in helping patients with autism spectrum disorder (ASD).

Google quickly found out a few years ago that the public wasn’t quite ready for Glass, its eyeglass frame-carrying combination of camera, computer and display. Stanford University Medical School researchers believed that if they added a crucial element—facial recognition software—Glass could be the right fit for a particular set of patients.

The result was a smartphone app and device combination—Superpower Glass (SG), the name chosen to appeal to kids—designed to aid young patients with ASD overcome the condition’s classic social challenge of decoding the facial expressions of others. The positive impact on study participants is detailed in a study published in JAMA Pediatrics.

The AMA is committed to making technology an asset rather than a burden, and developed a Digital Health Implementation Playbook that packages key steps, best practices and resources to extend care beyond the exam room.

The AMA also is a co-founder of Xcertia, a collaborative effort to establish and promote guidelines to improve the quality, safety and effectiveness of mobile health apps.

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The JAMA Pediatrics study points to what researchers said is an effective intervention that can be practiced at home with family.

“Children treated at home with the wearable intervention showed a significant improvement in socialization over children only receiving standard of care behavioral therapy,” the study says. “The mobile intervention, which teaches the recognition and relevance of emotion in the child’s natural setting, can augment standard of care therapy to achieve higher socialization in children with autism spectrum disorder.”

ASD patients aged 6 to 12 were outfitted with Glass devices that connected wirelessly to an Android smartphone app carrying facial recognition software able to distinguish among a range of emotions: happiness, sadness, anger, fear, surprise, disgust, bored indifference and neutrality. The software was developed from hundreds of thousands of facial images.

The Glass device has a user’s-eye-view camera, an onboard computer that communicates with the smartphone-based app, and a display that appears in the user’s right-side peripheral vision. When a face comes into view, Superpower Glass alerts the user with a green light and then displays an emoji representing the software-recognized emotion, as well as with an audio version of the information. It’s designed to train ASD patients to sharpen their own perceptions of what emotions they are seeing.

The standard ASD treatment is the intensive, one-on-one applied behavioral analysis (ABA), which the study authors note comes with the expert recommendation of 20 hours a week for two years. It’s delivered by a trained therapist and includes work with flash cards with facial expressions. All the 71 children in the Stanford study had access to ABA, and 40 were randomly selected to have that therapy augmented by SG.

Those in the SG group worked with their families at home with a goal of four 20-minute sessions a week for six weeks, in addition to an ABA session using SG. There were three learning activities for the sessions. For example, “capture the smile” cued the SG user to discern an emotion from the face of a family member, such as a smile in response to a joke.

The JAMA Pediatrics study’s senior author, Dennis P. Wall, PhD, said in an interview that his research group and a commercial partner have been granted “breakthrough device designation” by the Food and Drug Administration (FDA).

“With this designation we will work closely with the FDA to move it to a widely available solution that is covered by medical insurance,” Wall said.

Strain on the availability of standard treatment for ASD was a motivating factor for the research. ABA is not only intensive, but also expensive—$40,000 to $60,000 a year.

Even when those financial resources are available, the number of trained clinicians is limited. As the incidence of ASD has risen to 1 in 59 American children, it “has outpaced availability of behavioral therapists, creating wait-lists of up to 18 months in the United States,” the researchers noted.

As for the Glass device, after being withdrawn in 2015 from a short stint in the consumer market, development quietly moved forward with commercial users who added their own software to the device—the Glass Enterprise Edition. It’s used in an increasing number of settings, including manufacturing, logistics and health care.