Keshav Neha U, Vogt-Lowell Kevin, Vahabzadeh Arshya, Sahin Ned T
Brain Power, 1 Broadway, Cambridge, MA 02142, USA.
Department of Psychiatry, Massachusetts General Hospital, Boston, MA 02114, USA.
Children (Basel). 2019 May 28;6(6):72. doi: 10.3390/children6060072.
As many as half of school children with autism spectrum disorder (ASD) exhibit symptoms of attention-deficit/hyperactivity disorder (ADHD), resulting in marked negative academic, social, and behavioral outcomes. The focus of the US Food and Drug Administration (FDA) on real-world data from novel digital sources, and the emergence of Current Procedural Terminology (CPT) codes to reimburse for digital monitoring and neurobehavioral testing suggest an increasing acceptance of the role of technology in augmenting clinical care and research. Empowered Brain is an augmented reality and artificial intelligence-based social-emotional communication aid for students with ASD. In this study, student performance on Empowered Brain is correlated to validated clinical measures of ADHD. Seven high school students with a diagnosis of ASD were recruited from a public high school. All students were assessed for severity of ADHD-related symptoms via three clinical gold-standard assessments, namely the Aberrant Behavioral Checklist (ABC), Social Responsiveness Scale 2 (SRS-2), and Teacher Report Form (TRF). Students used Empowered Brain over a one-week period. We measured the correlation of student in-game performance (as measured by point- and star-based rewards) relative to the hyperactivity subscale of the ABC (ABC-H), and the ADHD-subscale of the TRF. All seven students completed the study and managed to successfully use Empowered Brain. Students received a culminative total of 32 sessions, an average of 4.6 sessions per student (range 2-8). Student in-game performance demonstrated highly significant correlation relative to ABC-H (points: = 0.0013; stars: p = 0.0013)., and significant correlation to TRF ADHD scores (points: p = 0.012; stars: p = 0.012). No adverse effects were noted among students who used Empowered Brain. New technologies may herald novel ways of identifying and characterizing symptoms of ADHD in student populations. This study provides evidence that Empowered Brain in-game performance correlates with ADHD symptom severity in students with ASD. Larger samples are required to validate these findings, with more diverse participants that can also widen the generalizability of these findings to a broader range of brain conditions that manifest with inattention, impulsivity, and hyperactivity. Through further research, we may find that such technologies can help us to identify and longitudinally monitor such symptoms, and potentially aid in severity stratification and digital phenotyping.
多达一半的患有自闭症谱系障碍（ASD）的学童表现出注意力缺陷多动障碍（ADHD）的症状，这会导致明显负面的学业、社交和行为结果。美国食品药品监督管理局（FDA）对来自新型数字来源的真实世界数据的关注，以及用于报销数字监测和神经行为测试的现行程序术语（CPT）代码的出现，表明人们越来越认可技术在加强临床护理和研究方面的作用。“赋能大脑”是一款基于增强现实和人工智能的针对患有ASD的学生的社交情感交流辅助工具。在这项研究中，学生在“赋能大脑”上的表现与经过验证的ADHD临床测量指标相关。从一所公立高中招募了七名被诊断患有ASD的高中生。通过三项临床金标准评估，即异常行为检查表（ABC）、社会反应量表2（SRS - 2）和教师报告表（TRF），对所有学生的ADHD相关症状严重程度进行了评估。学生们在为期一周的时间里使用“赋能大脑”。我们测量了学生在游戏中的表现（通过基于点数和星星的奖励来衡量）与ABC的多动分量表（ABC - H）以及TRF的ADHD分量表之间的相关性。所有七名学生都完成了研究，并成功使用了“赋能大脑”。学生们总共接受了32次课程，平均每名学生4.6次课程（范围为2 - 8次）。学生在游戏中的表现与ABC - H显示出高度显著的相关性（点数：p = 0.0013；星星：p = 0.0013），与TRF的ADHD分数也有显著相关性（点数：p = 0.012；星星：p = 0.012）。使用“赋能大脑”的学生中未发现不良反应。新技术可能预示着识别和表征学生群体中ADHD症状的新方法。这项研究提供了证据，表明“赋能大脑”的游戏表现与患有ASD的学生的ADHD症状严重程度相关。需要更大的样本量来验证这些发现，同时要有更多样化的参与者，这也可以将这些发现的普遍性扩展到更广泛的表现出注意力不集中、冲动和多动的脑部疾病。通过进一步的研究，我们可能会发现此类技术可以帮助我们识别并纵向监测这些症状，并可能有助于进行严重程度分层和数字表型分析。
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