title: Monitoring of autonomic response to sociocognitive tasks during treatment in children with Autism Spectrum Disorders by wearable technologies: A feasibility study.
abstract: Autism Spectrum Disorders (ASD) represent a heterogeneous set of neurodevelopmental disorders characterized by impairments in social domain, where the autonomic nervous system (ANS) plays an important role. Several researchers have studied the ANS in ASD, during specific cognitive or sensory stimuli while few studies have examined response during social interactions. Wearable technologies can be very helpful in monitoring autonomic response in children with ASD in semi-naturalistic setting. The novelty of this study is to use such technologies to acquire physiological signals during therapeutic sessions supported by interactive "serious games" and to correlate the ANS response to the engagement of the child during sociocognitive tasks for an evaluation of the treatment effect and for the personalization of the therapy.
  
  
  
  A wearable chest belt for electrocardiographic (ECG) signal recording was used and specific algorithms for the extraction of clinically relevant features (Heart Rate - HR, Root Mean Square of the Successive Differences - RMSSD and Respiratory Sinus Arrhythmia - RSA) were developed. Sociocognitive tasks were mediated by "serious games" implemented on two tablets, which allowed a precise coding of the behaviors of the children. A longitudinal assessment of the physiological response of the children during six months of treatment was performed.
  
  
  
  A link between physiological response, i.e. decrease in RMSSD and RSA, and engagement of the children during sociocognitive tasks was found. Longitudinal changes in the children's autonomic response, including a decrease of RSA during the engagement throughout the therapeutic sessions, were found.
  
  
  
  These results foster the feasibility of this methodology to be applied in a clinical setting for the monitoring of the ANS response of children with ASD during treatment. A larger sample of patients is needed to confirm these preliminary findings.
authors.affiliation: University of Pisa, Pisa, Italy.
authors.forename: Simone
authors.initials: S
authors.lastname: Di Palma
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy. Electronic address: atonacci@ifc.cnr.it.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Tonacci
authors.affiliation: Department of Developmental Neuroscience, Stella Maris Scientific Institute, Calambrone, Pisa, Italy.
authors.forename: Antonio
authors.initials: A
authors.lastname: Narzisi
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Domenici
authors.affiliation: National Research Council of Italy, Messina, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Pioggia
authors.affiliation: Department of Developmental Neuroscience, Stella Maris Scientific Institute, Calambrone, Pisa, Italy.
authors.forename: Filippo
authors.initials: F
authors.lastname: Muratori
authors.affiliation: Institute of Clinical Physiology, National Research Council of Italy (IFC-CNR), Pisa, Italy; Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
authors.forename: Lucia
authors.initials: L
authors.lastname: Billeci
mesh_terms: D001146:Arrhythmia, Sinus / Q000503:physiopathology; D000067877:Autism Spectrum Disorder / Q000503:physiopathology / Q000523:psychology; D002648:Child; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation / Q000379:methods; D005240:Feasibility Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D012815:Signal Processing, Computer-Assisted / Q000295:instrumentation; D012919:Social Behavior; D013647:Task Performance and Analysis; D000076251:Wearable Electronic Devices
keywords: Autism Spectrum Disorders (ASDs); Electrocardiogram (ECG); Heart Rate; Heart Rate Variability (HRV); Monitoring; Personalization; Respiratory Sinus Arrhythmia (RSA); Wearable platform