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Heart rate monitoring under stress condition during behavioral analysis in children with neurodevelopmental disorders

Monitoring physiological parameters under stress conditions – i.e., heart rate, breath frequency or heart rate variability - through non-invasive and comfortable wearable devices was a research topic of great interest in many medical fields. In the last decade, several wearable devices and methods have been developed for stress monitoring, showing suitable performance in estimating the stress indicator. In spite of the interest in the field, the development of wearable solutions suitable for child neuropsychiatry applications was still an open challenge. In this study, we evaluate the cardiac activity in children - with and without neurodevelopmental disorders - through a novel wearable solution in order to compare the stress response in different structured activities and games. Each subject was equipped with a 3-lead electrocardiograph device and a piezoelectric respiratory sensor embedded into a thoracic belt. Subjects were asked to carry out five different activities previously chosen from a subset of specific behavioral tests (three different free-games and two structured activities). All experimental sessions were video-recorded. Results highlighted how wearable devices could help in estimating stress indicators for long-tests (over twenty-five minutes). The clinical application was conducted on a cohort of 32 children so divided: 13 with Specific Language Disorder, 15 with Autism Spectrum Disorder, and 4 control children without neurodevelopmental disorders. Statistical differences were observed between populations in the heart rate. Moreover, all subjects experienced stress effects evidenced by variation of heart rate and standard deviation, which are supported by the video analysis.