Abstract

Autism spectrum disorder (ASD) is mostly diagnosed according to behavioral symptoms in sensory, social, and motor domains. Improper motor functioning, during diagnosis, involves the qualitative evaluation of stereotyped and repetitive behaviors, while quantitative methods that classify body movements’ frequencies of children with ASD are less addressed. Recent advances in neuroscience, technology, and data analysis techniques are improving the quantitative and ecological validity methods to measure specific functioning in ASD children. On one side, cutting-edge technologies, such as cameras, sensors, and virtual reality can accurately detect and classify behavioral biomarkers, as body movements in real-life simulations. On the other, machine-learning techniques are showing the potential for identifying and classifying patients’ subgroups. Starting from these premises, three real-simulated imitation tasks have been implemented in a virtual reality system whose aim is to investigate if machine-learning methods on movement features and frequency could be useful in discriminating ASD children from children with typical neurodevelopment. In this experiment, 24 children with ASD and 25 children with typical neurodevelopment participated in a multimodal virtual reality experience, and changes in their body movements were tracked by a depth sensor camera during the presentation of visual, auditive, and olfactive stimuli. The main results showed that ASD children presented larger body movements than TD children, and that head, trunk, and feet represent the maximum classification with an accuracy of 82.98%. Regarding stimuli, visual condition showed the highest accuracy (89.36%), followed by the visual-auditive stimuli (74.47%), and visual-auditive-olfactory stimuli (70.21%). Finally, the head showed the most consistent performance along with the stimuli, from 80.85% in visual to 89.36% in visual-auditive-olfactory condition. The findings showed the feasibility of applying machine learning and virtual reality to identify body movements’ biomarkers that could contribute to improving ASD diagnosis.

Highlights

  • Autism spectrum disorder (ASD) is a neurodevelopmental disorder mainly based on impairments in social communication and interactions’ abilities and on the presence of restricted, repetitive patterns of behavior, interests, or activities [1]

  • Repetitive behaviors (RBs) are defined as heterogeneous observable motor stereotyped or repetitive sequences characterized by rigidity, invariance, inappropriateness, and being purposeless [6,7]

  • ASD is diagnosed according to qualitative clinician judgments, based on symptoms, through semi-structured observations and interviews (ADOS; ADI-R)

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Summary

Introduction

Autism spectrum disorder (ASD) is a neurodevelopmental disorder mainly based on impairments in social communication and interactions’ abilities and on the presence of restricted, repetitive patterns of behavior, interests, or activities [1]. It affects 1 in 160 children [2] and its symptomatology tends to appear from two to four years old, in some cases it is possible to detect in six months old toddlers [3,4]. Repetitive behaviors (RBs) are defined as heterogeneous observable motor stereotyped or repetitive sequences characterized by rigidity, invariance, inappropriateness, and being purposeless [6,7]. RBs can occur currently with small changes of the routine or in presence of new and unknowns stimuli to reduce subjective arousal and to cope with unfamiliar events, to maintain homeostasis [8,9,10]

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