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Examining the Effect of a Wearable Physiology-Based Anxiety Detection Technology on Self-Awareness of Anxiety Signs in Autism Spectrum Disorder: Data from the Pond Network
Co-morbid anxiety is prevalent in autism spectrum disorder (ASD) and can negatively impact physical and mental health. Symptom awareness is fundamental to traditional anxiety treatments. However, self-awareness of anxiety symptomology can be challenging in ASD due to differences in emotional awareness and introspection. To address this challenge, we conducted a randomized controlled trial to assess the efficacy of the Anxiety Meter, a wearable, real-time anxiety detection technology, to support awareness of symptoms of anxiety in children and youth with ASD. The Anxiety Meter uses wearable sensors to translate heart rate into a visual display of anxiety (green = calm, red = anxious).
Objectives:
The objective is to determine if the Anxiety Meter can improve awareness of anxiety symptoms and increase self-initiation of relaxation techniques.
Methods:
Twenty-seven children and youth with ASD (Age = 12.9 ± 2.7, 16 males) participated in the study. All participants were part of the Province of Ontario Neurodevelopmental Disorders (POND) Network, had a full-scale IQ score above 50 (IQ = 98.7 ± 18.3), and had not previously received Cognitive Behaviour Therapy. All participants were trained on the use of the Anxiety Meter and taught a diaphragmatic breathing relaxation technique over three visits. On the fourth visit, participants were randomized to either receive feedback of their anxiety level (n = 14) or no feedback (n = 12) from the Anxiety Meter while completing a stress-eliciting task (public speaking) and asked to engage in deep breathing if anxious. Data from one participant in the no feedback group was excluded prior to analysis as the participant did not complete the task. The proportion of participants who initiated deep breathing in each group was measured.
Results:
The proportion of participants who initiated deep breathing to those who did not was significantly higher in the Anxiety Meter feedback group compared to the control group (14:0 versus 3:9; Fisher’s exact, p<0.0001). Of those who initiated deep breathing, 10/14 in the Anxiety Meter feedback group and 3/3 in the control group reported feeling calmer after deep breathing.
Conclusions:
Feedback from the Anxiety Meter was associated with a significant increase in the proportion of children who initiated deep breathing in response to anxiety. The results support the feasibility of using a wearable device and real-time feedback to improve anxiety symptom awareness in children with ASD.