Autism Test? There May Soon be an App for That

The app, which is in the testing stage, displays a series of videos designed to trigger some of the behavioral signs of autism.

by Laura Oleniacz, The Herald-Sun / December 23, 2014

(TNS) — Using image analysis software built to recognize people’s facial features and head orientation in an iPad image, a team of Duke University researchers is developing an app that they hope will successfully screen for risk behaviors for autism.

“This is research that — it has the right combination of being scientifically extremely challenging, and also being a tremendous contribution to society when we manage to solve it,” said Guillermo Sapiro, a professor of electrical and computer engineering at Duke who is leading the computer image analysis side of the project.

The app, which is in the testing stage, displays a series of videos designed to trigger some of the behavioral signs of autism.

The device’s camera captures the image of the child watching the videos, and they’ve developed software to analyze the child’s head position and facial expression.

Sapiro said they can train the computer to recognize emotions using databases of facial expressions. He started working on computer behavior analysis technology before he came to Duke about two years ago.

“We automatically detect your eyes, your mouth, your nose, your eyes,” he said. “The biggest challenge is to basically do that, and to make sure it works for children. A lot of times you see that in lab conditions children are not the most collaborative subjects you can find.”

Sapiro was also co-author on a paper published in June in Autism Research and Treatment. The study compared the accuracy of their computer program in screening screen children for autism in videotaped behavioral tests run by a trained evaluator.

According to a news release from Duke’s Pratt School of Engineering, they found that the program was more accurate than two students and a non-expert clinician in identifying behavioral signs of autism.

But with that screening test, Sapiro said it involved an expert running the behavioral test in the room. What they’re designing now would involve a child sitting in front of an iPad, watching a movie.

The app videos are designed to not only trigger what project collaborator Kimberly Carpenter said are some of the “core behavioral signs” of autism, but also to trigger behaviors that the technology can detect in an automated fashion. Carpenter is a postdoctoral associate at the Center for Developmental Epidemiology in the Duke University Medical Center Department of Psychiatry and Behavioral Sciences.

For example, one of the videos is of a puppet show. The video prompts someone in the room to say the child’s name, and the software is designed to detect the child’s response.

“In this case, after the clinician or nurse says the child’s name, (we look for) how long does it take the child look, or even, does the child look or doesn’t look,” said Jordan Hashemi, a doctoral candidate in electrical and computer engineering at Duke who is working on the project.

Another video is designed to test for what Campbell said is “social sharing” using puppets. If the child is engaged with the video, he or she may try to share what they what they’re looking at with a loved one — a sign of a child developing normally.

“They typically will look at the thing, and look at mom or somebody around, and look back and share it with them,” Carpenter said.

Carpenter said that one of their hopes is that the app will help with issues surrounding current standard screening tools that lead to long wait times for professional diagnosis.

In the typical screening process to see if a child should get a professional diagnosis, Carpenter said children are screened in their doctor’s offices using a test called the M-CHAT, or the Modified Checklist for Autism in Toddlers. There’s also a follow-up questionnaire for children who screened positive through the M-CHAT, she said.

Carpenter said the screener has high false positive rates, leading to what she said is a backlog of children seeking a professional diagnosis. And that waiting time eats away at “critical” months when kids could be getting behavioral interventions.

“So what we’re trying to do is capture some of those behaviors on the iPad, and have the engineering team’s algorithm score it immediately so the pediatrician can immediately get: this kid is at risk, this kid is not showing risk,” Carpenter said. “This isn’t meant to replace diagnosis, this isn’t meant to replace the M-CHAT, this is meant to help,” she added.

Kara Reagon, associate director of dissemination science at Autism Speaks, an autism science and advocacy organization, said the American Academy of Pediatrics recommends that pediatricians screen children for autism at 18 and 24 months, but not all children get screened. She said she believes there is a need for low-cost, easily implemented screening tools — especially in low-income or remote areas where there might be more barriers to screening.

“The reason why we want to diagnose or screen children early and then follow-up with a formal diagnosis is because it’s shown that intensive behavioral intervention can improve the quality of life, the skill sets, that these children have,” she said.

Ultimately, Sapiro said they want the test to be publicly available so parents can get immediate feedback, such as making it available online or at schools. But they are still testing the app. Sapiro said they are starting testing in the clinic and in the lab.

The project collaborators include Sapiro as well as experts in early childhood development at Duke. The work is being done under the Information Initiative at Duke, as well as the Duke Information and Child Mental Health Initiative, he said. He said they received internal funding for the project and from outside organizations.

“For me, as a computer scientist, to make this system work is a tremendous challenge,” Sapiro said of his interest in the project. “Secondly, I believe there is nothing more important than helping our children. I think that’s one of our primary goals of every society: just to make sure the children get the care that (they) deserve.”

©2014 The Herald-Sun (Durham, N.C.)