Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings

BackgroundAttention Deficit Hyperactivity Disorder (ADHD) among children younger than 6 years is quite impairing, nearly half these youth with ADHD experience school exclusion from mainstream preschool classes due to related emotional and behavioral outbursts. While a range of behavior rating scales...

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Main Authors: Ripudaman (Zeeba) Singh, Janav Panchal, Sami Ali, Beth Krone, Isaac J. Wert, Mark Owens, Mark Stein, Maulik V. Shah
Format: Article
Language:English
Published: Frontiers Media S.A. 2025-03-01
Series:Frontiers in Child and Adolescent Psychiatry
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Online Access:https://www.frontiersin.org/articles/10.3389/frcha.2025.1549220/full
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author Ripudaman (Zeeba) Singh
Janav Panchal
Sami Ali
Beth Krone
Isaac J. Wert
Mark Owens
Mark Stein
Maulik V. Shah
author_facet Ripudaman (Zeeba) Singh
Janav Panchal
Sami Ali
Beth Krone
Isaac J. Wert
Mark Owens
Mark Stein
Maulik V. Shah
author_sort Ripudaman (Zeeba) Singh
collection DOAJ
description BackgroundAttention Deficit Hyperactivity Disorder (ADHD) among children younger than 6 years is quite impairing, nearly half these youth with ADHD experience school exclusion from mainstream preschool classes due to related emotional and behavioral outbursts. While a range of behavior rating scales and subjective measures are used to assess these youth, objective methods of assessment and prediction derived from technology have potential to improve therapeutic and academic interventions outcomes for these youths. We hypothesized that biometric sensors would provide objective, highly sensitive and specific information regarding the physiological status of children prior to an impulsive outburst and could be feasibly implemented using a wearable device in the special education classroom.MethodsWe recruited two whole classrooms (N = 5 youth in the pre-K class and N = 5 youth from the first grade) of a specialized therapeutic day-school for youth with ADHD and other psychiatric and developmental disorders to examine feasibility of obtaining continuous physiological data associated with behavioral and emotional outbursts through smartwatch use. Children wore a sensor watch during their daily classroom activities for two weeks and trained observers collected data using behavioral logs. Using Ecological Momentary Assessment methodology, to examine correlations between objective sensor data and observer observation. Data collected from parents regarding prior night's sleep was also examined.ResultsAll participants completed the study. With a few tolerability or palatability issues. Associations were found between physiological and behavioral/questionnaire data. The methodology holds promise for reliably measuring behavioral and emotional outbursts in young children.ConclusionsThis is the first study to use a bio-marker device in vivo among severely dysregulated pre-school aged youth throughout a full school day. This study established the feasibility of utilizing sensor derived physiological data as an objective biomarker of ADHD within the special education therapeutic classroom. Further research with larger samples is required to build a more robust and personalized AI predictive model.
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spelling doaj-art-3f1b9d756b2f413487e33a2e7101246c2025-08-20T02:51:18ZengFrontiers Media S.A.Frontiers in Child and Adolescent Psychiatry2813-45402025-03-01410.3389/frcha.2025.15492201549220Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settingsRipudaman (Zeeba) Singh0Janav Panchal1Sami Ali2Beth Krone3Isaac J. Wert4Mark Owens5Mark Stein6Maulik V. Shah7MaxisHealth LLC., Edison, NJ, United StatesMaxisHealth LLC., Edison, NJ, United StatesMaxisHealth LLC., Edison, NJ, United StatesDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United StatesDepartment of Child and Adolescent Psychiatry, Grossman School of Medicine, New York University, New York, NY, United StatesPsychiatry and Pediatrics, University of Washington, Seattle, WA, United StatesMaxisHealth LLC., Edison, NJ, United StatesBackgroundAttention Deficit Hyperactivity Disorder (ADHD) among children younger than 6 years is quite impairing, nearly half these youth with ADHD experience school exclusion from mainstream preschool classes due to related emotional and behavioral outbursts. While a range of behavior rating scales and subjective measures are used to assess these youth, objective methods of assessment and prediction derived from technology have potential to improve therapeutic and academic interventions outcomes for these youths. We hypothesized that biometric sensors would provide objective, highly sensitive and specific information regarding the physiological status of children prior to an impulsive outburst and could be feasibly implemented using a wearable device in the special education classroom.MethodsWe recruited two whole classrooms (N = 5 youth in the pre-K class and N = 5 youth from the first grade) of a specialized therapeutic day-school for youth with ADHD and other psychiatric and developmental disorders to examine feasibility of obtaining continuous physiological data associated with behavioral and emotional outbursts through smartwatch use. Children wore a sensor watch during their daily classroom activities for two weeks and trained observers collected data using behavioral logs. Using Ecological Momentary Assessment methodology, to examine correlations between objective sensor data and observer observation. Data collected from parents regarding prior night's sleep was also examined.ResultsAll participants completed the study. With a few tolerability or palatability issues. Associations were found between physiological and behavioral/questionnaire data. The methodology holds promise for reliably measuring behavioral and emotional outbursts in young children.ConclusionsThis is the first study to use a bio-marker device in vivo among severely dysregulated pre-school aged youth throughout a full school day. This study established the feasibility of utilizing sensor derived physiological data as an objective biomarker of ADHD within the special education therapeutic classroom. Further research with larger samples is required to build a more robust and personalized AI predictive model.https://www.frontiersin.org/articles/10.3389/frcha.2025.1549220/fullADHDpre-Kemotionemotion dysregulationphysiological sensorschildren
spellingShingle Ripudaman (Zeeba) Singh
Janav Panchal
Sami Ali
Beth Krone
Isaac J. Wert
Mark Owens
Mark Stein
Maulik V. Shah
Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings
Frontiers in Child and Adolescent Psychiatry
ADHD
pre-K
emotion
emotion dysregulation
physiological sensors
children
title Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings
title_full Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings
title_fullStr Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings
title_full_unstemmed Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings
title_short Ecological Momentary Assessment of emotional dysregulation and outbursts among youth with ADHD: a feasibility study of a biomarker-driven predictive algorithm in the special education pre-K and early childhood classroom settings
title_sort ecological momentary assessment of emotional dysregulation and outbursts among youth with adhd a feasibility study of a biomarker driven predictive algorithm in the special education pre k and early childhood classroom settings
topic ADHD
pre-K
emotion
emotion dysregulation
physiological sensors
children
url https://www.frontiersin.org/articles/10.3389/frcha.2025.1549220/full
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