Runpeng Liu

Bio: Runpeng Liu is an academic researcher from Massachusetts Institute of Technology. The author has contributed to research in topics: Autism & Autism spectrum disorder. The author has an hindex of 4, co-authored 5 publications receiving 134 citations.

Feasibility of an Autism-Focused Augmented Reality Smartglasses System for Social Communication and Behavioral Coaching.

Abstract: Background: Autism Spectrum Disorder (ASD) is a childhood-onset neurodevelopmental disorder with a rapidly rising prevalence, currently affecting 1 in 68 children, and over 3.5 million people in the United States. Current ASD interventions are primarily based on in-person behavioral therapies that are both costly and difficult to access. These interventions aim to address some of the fundamental deficits that clinically characterize ASD, including deficits in social communication, and the presence of stereotypies, and other autism-related behaviors. Current diagnostic and therapeutic approaches seldom rely on quantitative data measures of symptomatology, severity, or condition trajectory. Methods: Given the current situation, we report on the Brain Power System (BPS), a digital behavioral aid with quantitative data gathering and reporting features. The BPS includes customized smartglasses, providing targeted personalized coaching experiences through a family of gamified augmented-reality applications utilizing artificial intelligence. These applications provide children and adults with coaching for emotion recognition, face directed gaze, eye contact, and behavioral self-regulation. This preliminary case report, part of a larger set of upcoming research reports, explores the feasibility of the BPS to provide coaching in two boys with clinically diagnosed ASD, aged 8 and 9 years. Results: The coaching intervention was found to be well tolerated and rated as being both engaging and fun. Both males could easily use the system, and no technical problems were noted. During the intervention, caregivers reported improved non-verbal communication, eye contact, and social engagement during the intervention. Both boys demonstrated decreased symptoms of ASD, as measured by the Aberrant Behavior Checklist at 24 hours’ post-intervention. Specifically, both cases demonstrated improvements in irritability, lethargy, stereotypy, hyperactivity/noncompliance, and inappropriate speech. Conclusions: Smartglasses using augmented reality may have an important future role in helping address the therapeutic needs of children with ASD. Quantitative data-gathering from such sensor-rich systems may allow for digital phenotyping and the refinement of social communication constructs of the Research Domain Criteria (RDoC). This report provides evidence for the feasibility, usability, and tolerability of one such specialized smartglasses system.

Improved Socio-Emotional and Behavioral Functioning in Students with Autism Following School-Based Smartglasses Intervention: Multi-Stage Feasibility and Controlled Efficacy Study.

Abstract: Background: Students with Autism Spectrum Disorder (ASD) commonly demonstrate prominent social communication deficits, symptoms of attention-deficit/hyperactivity disorder, and chronic irritability. These challenges hinder academic progress and frequently persist despite educational, behavioral, and medical interventions. An assistive smartglasses technology may aid these individuals, especially if the technology is efficacious in ecologically-valid school settings. This study explored the feasibility and efficacy of Empowered Brain, a computerized smartglasses intervention designed as a socio-emotional behavioral aid for students with ASD. Methods: This two-part six-week study involved four school children with ASD from a public elementary school. The study incorporated an initial three-week feasibility stage followed by a three-week controlled longitudinal efficacy stage. Both stages involved the use of a twice-daily socio-emotional intervention with the smartglasses. Educators completed pre-intervention and post-intervention Aberrant Behavioral Checklist (ABC) ratings at the start of the feasibility stage, and weekly during the efficacy stage. Primary outcome measures were improvements in the ABC subscales of irritability, hyperactivity, and social withdrawal. Results: Students in both feasibility and efficacy stages demonstrated improvements (decreases) in irritability, hyperactivity, and social withdrawal compared to a baseline period and control periods, respectively. Participants in the controlled efficacy stage demonstrated decreased ABC subscale scores of 90% for irritability, 41.6% for hyperactivity, and 45.6% for social withdrawal. An intervention exposure-response improvement in irritability and hyperactivity was found during the efficacy stage. Educators rated the technology as superior or vastly superior compared to other assistive technologies. Conclusion: A substantial number of school children with ASD demonstrate chronic and impairing cognitive and behavioral challenges. This study provides evidence that Empowered Brain, a smartglasses-based socio-emotional aid for autism, is both feasible and efficacious in improving symptoms of social withdrawal, irritability, and hyperactivity in students with autism. The improvement is demonstrated as part of a longitudinal school-based intervention. Further studies involving larger samples and incorporation of randomized controlled trial methodology are underway to further elucidate the impact of this technology.

Longitudinal socio-emotional learning intervention for autism via smartglasses: Qualitative school teacher descriptions of practicality, usability, and efficacy in general and special education classroom settings

Abstract: There is considerable demand for special education services for the over half a million students with autism in the United States. While assistive technology may augment educational services, its implementation is often prevented by a number of practical and attitudinal barriers. These barriers are especially pertinent for the newest and thus least familiar digital systems, such as computerized smartglasses loaded with specialized software modules. Computerized smartglasses are a technology that has already been shown to have an ability to deliver educational interventions through augmented reality. With this in mind, we sought to understand how school educators received and assessed the practicality of a smartglasses-based educational intervention in a single-subject study. The intervention was designed to aid with attention and social educational learning in autism. The intervention was delivered twice a day during a two-week study on a 13-year-old student with autism who was attending a mainstream middle school in Massachusetts. Three different school educators delivered the intervention: the student’s general education teacher, special education teacher, and paraprofessional. Educators recorded their attitudes, the practicality of the technology, and its impact on the student and their classroom through the use of a digital log and a series of in-person interviews. Overall, the school educators experienced a positive view of the smartglasses. The smartglasses intervention was found to be logistically practical to implement, easily usable by both the educator and student, and not time-consuming to learn or implement. Educators also identified the experience as being fun for the student, and felt that the student demonstrated improvement in his verbal and non-verbal skills. There were no adverse effects on the other students or the classroom, and the technology did not result in a distraction. These findings suggest that social skills interventions delivered by smartglasses may be practical, useful, and may lead to improvements in social communication skills. Further research on smartglasses may help to clarify the future role for augmenting special education in students with autism.

Case Study of a Digital Augmented Reality Intervention for Autism in School Classrooms: Associated With Improved Social Communication, Cognition, and Motivation via Educator and Parent Assessment

Abstract: Background: Impairment in social communication is the primary deficit in school-aged children with autism spectrum disorder (ASD). There are efficacious interventions to address social communication deficits, yet their delivery is hampered by the lack of human and time resources. Emerging assistive technologies, such as smartglasses, may be able to help augment the social communication interventions currently provided by human educators and therapists. While emerging research suggests assistive socio-emotional coaching smartglasses can be effective and usable in research settings, they have yet to be studied amidst the complex social, physical, and time-constrained environment of the school classroom. This structured case study reports on the feasibility and efficacy of 16 intervention sessions of the Empowered Brain Face2Face module, a smartglasses-based social communication intervention. Methods: A 13-year-old fully-verbal adolescent male student with a diagnosis of ASD received a total of 16 smartglasses-aided intervention sessions over a two-week period. Interventions occurred twice-daily during school days and were facilitated by school professionals in a middle school in Massachusetts, USA. Outcomes were measured using the Social Responsiveness Scale 2 (SRS-2), a commonly used validated measure of social communication in children with ASD, by the participant’s parent, paraprofessional, and two teachers. Difficulties in usability during the study were recorded through observation notes. Results: The participant completed the three-week study (one pre-intervention week (baseline) and two intervention weeks) without any observations of adverse effects or usability concerns. The parent and three educators completed the SRS-2 for the baseline and intervention weeks, and results demonstrated significant improvement in social communication after the intervention relative to baseline. The parent, special education teacher, and general education teacher noted marked reductions in SRS-2 total T score, with improvement in SRS-2 social communication, social motivation, social cognition, and restricted interests and repetitive behavior subscales. Conclusion: Smartglasses are a novel assistive technology that can help facilitate social communication and behavioral coaching for students with ASD. The use of the Face2Face module by educators over a two-week period was associated with improvements in social communication. This study supports the use of this novel technology to deliver assistive social communication and behavioral coaching in schools.

Patient Engagement Platform for Remote Monitoring of Vestibular Rehabilitation with Applications in Concussion Management and Elderly Fall Prevention

Abstract: Vestibular rehabilitation therapy includes exercises known to be an effective treatment for persistent symptoms of dizziness Despite this, dizziness often remains untreated from lack of adequate training, feedback, and patient engagement To address this, we propose a patient engagement platform for improving vestibular rehabilitation therapy outcomes The platform includes an exercise measuring smartphone application and a web portal for physical therapists to manage their patients The platform enables patients to have real-time instruction and performance feedback of therapeutic exercises, gamifies exercises so they are engaging and motivational, and enables physical therapists to remotely monitor exercise adherence and performance Here, we describe platform functionality and demonstrate a novel computer vision-driven method for measuring vestibular exercises using a smartphone Continued iterative development of this system will aide physical therapists in improving vestibular rehabilitation outcomes, including post-concussion management and elderly fall prevention

The economic burden of childhood autism spectrum disorders

Abstract: OBJECTIVE: To estimate the associations between autism spectrum disorder (ASD) diagnoses and service use, caregiver time, and cost outcomes. METHODS: We used national data from the Medical Expenditure Panel Survey linked to the National Health Interview Survey and a study-specific survey to estimate the annual utilization and costs for health care, school, ASD-related therapy, family-coordinated services, as well as caregiver time in children aged 3 to 17 years, with and without parent-reported ASD. Regression analyses estimated the association between ASD diagnosis and cost, controlling for child gender, age, race/ethnicity, insurance status, household income, country region and urban/rural classification, and non–ASD-related illnesses. RESULTS: Children with parent-reported ASD had higher levels of health care office visits and prescription drug use compared with children without ASD (P < .05). A greater proportion of children in the ASD group used special educational services (76% vs 7% in the control group, P < .05). After adjusting for child demographic characteristics and non–ASD-associated illnesses, ASD was associated with $3020 (95% confidence interval [CI]: $1017–$4259) higher health care costs and $14 061 (95% CI: $4390–$24 302) higher aggregate non–health care costs, including $8610 (95% CI: $6595–$10 421) higher school costs. In adjusted analyses, parents who reported that their child had ASD did not have significantly higher out-of-pocket costs or spend more time on caregiving activities compared with control parents. CONCLUSIONS: The economic burden associated with ASD is substantial and can be measured across multiple sectors of our society. Previous analyses that focused on health care underestimated this economic burden, particularly for school systems.

Wearables in Medicine

Abstract: Wearables as medical technologies are becoming an integral part of personal analytics, measuring physical status, recording physiological parameters, or informing schedule for medication. These continuously evolving technology platforms do not only promise to help people pursue a healthier life style, but also provide continuous medical data for actively tracking metabolic status, diagnosis, and treatment. Advances in the miniaturization of flexible electronics, electrochemical biosensors, microfluidics, and artificial intelligence algorithms have led to wearable devices that can generate real-time medical data within the Internet of things. These flexible devices can be configured to make conformal contact with epidermal, ocular, intracochlear, and dental interfaces to collect biochemical or electrophysiological signals. This article discusses consumer trends in wearable electronics, commercial and emerging devices, and fabrication methods. It also reviews real-time monitoring of vital signs using biosensors, stimuli-responsive materials for drug delivery, and closed-loop theranostic systems. It covers future challenges in augmented, virtual, and mixed reality, communication modes, energy management, displays, conformity, and data safety. The development of patient-oriented wearable technologies and their incorporation in randomized clinical trials will facilitate the design of safe and effective approaches.

Augmented Reality for Learning of Children and Adolescents With Autism Spectrum Disorder (ASD): A Systematic Review

Abstract: This paper presents a systematic review of relevant primary studies on the use of augmented reality (AR) to improve various skills of children and adolescents diagnosed with autism spectrum disorder (ASD) from years 2005 to 2018 inclusive in eight bibliographic databases. This systematic review attempts to address eleven specific research questions related to the learing skills, participants, AR technology, research design, data collection methods, settings, evaluation parameters, intervention outcomes, generalization, and maintenance. The social communication skill was the highly targeted skill, and individuals with ASD were part of all the studies. Computer, smartphone, and smartglass are more frequently used technologies. The commonly used research design was pre-test and post-test. Almost all the studies used observation as a data collection method, and classroom environment or controlled research environment were used as a setting of evaluation. Most of the evaluation parameters were human-assisted. The results of the studies show that AR benefited children with ASD in learning skills. The generalization test was conducted in one study only, but the results were not reported. The results of maintenance tests conducted in five studies during a short-term period following the withdrawal of intervention were positive. Although the effect of using AR towards the learning of individuals was positive, given the wide variety of skills targeted in the studies, and the heterogeneity of the participants, a summative conclusion regarding the effectiveness of AR for teaching or learning of skills related to ASD based on the existing literature is not possible. The review also proposes the research taxonomy for ASD. Future research addressing the effectiveness of AR among more participants, different technologies supporting AR for the intervention, generalization, and maintenance of learning skills, and the evaluation in the inslusive classroom environment and other settings is warranted.

Exploratory study examining the at-home feasibility of a wearable tool for social-affective learning in children with autism

Abstract: Although standard behavioral interventions for autism spectrum disorder (ASD) are effective therapies for social deficits, they face criticism for being time-intensive and overdependent on specialists. Earlier starting age of therapy is a strong predictor of later success, but waitlists for therapies can be 18 months long. To address these complications, we developed Superpower Glass, a machine-learning-assisted software system that runs on Google Glass and an Android smartphone, designed for use during social interactions. This pilot exploratory study examines our prototype tool's potential for social-affective learning for children with autism. We sent our tool home with 14 families and assessed changes from intake to conclusion through the Social Responsiveness Scale (SRS-2), a facial affect recognition task (EGG), and qualitative parent reports. A repeated-measures one-way ANOVA demonstrated a decrease in SRS-2 total scores by an average 7.14 points (F(1,13) = 33.20, p = <.001, higher scores indicate higher ASD severity). EGG scores also increased by an average 9.55 correct responses (F(1,10) = 11.89, p = <.01). Parents reported increased eye contact and greater social acuity. This feasibility study supports using mobile technologies for potential therapeutic purposes.

Sensors and Systems for Physical Rehabilitation and Health Monitoring-A Review.

Abstract: The use of wearable equipment and sensing devices to monitor physical activities, whether for well-being, sports monitoring, or medical rehabilitation, has expanded rapidly due to the evolution of sensing techniques, cheaper integrated circuits, and the development of connectivity technologies. In this scenario, this paper presents a state-of-the-art review of sensors and systems for rehabilitation and health monitoring. Although we know the increasing importance of data processing techniques, our focus was on analyzing the implementation of sensors and biomedical applications. Although many themes overlap, we organized this review based on three groups: Sensors in Healthcare, Home Medical Assistance, and Continuous Health Monitoring; Systems and Sensors in Physical Rehabilitation; and Assistive Systems.