PATCHES - Physiological Assessment Technology for Child-Caregiver Health and Emotional Synchrony

About This Grant

PROJECT SUMMARY Caregiver-mediated interventions are considered an evidence-based intervention for autistic children. However, caregivers of autistic children often experience chronic stress which can blunt the benefits of early parent- mediated interventions. A critical barrier to improving family support is the lack of a home-ready tool that can simultaneously capture branch-specific autonomic signals from both caregiver and child and link those signals to what the dyad is actually doing in the moment. PATCHES fills this gap with a 15-g, skin-soft chest patch that streams high-fidelity electrocardiogram (ECG) and seismocardiogram (SCG) to a smartphone app that also records synchronized video clips of family routines and delivers brief ecological-momentary surveys. Aim 1 will finalize the hardware, firmware, and HIPAA-compliant app-to-cloud pipeline, then validate physiological specificity in ten healthy adults by comparing patch-derived pre-ejection period (sympathetic) and respiratory sinus arrhythmia (parasympathetic) against laboratory gold standards during a battery of controlled autonomic challenges. Aim 2 will deploy PATCHES for one week in 25 caregiver–child dyads (ages 3–8 years) during both high-stress (mealtime) and low-stress (preferred play) routines, assessing feasibility, usability, and data yield while using cross-correlations, wavelet coherence analysis, and mixed effects models to map second- by-second physiological synchrony to video-coded behavioral observations and in-app stress ratings. Data travels over TLS 1.3 directly from phones to Mount Sinai’s HIPAA-compliant servers, where automated pipelines de-identify files, compute autonomic metrics, and archive outputs in a role-restricted repository. Innovation lies in integrating dual-branch cardiac sensing, auto-synchronized video, and real-time surveys into a single, caregiver-operated platform that quantifies dyadic autonomic regulation in natural settings. Expected outcomes include validated algorithms, feasibility benchmarks, and preliminary effect sizes that will underpin a multi-site efficacy trial. This novel platform will lay the foundation for future studies aiming to personalize parent- mediated interventions, ultimately improving both caregiver mental health and child developmental trajectories.