Exploring a Neurodiverse Oasis: BI’s Metaverse Experience

Behavior Imaging is known for our dedication to telehealth solutions that focus on and extend beyond autism. We’re constantly exploring innovative technological advancements that improve access to healthcare and services for individuals with autism. Recently, we had the chance to be part of a ‘metaverse’ community experience, an opportunity we couldn’t resist.

Our co-founder, Ron Oberleitner, and his son, Robby, participated in the first-ever Neurodiverse Community ‘Virtual Pavilion’, a showcase of 3D art and self-expression for those with autism.

Collaborating with immersive technologist Kathleen Cohen on her community based project for the Surel’s Place art residency (Link to Project Overview), her aim was to bring together people from Indigenous and Neurodiverse communities to share in authentic storytelling fashion where the commonalities are found. Additionally with the help of designer Julez (Julio Gonzalez) of the Autism XR Institute (AXRI Website), ArtAbility Uidaho, and local arcade VR1; together they developed 1 of 5 3D environments among Kathleen’s dedication, each accessible via any device with WiFi capabilities.

With these collaborators, Behavior Imaging took part in a multi-user 3D environment in Spatial.io. Websites like Spatial.io are called Web-Based Meeting Platforms, early forms of Metaverse locations that allow viewers explore an interactive 3D environment. These platforms can be accessed via Web Browser, Mobile Phone, Augmented Reality, Mixed Reality, and Virtual Reality devices all in synchronous!

Using this interactive multiuser experience, Robby’s art was punctuated by hand-drawn letters, exquisite calligraphy, and nostalgic scenes from beloved classics like Barney the Dinosaur, offers a unique lens into his world. As you can see in these videos, Robby is reaching out with his hands and drawing a live 3D painting.

In this collaboration, the spaces developed were geared toward community storytelling among Neurodiverse and Indigenous organizations. Partnering with AXRI to develop the space dedicated to neurodiversity, we explored what’s possible in regards to non-verbal communication using a 3D paint tool in the VR headset! (Link: See the space for yourself here!)

At Behavior Imaging, our conviction is unwavering. We see technology not just as a tool, but as an ally – one that dismantles barriers, enabling those with autism to weave their narratives into the larger tapestry of our shared human experience. This metaverse initiative wasn’t merely a demonstration of VR’s capabilities; it was a testament to the collaborative spirit, innovative drive, and deep-rooted compassion that paves the way for transformative experiences.

We cordially invite each one of you to partner with us, stepping into the vast, limitless realm of emerging technologies. Let’s craft a world where every voice is heard, every talent is recognized, and every individual can flourish in their unique brilliance.

Stay engaged with Behavior Imaging for more insights and updates on our metaverse exploration, as we continually strive to harness the magic of technology for the betterment of the autism community.

#BehaviorImaging #VRforAutism #MetaverseEmpowerment #NeurodiversityCelebrated #AutismCommunityInnovates #spatialcomputing #Spatial #Spatialio #3D #3Dpainting #XR #VR #AR #MR #Immersivetechnology #Nonverbalcommunciation #Idaho

Meaningful Support for Autistic Students with Behavior Imaging

(updated and reposted from August 2016) Starting school presents a number of challenges for any child, including resuming ‘normal’ life after a once-a-century pandemic. Unfortunately, children living with autism are often given fewer options in the classroom. As autism prevalence rises, resources in the educational system can fail to meet families’ needs. Families in rural communities are often unable to connect with expert clinicians. And families in urban communities are faced with long wait-times and lack of timely access to diagnostic and intervention services. Behavior Imaging seeks to introduce more options for students living with autism through remote behavior assessments. Two recent studies by Emory University School of Medicine and CAIU (Capital Area Intermediate Unit) 

employed Behavior Imaging’s technology in the classroom. We’re hopeful that the clear and simple evidence of meaningful outcomes from these studies can make all the difference for both students and families.

student support autism teachers study meaningful outcomes

Emory School of Medicine’s Center for Leadership and Disability Study

Teachers who don’t have immediate access to expert clinicians face difficulties when serving the behavioral needs of their autistic students. The Emory School of Medicine’s Center for Leadership and Disability recognized the growing potential for web-based video sharing technology to address these difficulties. The school launched a study to determine the feasibility of using Behavior Imaging’s technology to conduct remote behavioral assessments. Five students (ages 7-13) and their respective special education teachers participated in the study. These teachers were able to record video of their students’ behavior using our secure, HIPPA compliant Behavior Connect™ website. Clinicians then viewed, analyzed, and tagged video evidence. At the end of the process, clinicians provided teachers with a report of assessment and treatment recommendations. Not only was the overall study successful, there were reported cost-benefits as well. Savings were approximated at 40% according to the final results. We’re thrilled that the outcome of this study allowed for more potential ease between students living with autism and their teachers.

The CAIU Study

CAIU’s study addressed a slightly different need using the same components. Behavior Imaging’s technology was used to facilitate inclusion for students with autism and behavior challenges. Paula Kluth writes about the inclusive classroom in her book, You’re Going to Love This Kid!

“If students will need specialized supports to succeed academically, then teachers need to see the learner functioning in the inclusive classroom to know what types of supports will be needed.”

In a two-year pilot study, CAIU implemented Behavior Technology in a series of classrooms to facilitate inclusion between teachers and students. Their defining need was as follows,

“The reduction of frequency, duration, and magnitude of severe behaviors is critical in order to increase the inclusionary opportunities for these students as well as movement from more restrictive to less restrictive educational environments.”

Behavior Imaging Systems were employed to both accurately assess severe behaviors in autistic students, and to identify replacement behaviors while developing effective Positive Behavior Support plans. The study’s outcome saw a solid decrease in aggressive behaviors from a specific student living with autism, as well as cost savings of nearly $1300. What’s more, users found the technology adoption of Behavior Imaging tools overwhelmingly simple.

A Meaningful Tomorrow

Though both studies target a different need, they also point to the same hopeful conclusion. Providing support for autistic students, no matter the level of education, is vital. Empowering their teachers with simple and effective tools is just as important. Whether providing an accurate diagnosis or finding ways for inclusion within the classroom, Behavior Imaging always strives to provide the meaningful outcomes for those supporting children living with autism. We’re confident that these two studies provide a positive way forward for teachers, families, and students.

outcomes support students autism technology study meaningful

Sources:

https://www.med.emory.edu/

https://www.caiu.org/

https://behaviorimaging.com/

https://www.readingrockets.org/article/supporting-students-autism-10-ideas-inclusive-classrooms

Telehealth-based Systems for Diagnosis, Management and Treatment of Autism Spectrum Disorders: Challenges, Opportunities and Applications

The prevailing system for diagnosis, treatment, and management of Autism Spectrum Disorders (ASDs) in the US-the in-person service delivery-has been unable to address the increase in the demand for services and societal costs for those served, and the unattained societal benefits for those not diagnosed early enough or not offered early and intensive behavioral interventions. The authors discuss new developments in telehealth for diagnostic evaluation and ASD treatment in the US.

Read more: Telehealth-based Systems for Diagnosis- Angjellari-Dajci-Hershey-Dec, 2013-Book Chapter

Psychiatry’s new Generation of Telehealth Solutions

Behavior Imaging’s related research was featured at the annual American Academy of Child and Adolescent Psychiatry (AACAP) meet4 step workflow of BIing on October 27th, 2016 in New York City. CEO Ron Oberleitner presented on the company’s evidence-supported ‘asynchronous telehealth’ applications for diagnosis and treatment for autism spectrum disorder.  See abstract.

This new Clinical Perspectives Session was led by Dr. Kathleen Myers – University of Washington.

Formal publication of Behavior Imaging and other novel telehealth systems presented here will be described in an upcoming publication.

Feasibility of Conducting FBA’s in the Schools with Web-Based Video Recording Technology

Purpose of Current Study:

  • To determine the efficacy of using web-based video recording technology to conduct functional behavioral assessments (FBA’s) in the schools for children with ASD or related disorders.
  • Explore the cost-benefit (i.e., time and money) of using Behavior Imaging for FBA’s in the schools when compared to archival records of FBA’s conducted in person (i.e., traditional approach).

View the entire ABAI poster: ABAI Poster – 5-6 ro highlgihts

Telehealth System to Improve Medication Management of ASD Remotely

City: Boise
State/Province: ID
State/Province Full: Idaho
Country: United States

Behavior Imaging Solutions (BIS) has developed and successfully demonstrated a unique “telehealth” (or “e-visit”) technology platform called Behavior Imaging® (B.I.). Project would enhance this platform to help doctors more effectively administer evidence-based practice to address the scarcity of psychiatric services for the autism community via providing enabling technology to facilitate ‘medication management’, while providing doctor more contextual data from the patient’s natural environment. Company seeks to enhance its Behavior Connect platform – a HIPAA conforming online Consultation and Records Environment. It includes a personal health record, proprietary behavior imaging review tools, and other relevant functionality to facilitate remote interaction between families and their doctors who manage ongoing medication needs of these patients By enhancing the way a family can securely share prescribed captured video et al. health data from their home, the platform can facilitate a unique way to perform “e-visits”, which allow doctors to analyze – asynchronously – natural-environment behavior videos and other caregiver input quickly and efficiently. The resultant data that can be archived in the Behavior Connect platform may also have important implications to help a doctor: 1. better track patient progress longitudinally, and 2. gather unique naturalistic environment data that doctors can code to enrich their understanding of their patients’ behavioral phenotypes.

About The NIH SBIR Grant

Small Business Innovation Research (SBIR) – Grants for Brain and Behavior Tools

Download the Document

The National Institutes of Health (NIH) Blueprint for Neuroscience Research is a collaborative effort among the NIH Office of the Director and 15 institutes and centers to accelerate the pace of discovery and understanding in neuroscience research.

This Funding Opportunity Announcement (FOA) is affiliated with the Neuroscience Blueprint, with institutes and centers participating independently, and with participation by institutes that are not part of the Neuroscience Blueprint.

Until now, Phase II competing renewal SBIR grants have been encouraged for technologies that would ultimately require federal regulatory approval (e.g., drug development). There are, however, important technologies that would not be subject to such regulation, but that still require extraordinary time and effort to develop. The purpose of this FOA is to encourage applications for competing renewals of existing Phase II grants which are supporting research and development of such technologies. The competing renewal award would provide up to an additional three years of support at total cost funding levels of up to $800,000 per year.

Technologies encouraged by this FOA fall into three broad categories, which are described, below:

1. Complex instrumentation

This is instrumentation comprising several distinct parts that must work together. Very often the goal of such projects is to deliver turnkey products for researchers. For example, high density electroencephalography instrumentation includes electrode arrays, amplifiers, data analytic and data visualization software, etc. Another example is non-invasive near infrared imaging instrumentation, which might include photon sources and detectors, and timing devices for delivering photons, amplifiers, and software. Some high throughput assay systems may fall into this category.

2. Clinical Research Tools

Such tools would include those that are developed for clinical research use that do not require any federal regulatory approval, but still require extensive development in order to demonstrate validity in a diverse population. For example, computerized patient assessment tools for mental health disorders that are sensitive to developmental change, gender and cultural diversity, variation in cognitive and behavioral functioning, hearing and/or speech impairment, and co-morbidity with other disorders.

These tools may include data from blood work, medical history, biobehavioral information, and functional capacity, with the biobehavioral/functional information collected through clinician to patient surveys, clinician to caregiver surveys, patient self-assessment surveys, or a combination of surveys.

3. Behavioral interventions/treatments

Evidence-based behavioral interventions can play a role in the treatment of behavioral disorders. Novel therapies and novel means of providing these types of therapies (e.g., web-based tools) require not only their development, and small efficacy studies, but also extensive, large scale testing to determine the treatments’ true effectiveness across diverse patient populations.

Tech Innovation Goals

Behavior Imaging is researching how professionals can diagnose and assess individuals with Autism Spectrum Disorders by advancing its technology in the following ways:

Our Goals:

1. Move to a more mobile application of Behavior Capture by utilizing a Smartphone.

Example: A mobile app that can view notes, capture images, send and store data, and review captured data.

Accomplished!
Watch the video.
2. Make Behavior Connect state-of-the-art to give doctors and educators the ability to give ‘behavior prescriptions’ remotely.

Example: a practitioner can write a “prescription” for images of a specific behavior that can then be “filled” by the person capturing the data.

3. Provide video data evidence for the assessment process during both diagnosis and treatment.

Example: video data will support goal attainment and identify potential regression.

This is now build into
Behavior Connect the flexible behavior capturing and analyzing tool.

and can be seen on
Watch the video.
4. Improve technology to ensure that prescriptions are ‘appropriately filled.’

Example: “prescriber” can check to see that the correct data was captured and then followup with the appropriate person if further evidence is needed.

This feature is now built into
Behavior Connect the flexible behavior capturing and analyzing tool.

5. Create clinician online tools to accelerate health and education assessments.

Example: diagnostic criteria outlined and described so data is focused for collection efforts.

Apps like NODA now have instructional videos like

and users can use DSM4 and DSM5 criteria as you can see here
and read more information here

 

Current Innovations

4888532947_535c5482aaThe ability to start autism screening and diagnosis the same day – which saves an average of 6 to 9 months in earlier diagnosis and earlier intervention – sets the child miles ahead in development. Telehealth holds this same promise for a huge array of health and behavior issues where time is of the essence.

It’s innovations like that which has won grants and the support of our sponsors.

Here are more features of our current technology that our sponsors and supporters value:

Visual Evidence – “Visual Behavior Specimens” – are a Game-changer

  • Video makes for rich, quality, informative data
  • Multiple reviews/assessments of one set of evidence – Multiple examiners
  • These factors lead to evidence-based practice and less subjective research, diagnosis, and care
  • Unlike observation, video can be stored, archived, and can be revisited later
  • This builds a research subject pool for scientists
  • We’re creating a registry of data, the world’s largest video pool of “Visual Behavior Specimens”

NODA- Naturalistic Observation Diagnostic Assessment

  • Quality of data capture based in natural environments using NODA for direct observation
  • Application to wide array of health and behavior applications from nursing transfer training to PTSD and Alzheimer’s intervention, to medication management

Technology Lowers Connection Barriers

  • Accessible and Portable to overcome 5 barriers – Time, Geography, Professional expertise, Cost, Communication
  • Flexibility among Dx systems; Ease of transfer for Dx results
  • Quickly switch between DSM4 and DSM5 – debates may rage on but the video data never change
  • Access to specialists improves quality and speed of diagnosis and care

 

Problems We’re Tackling

The Critical Need For Telehealth Research

5-31-2013-7-49-56-PM-150x150There is a pressing need for diagnostic and intervention services to support the rapidly growing population of children with Autism Spectrum Disorders (Autism and Developmental Disabilities Monitoring (ADDM) Network, 2009). Direct observation of the child remains the gold standard practice in diagnosis, assessment, and treatment planning for children with autism and related developmental disabilities (Filipek, Accardo, Barnek, Cook, Dawson, Gordon, et al.,1999; National Research Council, 2001; Ozonoff, Goodlin-Jones & Solomon, 2005). Moreover, the literature supports early screening to ensure that children are referred for diagnostic assessments sooner, and that timely evaluations of eligibility for services result in immediate implementation of appropriate early intervention (American Academy of Pediatrics Council on Children With Disabilities, 2007; Johnson, Myers).

Despite this literature, many rural communities that are also characterized by low socio-economic status (SES) are marked by lack of access to autism-specific expertise among professionals in mental health, primary care, and education (Belfer & Saxena, 2006; Marcin, Ellis, Mawis, et al., 2004; Nesbitt, Rogers, Rich, et al., 2006). Even in urban communities where services are more widely available, timely access to diagnostic and intervention services is often hampered by long waiting lists at centers focused on diagnosis and treatment (Hayden, 2011).

Telehealth Practices Promising and in Need of More Research

Despite gvlcsnap-2013-02-18-18h44m59s235-e1379549601825-150x150rowing recognition of the potential for telehealth to improve access to care for individuals with ASDs (Karp, Grigsby, McSwiggan-Hardin, Pursley-Crotteau, Adams, Bell, W., et al., 2000; Saint-André, Zalentein, Robin, & Lazartigues, 2011; Terry, 2009; Baharav & Reiser, 2010), few peer-reviewed evaluations of telehealth technologies applied to autism have been published (Boisvert, Lang, Andrianopoulus & Boscardin, 2010). Boisvert and colleagues (2010) found that 7 of the 8 studies reviewed reported successful implementation and positive outcomes of services delivered via telepractice. However, the total number of participants across these studies was extremely small (n=46), most lacked a true experimental design, and only a single study directly compared the effectiveness of services delivered via telepractice to the same services delivered in person.

The authors concluded that telepractice is a promising service delivery approach for individuals with ASD that warrants additional research, particularly with respect to technological requirements to support diagnostic protocols and intervention procedures, analysis of clinical efficacy and effectiveness, and cost-benefit analyses. Based on these identified areas of need, our system for approaching both diagnostic assessment and treatment planning will address these shortcomings and the effectiveness and efficacy of the system will be tested in two separate clinical settings using rigorous scientific methods.

Shortening Wait Lists, Providing Care to Remote Areas

vlcsnap-2013-04-23-12h17m29s122-150x150Asynchronous (store-and-forward) telehealth technology, such as our own Behavior Imaging technology, demonstrates how contextual video capture and a complementary online consultation platform effectively address the need for observation of the child by a professional who can make more timely clinical decisions regarding diagnosis and treatment. Beyond the potential for such technology to improve access to care for remotely located children (i.e., rural areas, military bases, etc.), it can also enable clinical centers around the country to shorten their wait-lists by facilitating more timely communication with families about the nature and range of the child’s symptoms and needs. There is great potential for enabling these centers to quickly gather initial clinical impressions of the child by reviewing videos collected by caregivers in the home, and then to more effectively triage cases into those that are clear cut and those that require more extensive in-person assessment.

In addition, the system allows for multiple raters to view evidence thus providing a format for documenting inter-rater reliability. In cases where raters are not in full agreement as to a specific diagnosis or plan for treatment, this system also allows for a third rater to view the evidence and weigh in on the decision. This capability further allows clinicians and educational professionals to make more informed decisions based on visual evidence.

Capturing Behavior in a Natural Setting for More Efficient and Accurate Assessments

Behavior Imaging technology facilitates clinical decisions based on child behaviors captured as they occur in natural settings. In contrast, the current practice of observing the child in a specialized room at a clinic may produce reactivity effects in the child, both those introduced by a novel environment and unfamiliar observer (Gardner, 2000; Kazdin, 1982). Moreover, for many interventions like those targeting challenging behaviors, a key component of treatment planning involves understanding the function of the behavior. However, the stimuli that evoke the behavior as well as consequences that maintain it in the natural environment may not be observed in an artificial setting like a clinic.

parentconcern_psd-e1379549490516-150x150Thus, Behavior Imaging technology allows for families and caregivers to capture not only the behavior, but what happened right before it (i.e., antecedent) and what happened right after (i.e., consequence). With this knowledge, practitioners are able to further understand potential triggers for problem behaviors and actions that may be maintaining its occurrence. Results of a multi-site (Oberleitner et al., 2007) user study identified a need for this technology in the process of behavior assessment, supporting teaching practices, increasing administrative support, and the ability to gain input from experts in the field.

Enabling Collaboration between Families and Professionals

Behavior Imaging technology will further enable collaboration and consultation between families and professionals through a secure health record application that allows users to store, share, and annotate captured video. Our long-term vision is that this telehealth system will to a great extent replace current practices to provide patients with diagnoses and treatment plans based on information that is collected in natural environments, and is thus more ecologically valid. At the same time, our system will make more efficient use of professionals’ time and reduce office visit times for patients and their families. By providing a format for collecting and analyzing visual evidence, both diagnosis and treatment efforts will translate into a streamlined approach that is ultimately more reliable and cost effective for practitioners and families.