Collaborative research: adaptive intelligent healthcare garment: advancing real-time monitoring and behavioral interventions

Award: Collaborative Research: Adaptive Intelligent Healthcare Garment

Funding Agency & Program: National Science Foundation (NSF), Division of Civil, Mechanical, and Manufacturing Innovation; Engineering Program (CFDA 47.041)

Award Details: $182,791 | Award Date: September 1, 2025 | Project Period: September 1, 2025 – August 31, 2028

Emory University, in collaboration with Marcus Autism Center, Inc., is developing and evaluating an intelligent healthcare garment prototype featuring an adaptive splint designed to improve behavioral intervention outcomes for individuals with neurodevelopmental disabilities who engage in self-injurious behavior (SIB). The primary deliverable is a novel active splint garment that utilizes soft robotics design principles to dynamically adjust mechanical stiffness in real time through a clinician-controlled feedback mechanism. The device incorporates embedded sensors and communication capabilities to enable therapists to monitor patient responses, predict SIB episodes, and measure the frequency, intensity, and duration of self-injurious behaviors using ambulatory accelerometry and electrodermal activity models developed from retrospective data.

The project delivers interdisciplinary outcomes spanning behavioral intervention technology, wearable device engineering, and clinical measurement systems. Emory serves as the prime recipient, with Marcus Autism Center providing clinical coordination, subject recruitment, and clinician training services to support research validation. If successful, the adaptive garment prototype is anticipated to provide a significant advancement over current rigid splint interventions, improving quality of life for both patients with minimally verbal neurodevelopmental disorders and clinical practitioners managing severe self-injurious behaviors.

Abstract

This research project aims to prototype and evaluate an intelligent garment featuring an adaptive splint that clinicians can dynamically control to address the treatment goals of individuals with neurodevelopmental disabilities who engage in self-injurious behavior. This novel device will facilitate sensorimotor interaction between the adaptive splint and the individual. Additionally, the garment will communicate with therapists to enhance their understanding of the individual's responses to treatment decisions and to predict and analyze attempts at self-injurious behavior. Self-injurious behaviors in minimally verbal individuals with neurodevelopmental disorders can lead to significant physical, emotional, social, and economic challenges. Behavioral interventions currently represent the most established approach to managing self-injurious behaviors. Presently, interventions for severe cases involve individuals wearing rigid splints on their arms, which help mitigate injury risk while still allowing the behavior to occur. If successful, this research is anticipated to improve the quality of life for both patients and clinicians alike. The adaptive garment prototype will feature an active split that can adjust its mechanical stiffness in real time with a clinician-in-the-loop feedback mechanism. This research initiative has several key interdisciplinary objectives: 1) to assess the effectiveness of the first active splint designed for behavioral interventions, drawing on design and actuation principles from soft robotics, which is capable of withstanding self-injurious behaviors; 2) to address the challenge of accurately and automatically measuring the frequency, intensity, and duration of self-injurious behaviors in therapeutic settings, utilizing models developed from retrospective data gathered through ambulatory accelerometry, electrodermal activity, and photoplethysmography via a wearable biosensor, in conjunction with video data; 3) to analyze and evaluate the interactions between individuals and therapists during behavioral intervention sessions that incorporate the garment; and 4) to examine how the garment impacts therapists' decision-making processes. If successful, this research program will lay the foundation for healthcare garments capable of reasoning and modeling wearer behaviors to improve therapeutic outcomes. This award reflects NSF's statutory mission and has been deemed worthy of support through evaluation using the foundation's intellectual merit and broader impacts review criteria.- subawards are planned for this award.