Journal of Autism and Developmental Disorders

, Volume 48, Issue 5, pp 1458–1466 | Cite as

Automated Detection of Repetitive Motor Behaviors as an Outcome Measurement in Intellectual and Developmental Disabilities

  • Kristin H. Gilchrist
  • Meghan Hegarty-Craver
  • Robert B. Christian
  • Sonia Grego
  • Ashley C. Kies
  • Anne C. Wheeler
Original Paper


Repetitive sensory motor behaviors are a direct target for clinical treatment and a potential treatment endpoint for individuals with intellectual or developmental disabilities. By removing the burden associated with video annotation or direct observation, automated detection of stereotypy would allow for longer term monitoring in ecologic settings. We report automated detection of common stereotypical motor movements using commercially available accelerometers affixed to the body and a generalizable detection algorithm. The method achieved a sensitivity of 80% for body rocking and 93% for hand flapping without individualized algorithm training or foreknowledge of subject’s specific movements. This approach is well-suited for implementation in a continuous monitoring system outside of a clinical setting.


Accelerometer Wearable sensor Motor stereotypy Repetitive behaviors Activity recognition Neurodevelopmental disorders 



The project described was supported by the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through Grant Award Number UL1TR001111 to the NC TraCS Institute, UNC’s NIH Clinical and Translational Science Award (CTSA). The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.

Author Contributions

KHG and MHC contributed to analysis of sensor data, algorithm development, and preparation of the manuscript. RBC contributed to study conceptualization and design, participant recruitment, behavior annotation, and preparation of the manuscript. SG contributed to study conceptualization and design, sensor selection and preparation of the manuscript. ACK contributed to participant recruitment, performed the data collection sessions, and contributed to preparation of the manuscript. ACW contributed to study conceptualization and design, provided supervision for all data collection, and contributed to preparation of the manuscript. All authors read and approved the final manuscript.

Compliance with Ethical Standards

Conflict of interest

All authors declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.


  1. Albinali, F., Goodwin, M. S., & Intille, S. (2012). Detecting stereotypical motor movements in the classroom using accelerometry and pattern recognition algorithms. Pervasive and Mobile Computing, 8(1), 103–114.CrossRefGoogle Scholar
  2. Aman, M. G., Singh, N. N., Stewart, A. W., & Field, C. J. (1985). The aberrant behavior checklist: A behavior rating scale for the assessment of treatment effects. American Journal of Mental Deficiency, 89(5), 485–491.PubMedGoogle Scholar
  3. Berry-Kravis, E., Hessl, D., Abbeduto, L., Reiss, A. L., Beckel-Mitchener, A., Urv, T. K., et al. (2013). Outcome measures for clinical trials in fragile X syndrome. Journal of Developmental and Behavioral Pediatrics, 34(7), 508–522. Scholar
  4. Bishop, S. L., Richler, J., Cain, A. C., Lord, C., & Floyd, F. (2007). Predictors of perceived negative impact in mothers of children with autism spectrum disorder. American Journal on Mental Retardation, 112(6), 450–461.CrossRefPubMedGoogle Scholar
  5. Bishop, S. L., Richler, J., & Lord, C. (2006). Association between restricted and repetitive behaviors and nonverbal IQ in children with autism spectrum disorders. Child Neuropsychology, 12(4–5), 247–267.CrossRefPubMedGoogle Scholar
  6. Bodfish, J. W., Symons, F. J., Parker, D. E., & Lewis, M. H. (2000). Varieties of repetitive behavior in autism: Comparisons to mental retardation. Journal of Autism and Developmental Disorders, 30(3), 237–243.CrossRefPubMedGoogle Scholar
  7. Boyd, B. A., Baranek, G. T., Sideris, J., Poe, M. D., Watson, L. R., Patten, E., et al. (2010). Sensory features and repetitive behaviors in children with autism and developmental delays. Autism Research, 3(2), 78–87.PubMedPubMedCentralGoogle Scholar
  8. Boyd, B. A., McDonough, S. G., & Bodfish, J. W. (2012). Evidence-based behavioral interventions for repetitive behaviors in autism. Journal of Autism and Developmental Disorders, 42(6), 1236–1248.CrossRefPubMedPubMedCentralGoogle Scholar
  9. Carrasco, M., Volkmar, F. R., & Bloch, M. H. (2012). Pharmacologic treatment of repetitive behaviors in autism spectrum disorders: Evidence of publication bias. Pediatrics, 129(5), e1301–e1310.CrossRefPubMedPubMedCentralGoogle Scholar
  10. Devine, S. L., Rapp, J. T., Testa, J. R., Henrickson, M. L., & Schnerch, G. (2011). Detecting changes in simulated events using partial-interval recording and momentary time sampling III: Evaluating sensitivity as a function of session length. Behavioral Interventions, 26(2), 103–124.CrossRefGoogle Scholar
  11. Eilam, D., Zor, R., Szechtman, H., & Hermesh, H. (2006). Rituals, stereotypy and compulsive behavior in animals and humans. Neuroscience & Biobehavioral Reviews, 30(4), 456–471.CrossRefGoogle Scholar
  12. Goodwin, M. S., Intille, S. S., Albinali, F., & Velicer, W. F. (2011). Automated detection of stereotypical motor movements. Journal of Autism and Developmental Disorders, 41(6), 770–782. Scholar
  13. Gross, C., Hoffmann, A., Bassell, G. J., & Berry-Kravis, E. M. (2015). Therapeutic strategies in fragile X syndrome: From bench to bedside and back. Neurotherapeutics, 12(3), 584–608.CrossRefPubMedPubMedCentralGoogle Scholar
  14. Harrop, C., McConachie, H., Emsley, R., Leadbitter, K., Green, J., & Consortium, P. (2014). Restricted and repetitive behaviors in autism spectrum disorders and typical development: Cross-sectional and longitudinal comparisons. Journal of Autism and Developmental Disorders, 44(5), 1207–1219.CrossRefPubMedGoogle Scholar
  15. Hoch, J., Spofford, L., Dimian, A., Tervo, R., MacLean, W. E., & Symons, F. J. (2016). A direct comparison of self-injurious and stereotyped motor behavior between preschool-aged children with and without developmental delays. Journal of Pediatric Psychology, 41(5), 566–572.CrossRefPubMedGoogle Scholar
  16. Homberg, J. R., Kyzar, E. J., Scattoni, M. L., Norton, W. H., Pittman, J., Gaikwad, S., et al. (2016). Genetic and environmental modulation of neurodevelopmental disorders: Translational insights from labs to beds. Brain Research Bulletin, 125, 79–91.CrossRefPubMedGoogle Scholar
  17. Kolt, L. D., & Rapp, J. T. (2014). Assessment of therapists’ preferences for discontinuous measurement systems. Behavioral Interventions, 29(4), 304–314.CrossRefGoogle Scholar
  18. Lewis, M. H. (2004). Environmental complexity and central nervous system development and function. Mental Retardation and Developmental Disabilities Research Reviews, 10(2), 91–95.CrossRefPubMedGoogle Scholar
  19. Loftin, R. L., Odom, S. L., & Lantz, J. F. (2008). Social interaction and repetitive motor behaviors. Journal of Autism and Developmental Disorders, 38(6), 1124–1135.CrossRefPubMedGoogle Scholar
  20. Lounds, J., Seltzer, M. M., Greenberg, J. S., Shattuck, P. T., & MacLean, J., & William, E. (2007). Transition and change in adolescents and young adults with autism: Longitudinal effects on maternal well-being. American Journal on Mental Retardation, 112(6), 401–417.CrossRefPubMedGoogle Scholar
  21. Matson, J. L., & Minshawi, N. F. (2007). Functional assessment of challenging behavior: Toward a strategy for applied settings. Research in Developmental Disabilities, 28(4), 353–361. Scholar
  22. Matson, J. L., Terlonge, C., Gonzalez, M. L., & Rivet, T. (2006). An evaluation of social and adaptive skills in adults with bipolar disorder and severe/profound intellectual disability. Research in Developmental Disabilities, 27(6), 681–687. Scholar
  23. McCracken, J. T., Aman, M. G., McDougle, C. J., Tierney, E., Shiraga, S., Whelan, F., et al. (2010). Possible influence of variant of the P-glycoprotein gene (MDR1/ABCB1) on clinical response to guanfacine in children with pervasive developmental disorders and hyperactivity. Journal of Child and Adolescent Psychopharmacology, 20(1), 1–5. Scholar
  24. Nadig, A., Lee, I., Singh, L., Bosshart, K., & Ozonoff, S. (2010). How does the topic of conversation affect verbal exchange and eye gaze? A comparison between typical development and high-functioning autism. Neuropsychologia, 48(9), 2730–2739.CrossRefPubMedPubMedCentralGoogle Scholar
  25. Oliver, C., Petty, J., Ruddick, L., & Bacarese-Hamilton, M. (2012). The association between repetitive, self-injurious and aggressive behavior in children with severe intellectual disability. Journal of Autism and Developmental Disorders, 42(6), 910–919. Scholar
  26. Pierce, K., & Courchesne, E. (2001). Evidence for a cerebellar role in reduced exploration and stereotyped behavior in autism. Biological Psychiatry, 49(8), 655–664.CrossRefPubMedGoogle Scholar
  27. Plotz, T., Hammerla, N. Y., Rozga, A., Reavis, A., Call, N., & Abowd, G. D. (2012). Automatic Assessment of Problem Behavior in Individuals with Developmental Disabilities. Paper presented at the UbiComp ‘12, Pittsburgh, USA.Google Scholar
  28. Rapp, J. T., & Vollmer, T. R. (2005). Stereotypy I: A review of behavioral assessment and treatment. Research in Developmental Disabilities, 26(6), 527–547.CrossRefPubMedGoogle Scholar
  29. Rodrigues, J. L., Gonçalves, N., Costa, S., & Soares, F. (2013). Stereotyped movement recognition in children with ASD. Sensors and Actuators A: Physical, 202, 162–169.CrossRefGoogle Scholar
  30. Scahill, L., Aman, M. G., Lecavalier, L., Halladay, A. K., Bishop, S. L., Bodfish, J. W., et al. (2015). Measuring repetitive behaviors as a treatment endpoint in youth with autism spectrum disorder. Autism, 19(1), 38–52.CrossRefPubMedGoogle Scholar
  31. Shattuck, P. T., Seltzer, M. M., Greenberg, J. S., Orsmond, G. I., Bolt, D., Kring, S., et al. (2007). Change in autism symptoms and maladaptive behaviors in adolescents and adults with an autism spectrum disorder. Journal of Autism and Developmental Disorders, 37(9), 1735–1747.CrossRefPubMedGoogle Scholar
  32. Wirth, O., Slaven, J., & Taylor, M. A. (2014). Interval sampling methods and measurement error: A computer simulation. Journal of Applied Behavior Analysis, 47(1), 83–100.CrossRefPubMedGoogle Scholar
  33. Wittenburg, P., Brugman, H., Russel, A., Klassmann, A., & Sloetjes, H. Elan: a professional framework for multimodality research. In Proceedings of LREC, 2006 (Vol. 2006, p. 5).Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2017

Authors and Affiliations

  • Kristin H. Gilchrist
    • 1
  • Meghan Hegarty-Craver
    • 1
  • Robert B. Christian
    • 2
  • Sonia Grego
    • 1
  • Ashley C. Kies
    • 2
    • 3
  • Anne C. Wheeler
    • 1
  1. 1.RTI InternationalResearch Triangle ParkUSA
  2. 2.Carolina Institute for Developmental DisabilitiesUniversity of North CarolinaChapel HillUSA
  3. 3.Child and Family Development, Inc.CharlotteUSA

Personalised recommendations