Citation: Aguilar-Rivera, M.; Kable,
J.A.; Yevtushok, L.; Kulikovsky, Y.;
Zymak-Zakutnya, N.; Dubchak, I.;
Akhmedzhanova, D.; Wertelecki, W.;
Chambers, C.; Coleman, T.P. Wireless
Heart Sensor for Capturing Cardiac
Orienting Response for Prediction of
Neurodevelopmental Delay in
Infants. Sensors 2022, 22, 9140.
https://doi.org/10.3390/s22239140
Academic Editor: Antonio Lázaro
Received: 8 July 2022
Accepted: 18 November 2022
Published: 25 November 2022
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Communication
Wireless Heart Sensor for Capturing Cardiac Orienting
Response for Prediction of Neurodevelopmental Delay
in Infants
Marcelo Aguilar-Rivera
1,
*, Julie A. Kable
2
, Lyubov Yevtushok
3,4
, Yaroslav Kulikovsky
3,4
,
Natalya Zymak-Zakutnya
3,5
, Iryna Dubchak
3,5
, Diana Akhmedzhanova
5
, Wladimir Wertelecki
3
,
Christina Chambers
6,7
and Todd P. Coleman
1
1
Department of Bioengineering, University of California San Diego, La Jolla, CA 92093, USA
2
Departments of Psychiatry and Behavioral Science and Pediatrics, School of Medicine, Emory University,
Atlanta, GA 30322, USA
3
OMNI-Net Ukraine Birth Defects Program, 33028 Rivne, Ukraine
4
Post-Graduate Extension Program, Rivne Regional Medical Diagnostic Center, Lviv National Medical
University, 79010 Lviv, Ukraine
5
Khmelnytsky City Perinatal Center, 29008 Khmelnytskyi, Ukraine
6
Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA
7
Herbert Wertheim School of Public Health and Human Longevity Science, University of California San Diego,
La Jolla, CA 92093, USA
* Correspondence: aguilarr@stanford.edu
Abstract:
Early identification of infants at risk of neurodevelopmental delay is an essential public
health aim. Such a diagnosis allows early interventions for infants that maximally take advantage
of the neural plasticity in the developing brain. Using standardized physiological developmental
tests, such as the assessment of neurophysiological response to environmental events using car-
diac orienting responses (CORs), is a promising and effective approach for early recognition of
neurodevelopmental delay. Previous CORs have been collected on children using large bulky equip-
ment that would not be feasible for widespread screening in routine clinical visits. We developed a
portable wireless electrocardiogram (ECG) system along with a custom application for IOS tablets
that, in tandem, can extract CORs with sufficient physiologic and timing accuracy to reflect the
well-characterized ECG response to both auditory and visual stimuli. The sensor described here
serves as an initial step in determining the extent to which COR tools are cost-effective for the early
screening of children to determine who is at risk of developing neurocognitive deficits and may
benefit from early interventions. We demonstrated that our approach, based on a wireless heartbeat
sensor system and a custom mobile application for stimulus display and data recording, is sufficient
to capture CORs from infants. The COR monitoring approach described here with mobile technology
is an example of a desired standardized physiologic assessment that is a cost-and-time efficient,
scalable method for early recognition of neurodevelopmental delay.
Keywords:
wireless sensor; electrocardiogram; cardiac orienting response; monitoring; neurodevel-
opment delay; auditory and visual stimuli; mobile application; tablet
1. Introduction
Two to five percent of first-graders in the U.S. have evidence of Fetal Alcohol Spectrum
Disorders (FASD) [
1
]. Unfortunately, many of these children are misdiagnosed, or their
diagnosis is wholly missed, especially in infancy and throughout early childhood [
2
].
Earlier and more accurate identification of children with prenatal alcohol exposure (PAE)
can lead to interventions that engage neuroplasticity associated with early brain maturation,
thus affording these children the best chance of improving outcomes. However, early
identification of individuals who are neurodevelopmentally impaired as a function of
Sensors 2022, 22, 9140. https://doi.org/10.3390/s22239140 https://www.mdpi.com/journal/sensors
