EarliTec Dx, a medtech company based in Georgia, has developed the EarliPoint Evaluation System for Autism Spectrum Disorder (ASD). This common neurodevelopmental condition is often overlooked in affected children, leading to a lack of early intervention and care. Part of the issue is a lack of access to specialists who can diagnose the condition.
Another issue is the lack of quantitative tools that can assist clinicians in diagnosing ASD, and instead they rely on subjective measurements and observations. The EarliPoint system is hosted on a touchscreen tablet, and involves children observing a video feed of social interactions.
Those with ASD may be less likely to observe the people in the video, instead focusing on objects within the video. The tablet camera uses eye tracking technology to determine where the subjects are looking, and this information is then used by a clinician to inform a diagnosis.
Here’s an EarliTec Dx video introducing the EarliPoint system:
Medgadget had the opportunity to speak with Tom Ressemann, CEO at EarliTec Dx, about the technology.
Conn Hastings, Medgadget: Please give us an overview of Autism Spectrum Disorder and how it affects people.
Tom Ressemann, EarliTec Dx: Autism Spectrum Disorder, or ASD, is the most common complex neuro-developmental condition, affecting 1 in 36 children. Every year, 95,000 children are born who will have autism. Children with ASD often miss key speech, language and social milestones during early childhood compared to neurotypical children and present with delayed development in multiple areas.
As autistic individuals progress and age, many experience frustrating difficulties with social interactions, communication, and participation in daily activities that continue into adulthood.
As awareness of autism has increased, so has the expectation that autistic people can thrive. However, they face long wait times to specialized providers who can make an ASD diagnosis, without which it is very difficult to access treatment. Consequently, children usually aren’t diagnosed until ages 4 or 5 when an earlier diagnosis and intervention could have more positively impacted their long-term quality of life.
Medgadget: How is ASD diagnosed at present? How is this suboptimal?
Tom Ressemann: To diagnose ASD, healthcare providers currently rely on subjective methods like parent questionnaires and behavioral observations of social interaction and communication skills, to identify autistic symptoms and restricted and repetitive patterns of behavior which define the condition. Gold standard instruments for diagnosis and assessment include tools such as the Autism Diagnostic Observation Schedule (ADOS-2), Autism Diagnostic Interview-Revised (ADI-R), Mullen Scales of Early Learning, and other standardized tests of a child’s language and cognitive skills.
As a genetically based condition, the presentation of ASD varies widely across all individuals, making it challenging to offer a diagnosis with subjective tools. When ASD is not diagnosed early, before age three, when treatment is most impactful, we miss an opportunity to optimize outcomes and help these children achieve a fulfilling life.
Identifying ASD often becomes a diagnostic odyssey that can unfold over years, largely due to lack of access to expert clinicians – particularly for minority, rural and low-income families. This limited access can leave many children undiagnosed, with a delayed diagnosis or with a misdiagnosis.
Medgadget: Please give us an overview of the EarliPoint system, its features and how it is used.
Tom Ressemann: EarliPoint Evaluation represents a first-of-its-kind advancement in ASD diagnosis and assessment. The system includes a portable tablet that displays curated video scenes of social interactions. Qualified healthcare providers administer these evaluations during an existing appointment. The embedded eye-tracking technology can safely and effectively identify autism in a more efficient, objective way.
When typically developing children watch videos of social interactions, the most socially meaningful and important moments in those videos are engaging and draw their responses. The majority of these children engage in the same elements of the social interactions at the same moments in time (such as children interacting and their facial expressions). But for autistic children, this is often not the case. Instead, autistic children miss many of those key moments, with their attention pulled in other directions by things that are less helpful to their early learning (for example, focusing on objects rather than people). Since children learn by watching others, if children don’t look at important visual information in the environment, they repeatedly miss opportunities to learn, delaying their development. In fact, toddlers with autism may miss many hundreds of opportunities for social learning within 5 minutes of viewing of ordinary peer social interaction.
Embedded within the tablet, eye-tracking technology measures more than 120 focal preferences per second. Using patented analysis technology, these data are compared to age-expected reference metrics to determine if the child is missing key moments of social learning.
Upon review of the data, including a personalized and detailed report that includes visualizations from the test, healthcare providers can provide a timely, objective and accurate read of the presence of autism, the severity of the child’s social disability, and the child’s level of verbal ability and non-verbal learning.
Medgadget: How does the system work to assist in diagnosing ASD? How does it improve on existing techniques?
Tom Ressemann: This novel diagnostic tool is objective and obviates the need for more laborious and subjective testing and analysis, and provides a clear understanding of whether the child is autistic or not and its severity. It also identifies where a child with autism falls within the spectrum relative to typically developing peers. The tool increases access by providing expert level diagnosis, proxying gold standard instruments for the diagnosis of autism, such as the ADOS-2, and for the assessment of developmental level, such as the Mullen Scales of Early Learning.
In most cases, the EarliPoint Evaluation can be completed during an existing appointment, which helps alleviate waitlists for a diagnosis and expedites the time to access treatment. Despite the prevalence of ASD, the median age for diagnosis in the U.S. is between ages 4-5 – missing a critical developmental window when children have the strongest neuroplasticity or capacity for learning. EarliPoint Evaluation was developed with the goal to help children access treatment and early intervention services before the age of three. The FDA-cleared indication for EarliPoint Evaluation is for the diagnosis and assessment of ASD for children aged 16 to 30 months. Our goal is to provide earlier diagnoses to help families and healthcare providers take advantage of early neuroplasticity and to help personalize interventions to a child’s individual profile, and, in this way, to ultimately improve their lifetime outcomes.
Medgadget: What inspired you to develop this technology? How did the idea for it come about?
Tom Ressemann: At ETDx, many of us have personal connections to autism, and it is what drives and inspires us each day. We want more children and families to have individualized care and better access to tools to help them earlier on.
Our founders, Ami Klin and Warren Jones, started the development journey of EarliPoint more than two decades ago at Yale. Understanding how critical a child’s formative years are in determining the severity of autism, they had the idea to create a tool that could aid healthcare providers with an objective individualized assessment of ASD. By utilizing Dynamic Quantification of Social-Visual Engagement (DQSVE), they discovered and developed a proprietary method to track moment-by-moment looking as an accurate and reliable predictor of ASD.
The technology was brought to market and developed largely by the philanthropic support of Bernie Marcus of The Marcus Foundation, with additional investments made by the Georgia Research Alliance. The science that led to this breakthrough was funded over the years largely by NIH.
Medgadget: How would you like to see these types of technologies develop in the future? Do you have any plans to develop additional technologies for ASD or other conditions?
Tom Ressemann: Our primary focus is on the successful commercialization of EarliPoint Evaluation, with the end goal to make the technology as widely available as possible.
Like any digital health product, EarliPoint will improve over time, with new functionality and capabilities added. In future iterations of the technology, we are looking to add additional metrics valued by diagnostic and treatment providers. We’ll also expand the age range for which the tool can be used for. Likewise, as we continue to build our platform, we would like to offer healthcare providers prescriptive guidance for therapies proven to be beneficial to an individual child’s autism presentation.
As ASD prevalence continues to increase, we’d like to see an environment where all children with autism have early access to tools that can afford them the support they need, when they need it most, so that they can fulfill their promise and live productive and self-fulfilling lives.
Link: EarliTec Dx homepage…