New Smartphone App Aims to Monitor Your Mental Health
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She was previously with Reuters, covering digital health and Apple and before that, she reported for Venture Beat. Christina was born and raised in London and has graduate degrees from University of London and the Stanford School of Journalism. Farr’s work has appeared in a variety of publications, including the New York Times, the Daily Telegraph, the Bay Citizen and SFGate.com. She has appeared as a featured expert on NBC, ABC and Reuters TV, among others, and frequently speaks at health and technology conferences. She is also co-founder of Ladies Who Vino, a networking group for women in technology and business.","avatar":"https://secure.gravatar.com/avatar/22c63869a7901c61c15e204391c1261d?s=600&d=blank&r=g","twitter":null,"facebook":null,"instagram":null,"linkedin":null,"sites":[{"site":"futureofyou","roles":["administrator"]},{"site":"stateofhealth","roles":["author"]},{"site":"science","roles":["editor"]}],"headData":{"title":"Christina Farr | KQED","description":null,"ogImgSrc":"https://secure.gravatar.com/avatar/22c63869a7901c61c15e204391c1261d?s=600&d=blank&r=g","twImgSrc":"https://secure.gravatar.com/avatar/22c63869a7901c61c15e204391c1261d?s=600&d=blank&r=g"},"isLoading":false,"link":"/author/cfarr"}},"breakingNewsReducer":{},"campaignFinanceReducer":{},"firebase":{"requesting":{},"requested":{},"timestamps":{},"data":{},"ordered":{},"auth":{"isLoaded":false,"isEmpty":true},"authError":null,"profile":{"isLoaded":false,"isEmpty":true},"listeners":{"byId":{},"allIds":[]},"isInitializing":false,"errors":[]},"navBarReducer":{"navBarId":"home","fullView":true,"showPlayer":false},"navMenuReducer":{"menus":[{"key":"menu1","items":[{"name":"News","link":"/","type":"title"},{"name":"Politics","link":"/politics"},{"name":"Science","link":"/science"},{"name":"Education","link":"/educationnews"},{"name":"Housing","link":"/housing"},{"name":"Immigration","link":"/immigration"},{"name":"Criminal Justice","link":"/criminaljustice"},{"name":"Silicon Valley","link":"/siliconvalley"},{"name":"Forum","link":"/forum"},{"name":"The California Report","link":"/californiareport"}]},{"key":"menu2","items":[{"name":"Arts & Culture","link":"/arts","type":"title"},{"name":"Critics’ Picks","link":"/thedolist"},{"name":"Cultural Commentary","link":"/artscommentary"},{"name":"Food & Drink","link":"/food"},{"name":"Bay Area Hip-Hop","link":"/bayareahiphop"},{"name":"Rebel Girls","link":"/rebelgirls"},{"name":"Arts Video","link":"/artsvideos"}]},{"key":"menu3","items":[{"name":"Podcasts","link":"/podcasts","type":"title"},{"name":"Bay Curious","link":"/podcasts/baycurious"},{"name":"Rightnowish","link":"/podcasts/rightnowish"},{"name":"The Bay","link":"/podcasts/thebay"},{"name":"On Our Watch","link":"/podcasts/onourwatch"},{"name":"Mindshift","link":"/podcasts/mindshift"},{"name":"Consider This","link":"/podcasts/considerthis"},{"name":"Political Breakdown","link":"/podcasts/politicalbreakdown"}]},{"key":"menu4","items":[{"name":"Live Radio","link":"/radio","type":"title"},{"name":"TV","link":"/tv","type":"title"},{"name":"Events","link":"/events","type":"title"},{"name":"For Educators","link":"/education","type":"title"},{"name":"Support KQED","link":"/support","type":"title"},{"name":"About","link":"/about","type":"title"},{"name":"Help Center","link":"https://kqed-helpcenter.kqed.org/s","type":"title"}]}]},"pagesReducer":{},"postsReducer":{"stream_live":{"type":"live","id":"stream_live","audioUrl":"https://streams.kqed.org/kqedradio","title":"Live Stream","excerpt":"Live Stream information currently unavailable.","link":"/radio","featImg":"","label":{"name":"KQED Live","link":"/"}},"stream_kqedNewscast":{"type":"posts","id":"stream_kqedNewscast","audioUrl":"https://www.kqed.org/.stream/anon/radio/RDnews/newscast.mp3?_=1","title":"KQED Newscast","featImg":"","label":{"name":"88.5 FM","link":"/"}},"futureofyou_444844":{"type":"posts","id":"futureofyou_444844","meta":{"index":"posts_1591205157","site":"futureofyou","id":"444844","score":null,"sort":[1538667576000]},"guestAuthors":[],"slug":"new-smartphone-app-aims-to-monitor-your-mental-health","title":"New Smartphone App Aims to Monitor Your Mental Health","publishDate":1538667576,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.[contextly_sidebar id=\"KMLJnak6yPOdRS3TfVoiDTc6a7Cm51Xf\"]\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.[contextly_sidebar id=\"Kw9tNYwAAP3TxDDlzs24FDdim0qufSVP\"]\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)[contextly_sidebar id=\"XHhLlvPBCoPTlN54jyme2G0wpse1GITN\"]\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.[contextly_sidebar id=\"KGoxoWR6m8MUKnLishPvyacpod0HWpt7\"]\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.[contextly_sidebar id=\"8bFNH4xsL9O8lTSDRHnxnqtYwxOF2Z5k\"]\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n","blocks":[],"excerpt":"The app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage.","status":"publish","parent":0,"modified":1538668957,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":49,"wordCount":2272},"headData":{"title":"New Smartphone App Aims to Monitor Your Mental Health | KQED","description":"The app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"New Smartphone App Aims to Monitor Your Mental Health","datePublished":"2018-10-04T15:39:36.000Z","dateModified":"2018-10-04T16:02:37.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"444844 https://ww2.kqed.org/futureofyou/?p=444844","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/10/04/new-smartphone-app-aims-to-monitor-your-mental-health/","disqusTitle":"New Smartphone App Aims to Monitor Your Mental Health","source":"DIY Health","nprByline":"Kate Sheridan\u003cbr />STAT","path":"/futureofyou/444844/new-smartphone-app-aims-to-monitor-your-mental-health","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp class=\"danger-zone\">In the world of digital health, Silicon Valley-based \u003ca href=\"https://www.statnews.com/2017/08/07/mindstrong-insel-mental-illness/\" target=\"_blank\" rel=\"noopener\">Mindstrong\u003c/a> stands out. It has a star-studded team and tens of millions in venture capital funding, including from Jeff Bezos’ VC firm.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp class=\"danger-zone\">It also has a captivating idea: that its app, based on cognitive functioning research, can help detect troubling mental health patterns by collecting data on a person’s smartphone usage — how quickly they type or scroll, for instance.\u003c/p>\n\u003cp class=\"danger-zone\">The promise of that technology has helped Mindstrong build incredible momentum since it launched last year; already more than a dozen counties in California have agreed to deploy the company’s app to patients.\u003c/p>\n\u003cp class=\"\">Does the app live up to its promise? There’s no way to tell. Almost no one outside the company has any idea whether it works. Most of the company’s key promises or claims aren’t yet backed up by published, peer-reviewed data — leading some experts to wonder if the technology is ready for the real world.\u003c/p>\n\u003cp class=\"\">“I wouldn’t waste all that time and money in the wild until they get sure that some of those things are as specific as they hope they are,” said Rosalind Picard, a researcher at MIT Media Lab who is familiar with Mindstrong’s work and tries to use data from smartphones and wearables to detect a person’s mood.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Even as one of the company’s executives, Dr. Tom Insel, acknowledged to STAT that the app isn’t perfect, the company’s CEO emphasized that Mindstrong could provide unprecedented insight into conditions like depression.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong is not alone in pushing the frontiers of smartphone-based digital health. Many companies use so-called digital phenotyping, collecting scientific data on a person’s digital life, to gain insights into his or her physical or mental health.\u003c/p>\n\u003cp>The company’s app collects information about how people are typing and runs it through a machine learning algorithm to determine which data can predict their emotional state. Mindstrong has already used it in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a \u003ca href=\"https://www.statnews.com/2018/09/24/ketamine-clinics-severe-depression-treatment/\" target=\"_blank\" rel=\"noopener\">ketamine clinic\u003c/a>. The app is available in Apple’s app store, but requires a participant code to access it.\u003c/p>\n\u003cp>“We’ve done the validation work against the gold-standard clinical tests for depression, for anxiety, for cognitive decline, whether it’s memory or executive function,” said Dr. Paul Dagum, the company’s founder. “We’re confident, we’re already seeing some really exciting results.”\u003c/p>\n\u003cp>In the last year, Mindstrong’s footprint and reach have already grown exponentially. The Palo Alto-based company’s workforce has doubled to 42 employees and it made \u003ca href=\"https://www.hsph.harvard.edu/magazine/magazine_article/philanthropic-impact-digital-phenotyping/\" target=\"_blank\" rel=\"noopener\">a sizable gift\u003c/a> to Harvard’s school of public health. In February, it launched a partnership with Takeda to develop new biomarkers that will be able to aid the pharmaceutical giant’s clinical trials for depression treatments.\u003c/p>\n\u003cp>The idea is to use that data to establish a “normal” pattern — so it can be compared against someone’s typing habits on any given day. If the habits look off, slower or more agitated than normal, the app can alert a health care provider.\u003c/p>\n\u003cp>Abnormal patterns, Mindstrong says, might show up if a person is more depressed or anxious, or if just about anything else about their mental health changes. When asked which disorders Mindstrong might be able to detect, Dagum replied, “all of them.” (Dagum, a data scientist and physician, founded the company in 2017 with Rick Klausner, the founder and director of CAR-T pioneer Juno Therapeutics and \u003ca href=\"https://www.statnews.com/2018/06/02/grail-cancer-blood-test-asco/\" target=\"_blank\" rel=\"noopener\">Grail\u003c/a>, a liquid biopsy company.)\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>Mindstrong officials told STAT that among their most encouraging results is that its app can even predict how a person will feel next week, or at least how a person will perform on the Hamilton Rating Scale for depression — kind of like a weather app for your mood.\u003c/p>\n\u003cp>The data behind this claim is being published soon, said Insel, who is the former head of the National Institute of Mental Health and came to the company in 2017 after a short stint at \u003ca href=\"https://www.statnews.com/2016/03/28/google-life-sciences-exodus/\" target=\"_blank\" rel=\"noopener\">Verily\u003c/a>.\u003c/p>\n\u003cp>The app can detect a seven-point change on the Hamilton scale, Insel said. That kind of difference could indicate a patient who is not normally depressed now shows signs of mild or moderate depression, or that a person with moderate depression is now showing signs of a very severe condition.\u003c/p>\n\u003cp>“For a clinician and for someone taking care of a patient, knowing that, it could be very, very powerful,” Dagum said.\u003c/p>\n\u003cp>The company’s momentum has taken it to the cusp of a real-world deployment in California. About 15 counties — including the most populous county in the United States, Los Angeles County — will be spending about $60 million over the next four years to bring companies like Mindstrong and other apps into their health care system.\u003c/p>\n\u003cp>These counties hope apps will help them get better services to people with mental illnesses like depression, schizophrenia, bipolar disorder, and post-traumatic stress disorder.\u003c/p>\n\u003cp>The Mindstrong program itself is limited: Patients can choose voluntarily whether to use the app, which will be free to them, and that decision won’t affect the rest of the mental health services they can access.\u003c/p>\n\u003cp>\u003cstrong>Lack of Public Data\u003c/strong>\u003c/p>\n\u003cp>So far, the Mindstrong app has only been used in controlled clinical settings and trials — including one run by a company developing new antidepressants and another done in a ketamine clinic. The company has also claimed that a “\u003ca href=\"https://mindstronghealth.com/clinical-programs/\" target=\"_blank\" rel=\"noopener\">nationwide employer\u003c/a>” and private substance abuse clinics in D.C. are using the app.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>But other than the change on the Hamilton scale — which hasn’t yet gone through peer review and was disclosed to STAT in an interview — almost no data about how well Mindstrong’s technology works is available to independent observers.\u003c/p>\n\u003cp>The company’s website describes five completed clinical trials, but it has not yet published the results of any. Only a handful of other published works — all from the last year — have hinted at how well it works or its scope with data to back up the claims.\u003c/p>\n\u003cp>The company \u003ca href=\"https://www.nature.com/articles/s41746-018-0018-4\" target=\"_blank\" rel=\"noopener\">published\u003c/a> a 27-person pilot study in the journal npj Digital Medicine earlier this year. Dagum is also an author on a poster \u003ca href=\"https://www.nature.com/articles/npp2017265#t122-assessing-anhedonia-with-quantitative-tasks-digital-and-patient-reported-measures-in-a-multicenter-doubleblind-trial-with-btrx246040-for-the-treatment-of-major-depressive-disorder\" target=\"_blank\" rel=\"noopener\">presentation\u003c/a> given at the American College of Neuropsychopharmacology’s 2017 conference, another \u003ca href=\"https://isctm.org/public_access/Feb2018/PDFs/Smith-poster.pdf\" target=\"_blank\" rel=\"noopener\">poster\u003c/a> that reported results from a very wide variety of digital phenotyping techniques — not just typing — and a \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29074231\" target=\"_blank\" rel=\"noopener\">paper\u003c/a> describing a clinical trial protocol — not results.\u003c/p>\n\u003cp>As Mindstrong steps toward a wider rollout, the scientific studies behind its claims will matter. Federal regulators, for one, have \u003ca href=\"https://www.ftc.gov/news-events/blogs/business-blog/2016/01/mind-gap-what-lumosity-promised-vs-what-it-could-prove\" target=\"_blank\" rel=\"noopener\">cracked down\u003c/a> on \u003ca href=\"https://www.ftc.gov/news-events/press-releases/2016/12/marketers-blood-pressure-app-settle-ftc-charges-regarding\" target=\"_blank\" rel=\"noopener\">commercial apps\u003c/a>that misleadingly reference a study’s conclusions to market their app.\u003c/p>\n\u003cp>Based on her own research, at least one expert in digital health and mood said she’s skeptical that Mindstrong can, in a general population, work as well as the company claims. MIT’s Picard said that while there are ways to predict or detect mood changes, you usually need more than just a single type of data to do so.\u003c/p>\n\u003cp>“I’m suspicious that a single modality like typing is going to be sufficient. It would be like saying there’s a single question [on a screening questionnaire] that a doctor could be using,” said Picard, who is also CEO of a company that works on digital phenotyping, like Mindstrong does.\u003c/p>\n\u003cp>“My guess is that their specificity to depression is going to be relatively low,” Picard said.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>Her \u003ca href=\"https://www.jmir.org/2018/6/e210/\" target=\"_blank\" rel=\"noopener\">own\u003c/a> \u003ca href=\"https://ieeexplore.ieee.org/abstract/document/954607\" target=\"_blank\" rel=\"noopener\">research\u003c/a>, for example, relies on temperature and skin conductivity as well as calls and the amount of time spent on a phone to predict mood changes. It is about 80 percent accurate.\u003c/p>\n\u003cdiv class=\"quote-inner\">\n\u003cp>Especially in the field of digital mental health, “we need more peer review,” said Dr. Steven Steinhubl, the director of digital medicine at Scripps Research Translational Institute. (Steinhubl is also the co-editor-in-chief of npj Digital Medicine.) Though he said he strongly believes in the potential of apps like Mindstrong, Steinhubl cautioned that peer review has a purpose.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>“[Peer review] is a very imperfect system, but there’s really nothing in the peer-reviewed literature. That means that other experts aren’t able to weigh in,” he said. “If you have committees and other people reviewing something who maybe don’t have the same level of expertise, you’ll have people saying, ‘Yeah, that sounds good.’”\u003c/p>\n\u003cp>Other researchers have also found that neuropsychological tests, more broadly, have relatively low accuracy rates.\u003c/p>\n\u003cp>In a study that examined people who were already being treated for depression, one computerized test could only accurately predict their condition in about 40 percent of cases. Another showed a 44 percent accuracy rate for a similar computerized test used to examine people with major depression.\u003c/p>\n\u003cp>A neuropsychological test — if it’s used as a screening test — is “going to miss a lot of people who are depressed,” said Richard Porter, a psychology researcher based at the University of Otago in New Zealand who conducted one of the studies.\u003c/p>\n\u003cp>And even if depressed people do show some kind of cognitive impairment, it’s impossible to tell what caused it.\u003c/p>\n\u003cp>Many things other than mental illness might cause a person to perform poorly on cognitive tests — like living with another disorder, having a lower baseline performance on cognitive tests, having a drink or taking prescription, over-the-counter, or illegal drugs.\u003c/p>\n\u003cp>Mindstrong’s leaders aren’t worried about that kind of noise in their data. Some of those factors are important to note, both for patients and the health care professionals working with them.\u003c/p>\n\u003cp>“You’re hungover, you didn’t sleep well, you didn’t take your medication, you have a medication side effects, you’re having stress and challenges at work and at home. Those are things that we want to measure,” Dagum said.\u003c/p>\n\u003cp>But even Insel admitted that there are plenty of issues that could affect typing speed — and which Mindstrong hasn’t figured out how to sort out yet. Sticky fingers after lunch, full hands at an airport, wearing gloves during winter, or a broken hand might also plausible affect a person’s typing speed — and, therefore, the app’s performance.\u003c/p>\n\u003cp>“One thing we’ve thought about is how we factor in those unusual environmental issues,” Insel said. “We’re working on that. But I can’t say that we’ve solved all of those possible issues.”\u003c/p>\n\u003cp>\u003cstrong>A Looming Launch in the Golden State\u003c/strong>\u003c/p>\n\u003cp>Insel and others linked with the company are fond of comparing their app to a smoke detector — something that’s intended to enhance humans’ senses to detect danger.\u003c/p>\n\u003cp>But part of the value of a smoke detector is that if it’s functioning properly, we know it isn’t going off at random. It only goes off in certain conditions and carries a specific message: Your house is on fire or about to be. Do something.\u003c/p>\n\u003cp>At least for now, that’s where Mindstrong differs from a smoke detector. There’s no way to tell, yet, how specific it is or how sensitive its algorithm is.\u003c/p>\n\u003cp>Insel said that information is coming. He said the company has the data about the app’s accuracy — but he declined to provide those figures, citing papers pending publication. “[They] square very well with clinically used biomarkers,” he said.\u003c/p>\n\u003cp>California authorities suggest they have been shown some of that data. But they’re nevertheless cautious about how the app will work in their new, different setting.\u003c/p>\n\u003cp>One official said there will be “clear writing” included with the state’s version of the app about what it can do, what it cannot do, and what goals the counties hope it will help them achieve.\u003c/p>\n\u003cp>Those goals are pretty lofty. At least some counties eventually plan to use it not only to supplement the existing system, but potentially to bring more people into its fold.\u003c/p>\n\u003cp>“We might be able to go to colleges, emergency departments, other places,” said Debbie Innes-Gomberg, a deputy director at the Los Angeles County Department of Mental Health. “There’s a process of identifying that they’re symptomatic, but [our target population is] people that are in our system and people who maybe need to be.”\u003c/p>\n\u003cp>And even before the app launched in the original five counties that had signed on, the pilot has expanded. Another 11 counties have recently decided to join.\u003c/p>\n\u003cp>Still, Innes-Gomberg said, it’s going to be rolled out with caution. “We’re not going to oversell this.”\u003c/p>\n\u003cp>\u003ci>\u003cspan style=\"font-weight: 400\">This \u003c/span>\u003c/i>\u003ca href=\"https://www.statnews.com/2018/10/04/mindstrong-questions-over-evidence/\" target=\"_blank\" rel=\"noopener\">\u003ci>\u003cspan style=\"font-weight: 400\">story\u003c/span>\u003c/i>\u003c/a>\u003ci>\u003cspan style=\"font-weight: 400\"> was originally published by STAT, an online publication of Boston Globe Media that covers health, medicine, and scientific discovery.\u003c/span>\u003c/i>\u003c/p>\n\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/444844/new-smartphone-app-aims-to-monitor-your-mental-health","authors":["byline_futureofyou_444844"],"categories":["futureofyou_1060","futureofyou_1062","futureofyou_1","futureofyou_73"],"tags":["futureofyou_537","futureofyou_56","futureofyou_1224"],"collections":["futureofyou_1093","futureofyou_1097"],"featImg":"futureofyou_18197","label":"source_futureofyou_444844"},"futureofyou_440335":{"type":"posts","id":"futureofyou_440335","meta":{"index":"posts_1591205157","site":"futureofyou","id":"440335","score":null,"sort":[1521569436000]},"guestAuthors":[],"slug":"black-and-latino-children-are-often-overlooked-when-it-comes-to-autism","title":"Black And Latino Children Are Often Overlooked When It Comes To Autism","publishDate":1521569436,"format":"standard","headTitle":"Future of You | KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Sherry Alvarez says she knew there was \u003ca href=\"https://www.kqed.org/futureofyou/357617/sesame-street-to-introduce-muppet-with-autism\" target=\"_blank\" rel=\"noopener\">something different\u003c/a> about her son since he was about 9 months old. Back then Sherry says his pediatrician told her there was nothing to worry about, \" 'Boys are a little slower than girls, so let's just wait until his second birthday.' \" We aren't using Sherry's son's name to protect his privacy.\u003c/p>\n\u003cp>By her son's second birthday, Sherry says she was getting desperate. She didn't know why he wasn't talking yet or showing affection like other kids. At 2 1/2, he was referred to Children's Hospital Los Angeles.[contextly_sidebar id=\"HF94QtAhJ0QaonfGcwoc1BDmUjMCZqvd\"]\u003c/p>\n\u003cp>There, after four hours of tests, Sherry says the doctor handed her a 20-page report explaining his autism spectrum disorder diagnosis, among others. She says she was paralyzed by emotion.\u003c/p>\n\u003cp>ASD is a disease that affects people of all races and ethnicities, but \u003ca href=\"http://www.jaacap.com/article/S0890-8567(09)60739-5/abstract\" target=\"_blank\" rel=\"noopener\">research \u003c/a>shows that African-American and Latino children with autism are diagnosed at older ages than white children, giving them less of an opportunity for proper intervention and treatment.\u003c/p>\n\u003cp>This is especially true of minimally verbal kids like Sherry's son and there are many possible reasons for a late diagnosis. Some families face healthcare access issues and prohibitive costs for treatment, and some families just don't know how important it is to \u003ca href=\"https://www.kqed.org/futureofyou/436442/cdc-app-tells-parents-when-to-be-concerned-about-child-development\" target=\"_blank\" rel=\"noopener\">get diagnosed to move on\u003c/a> to the treatment phase. The dialog between doctors and minority families during the diagnosis process is critical.[contextly_sidebar id=\"i6RhCi4DH3w2V0Rp0zM5OR4cXRLu6ZFc\"]\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29100475\" target=\"_blank\" rel=\"noopener\">A recent study\u003c/a> from Georgia State University found that African-American parents reported fewer concerns about behaviors like delayed speech and repetitive behaviors, even though their children showed a greater severity with these symptoms, overall. But, of course, it isn't all up to parents.\u003c/p>\n\u003cp>\"There are very likely parent aspects of this and very likely clinician aspects of this,\" says Meghan Rose Donohue, a lead researcher on the study. Perhaps families, like Sherry's, don't have the information necessary to really push physicians, but it is also possible that doctors don't take these cases seriously enough from the beginning.\u003c/p>\n\u003cp>\u003cstrong>Misdiagnosis\u003c/strong>\u003cbr>\nFamilies and doctors, alike, can mistake ASD for simple bad behavior, especially in boys, as research has shown over the past couple of decades. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11575603\" target=\"_blank\" rel=\"noopener\">A 2001 study\u003c/a> at McGill University in Montreal found that doctors were more hesitant to diagnose ASD in minority families.[contextly_sidebar id=\"z5QvKJ1QNa5Nn1EGXEj633LNkljonhOJ\"]\u003c/p>\n\u003cp>In 2007, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17160456\" target=\"_blank\" rel=\"noopener\">a study\u003c/a> by a team at the Center for Autism and Developmental Disabilities Research and Epidemiology, University of Pennsylvania, found that African-American children were 5.1 times more likely to be misdiagnosed with conduct disorders before being diagnosed with ASD.\u003c/p>\n\u003cp>When Sherry was growing up, she had a cousin who the family thought of as \"different,\" she says. \"He was basically hidden. We didn't talk about it as a community.\" He had autism. \"We have to retrain ourselves. It's not OK to hide our kids.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.dds.ca.gov/RC/\" target=\"_blank\" rel=\"noopener\">Regional Centers\u003c/a> in Los Angeles, which offer services to the developmentally disabled, are now starting to look at the \u003ca href=\"https://www.kqed.org/futureofyou/245794/researchers-hunt-for-the-microbiome-of-autism\" target=\"_blank\" rel=\"noopener\">diagnosis disparity problem\u003c/a>. Westside Regional Center in Culver City just received a grant from the state to look at how autism diagnosis disparities manifest within their intake and treatment programs.[contextly_sidebar id=\"nMqm3DUyCpzzodOPiyxyxYVgb9M171ki\"]\u003c/p>\n\u003cp>\"We've implemented a series of trainings with intake counselors on cultural awareness and sensitivity, and we're starting to have a lot of conversations about biases,\" says Tom Kelly, Westside's chief psychologist.\u003c/p>\n\u003cp>One of the apparent biases among intake counselors at the center stems from the difference in the documentation that arrives with each new child. African-American families tend to arrive at the center with lots of documentation detailing behavior issues from their child's school or social services. With all those official papers sitting in front of them, it's much easier for a counselor to think \"behavior disease\" rather than \"autism,\" says Kelly.\u003c/p>\n\u003cp>\u003cstrong>Economic Disparities\u003c/strong>\u003cbr>\nAnd that disparity exists in dollars spent, as well. As reported in \u003ca href=\"https://issuu.com/publiccounsel/docs/assuring_equitable_funding_of_servi?e=29495352/49041713\" target=\"_blank\" rel=\"noopener\">a 2017 survey\u003c/a>, South Central Regional Center spends $8,000 less per client than the Westside location and the racial disparity \u003ca href=\"http://www.calhealthreport.org/2016/12/12/marked-racial-disparities-in-money-spent-to-help-disabled/\" target=\"_blank\" rel=\"noopener\">persists statewide\u003c/a>.\u003c/p>\n\u003cp>But there are more resources for minority families today than compared to when Sherry's son was young. The Autism Society of Los Angeles runs a hotline to help parents navigate the diagnosis and healthcare landscape and Children's Hospital Los Angeles now employs liaisons to help families connect with the right resources. But, the spending gap persists.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Today, Sherry says her now 15-year-old son is happy. He attends Hamilton High School and communicates almost solely through a typing device. \"This is the time in his life where those early treatments could have made a difference,\" she laments.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Black+And+Latino+Children+Are+Often+Overlooked+When+It+Comes+To+Autism&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Research suggests that minority youth are poorly diagnosed because of healthcare bias and lack of access.","status":"publish","parent":0,"modified":1521569436,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":18,"wordCount":799},"headData":{"title":"Black And Latino Children Are Often Overlooked When It Comes To Autism | KQED","description":"Research suggests that minority youth are poorly diagnosed because of healthcare bias and lack of access.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Black And Latino Children Are Often Overlooked When It Comes To Autism","datePublished":"2018-03-20T18:10:36.000Z","dateModified":"2018-03-20T18:10:36.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"440335 https://ww2.kqed.org/futureofyou/?p=440335","disqusUrl":"https://ww2.kqed.org/futureofyou/2018/03/20/black-and-latino-children-are-often-overlooked-when-it-comes-to-autism/","disqusTitle":"Black And Latino Children Are Often Overlooked When It Comes To Autism","source":"KQED Future of You","nprByline":"Casey Rentz\u003cbr />NPR Shots","nprImageAgency":"Shannon Wright for NPR","nprStoryId":"587249339","nprApiLink":"http://api.npr.org/query?id=587249339&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"https://www.npr.org/sections/health-shots/2018/03/19/587249339/black-and-latino-children-are-often-overlooked-when-it-comes-to-autism?ft=nprml&f=587249339","nprRetrievedStory":"1","nprPubDate":"Mon, 19 Mar 2018 16:42:00 -0400","nprStoryDate":"Mon, 19 Mar 2018 15:24:00 -0400","nprLastModifiedDate":"Mon, 19 Mar 2018 16:42:27 -0400","path":"/futureofyou/440335/black-and-latino-children-are-often-overlooked-when-it-comes-to-autism","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Sherry Alvarez says she knew there was \u003ca href=\"https://www.kqed.org/futureofyou/357617/sesame-street-to-introduce-muppet-with-autism\" target=\"_blank\" rel=\"noopener\">something different\u003c/a> about her son since he was about 9 months old. Back then Sherry says his pediatrician told her there was nothing to worry about, \" 'Boys are a little slower than girls, so let's just wait until his second birthday.' \" We aren't using Sherry's son's name to protect his privacy.\u003c/p>\n\u003cp>By her son's second birthday, Sherry says she was getting desperate. She didn't know why he wasn't talking yet or showing affection like other kids. At 2 1/2, he was referred to Children's Hospital Los Angeles.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>There, after four hours of tests, Sherry says the doctor handed her a 20-page report explaining his autism spectrum disorder diagnosis, among others. She says she was paralyzed by emotion.\u003c/p>\n\u003cp>ASD is a disease that affects people of all races and ethnicities, but \u003ca href=\"http://www.jaacap.com/article/S0890-8567(09)60739-5/abstract\" target=\"_blank\" rel=\"noopener\">research \u003c/a>shows that African-American and Latino children with autism are diagnosed at older ages than white children, giving them less of an opportunity for proper intervention and treatment.\u003c/p>\n\u003cp>This is especially true of minimally verbal kids like Sherry's son and there are many possible reasons for a late diagnosis. Some families face healthcare access issues and prohibitive costs for treatment, and some families just don't know how important it is to \u003ca href=\"https://www.kqed.org/futureofyou/436442/cdc-app-tells-parents-when-to-be-concerned-about-child-development\" target=\"_blank\" rel=\"noopener\">get diagnosed to move on\u003c/a> to the treatment phase. The dialog between doctors and minority families during the diagnosis process is critical.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/29100475\" target=\"_blank\" rel=\"noopener\">A recent study\u003c/a> from Georgia State University found that African-American parents reported fewer concerns about behaviors like delayed speech and repetitive behaviors, even though their children showed a greater severity with these symptoms, overall. But, of course, it isn't all up to parents.\u003c/p>\n\u003cp>\"There are very likely parent aspects of this and very likely clinician aspects of this,\" says Meghan Rose Donohue, a lead researcher on the study. Perhaps families, like Sherry's, don't have the information necessary to really push physicians, but it is also possible that doctors don't take these cases seriously enough from the beginning.\u003c/p>\n\u003cp>\u003cstrong>Misdiagnosis\u003c/strong>\u003cbr>\nFamilies and doctors, alike, can mistake ASD for simple bad behavior, especially in boys, as research has shown over the past couple of decades. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/11575603\" target=\"_blank\" rel=\"noopener\">A 2001 study\u003c/a> at McGill University in Montreal found that doctors were more hesitant to diagnose ASD in minority families.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>In 2007, \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/17160456\" target=\"_blank\" rel=\"noopener\">a study\u003c/a> by a team at the Center for Autism and Developmental Disabilities Research and Epidemiology, University of Pennsylvania, found that African-American children were 5.1 times more likely to be misdiagnosed with conduct disorders before being diagnosed with ASD.\u003c/p>\n\u003cp>When Sherry was growing up, she had a cousin who the family thought of as \"different,\" she says. \"He was basically hidden. We didn't talk about it as a community.\" He had autism. \"We have to retrain ourselves. It's not OK to hide our kids.\"\u003c/p>\n\u003cp>\u003ca href=\"http://www.dds.ca.gov/RC/\" target=\"_blank\" rel=\"noopener\">Regional Centers\u003c/a> in Los Angeles, which offer services to the developmentally disabled, are now starting to look at the \u003ca href=\"https://www.kqed.org/futureofyou/245794/researchers-hunt-for-the-microbiome-of-autism\" target=\"_blank\" rel=\"noopener\">diagnosis disparity problem\u003c/a>. Westside Regional Center in Culver City just received a grant from the state to look at how autism diagnosis disparities manifest within their intake and treatment programs.\u003c/p>\u003cp>\u003c/p>\u003cp>\u003c/p>\n\u003cp>\"We've implemented a series of trainings with intake counselors on cultural awareness and sensitivity, and we're starting to have a lot of conversations about biases,\" says Tom Kelly, Westside's chief psychologist.\u003c/p>\n\u003cp>One of the apparent biases among intake counselors at the center stems from the difference in the documentation that arrives with each new child. African-American families tend to arrive at the center with lots of documentation detailing behavior issues from their child's school or social services. With all those official papers sitting in front of them, it's much easier for a counselor to think \"behavior disease\" rather than \"autism,\" says Kelly.\u003c/p>\n\u003cp>\u003cstrong>Economic Disparities\u003c/strong>\u003cbr>\nAnd that disparity exists in dollars spent, as well. As reported in \u003ca href=\"https://issuu.com/publiccounsel/docs/assuring_equitable_funding_of_servi?e=29495352/49041713\" target=\"_blank\" rel=\"noopener\">a 2017 survey\u003c/a>, South Central Regional Center spends $8,000 less per client than the Westside location and the racial disparity \u003ca href=\"http://www.calhealthreport.org/2016/12/12/marked-racial-disparities-in-money-spent-to-help-disabled/\" target=\"_blank\" rel=\"noopener\">persists statewide\u003c/a>.\u003c/p>\n\u003cp>But there are more resources for minority families today than compared to when Sherry's son was young. The Autism Society of Los Angeles runs a hotline to help parents navigate the diagnosis and healthcare landscape and Children's Hospital Los Angeles now employs liaisons to help families connect with the right resources. But, the spending gap persists.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Today, Sherry says her now 15-year-old son is happy. He attends Hamilton High School and communicates almost solely through a typing device. \"This is the time in his life where those early treatments could have made a difference,\" she laments.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2018 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"https://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Black+And+Latino+Children+Are+Often+Overlooked+When+It+Comes+To+Autism&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/440335/black-and-latino-children-are-often-overlooked-when-it-comes-to-autism","authors":["byline_futureofyou_440335"],"programs":["futureofyou_54"],"categories":["futureofyou_1060","futureofyou_1"],"tags":["futureofyou_555","futureofyou_537","futureofyou_141","futureofyou_756","futureofyou_198","futureofyou_1434"],"collections":["futureofyou_1093"],"featImg":"futureofyou_440336","label":"source_futureofyou_440335"},"futureofyou_229919":{"type":"posts","id":"futureofyou_229919","meta":{"index":"posts_1591205157","site":"futureofyou","id":"229919","score":null,"sort":[1472065163000]},"guestAuthors":[],"slug":"japan-trains-public-to-recognize-signs-of-dementia","title":"Japan Trains Public to Recognize Signs of Dementia","publishDate":1472065163,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{},"content":"\u003cp>Early mornings are routine for 69-year-old Hiroyuko Yamamoto. He's typically at a busy intersection in the city of Matsudo, near Tokyo, where he volunteers as a school crossing guard. But one rainy morning a little over a year ago, an old woman caught his attention.\u003c/p>\n\u003cp>She was pushing a bicycle. She was kind of disheveled. Despite the rain, she didn't have an umbrella. When Yamamoto spoke to the woman, she said she was trying to get to the city of Kamisuwa. That's about four hours away by train.\u003c/p>\n\u003cp>Yamamoto recognized that the woman had several signs of dementia he'd learned about when he took his city's dementia awareness training.\u003c/p>\n\u003cp>Yamamoto volunteers with Matsudo's Orange Patrol. The organization's formal name in Japanese — Olenji koe kake tai — translates awkwardly into English as \"Troop that calls out to the elderly.\" But the name accurately describes what the members do. Yamamoto says that just a simple, \"Hello, what a nice day,\" can tell you if someone is OK or needs help.\u003c/p>\n\u003cp>Because of his training, Yamamoto says, he knew how to talk with the old woman pushing the bicycle.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"I talked to her about things that, according to the training manual, would not upset her,\" he says. \"And I spoke in a gentle manner.\" These things helped him persuade the woman to stay with him until the police arrived about 20 minutes later.\u003c/p>\n\u003cp>If it hadn't been for her chance encounter with Yamamoto, the woman might have gone missing, or worse. Last year, 12,208 people with dementia were reported missing to the National Police Agency in Japan. Most were found alive within a week. But 479 were found dead, and 150 were never found.\u003c/p>\n\u003caside class=\"pullquote alignright\">The Japanese government expects that by 2025 more than 7 million of the nation's residents will have dementia.\u003c/aside>\n\u003cp>These numbers have been increasing every year as the number of older people in Japan continues to rise. \u003ca href=\"http://www.japantimes.co.jp/news/2016/07/13/national/japans-population-drops-fastest-pace-record/#.V7JiKKLmhyV\">Nearly 27 percent\u003c/a> of the Japanese population is now 65 or older. And, as the number of older people grows, so does the number of people with Alzheimer's disease or other dementia. The Japanese government expects that by 2025 more than 7 million of the nation's residents will have dementia.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.japantoday.com/category/national/view/govt-adopts-new-plan-to-deal-with-dementia-patients\">comprehensive plan\u003c/a> for dealing with that expected rise in dementia cases was passed by the national government last year. But Matsudo has been providing dementia awareness training for city residents since 2010. Thousands of people have taken it.\u003c/p>\n\u003cp>Atsuko Yoshioka conducts dementia awareness classes for the city of Matsudo. She says the sessions are brief — just 60 to 90 minutes — so she tries to customize the content for students.\u003c/p>\n\u003cp>For example, pharmacist Takayuki Yoshida says he sometimes had clients who \"even after I gave the medication to them, they'd come back and say they didn't get the drugs.\" Now he knows that may be a sign of dementia, and he contacts the patient's doctor.\u003c/p>\n\u003cp>Many post office workers have also taken the training. In Japan, post offices also conduct some banking transactions. Hiroki Yaita says sometimes an older client will come in several times to say that someone has stolen their bankbook. Now, because of the training, \"we would think that maybe that person has dementia and we would talk to the family about that possibility.\"\u003c/p>\n\u003cp>The purpose of the training isn't to make Matsudo residents experts in dementia, says Tadashi Watanabe, chief of the city's Welfare and Longevity Department. The goal, he says, is just \"to support those with dementia, as well as their families, and make this a town where it's more comfortable for them to live.\"\u003c/p>\n\u003cp>Some communities in the United States \u003ca href=\"http://www.usagainstalzheimers.org/press/dementia-friendly-america-initiative-launches-communities-across-us-maryland-california\">have begun similar programs\u003c/a>. And in Japan what's been going on in Matsudo is now national policy. The comprehensive plan adopted by the government last year includes research and prevention and nursing services. It also includes a campaign for increasing dementia awareness among the general public. The country is on track to train 8 million people by the end of the next fiscal year.\u003c/p>\n\u003cp>Hidenori Kawashima, deputy director for dementia policy in Japan's Ministry of Labor, Health, and Welfare, says the expected rise in dementia cases should not be seen as a threat. Interacting with people with dementia will become normal.\u003c/p>\n\u003cp>\"It would be a familiar thing,\" says Kawashima. \"So we wanted the plan: First, to create a structure in the local communities to support those with dementia and, second, to create a society where it will be natural for them to live.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>No government plan can keep people with dementia from wandering. But health officials in Japan hope there eventually will be entire communities prepared to help keep them safe, if and when they do.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Japanese+City+Takes+Community+Approach+To+Dealing+With+Dementia&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n","blocks":[],"excerpt":"Japan expects 7 million cases of dementia among its long-lived residents by 2025. It has started training pharmacists, bankers and postal workers in how to recognize the signs and be supportive.","status":"publish","parent":0,"modified":1472065163,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":19,"wordCount":817},"headData":{"title":"Japan Trains Public to Recognize Signs of Dementia | KQED","description":"Japan expects 7 million cases of dementia among its long-lived residents by 2025. It has started training pharmacists, bankers and postal workers in how to recognize the signs and be supportive.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"Japan Trains Public to Recognize Signs of Dementia","datePublished":"2016-08-24T18:59:23.000Z","dateModified":"2016-08-24T18:59:23.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"229919 http://ww2.kqed.org/futureofyou/?p=229919","disqusUrl":"https://ww2.kqed.org/futureofyou/2016/08/24/japan-trains-public-to-recognize-signs-of-dementia/","disqusTitle":"Japan Trains Public to Recognize Signs of Dementia","source":"NPR","sourceUrl":"www.npr.org","nprByline":"Ina Jaffe\u003c/br>NPR","nprImageAgency":"Ina Jaffe/NPR","nprStoryId":"489629931","nprApiLink":"http://api.npr.org/query?id=489629931&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2016/08/23/489629931/japan-offers-dementia-awareness-courses-to-city-workers?ft=nprml&f=489629931","nprRetrievedStory":"1","nprPubDate":"Tue, 23 Aug 2016 19:52:00 -0400","nprStoryDate":"Tue, 23 Aug 2016 14:10:00 -0400","nprLastModifiedDate":"Tue, 23 Aug 2016 18:09:09 -0400","nprAudio":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2016/08/20160823_atc_japan_offers_dementia_awareness_courses_to_city_workers.mp3?orgId=1&topicId=1128&d=327&p=2&story=489629931&t=progseg&e=491014243&seg=10&ft=nprml&f=489629931","nprAudioM3u":"http://api.npr.org/m3u/1491103739-883b3d.m3u?orgId=1&topicId=1128&d=327&p=2&story=489629931&t=progseg&e=491014243&seg=10&ft=nprml&f=489629931","path":"/futureofyou/229919/japan-trains-public-to-recognize-signs-of-dementia","audioUrl":"https://ondemand.npr.org/anon.npr-mp3/npr/atc/2016/08/20160823_atc_japan_offers_dementia_awareness_courses_to_city_workers.mp3?orgId=1&topicId=1128&d=327&p=2&story=489629931&t=progseg&e=491014243&seg=10&ft=nprml&f=489629931","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>Early mornings are routine for 69-year-old Hiroyuko Yamamoto. He's typically at a busy intersection in the city of Matsudo, near Tokyo, where he volunteers as a school crossing guard. But one rainy morning a little over a year ago, an old woman caught his attention.\u003c/p>\n\u003cp>She was pushing a bicycle. She was kind of disheveled. Despite the rain, she didn't have an umbrella. When Yamamoto spoke to the woman, she said she was trying to get to the city of Kamisuwa. That's about four hours away by train.\u003c/p>\n\u003cp>Yamamoto recognized that the woman had several signs of dementia he'd learned about when he took his city's dementia awareness training.\u003c/p>\n\u003cp>Yamamoto volunteers with Matsudo's Orange Patrol. The organization's formal name in Japanese — Olenji koe kake tai — translates awkwardly into English as \"Troop that calls out to the elderly.\" But the name accurately describes what the members do. Yamamoto says that just a simple, \"Hello, what a nice day,\" can tell you if someone is OK or needs help.\u003c/p>\n\u003cp>Because of his training, Yamamoto says, he knew how to talk with the old woman pushing the bicycle.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"I talked to her about things that, according to the training manual, would not upset her,\" he says. \"And I spoke in a gentle manner.\" These things helped him persuade the woman to stay with him until the police arrived about 20 minutes later.\u003c/p>\n\u003cp>If it hadn't been for her chance encounter with Yamamoto, the woman might have gone missing, or worse. Last year, 12,208 people with dementia were reported missing to the National Police Agency in Japan. Most were found alive within a week. But 479 were found dead, and 150 were never found.\u003c/p>\n\u003caside class=\"pullquote alignright\">The Japanese government expects that by 2025 more than 7 million of the nation's residents will have dementia.\u003c/aside>\n\u003cp>These numbers have been increasing every year as the number of older people in Japan continues to rise. \u003ca href=\"http://www.japantimes.co.jp/news/2016/07/13/national/japans-population-drops-fastest-pace-record/#.V7JiKKLmhyV\">Nearly 27 percent\u003c/a> of the Japanese population is now 65 or older. And, as the number of older people grows, so does the number of people with Alzheimer's disease or other dementia. The Japanese government expects that by 2025 more than 7 million of the nation's residents will have dementia.\u003c/p>\n\u003cp>A \u003ca href=\"http://www.japantoday.com/category/national/view/govt-adopts-new-plan-to-deal-with-dementia-patients\">comprehensive plan\u003c/a> for dealing with that expected rise in dementia cases was passed by the national government last year. But Matsudo has been providing dementia awareness training for city residents since 2010. Thousands of people have taken it.\u003c/p>\n\u003cp>Atsuko Yoshioka conducts dementia awareness classes for the city of Matsudo. She says the sessions are brief — just 60 to 90 minutes — so she tries to customize the content for students.\u003c/p>\n\u003cp>For example, pharmacist Takayuki Yoshida says he sometimes had clients who \"even after I gave the medication to them, they'd come back and say they didn't get the drugs.\" Now he knows that may be a sign of dementia, and he contacts the patient's doctor.\u003c/p>\n\u003cp>Many post office workers have also taken the training. In Japan, post offices also conduct some banking transactions. Hiroki Yaita says sometimes an older client will come in several times to say that someone has stolen their bankbook. Now, because of the training, \"we would think that maybe that person has dementia and we would talk to the family about that possibility.\"\u003c/p>\n\u003cp>The purpose of the training isn't to make Matsudo residents experts in dementia, says Tadashi Watanabe, chief of the city's Welfare and Longevity Department. The goal, he says, is just \"to support those with dementia, as well as their families, and make this a town where it's more comfortable for them to live.\"\u003c/p>\n\u003cp>Some communities in the United States \u003ca href=\"http://www.usagainstalzheimers.org/press/dementia-friendly-america-initiative-launches-communities-across-us-maryland-california\">have begun similar programs\u003c/a>. And in Japan what's been going on in Matsudo is now national policy. The comprehensive plan adopted by the government last year includes research and prevention and nursing services. It also includes a campaign for increasing dementia awareness among the general public. The country is on track to train 8 million people by the end of the next fiscal year.\u003c/p>\n\u003cp>Hidenori Kawashima, deputy director for dementia policy in Japan's Ministry of Labor, Health, and Welfare, says the expected rise in dementia cases should not be seen as a threat. Interacting with people with dementia will become normal.\u003c/p>\n\u003cp>\"It would be a familiar thing,\" says Kawashima. \"So we wanted the plan: First, to create a structure in the local communities to support those with dementia and, second, to create a society where it will be natural for them to live.\"\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>No government plan can keep people with dementia from wandering. But health officials in Japan hope there eventually will be entire communities prepared to help keep them safe, if and when they do.\u003c/p>\n\u003cdiv class=\"fullattribution\">Copyright 2016 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=Japanese+City+Takes+Community+Approach+To+Dealing+With+Dementia&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\">\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/229919/japan-trains-public-to-recognize-signs-of-dementia","authors":["byline_futureofyou_229919"],"categories":["futureofyou_1"],"tags":["futureofyou_537","futureofyou_1023","futureofyou_1008","futureofyou_1024"],"featImg":"futureofyou_229920","label":"source_futureofyou_229919"},"futureofyou_16222":{"type":"posts","id":"futureofyou_16222","meta":{"index":"posts_1591205157","site":"futureofyou","id":"16222","score":null,"sort":[1437590455000]},"guestAuthors":[],"slug":"for-kids-with-tourettes-online-training-could-help","title":"For Kids With Tourette's, Online Training Could Help","publishDate":1437590455,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>If you've ever had hiccups in a quiet room, you know how embarrassing and completely uncontrollable they can feel. What if, instead of the hiccups, your body jerked involuntarily or you blurted out words without meaning to? That's a rough idea of what living with \u003ca href=\"http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm\">Tourette syndrome\u003c/a> can be like.\u003c/p>\n\u003cp>Designers of a new computer program called \u003ca href=\"http://www.tichelper.com/\">TicHelper\u003c/a> hope that they will be able to help children recognize and control these impulses themselves.\u003c/p>\n\u003cp>People with Tourette's perform repetitive movements or vocalizations called \u003ca href=\"http://www.cdc.gov/ncbddd/tourette/facts.html\">tics\u003c/a>. A simple tic might be something like head jerking, eye blinking, or throat clearing, and a complex tic might involve patterns of movement or saying multiple words or phrases.\u003c/p>\n\u003cp>We don't know exactly what causes Tourette's, says \u003ca href=\"http://bit.ly/1TOnGlR\">Douglas Woods\u003c/a>, a psychologist at Texas A&M University. Woods, who is also co-chair of the \u003ca href=\"http://tourette.org/\">Tourette Association of America\u003c/a> Medical Advisory Board, is one of the minds behind TicHelper.\u003c/p>\n\u003cp>Tourette's affects more boys than girls, and symptoms usually start between ages 3-7.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>\"Sometimes kids will grow out of [Tourette's],\" Woods says. But if the wait-and-see approach isn't working, and the tics are interfering with daily life, there are a few treatment options.\u003c/p>\n\u003cp>One option is medication. Woods says there are a few different antipsychotic drugs that are used to manage Tourette syndrome, but they have side effects and don't always work. An alternative to pharmaceutical treatment is behavioral therapy.\u003c/p>\n\u003cp>A form of behavioral therapy called \u003ca href=\"http://www.tsa-usa.org/Medical/CBIT.html\">comprehensive behavioral intervention for tics\u003c/a>, or CBIT for short, is commonly used. CBIT training teaches people with Tourette's to recognize the onset of a tic and to perform a different behavior when they feel one coming on.\u003c/p>\n\u003cp>\"The idea is that when someone has a tic, they tend to have an urge,\" says clinical psychologist \u003ca href=\"http://health.usf.edu/medicine/pediatrics/profile.html?person_id=62245\">Eric Storch\u003c/a>, a professor at the University of South Florida and Clinical Director of Pediatrics at Rogers Memorial Hospital in Tampa. \"It's like when you're about to yawn. You know just before it happens that a yawn's coming. [CBIT] teaches a person to be aware.\"\u003c/p>\n\u003cp>And it gives them the tools to manage tics. Storch describes a patient whose tic was rubbing two fingers together, to the point of rubbing off skin. With CBIT, the boy was able to recognize the onset of a tic and instead unobtrusively press down on his kneecap until the urge went away.\u003c/p>\n\u003cp>A typical CBIT training program involves eight sessions with a therapist, spread over 10 weeks. Results, Woods says, can be maintained up to six months.\u003c/p>\n\u003cp>Both psychologists say that CBIT is at least as effective as medical treatments. The problem is that it requires specially trained therapists — and there aren't that many of them. Which is where TicHelper comes in.\u003c/p>\n\u003cp>\"It's essentially a self-help, self-guided program that leads the patient through a CBIT treatment,\" Woods says. He and his colleagues received funding from the National Institute of Mental Health to develop TicHelper, which is now being tested. So far, the results look promising. \"The kids that go through it, enjoy it,\" Woods says. They're able to do the skills,\"\u003c/p>\n\u003cp>The program has four main sections: tic education, reducing tic triggers, tic awareness and tic blocking. Videos featuring a friendly actress guide patients thorough each section. The program personalizes treatment based on feedback from the patient. Woods says the testing will help the designers modify and improve it based on user feedback. Though TicHelper isn't available yet, interested patients or doctors can sign up to receive updates on its progress.\u003c/p>\n\u003cp>The website currently lists the cost of an 8-week program through TicHelper at $150, but Woods says that the price isn't set.\u003c/p>\n\u003cp>Storch, who is unaffiliated with TicHelper, is enthusiastic about the idea of at-home treatment for tics. \"I really think it's an exciting development that has a lot of practicality,\" he says. \"We know what behavioral treatments work well for tics, but the dissemination is really terrible.\"\u003c/p>\n\u003cp>Storch says the biggest advantage of TicHelper will be its accessibility. CBIT, he says, works well and is incredibly safe compared with pharmaceuticals. TicHelper would maximize the benefits of CBIT by making it more inexpensive and easier to get to than therapy.\u003c/p>\n\u003cp>Which is not to say that Storch or Woods would recommend TicHelper as the only form of tic management. Both psychologists suggest that this program might work best as part of a management plan. One option, Woods says, might be to start treatment with TicHelper at first diagnosis and proceed to more intensive care if in-home treatment isn't working.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Storch thinks that ideally the patient would work with the program, but touch base periodically with an experienced therapist or health care provider to check progress. But, he says, \"we don't have enough providers.\" And some treatment, he says, is better than no treatment at all.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Kids+With+Tourette%27s%2C+At-Home+Training+Could+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n","blocks":[],"excerpt":"Psychologists are working on an online training program that draws on principles of in-person behavioral therapy to help patients with Tourette syndrome manage their tics.","status":"publish","parent":0,"modified":1437590455,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":21,"wordCount":838},"headData":{"title":"For Kids With Tourette's, Online Training Could Help | KQED","description":"Psychologists are working on an online training program that draws on principles of in-person behavioral therapy to help patients with Tourette syndrome manage their tics.","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"For Kids With Tourette's, Online Training Could Help","datePublished":"2015-07-22T18:40:55.000Z","dateModified":"2015-07-22T18:40:55.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"16222 http://ww2.kqed.org/futureofyou/?p=16222","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/07/22/for-kids-with-tourettes-online-training-could-help/","disqusTitle":"For Kids With Tourette's, Online Training Could Help","nprByline":"Jessie Rack","nprStoryId":"424722960","nprApiLink":"http://api.npr.org/query?id=424722960&apiKey=MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004","nprHtmlLink":"http://www.npr.org/sections/health-shots/2015/07/22/424722960/for-kids-with-tourettes-at-home-training-could-help?ft=nprml&f=424722960","nprRetrievedStory":"1","nprPubDate":"Wed, 22 Jul 2015 14:11:00 -0400","nprStoryDate":"Wed, 22 Jul 2015 08:26:00 -0400","nprLastModifiedDate":"Wed, 22 Jul 2015 14:11:11 -0400","path":"/futureofyou/16222/for-kids-with-tourettes-online-training-could-help","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>If you've ever had hiccups in a quiet room, you know how embarrassing and completely uncontrollable they can feel. What if, instead of the hiccups, your body jerked involuntarily or you blurted out words without meaning to? That's a rough idea of what living with \u003ca href=\"http://www.ninds.nih.gov/disorders/tourette/detail_tourette.htm\">Tourette syndrome\u003c/a> can be like.\u003c/p>\n\u003cp>Designers of a new computer program called \u003ca href=\"http://www.tichelper.com/\">TicHelper\u003c/a> hope that they will be able to help children recognize and control these impulses themselves.\u003c/p>\n\u003cp>People with Tourette's perform repetitive movements or vocalizations called \u003ca href=\"http://www.cdc.gov/ncbddd/tourette/facts.html\">tics\u003c/a>. A simple tic might be something like head jerking, eye blinking, or throat clearing, and a complex tic might involve patterns of movement or saying multiple words or phrases.\u003c/p>\n\u003cp>We don't know exactly what causes Tourette's, says \u003ca href=\"http://bit.ly/1TOnGlR\">Douglas Woods\u003c/a>, a psychologist at Texas A&M University. Woods, who is also co-chair of the \u003ca href=\"http://tourette.org/\">Tourette Association of America\u003c/a> Medical Advisory Board, is one of the minds behind TicHelper.\u003c/p>\n\u003cp>Tourette's affects more boys than girls, and symptoms usually start between ages 3-7.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\"Sometimes kids will grow out of [Tourette's],\" Woods says. But if the wait-and-see approach isn't working, and the tics are interfering with daily life, there are a few treatment options.\u003c/p>\n\u003cp>One option is medication. Woods says there are a few different antipsychotic drugs that are used to manage Tourette syndrome, but they have side effects and don't always work. An alternative to pharmaceutical treatment is behavioral therapy.\u003c/p>\n\u003cp>A form of behavioral therapy called \u003ca href=\"http://www.tsa-usa.org/Medical/CBIT.html\">comprehensive behavioral intervention for tics\u003c/a>, or CBIT for short, is commonly used. CBIT training teaches people with Tourette's to recognize the onset of a tic and to perform a different behavior when they feel one coming on.\u003c/p>\n\u003cp>\"The idea is that when someone has a tic, they tend to have an urge,\" says clinical psychologist \u003ca href=\"http://health.usf.edu/medicine/pediatrics/profile.html?person_id=62245\">Eric Storch\u003c/a>, a professor at the University of South Florida and Clinical Director of Pediatrics at Rogers Memorial Hospital in Tampa. \"It's like when you're about to yawn. You know just before it happens that a yawn's coming. [CBIT] teaches a person to be aware.\"\u003c/p>\n\u003cp>And it gives them the tools to manage tics. Storch describes a patient whose tic was rubbing two fingers together, to the point of rubbing off skin. With CBIT, the boy was able to recognize the onset of a tic and instead unobtrusively press down on his kneecap until the urge went away.\u003c/p>\n\u003cp>A typical CBIT training program involves eight sessions with a therapist, spread over 10 weeks. Results, Woods says, can be maintained up to six months.\u003c/p>\n\u003cp>Both psychologists say that CBIT is at least as effective as medical treatments. The problem is that it requires specially trained therapists — and there aren't that many of them. Which is where TicHelper comes in.\u003c/p>\n\u003cp>\"It's essentially a self-help, self-guided program that leads the patient through a CBIT treatment,\" Woods says. He and his colleagues received funding from the National Institute of Mental Health to develop TicHelper, which is now being tested. So far, the results look promising. \"The kids that go through it, enjoy it,\" Woods says. They're able to do the skills,\"\u003c/p>\n\u003cp>The program has four main sections: tic education, reducing tic triggers, tic awareness and tic blocking. Videos featuring a friendly actress guide patients thorough each section. The program personalizes treatment based on feedback from the patient. Woods says the testing will help the designers modify and improve it based on user feedback. Though TicHelper isn't available yet, interested patients or doctors can sign up to receive updates on its progress.\u003c/p>\n\u003cp>The website currently lists the cost of an 8-week program through TicHelper at $150, but Woods says that the price isn't set.\u003c/p>\n\u003cp>Storch, who is unaffiliated with TicHelper, is enthusiastic about the idea of at-home treatment for tics. \"I really think it's an exciting development that has a lot of practicality,\" he says. \"We know what behavioral treatments work well for tics, but the dissemination is really terrible.\"\u003c/p>\n\u003cp>Storch says the biggest advantage of TicHelper will be its accessibility. CBIT, he says, works well and is incredibly safe compared with pharmaceuticals. TicHelper would maximize the benefits of CBIT by making it more inexpensive and easier to get to than therapy.\u003c/p>\n\u003cp>Which is not to say that Storch or Woods would recommend TicHelper as the only form of tic management. Both psychologists suggest that this program might work best as part of a management plan. One option, Woods says, might be to start treatment with TicHelper at first diagnosis and proceed to more intensive care if in-home treatment isn't working.\u003c/p>\n\u003cp>\u003c/p>\n\u003cp>Storch thinks that ideally the patient would work with the program, but touch base periodically with an experienced therapist or health care provider to check progress. But, he says, \"we don't have enough providers.\" And some treatment, he says, is better than no treatment at all.\u003c/p>\n\u003cdiv class=\"fullattribution\">\u003cem>Copyright 2015 NPR. To see more, visit http://www.npr.org/.\u003cimg src=\"http://www.google-analytics.com/__utm.gif?utmac=UA-5828686-4&utmdt=For+Kids+With+Tourette%27s%2C+At-Home+Training+Could+Help&utme=8(APIKey)9(MDAxOTAwOTE4MDEyMTkxMDAzNjczZDljZA004)\" alt=\"\">\u003c/em>\u003c/div>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/16222/for-kids-with-tourettes-online-training-could-help","authors":["byline_futureofyou_16222"],"categories":["futureofyou_1"],"tags":["futureofyou_489","futureofyou_537","futureofyou_80","futureofyou_536"],"featImg":"futureofyou_16225","label":"futureofyou"},"futureofyou_2122":{"type":"posts","id":"futureofyou_2122","meta":{"index":"posts_1591205157","site":"futureofyou","id":"2122","score":null,"sort":[1429830690000]},"guestAuthors":[],"slug":"these-apps-are-turning-the-apple-watch-into-a-personal-health-coach","title":"These Apps are Turning the Apple Watch into a Personal Health Coach","publishDate":1429830690,"format":"standard","headTitle":"KQED Future of You | KQED Science","labelTerm":{"site":"futureofyou"},"content":"\u003cp>You're waiting in line for a coffee, eyeing a pastry, and your wrist-watch buzzes with a warning.\u003c/p>\n\u003cp>Flashing on the tiny screen of your \u003ca href=\"https://www.apple.com/watch/\">Apple Watch\u003c/a> is a message from an app called \u003ca href=\"http://lark.com/\">Lark\u003c/a>, suggesting that you lay off the carbs for today. Speak into the Apple Watch's built-in mic about your food, sleep and exercise, and the app will send helpful tips back to you.\u003c/p>\n\u003cp>The notion of receiving nutrition advice from artificial intelligence on your wrist may seem like science fiction. But health developers like Lark are making a bet that Apple's first wearable device, the Apple Watch, will fly off the shelves and this kind of behavior will become the norm.\u003c/p>\n\u003cfigure id=\"attachment_2276\" class=\"wp-caption alignright\" style=\"max-width: 263px\">\u003cimg class=\" wp-image-2276\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Screenshots-with-Apple-Watch.002.png\" alt=\"A typical interaction with a Lark weight loss coach\" width=\"263\" height=\"301\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screenshots-with-Apple-Watch.002.png 436w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screenshots-with-Apple-Watch.002-400x457.png 400w\" sizes=\"(max-width: 263px) 100vw, 263px\">\u003cfigcaption class=\"wp-caption-text\">A typical interaction with a Lark weight loss coach \u003ccite>(Lark)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lark is just one of over a dozen health developers with new apps for the Apple Watch, which are focused on improving people's health and fitness. Some of these apps are essentially a smaller version of an existing iPhone app; others take advantage of the unique capabilities of the Apple Watch.\u003c/p>\n\u003cp>Apple has made no secret of its interest in medicine, and has recruited industry experts to work on services like \u003ca href=\"https://www.apple.com/pr/library/2015/04/14Apple-Announces-ResearchKit-Available-Today-to-Medical-Researchers.html\">ResearchKit\u003c/a> and \u003ca href=\"https://developer.apple.com/healthkit/\">HealthKit\u003c/a>, which aim to open up the flow of health data between consumers, mobile developers and medical researchers.\u003c/p>\n\u003cp>[ad fullwidth]\u003c/p>\n\u003cp>But as it dabbles in health care, a notoriously regulated and privacy-conscious sector, Apple has also made steps to put you in control of how your data is shared.\u003c/p>\n\u003cp>Here's how it works for the Apple Watch: You can choose to share health information with third-party apps like Lark, including the amount of steps you've walked, via \u003ca href=\"https://www.apple.com/ios/whats-new/health/\">Apple's Health app\u003c/a>, which comes with the device. Your health data, collected via the Apple Watch or the iPhone, is stored on Apple's \u003ca href=\"https://developer.apple.com/healthkit/\">HealthKit.\u003c/a>\u003c/p>\n\u003cp>In advance of the Apple Watch's April 24th ship-date (although recent reports \u003ca href=\"http://www.denverpost.com/news/ci_27957664/dont-plan-line-up-apple-watch-next-week\">suggest there will be delays\u003c/a> before the watch reaches your local Apple Store), \u003cem>KQED\u003c/em> spoke with mobile developers from startups and big brands. Their offerings for the Apple Watch range from medication management apps to \u003ca href=\"http://hitconsultant.net/2015/04/13/healthtaps-apple-watch-app/\">a button that provides instant, virtual access to a doctor. \u003c/a>\u003c/p>\n\u003cp>\"We haven't had a developer ecosystem for a product like a smartwatch,\" said Ben Bajarin, who specializes in consumer technology for Creative Strategies, a consulting firm. Similarly to the iPhone, the Apple Watch has its own App Store, \u003ca href=\"http://blogs.wsj.com/digits/2015/04/23/as-first-watches-ship-apple-opens-app-store-for-new-device/\">which goes live on Thursday\u003c/a>.\u003c/p>\n\u003cp>\"This is unchartered territory.\"\u003c/p>\n\u003cp>\u003cstrong>A Message on the Wrist \u003c/strong>\u003c/p>\n\u003cp>Health app developers hope the Apple Watch will improve how doctors and patients communicate, particularly when it comes to sending urgent notifications and alerts.\u003c/p>\n\u003cp>Imagine a doctor receiving a buzz on the wrist for an e-prescription request, which could be approved with a few taps. A patient could receive a similar alert when test results are available, and caregivers might receive a flashing message on their Apple Watch when an elderly patient has taken a bad fall and needs assistance.\u003c/p>\n\u003cp>Developers are exploring all these possibilities and more.\u003c/p>\n\u003cp>[Scroll down to the graphic at the bottom for a more extensive list of apps. \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/04/23/29-of-the-most-promising-apple-watch-health-apps-graphic/\">Or click the link here.\u003c/a>]\u003c/p>\n\u003cp>Those of us with a smartphone have grown accustomed to receiving notifications from apps, such as an email from a medical clinic, which often goes unchecked. But with the watch, the notification is seen, heard, and most importantly, felt on the body.\u003c/p>\n\u003cp>\"We are predisposed to small changes on the skin. It was not that long ago -- and is still the case in parts of the world -- that mosquitoes used to kill us with a light touch,\" said Ron Gutman, chief executive of \u003ca href=\"http://healthtap.com\">HealthTap\u003c/a>, a website and mobile app for secure video calls with a doctor.\u003c/p>\n\u003cp>\"It is so easy to turn off a notification from a website, but you can't ignore what's on your wrist,\" he said.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"How does this change people's behaviors and goal settings for the better? That’s the step that has been missing in the wearables trend. That’s where we need to go.\"\u003cbr>\n\u003ccite>Ben Bajarin, Director at Creative Strategies \u003c/cite>\u003c/aside>\n\u003cp>Gutman was so intrigued by Apple's smartwatch that he developed three apps: One to help you \u003ca href=\"https://itunes.apple.com/us/app/healthtap-immediate-doctor/id466079030?mt=8\">manage you meds\u003c/a> with notification reminders; another that\u003ca href=\"http://hitconsultant.net/2015/04/13/healthtaps-apple-watch-app/\"> connects you to a primary care doctor\u003c/a> with the touch of a button\u003ca href=\"http://hitconsultant.net/2015/04/13/healthtaps-apple-watch-app/\">;\u003c/a> and a third, which helps physicians\u003ca href=\"https://itunes.apple.com/us/app/healthtap-for-u.s.-doctors/id466099564?mt=8\"> reach new patients\u003c/a>.\u003c/p>\n\u003cp>Electronic health record company \u003ca href=\"http://drchrono.com\">Drchrono\u003c/a> developed two apps for the Watch. Both these apps (one is targeted to the patient; the other for the physician) are intended to help people manage chronic medical conditions, including diabetes and heart disease.\u003c/p>\n\u003cp>\"Sometimes having alerts on your wrist is critical,\" said Daniel Kivatinos, cofounder of Drchrono.\u003c/p>\n\u003cp>\"We've all had the experience of going to a hospital or doctor's office, and having no idea that they messaged me blood test results four or five months ago,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Managing Medications\u003c/strong>\u003c/p>\n\u003cp>Gutman isn't the only developer delivering notifications to the wrist, with the hopes of changing people's behavior.\u003c/p>\n\u003cp>One popular category of the early Apple Watch apps is medication management. For people who are juggling a variety of medications -- all with different dose requirements -- an app that sends alerts to the wrist could prove useful.\u003c/p>\n\u003cp>\u003ca href=\"http://webmd.com\">WebMD\u003c/a>, the company used by millions of people to check their medical symptoms, tossed around a bunch of ideas before settling on medication adherence.\u003c/p>\n\u003cp>\"Of all the options we looked at, medication reminders was the crown jewel,\" said Ben Greenberg, who heads up mobile products at WebMD. Greenberg said the ideal interaction between the app and the user should be 10 seconds or less.\u003c/p>\n\u003cp>\"All we wanted is for the user to be reminded that it's time to take their medication, and then quickly tell us whether they plan to take it or skip it or snooze. That interaction demands so little,\" he said. The app also instructs people whether to take their medication with food, or at a certain time of day.\u003c/p>\n\u003cp>Other companies that are developing medication adherence apps for the Apple Watch include \u003ca href=\"http://mangohealth.com\">MangoHealth\u003c/a>, which can also tell you \u003ca href=\"http://techcrunch.com/2015/03/16/mango-health-smartwatch-app/\">how well you've managed your prescriptions\u003c/a> over time, and pharmacy giant \u003ca href=\"http://www.walgreens.com/\">Walgreens\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Appealing to Doctors\u003c/strong>\u003c/p>\n\u003cp>Some developers hope the Apple Watch will appeal to doctors to help them manage an overload of information.\u003c/p>\n\u003cfigure id=\"attachment_2279\" class=\"wp-caption alignright\" style=\"max-width: 310px\">\u003cimg class=\" wp-image-2279\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/bajarin-450x600.jpg\" alt=\"Analyst Ben Bajarin received early access to the Apple Watch, which he uses during exercize\" width=\"310\" height=\"413\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-885x1180.jpg 885w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-960x1280.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin.jpg 1224w\" sizes=\"(max-width: 310px) 100vw, 310px\">\u003cfigcaption class=\"wp-caption-text\">Analyst Ben Bajarin received early access to the Apple Watch, which he uses during exercise\u003c/figcaption>\u003c/figure>\n\u003cp>Kivatinos, a developer and cofounder of Drchrono, is convinced that digitally-savvy doctors will flock to buy an Apple Watch, particularly those who work in small medical practices.\u003c/p>\n\u003cp>\"Doctors are finally getting amazing hardware that just works, and they're willing to pay a premium for it,\" he said. Using DrChrono's app for the watch, a doctor can receive alerts, such as when a patient has arrived at their office.\u003c/p>\n\u003cp>The watch could prove useful in helping doctors communicate with each other about tricky medical cases, as well as with their patients. \u003ca href=\"http://doximity.com\">Doximity\u003c/a>, the Facebook for doctors, \u003ca href=\"http://www.pcworld.com/article/2911732/first-apple-watch-health-it-apps-bring-important-messages-to-the-wrist.html\">has developed an app that care providers can use\u003c/a> to dictate notes, send messages, and receive notifications that a fax has arrived.\u003c/p>\n\u003cp>However, the Apple Watch's appeal may be limited to certain specialties, such as family physicians and dermatologists.\u003c/p>\n\u003cp>Unlike Google Glass, the futuristic eyewear \u003ca href=\"http://well.blogs.nytimes.com/2014/06/01/google-glass-enters-the-operating-room/?_r=0\">which has found some success in operating theaters\u003c/a>, many surgeons routinely remove their rings and watches before procedures, to ensure their hands stay sterile.\u003c/p>\n\u003cp>\u003cstrong>Opportunities and Challenges\u003c/strong>\u003c/p>\n\u003cp>Privacy experts and policymakers have long-been concerned about developers that collect and sell personal health information.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Doctors are finally getting amazing hardware that just works, and their willing to pay a premium for it\"\u003cbr>\n\u003ci>Daniel Kivatinos, cofounder of Drchrono \u003c/i>\u003c/aside>\n\u003cp>Apple has responded to some of these fears by \u003ca href=\"https://www.apple.com/privacy/\">stressing its commitment to privacy\u003c/a>, and barring third-party developers from selling health data to advertisers that it collects via Apple devices, like the iPhone and Apple Watch. After some high-profile hacks to celebrities' accounts, \u003ca href=\"http://www.cnbc.com/id/101967634\">Apple forbade developers\u003c/a> from storing sensitive health information in \u003ca href=\"https://www.icloud.com/\">iCloud\u003c/a>.\u003c/p>\n\u003cp>\"Apple has clear privacy rules, but consumers should still be on guard,\" said Morgan Reed, executive director at \u003ca href=\"http://actonline.org/\">The App Association\u003c/a>, a Washington, D.C. nonprofit that works with patient advocates and app developers.\u003c/p>\n\u003cp>\"Be prepared to take charge of your health information, and feel free to say no to sharing data with apps,\" said Reed.\u003c/p>\n\u003cp>In the future, there may be new privacy questions and concerns. Health experts and analysts expect to see far more sophisticated health-tracking in the Apple Watch, including a sweat sensor. At that point, the Watch may function as a regulated medical device of sorts, rather than a glorified fitness tracker.\u003c/p>\n\u003cp>Many health developers hope the watch will prove to be a tool for behavior change, as well as a new communications tool for doctors and patients alike.\u003c/p>\n\u003cp>\"What we do know is that the general tracking of your steps and calorie intake isn't enough,\" said Bajarin, the analyst with Creative Strategies.\u003c/p>\n\u003cp>\"How does this change people's behaviors and goal settings for the better? That’s the step that has been missing in the wearables trend. That’s where we need to go.\"\u003c/p>\n\u003cp>[ad floatright]\u003c/p>\n\u003cp>\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/1.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/2.2-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/3.2-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/4.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/5.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/6.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/7.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/8.2-Medical-IWatch-apps.jpg\" alt=\"\">\u003c/p>\n\n","blocks":[],"excerpt":"The new health and fitness apps for the Apple Watch can do everything from medication alerts to weight loss management. ","status":"publish","parent":0,"modified":1477282940,"stats":{"hasAudio":false,"hasVideo":false,"hasChartOrMap":false,"iframeSrcs":[],"hasGoogleForm":false,"hasGallery":false,"hasHearkenModule":false,"hasPolis":false,"paragraphCount":48,"wordCount":1616},"headData":{"title":"These Apps are Turning the Apple Watch into a Personal Health Coach | KQED","description":"The new health and fitness apps for the Apple Watch can do everything from medication alerts to weight loss management. ","ogTitle":"","ogDescription":"","ogImgId":"","twTitle":"","twDescription":"","twImgId":"","schema":{"@context":"http://schema.org","@type":"Article","headline":"These Apps are Turning the Apple Watch into a Personal Health Coach","datePublished":"2015-04-23T23:11:30.000Z","dateModified":"2016-10-24T04:22:20.000Z","image":"https://cdn.kqed.org/wp-content/uploads/2020/02/KQED-OG-Image@1x.png"}},"disqusIdentifier":"2122 http://ww2.kqed.org/futureofyou/?p=2122","disqusUrl":"https://ww2.kqed.org/futureofyou/2015/04/23/these-apps-are-turning-the-apple-watch-into-a-personal-health-coach/","disqusTitle":"These Apps are Turning the Apple Watch into a Personal Health Coach","path":"/futureofyou/2122/these-apps-are-turning-the-apple-watch-into-a-personal-health-coach","audioTrackLength":null,"parsedContent":[{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003cp>You're waiting in line for a coffee, eyeing a pastry, and your wrist-watch buzzes with a warning.\u003c/p>\n\u003cp>Flashing on the tiny screen of your \u003ca href=\"https://www.apple.com/watch/\">Apple Watch\u003c/a> is a message from an app called \u003ca href=\"http://lark.com/\">Lark\u003c/a>, suggesting that you lay off the carbs for today. Speak into the Apple Watch's built-in mic about your food, sleep and exercise, and the app will send helpful tips back to you.\u003c/p>\n\u003cp>The notion of receiving nutrition advice from artificial intelligence on your wrist may seem like science fiction. But health developers like Lark are making a bet that Apple's first wearable device, the Apple Watch, will fly off the shelves and this kind of behavior will become the norm.\u003c/p>\n\u003cfigure id=\"attachment_2276\" class=\"wp-caption alignright\" style=\"max-width: 263px\">\u003cimg class=\" wp-image-2276\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/Screenshots-with-Apple-Watch.002.png\" alt=\"A typical interaction with a Lark weight loss coach\" width=\"263\" height=\"301\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screenshots-with-Apple-Watch.002.png 436w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/Screenshots-with-Apple-Watch.002-400x457.png 400w\" sizes=\"(max-width: 263px) 100vw, 263px\">\u003cfigcaption class=\"wp-caption-text\">A typical interaction with a Lark weight loss coach \u003ccite>(Lark)\u003c/cite>\u003c/figcaption>\u003c/figure>\n\u003cp>Lark is just one of over a dozen health developers with new apps for the Apple Watch, which are focused on improving people's health and fitness. Some of these apps are essentially a smaller version of an existing iPhone app; others take advantage of the unique capabilities of the Apple Watch.\u003c/p>\n\u003cp>Apple has made no secret of its interest in medicine, and has recruited industry experts to work on services like \u003ca href=\"https://www.apple.com/pr/library/2015/04/14Apple-Announces-ResearchKit-Available-Today-to-Medical-Researchers.html\">ResearchKit\u003c/a> and \u003ca href=\"https://developer.apple.com/healthkit/\">HealthKit\u003c/a>, which aim to open up the flow of health data between consumers, mobile developers and medical researchers.\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"fullwidth"},"numeric":["fullwidth"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>But as it dabbles in health care, a notoriously regulated and privacy-conscious sector, Apple has also made steps to put you in control of how your data is shared.\u003c/p>\n\u003cp>Here's how it works for the Apple Watch: You can choose to share health information with third-party apps like Lark, including the amount of steps you've walked, via \u003ca href=\"https://www.apple.com/ios/whats-new/health/\">Apple's Health app\u003c/a>, which comes with the device. Your health data, collected via the Apple Watch or the iPhone, is stored on Apple's \u003ca href=\"https://developer.apple.com/healthkit/\">HealthKit.\u003c/a>\u003c/p>\n\u003cp>In advance of the Apple Watch's April 24th ship-date (although recent reports \u003ca href=\"http://www.denverpost.com/news/ci_27957664/dont-plan-line-up-apple-watch-next-week\">suggest there will be delays\u003c/a> before the watch reaches your local Apple Store), \u003cem>KQED\u003c/em> spoke with mobile developers from startups and big brands. Their offerings for the Apple Watch range from medication management apps to \u003ca href=\"http://hitconsultant.net/2015/04/13/healthtaps-apple-watch-app/\">a button that provides instant, virtual access to a doctor. \u003c/a>\u003c/p>\n\u003cp>\"We haven't had a developer ecosystem for a product like a smartwatch,\" said Ben Bajarin, who specializes in consumer technology for Creative Strategies, a consulting firm. Similarly to the iPhone, the Apple Watch has its own App Store, \u003ca href=\"http://blogs.wsj.com/digits/2015/04/23/as-first-watches-ship-apple-opens-app-store-for-new-device/\">which goes live on Thursday\u003c/a>.\u003c/p>\n\u003cp>\"This is unchartered territory.\"\u003c/p>\n\u003cp>\u003cstrong>A Message on the Wrist \u003c/strong>\u003c/p>\n\u003cp>Health app developers hope the Apple Watch will improve how doctors and patients communicate, particularly when it comes to sending urgent notifications and alerts.\u003c/p>\n\u003cp>Imagine a doctor receiving a buzz on the wrist for an e-prescription request, which could be approved with a few taps. A patient could receive a similar alert when test results are available, and caregivers might receive a flashing message on their Apple Watch when an elderly patient has taken a bad fall and needs assistance.\u003c/p>\n\u003cp>Developers are exploring all these possibilities and more.\u003c/p>\n\u003cp>[Scroll down to the graphic at the bottom for a more extensive list of apps. \u003ca href=\"http://ww2.kqed.org/futureofyou/2015/04/23/29-of-the-most-promising-apple-watch-health-apps-graphic/\">Or click the link here.\u003c/a>]\u003c/p>\n\u003cp>Those of us with a smartphone have grown accustomed to receiving notifications from apps, such as an email from a medical clinic, which often goes unchecked. But with the watch, the notification is seen, heard, and most importantly, felt on the body.\u003c/p>\n\u003cp>\"We are predisposed to small changes on the skin. It was not that long ago -- and is still the case in parts of the world -- that mosquitoes used to kill us with a light touch,\" said Ron Gutman, chief executive of \u003ca href=\"http://healthtap.com\">HealthTap\u003c/a>, a website and mobile app for secure video calls with a doctor.\u003c/p>\n\u003cp>\"It is so easy to turn off a notification from a website, but you can't ignore what's on your wrist,\" he said.\u003c/p>\n\u003caside class=\"pullquote alignright\">\"How does this change people's behaviors and goal settings for the better? That’s the step that has been missing in the wearables trend. That’s where we need to go.\"\u003cbr>\n\u003ccite>Ben Bajarin, Director at Creative Strategies \u003c/cite>\u003c/aside>\n\u003cp>Gutman was so intrigued by Apple's smartwatch that he developed three apps: One to help you \u003ca href=\"https://itunes.apple.com/us/app/healthtap-immediate-doctor/id466079030?mt=8\">manage you meds\u003c/a> with notification reminders; another that\u003ca href=\"http://hitconsultant.net/2015/04/13/healthtaps-apple-watch-app/\"> connects you to a primary care doctor\u003c/a> with the touch of a button\u003ca href=\"http://hitconsultant.net/2015/04/13/healthtaps-apple-watch-app/\">;\u003c/a> and a third, which helps physicians\u003ca href=\"https://itunes.apple.com/us/app/healthtap-for-u.s.-doctors/id466099564?mt=8\"> reach new patients\u003c/a>.\u003c/p>\n\u003cp>Electronic health record company \u003ca href=\"http://drchrono.com\">Drchrono\u003c/a> developed two apps for the Watch. Both these apps (one is targeted to the patient; the other for the physician) are intended to help people manage chronic medical conditions, including diabetes and heart disease.\u003c/p>\n\u003cp>\"Sometimes having alerts on your wrist is critical,\" said Daniel Kivatinos, cofounder of Drchrono.\u003c/p>\n\u003cp>\"We've all had the experience of going to a hospital or doctor's office, and having no idea that they messaged me blood test results four or five months ago,\" he said.\u003c/p>\n\u003cp>\u003cstrong>Managing Medications\u003c/strong>\u003c/p>\n\u003cp>Gutman isn't the only developer delivering notifications to the wrist, with the hopes of changing people's behavior.\u003c/p>\n\u003cp>One popular category of the early Apple Watch apps is medication management. For people who are juggling a variety of medications -- all with different dose requirements -- an app that sends alerts to the wrist could prove useful.\u003c/p>\n\u003cp>\u003ca href=\"http://webmd.com\">WebMD\u003c/a>, the company used by millions of people to check their medical symptoms, tossed around a bunch of ideas before settling on medication adherence.\u003c/p>\n\u003cp>\"Of all the options we looked at, medication reminders was the crown jewel,\" said Ben Greenberg, who heads up mobile products at WebMD. Greenberg said the ideal interaction between the app and the user should be 10 seconds or less.\u003c/p>\n\u003cp>\"All we wanted is for the user to be reminded that it's time to take their medication, and then quickly tell us whether they plan to take it or skip it or snooze. That interaction demands so little,\" he said. The app also instructs people whether to take their medication with food, or at a certain time of day.\u003c/p>\n\u003cp>Other companies that are developing medication adherence apps for the Apple Watch include \u003ca href=\"http://mangohealth.com\">MangoHealth\u003c/a>, which can also tell you \u003ca href=\"http://techcrunch.com/2015/03/16/mango-health-smartwatch-app/\">how well you've managed your prescriptions\u003c/a> over time, and pharmacy giant \u003ca href=\"http://www.walgreens.com/\">Walgreens\u003c/a>.\u003c/p>\n\u003cp>\u003cstrong>Appealing to Doctors\u003c/strong>\u003c/p>\n\u003cp>Some developers hope the Apple Watch will appeal to doctors to help them manage an overload of information.\u003c/p>\n\u003cfigure id=\"attachment_2279\" class=\"wp-caption alignright\" style=\"max-width: 310px\">\u003cimg class=\" wp-image-2279\" src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/bajarin-450x600.jpg\" alt=\"Analyst Ben Bajarin received early access to the Apple Watch, which he uses during exercize\" width=\"310\" height=\"413\" srcset=\"https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-450x600.jpg 450w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-400x533.jpg 400w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-885x1180.jpg 885w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-1180x1573.jpg 1180w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin-960x1280.jpg 960w, https://ww2.kqed.org/app/uploads/sites/13/2015/04/bajarin.jpg 1224w\" sizes=\"(max-width: 310px) 100vw, 310px\">\u003cfigcaption class=\"wp-caption-text\">Analyst Ben Bajarin received early access to the Apple Watch, which he uses during exercise\u003c/figcaption>\u003c/figure>\n\u003cp>Kivatinos, a developer and cofounder of Drchrono, is convinced that digitally-savvy doctors will flock to buy an Apple Watch, particularly those who work in small medical practices.\u003c/p>\n\u003cp>\"Doctors are finally getting amazing hardware that just works, and they're willing to pay a premium for it,\" he said. Using DrChrono's app for the watch, a doctor can receive alerts, such as when a patient has arrived at their office.\u003c/p>\n\u003cp>The watch could prove useful in helping doctors communicate with each other about tricky medical cases, as well as with their patients. \u003ca href=\"http://doximity.com\">Doximity\u003c/a>, the Facebook for doctors, \u003ca href=\"http://www.pcworld.com/article/2911732/first-apple-watch-health-it-apps-bring-important-messages-to-the-wrist.html\">has developed an app that care providers can use\u003c/a> to dictate notes, send messages, and receive notifications that a fax has arrived.\u003c/p>\n\u003cp>However, the Apple Watch's appeal may be limited to certain specialties, such as family physicians and dermatologists.\u003c/p>\n\u003cp>Unlike Google Glass, the futuristic eyewear \u003ca href=\"http://well.blogs.nytimes.com/2014/06/01/google-glass-enters-the-operating-room/?_r=0\">which has found some success in operating theaters\u003c/a>, many surgeons routinely remove their rings and watches before procedures, to ensure their hands stay sterile.\u003c/p>\n\u003cp>\u003cstrong>Opportunities and Challenges\u003c/strong>\u003c/p>\n\u003cp>Privacy experts and policymakers have long-been concerned about developers that collect and sell personal health information.\u003c/p>\n\u003caside class=\"pullquote alignleft\">\"Doctors are finally getting amazing hardware that just works, and their willing to pay a premium for it\"\u003cbr>\n\u003ci>Daniel Kivatinos, cofounder of Drchrono \u003c/i>\u003c/aside>\n\u003cp>Apple has responded to some of these fears by \u003ca href=\"https://www.apple.com/privacy/\">stressing its commitment to privacy\u003c/a>, and barring third-party developers from selling health data to advertisers that it collects via Apple devices, like the iPhone and Apple Watch. After some high-profile hacks to celebrities' accounts, \u003ca href=\"http://www.cnbc.com/id/101967634\">Apple forbade developers\u003c/a> from storing sensitive health information in \u003ca href=\"https://www.icloud.com/\">iCloud\u003c/a>.\u003c/p>\n\u003cp>\"Apple has clear privacy rules, but consumers should still be on guard,\" said Morgan Reed, executive director at \u003ca href=\"http://actonline.org/\">The App Association\u003c/a>, a Washington, D.C. nonprofit that works with patient advocates and app developers.\u003c/p>\n\u003cp>\"Be prepared to take charge of your health information, and feel free to say no to sharing data with apps,\" said Reed.\u003c/p>\n\u003cp>In the future, there may be new privacy questions and concerns. Health experts and analysts expect to see far more sophisticated health-tracking in the Apple Watch, including a sweat sensor. At that point, the Watch may function as a regulated medical device of sorts, rather than a glorified fitness tracker.\u003c/p>\n\u003cp>Many health developers hope the watch will prove to be a tool for behavior change, as well as a new communications tool for doctors and patients alike.\u003c/p>\n\u003cp>\"What we do know is that the general tracking of your steps and calorie intake isn't enough,\" said Bajarin, the analyst with Creative Strategies.\u003c/p>\n\u003cp>\"How does this change people's behaviors and goal settings for the better? That’s the step that has been missing in the wearables trend. That’s where we need to go.\"\u003c/p>\n\u003cp>\u003c/p>\u003c/div>","attributes":{"named":{},"numeric":[]}},{"type":"component","content":"","name":"ad","attributes":{"named":{"label":"floatright"},"numeric":["floatright"]}},{"type":"contentString","content":"\u003cdiv class=\"post-body\">\u003cp>\u003c/p>\n\u003cp>\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/1.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/2.2-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/3.2-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/4.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/5.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/6.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/7.1-Medical-IWatch-apps.jpg\" alt=\"\">\u003cimg src=\"http://ww2.kqed.org/futureofyou/wp-content/uploads/sites/13/2015/04/8.2-Medical-IWatch-apps.jpg\" alt=\"\">\u003c/p>\n\n\u003c/div>\u003c/p>","attributes":{"named":{},"numeric":[]}}],"link":"/futureofyou/2122/these-apps-are-turning-the-apple-watch-into-a-personal-health-coach","authors":["3252"],"categories":["futureofyou_1060"],"tags":["futureofyou_235","futureofyou_236","futureofyou_537","futureofyou_241","futureofyou_240","futureofyou_243","futureofyou_237","futureofyou_244","futureofyou_80","futureofyou_242","futureofyou_238","futureofyou_239","futureofyou_245","futureofyou_227","futureofyou_246"],"featImg":"futureofyou_2280","label":"futureofyou"}},"programsReducer":{"possible":{"id":"possible","title":"Possible","info":"Possible is hosted by entrepreneur Reid Hoffman and writer Aria Finger. Together in Possible, Hoffman and Finger lead enlightening discussions about building a brighter collective future. The show features interviews with visionary guests like Trevor Noah, Sam Altman and Janette Sadik-Khan. Possible paints an optimistic portrait of the world we can create through science, policy, business, art and our shared humanity. It asks: What if everything goes right for once? How can we get there? 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You ask the questions. You decide what Bay Curious investigates. 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Hosted by journalists of color, the show tackles the subject of race head-on, exploring how it impacts every part of society — from politics and pop culture to history, sports and more.\u003cbr />\u003cbr />\u003cem>Life Kit\u003c/em>, which will be in the second part of the hour, guides you through spaces and feelings no one prepares you for — from finances to mental health, from workplace microaggressions to imposter syndrome, from relationships to parenting. The show features experts with real world experience and shares their knowledge. Because everyone needs a little help being human.\u003cbr />\u003cbr />\u003ca href=\"https://www.npr.org/podcasts/510312/codeswitch\">\u003cem>Code Switch\u003c/em> offical site and podcast\u003c/a>\u003cbr />\u003ca href=\"https://www.npr.org/lifekit\">\u003cem>Life Kit\u003c/em> offical site and podcast\u003c/a>\u003cbr />","airtime":"SUN 9pm-10pm","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Code-Switch-Life-Kit-Podcast-Tile-360x360-1.jpg","meta":{"site":"radio","source":"npr"},"link":"/radio/program/code-switch-life-kit","subscribe":{"apple":"https://podcasts.apple.com/podcast/1112190608?mt=2&at=11l79Y&ct=nprdirectory","google":"https://podcasts.google.com/feed/aHR0cHM6Ly93d3cubnByLm9yZy9yc3MvcG9kY2FzdC5waHA_aWQ9NTEwMzEy","spotify":"https://open.spotify.com/show/3bExJ9JQpkwNhoHvaIIuyV","rss":"https://feeds.npr.org/510312/podcast.xml"}},"commonwealth-club":{"id":"commonwealth-club","title":"Commonwealth Club of California Podcast","info":"The Commonwealth Club of California is the nation's oldest and largest public affairs forum. 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You can also visit the MindShift website for episodes and supplemental blog posts or tweet us \u003ca href=\"https://twitter.com/MindShiftKQED\">@MindShiftKQED\u003c/a> or visit us at \u003ca href=\"/mindshift\">MindShift.KQED.org\u003c/a>","imageSrc":"https://cdn.kqed.org/wp-content/uploads/2024/04/Mindshift-Podcast-Tile-703x703-1.jpg","imageAlt":"KQED MindShift: How We Will Learn","officialWebsiteLink":"/mindshift/","meta":{"site":"news","source":"kqed","order":"2"},"link":"/podcasts/mindshift","subscribe":{"apple":"https://podcasts.apple.com/us/podcast/mindshift-podcast/id1078765985","google":"https://podcasts.google.com/feed/aHR0cHM6Ly9mZWVkcy5tZWdhcGhvbmUuZm0vS1FJTkM1NzY0NjAwNDI5","npr":"https://www.npr.org/podcasts/464615685/mind-shift-podcast","stitcher":"https://www.stitcher.com/podcast/kqed/stories-teachers-share","spotify":"https://open.spotify.com/show/0MxSpNYZKNprFLCl7eEtyx"}},"morning-edition":{"id":"morning-edition","title":"Morning Edition","info":"\u003cem>Morning Edition\u003c/em> takes listeners around the country and the world with multi-faceted stories and commentaries every weekday. 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