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A scoping review on ambulatory stress assessment methods for young children and babies

Greiwe, J. (2021) A scoping review on ambulatory stress assessment methods for young children and babies.

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Abstract:Introduction: Repeated exposure to stress in the first years of life yields the risk of major health consequences and developmental delay. In order to detect critical exposure to stress, methods that allow for assessment in natural settings need to be established. At present, ambulatory assessment of stress within this target group mainly focuses on observation, caregiver report or cry detection. Physiological signals can serve as reliable indicators for stress. However, up till now, assessing stress by means of physiological signals is oftentimes conducted in clinical settings. In order to get an insight into current practice, physiological signals that qualify for ambulatory assessment, environments in which stress assessment is implemented and technological devices for assessment are explored. Methods: A scoping review was conducted by exploring the databases Web of Science, Scopus and Science Direct. The concepts “ambulatory assessment”, “physiological stress”, and “children” served as the basis for the search. Results: In total, 12 studies that matched the search criteria have been selected after a thorough literature search. Heart rate was identified as the most prevalent physiological signal and most effective in detecting a stress response. Based on respiratory sinus arrhythmia, a stress response was effectively detected in four out of six studies. The remaining physiological signals, heart rate variability, respiration and skin conductance did not show effectiveness in assessing stress in more than one study. It got apparent that ambulatory stress assessment in infants is mainly conducted in laboratory settings and lacks implementation in the natural environment. Here, studies aimed at understanding underlying physiological process and factors that increase or decrease stress. Studies targeting children with neurodevelopmental disorders either aimed at assessing challenging behaviour episodes or validating a tool in order to allow integration into daily life. Thus, among this population integration into the natural environment was identified to be more progressed. With regard to the implemented technology, rather traditional methods were used for infants such as electrodes and electrocardiogram. The remaining devices displayed higher innovation as they were more adapted to being used by a child in their daily life. Discussion: Considering the results it got apparent that research on ambulatory physiological stress assessment in infants still relies on rather traditional methods. Even though the necessity of stress assessment in infants has been widely recognized, implementation into daily life still seems to lack. It could be observed that research targeting children with neurodevelopmental disorders is more innovative and oriented towards implementation into natural environments. Finally, an advice for target users entails that heart rate as a physiological should be considered when designing devices in the future. Respiratory sinus arrhythmia is partly recommended as the effectiveness of the signal was only fully established in four out of six studies. Especially among infants, the devices in this study turned out to be impractical for longer use by infants. Therefore, development of an ambulatory tool that does not constrain the child in its natural environment would be an asset to the field.
Item Type:Essay (Master)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology MSc (66604)
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