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Wearable sensor data characterizes vigilance and avoidance behaviors in young children with mental health symptoms during a threat induction task

Cohen, J. G.; Mascia, G.; Loftness, B. C.; Bradshaw, M. C.; Halvorson-Phelan, J.; Cherian, J.; Kairamkonda, D. D.; Jangraw, D. C.; McGinnis, R. S.; McGinnis, E. W.

2026-04-02 psychiatry and clinical psychology
10.64898/2026.03.31.26349900 medRxiv
Show abstract

Early childhood mental health problems are common and difficult to detect due to reliance on caregiver reports of often unobservable symptoms. This study quantified threat response movement patterns during a 30-second laboratory threat induction task using wearable inertial sensors. Movement patterns were used to examine (1) changes in stimuli response across the task (task validity) and (2) associations with symptom severity (clinical validity). Sacral accelerometer and gyroscope data were analyzed from 91 children aged 4-8 years during the brief task, 48.4% of whom had a mental health diagnosis. Consistent with task validity, Turning Speed varied across task phases differing in potential threat intensity. Consistent with clinical validity, internalizing symptoms were associated with smaller Turning Angle, possibly indicating vigilance. This effect was moderated by comorbid externalizing symptoms, such that children with high internalizing and high externalizing symptoms exhibited larger Turning Angles, possibly indicating avoidance. Findings demonstrate that brief wearable-enabled tasks can capture subtle objective behavioral markers of threat responses and underscore the importance of considering comorbid symptom dimensions in early childhood mental health screening.

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