“Diagnosis by Behavioral Observation” Home-Videosomnography – A Rigorous Ethnographic Approach to Sleep of Children with Neurodevelopmental Conditions

Introduction: Advanced video technology is available for sleep-laboratories. However, low-cost equipment for screening in the home setting has not been identified and tested, nor has a methodology for analysis of video recordings been suggested. Methods: We investigated different combinations of hardware/software for home-videosomnography (HVS) and established a process for qualitative and quantitative analysis of HVS-recordings. A case vignette (HVS analysis for a 5.5-year-old girl with major insomnia and several co-morbidities) demonstrates how methodological considerations were addressed and how HVS added value to clinical assessment. Results: We suggest an “ideal set of hardware/software” that is reliable, affordable (∼$500) and portable (=2.8 kg) to conduct non-invasive HVS, which allows time-lapse analyses. The equipment consists of a net-book, a camera with infrared optics, and a video capture device. (1) We present an HVS-analysis protocol consisting of three steps of analysis at varying replay speeds: (a) basic overview and classification at 16× normal speed; (b) second viewing and detailed descriptions at 4–8× normal speed, and (c) viewing, listening, and in-depth descriptions at real-time speed. (2) We also present a custom software program that facilitates video analysis and note-taking (Annotator©), and Optical Flow software that automatically quantifies movement for internal quality control of the HVS-recording. The case vignette demonstrates how the HVS-recordings revealed the dimension of insomnia caused by restless legs syndrome, and illustrated the cascade of symptoms, challenging behaviors, and resulting medications. Conclusion: The strategy of using HVS, although requiring validation and reliability testing, opens the floor for a new “observational sleep medicine,” which has been useful in describing discomfort-related behavioral movement patterns in patients with communication difficulties presenting with challenging/disruptive sleep/wake behaviors.

• Publication year

  2015

• Venue

  Frontiers in Psychiatry

• Publication date

  2015-03-17

• Fields of study

  Medicine, Computer Science

• Identifiers
  DOI 10.3389/fpsyt.2015.00039PMID 25852578PMCID 4362082
• External record

  Open on Semantic Scholar

• Source metadata

  Semantic Scholar, PubMed

• No claims are published for this paper.

• No concepts are published for this paper.

• Quality Improvement Is Research.

  2016influential reference
• Pathways to Overmedication and Polypharmacy: Case Examples from Adolescents with Fetal Alcohol Spectrum Disorders

  2015cited by this paper
• How can I ‘do’ family-centred, shared goal-setting? An interactive workshop for service providers and parents.

  2014cited by this paper
• Restless legs syndrome/Willis-Ekbom disease diagnostic criteria: updated International Restless Legs Syndrome Study Group (IRLSSG) consensus criteria--history, rationale, description, and significance.

  2014cited by this paper
• Pediatric restless legs syndrome diagnostic criteria: an update by the International Restless Legs Syndrome Study Group.

  2013cited by this paper
• Gabapentin Shows Promise in Treating Refractory Insomnia in Children

  2013cited by this paper
• "They silently live in terror…" why sleep problems and night-time related quality-of-life are missed in children with a fetal alcohol spectrum disorder.

  2013cited by this paper
• Early childhood‐onset restless legs syndrome: symptoms and effect of oral iron treatment

  2013cited by this paper
• Sleepwalking: long-term home video monitoring.

  2013cited by this paper
• Body movement analysis during sleep for children with ADHD using video image processing

  2013cited by this paper
• The sleep phenotypes of attention deficit hyperactivity disorder: the role of arousal during sleep and implications for treatment.

  2012cited by this paper
• Quantifying time-varying coordination of multimodal speech signals using correlation map analysis.

  2012cited by this paper
• Neurophysiology of circadian rhythm sleep disorders of children with neurodevelopmental disabilities.

  2012cited by this paper
• W-L-096 RESTLESS LEG SYNDROME (RLS) IN CHILDREN AND YOUTH WITH NEURODEVELOPMENTAL CONDITIONS – A CLINICALLY MISSED DIAGNOSIS AGGRAVATING THE CHALLENGING BEHAVIOUR OF UNDERLYING CONDITIONS?

  2011cited by this paper
• Sleep and Sensory Characteristics in Young Children With Fetal Alcohol Spectrum Disorder

  2011cited by this paper
• Does idiopathic REM sleep behavior disorder (iRBD) really exist? What are the potential markers of neurodegeneration in iRBD?

  2011cited by this paper
• Loss of response to melatonin treatment is associated with slow melatonin metabolism.

  2010cited by this paper
• The early and accurate objective diagnosis of RBD—Why should we care?

  2010cited by this paper
• Sleep disorders in children with Attention-Deficit/Hyperactivity Disorder (ADHD) recorded overnight by video-polysomnography.

  2009cited by this paper
• The use of actigraphy to study sleep disorders in preschoolers: some concerns about detection of nighttime awakenings.

  2008cited by this paper
• Examination of non-restrictive and non-invasive sleep evaluation technique for children using difference images

  2008cited by this paper
• Sleep Hygiene for Children With Neurodevelopmental Disabilities

  2008influential reference
• Midbrain sonography in patients with essential tremor

  2007cited by this paper
• RLS, PLM, and their differential diagnosis—A video guide

  2007cited by this paper
• Families with disabled children

  2006cited by this paper
• Anthropology in the Clinic: The Problem of Cultural Competency and How to Fix It

  2006cited by this paper
• Reference Values for Nocturnal Home Polysomnography in Primary Schoolchildren

  2005cited by this paper
• Bed-sharing and the infant’s thermal environment in the home setting

  2004cited by this paper
• Health services use and health care expenditures for children with disabilities.

  2004cited by this paper
• Scoring arousals in the home environment.

  2002cited by this paper
• Sleeping habits in the Austrian population.

  2002cited by this paper
• The role of actigraphy in sleep medicine.

  2002cited by this paper
• NREM parasomnias: arousal disorders and differentiation from nocturnal frontal lobe epilepsy.

  2000cited by this paper
• The Treatment of Restless Legs Syndrome and Periodic Limb Movement Disorder

  2000cited by this paper
• The treatment of restless legs syndrome and periodic limb movement disorder. An American Academy of Sleep Medicine Review.

  1999cited by this paper
• Development and reliability of a system to classify gross motor function in children with cerebral palsy

  1997influential reference
• Screening obstructive sleep apnoea syndrome by home videotape recording in children.

  1996cited by this paper
• Can sleep and wakefulness be distinguished in children by cardiorespiratory and videotape recordings?

  1996cited by this paper
• [The illness narratives: suffering, healing and the human condition].

  1991cited by this paper
• The effect of niaprazine on some common sleep disorders in children

  1991cited by this paper
• Out of the clinic into the home: control and patient-physician communication.

  1986cited by this paper
• Developmental course of nighttime sleep-wake patterns in full-term and premature infants during the first year of life. I.

  1985cited by this paper
• The use of time lapse video recording of sleep-wake behavior in human infants.

  1976cited by this paper
• An American Sleep Disorders Association Review The Role of Actigraphy in the Evaluation of Sleep Disorders

  year unknowncited by this paper

• Impact of Developmental Alcohol Exposure on Sleep Physiology.

  2025cites this paper
• Iron Deficiency and Restless Sleep/Wake Behaviors in Neurodevelopmental Disorders and Mental Health Conditions

  2024cites this paper
• Sleep problems in children with Angelman Syndrome: The effect of a behavioral intervention program.

  2023cites this paper
• Simultaneous Recording of Objective Sleep in Mothers and School-aged Children with Developmental Disabilities: A Pilot Study of Actigraphy and Videosomnography

  2023influential citation
• A preliminary study on the performance of the Nanit auto-videosomnography scoring system against observed video scoring and actigraphy to estimate sleep-wake states in infants.

  2023cites this paper
• Revisiting the Concept of Vigilance

  2022cites this paper
• Researcher Choices for Infant Sleep Assessment: Parent Report, Actigraphy, and a Novel Video System

  2021influential citation
• Is Fidgety Philip's ground truth also ours? The creation and application of a machine learning algorithm.

  2020cites this paper
• Evaluating motion detection to score sleep disturbance for children: A translational approach to developing a measurement system.

  2019cites this paper
• Restless Legs Syndrome in NKX2-1-related chorea: An expansion of the disease spectrum.

  2019cites this paper
• Prenatal alcohol exposure and sleep-wake behaviors: exploratory and naturalistic observations in the clinical setting and in an animal model.

  2019cites this paper
• Video-polysomnographic characterization of sleep movements in children with restless sleep disorder

  2019cites this paper
• Classification of Sleep Videos Using Deep Learning

  2019influential citation
• Note-Taking Skill Among Bilingual Students in Academia: Literacy, Language and Cognitive Examination

  2019cites this paper
• Data acquisition and visual analytic tool-set for paediatric sleep data

  2019cites this paper
• Video Analysis of Parent–Child Interactions in Behavioral Sleep Disorders: Development of a Scoring Algorithm

  2019cites this paper
• Sleep and Challenging Behaviors in the Context of Intensive Behavioral Intervention for Children with Autism

  2018cites this paper
• Impact of Sleep in Children

  2018cites this paper
• Sleep Analysis Using Motion and Head Detection

  2018cites this paper
• The effect of cognitive training on subsequent sleep characteristics

  2018cites this paper
• Evaluation of the accuracy, reliability, efficiency, and acceptability of fast forwarding to score problem behavior.

  2018cites this paper
• Sleep: An underemphasized aspect of health and development in neurorehabilitation.

  2017cites this paper
• Food for thought: Novel insights into childhood ADHD

  2017cites this paper
• A feasibility study assessing home video telemetry polysomnography (HVTP) as a diagnostic procedure for adult patients undergoing investigation for parasomnias

  2017cites this paper
• Applying ethnographic methodologies & ecology to unveil dimensions of sleep problems in children & youth with neurodevelopmental conditions

  2016cites this paper
• “Emplotted Narratives” and Structured “Behavioral Observations” Supporting the Diagnosis of Willis‐Ekbom Disease/Restless Legs Syndrome in Children with Neurodevelopmental Conditions

  2016cites this paper
• Sibling Sleep—What Can It Tell Us About Parental Sleep Reports in the Context of Autism?

  2016cites this paper
• Sleep in Neurodevelopmental Disorders.

  2016cites this paper
• No objectively measured sleep disturbances in children with attention‐deficit/hyperactivity disorder

  2016cites this paper
• Challenging sleep-wake behaviors reported in informal, conversational interviews of caregivers of children with fetal alcohol spectrum disorder

  2016cites this paper
• A Comparison of Measurement Systems to Score Sleep Disturbance for Children With Autism Spectrum Disorders

  2015cites this paper
• Leg kicking and rubbing as a highly suggestive sign of pediatric restless legs syndrome.

  2015cites this paper