MedCity Influencers, Health Tech

Digital therapeutics can solve the greatest unmet need in behavioral healthcare: early intervention

Digital therapeutics have the potential to empower every physician in ways that reach more children when it matters most.

Our mental and behavioral health is largely determined by how the brain develops during the first few years of life when the brain is most actively developing. During this critical period of “neuroplasticity” when the brain is actively changing and developing, there is the greatest opportunity to positively influence brain and behavioral development. The brain circuits that are more frequently activated become “stronger”, while the connections that are less used are “pruned” away. What a child is repeatedly exposed to and experiences during this time significantly influences positive or adverse brain development, laying the foundation of a lifetime of mental and behavioral health.

For children with developmental delays and behavioral health conditions, optimal treatments that target this critical neurodevelopmental window promote positive brain development through neuromodulation of specific brain networks. This can improve functional connectivity and create lifelong gains. Published studies have shown that earlier diagnosis and treatment can enable up to 25% of high-functioning autism patients to progress beyond their original diagnosis, and over 75% of children with autism to participate in mainstream education, as opposed to special education classrooms.

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While the long term and potentially life-changing implications of early intervention are well researched, access to timely care is a persistent challenge. Today in the U.S., one in five children has a diagnosable behavioral health disorder, but only 21% of those children receive needed treatment.

Virtually all of the diagnostic burden, that enables access to early treatments, rests in pediatric specialty care settings, where we face a growing shortage of behavioral health specialists. Parents who develop behavioral concerns and/or notice developmental delays do so at a very early stage when their child is around 13 months of age, yet they must often wait one to three years to receive the proper diagnosis and treatment for their child. And while the trusted pediatrician or family doctor is the person families turn to first with concerns, these doctors report a lack of adequate training and confidence in mental health care.

As a result, the standard of care today misses the critical early neurodevelopmental window when treatments have the greatest opportunity to change lives and improve clinical and economic outcomes. As a clinically active pediatric neurologist, one of the most heartbreaking situations we face is seeing a patient who could have benefitted from early treatment. The opportunity to remove barriers to early diagnosis and treatment with technology exists today.

Technology innovations are already demonstrating an ability to advance the standard of care and improve lifelong outcomes for children. Referred to as “digital therapeutics” or “digital medicines”, medical devices that incorporate artificial intelligence can play a significant role in the identification and personalized treatment of pediatric behavioral health conditions. Digital therapeutics are particularly suited to become the first-line-of-care within pediatric behavioral health because of their superior safety and low-risk profile, compared to pharmaceutical interventions.

One of the advantages of digital therapeutics is the ability to utilize machine learning. Machine learning, a type of artificial intelligence, allows for the use of large data sets to identify patterns between thousands or hundreds of features in ways clinicians cannot. The most successful implementations utilize multi-modal approaches in conjunction with guidance from expert clinicians. In addition, when digital therapeutics are delivered through ubiquitous devices such as mobile phones, it is possible to collect data that was previously difficult or even impossible to obtain, such as videos of a child’s natural behavior at home. When this once unattainable information is presented to clinicians, the benefits to health are immense.

By leveraging these new inputs combined with learnings from big data, machine learning algorithms can be trained to identify current and future states of pediatric behavioral health. These powerful insights, combined with the physician’s own clinical observations and historical patient context, enable physicians to make more timely, informed, and accurate clinical diagnoses and decisions about patient care. When applied further along the care continuum, machine learning can continuously monitor and track responses to therapies, enabling providers to adjust therapies in more personalized ways.

Digital therapeutics have the potential to empower every physician in ways that reach more children when it matters most. By incorporating new information and applying predictive analytics, digital therapeutics can enable physicians to identify conditions and prescribe treatments with greater efficiency, personalization, and accuracy than the current standard of care.

Picture: mrspopman, Getty Images



Dr. Sharief Taraman, M.D. is dual board-certified in Neurology with special qualifications in Child Neurology from the American Board of Psychiatry and Neurology and Clinical Informatics from the American Board of Preventive Medicine. He is the Division Chief of Pediatric Neurology for the CHOC Children’s Specialists Pediatric Subspecialty Faculty and Associate Clinical Professor at UC Irvine School of Medicine. Dr. Taraman is the Chief Medical Officer of Cognoa, a pediatric behavioral health company that has received two FDA Breakthrough Device designations for its first two prescription digital devices designed to improve the standard of care for the early treatment of behavioral health conditions.