68% of autistic children have been aggressive toward a caregiver at some point.
56% still are. 49% toward other people. 1,380 children, ages 4 to 17.
Emozu / Research
Research
The evidence behind Emozu.
The problem in numbers, four studies that predict episodes from a wearable, the gap at home, how our pilot works, and every source. Updated November 2026.
The problem
Today a parent finds out by watching it happen.
This started with one family close to us. Then we read what other parents write, and saw the same picture. The child often cannot say what is wrong. The parent looks for a trigger after the fact, and the next one comes without warning.
“How do other parents sense that a meltdown is coming?”
“My child wakes up already on the edge, and I can't see why.”
“I'm looking for a wearable that could help us avoid meltdowns.”
What 409 parent posts are about
Share of posts that touch each topic. One post can touch several.
Our own tagging of 409 public posts: 370 from r/Autism_Parenting, 39 from other parent communities. Most are from 2025 and 2026. Not a clinical sample. The three lines above are paraphrased, not quotes.
In the published numbers
This is not a rare, bad day. It is what many families live with.
Each card links to its source. All links are also listed at the end of the page.
42% of autistic people self-injure.
A pooled estimate from 37 studies and 14,379 people.
49% of children tried to run away after age 4.
Among those who went missing, 65% had a close call with traffic and 24% with drowning. 1,218 children.
Parents of autistic children carry far more stress than other parents.
A meta-analysis of studies with comparison groups. The gap was large.
Parents describe a meltdown as something that grows.
They wait for it with anxiety, and feel helpless and judged. Six in-depth parent interviews.
1 in 31 eight-year-olds in the US has an autism diagnosis.
CDC monitoring network, 2022 data, 16 US sites.
What it is based on
The body changes first. That can be measured.
Four studies from 2019 to 2026 use a wearable sensor to catch an episode. Three of them predict it, 1 to 10 minutes ahead. The models look for this: heart rate goes up, heart rate variability goes down, and skin conductance bursts come more often.
Heart rate ↑
HRV ↓
Skin conductance ↑
warning window
Minutes before the episode. Curves are illustrative. The window comes from Imbiriba 2023 (3 min) and Kartha 2026, preprint (10 min).
The four studies
AUROC measures how well a model separates “episode soon” from “all quiet”. 0.5 is a coin flip, 1.0 is perfect. Models, groups, and horizons differ, so compare with care. In these studies an “episode” means aggression or other challenging behavior, which is not always what a parent calls a meltdown.
Goodwin et al.
2019 · Autism Research20 young people, ages 6 to 17 · inpatient psychiatric unit · 1 minute ahead
General model 0.71Personal model 0.84
The first study of this kind, and the only one where a personal model clearly won. The group was small, so this result is quoted often but should not stand alone.
Plain-language summary: Northeastern University.
Imbiriba et al.
2023 · JAMA Network Open70 young people, ages 5 to 19 · 4 psychiatric hospitals · 3 minutes ahead
Main result 0.80Best case 0.87
- The largest study: 429 sessions, 497 hours, 6,665 episodes. 86 enrolled, 70 analyzed. 8 refused the sensor, 8 were discharged.
- 0.80 is the main result, logistic regression at 3 minutes. 0.87 is the best case, SVM on a split by session.
- On people the model had never seen: 0.82 (SVM) and 0.77 (logistic regression).
- Here the personal model did worse: 0.74.
Kartha et al.
2026 · preprint9 males, ages 10 to 21 · special-ed class · 10 minutes ahead
At 10 minutes 0.78 ± 0.10
- The only study outside a clinic: 110.7 hours in a classroom, with the sensor on the ankle for 8 of 9 children.
- Still above 0.75 at 30 minutes.
- Precision 0.31, recall 0.55. That means about 2 of 3 alerts are false. It is the only study that gives this number.
Bahrami Rad et al.
2025 · Physiological Measurement11 boys, ages 10 to 20 · The Center for Discovery · detection, not ahead
Accelerometer 0.71
This study detects an episode as it happens, it does not warn ahead. An uncomfortable result worth saying out loud: the best channel here was motion, not skin conductance. Personal models did not win consistently. A cheap accelerometer should not be written off.
This group likely overlaps with Kartha 2026, so we do not add these 11 children to the total.
What we took from them
A personal model helps, but not always.
Better in 2019, worse in 2023. The pilot tests it directly: a general model plus two weeks of personal calibration.
Motion is a strong channel.
In one study an accelerometer alone beat skin conductance at detecting episodes (AUROC 0.71). So even a simple module carries signal.
The horizon can reach 10 minutes.
On the ankle, in a classroom. The sensor went there because children keep it on, and that matters as much as the model.
The hard part: about 2 of 3 alerts were false.
A parent who gets pulled away for nothing stops listening. So we do not start with alerts. We start silent: record, label, and look back. “Yesterday at 16:40 it began eight minutes before you noticed” has no false alarms at all. Live alerts come later, and only if the numbers hold.
Where to measure
The wrist is easy, but not the best place for skin conductance.
Sweat glands are denser on the hands and feet. In a lab comparison of 45 students, the wrist responded least of all sites. So the same pod moves: wrist, arm, ankle. The pilot chooses the place by data, and by what the child will actually keep on.
Sweat glands per cm²
Wrist and ankle are not in the source table. Their values are estimates from nearby sites, not measurements.
The gap
99 children in the literature. None of them at home.
Every model was trained in a hospital, a clinic, or a classroom. Home is where a parent needs the warning most, and we found no labeled data from there. That is the piece Emozu wants to collect first.
Goodwin 2019 20
hospital unit
Imbiriba 2023 70
4 psychiatric hospitals
Kartha 2026 9
special-ed class
At home
labeled episodes
0first set: Emozu
Why now
The models arrived. The devices they were trained on left the market.
- 2013Q-Sensor stopped
Kartha and Bahrami Rad used it
- 2019Goodwin
First model, 20 children
- 2023Imbiriba
70 children, 4 hospitals
- 2025Empatica E4 retired
Imbiriba used it
- 2025Bahrami Rad
Best channel: motion
- 2026Kartha
10 minutes, preprint
- NextEmozu
A family device and home data
Sources: Q-Sensor · Empatica E4 sunset. A school student in Ukraine also built a similar band on their own this year (Ukrainska Pravda), so the idea is in the air.
Warn before the episode, and sell to a family: that cell is empty.
Family buys · after the episode
Apollo Neurocalms afterTouchPointscalms afterMightiertrains skills
Family buys · before the episodeEmozuhypothesis we are testing
Organizations · after the episodeEmpaticaplatform, no meltdown model
Organizations · before the episodeAwake Labsorganizations only4 academic modelsno device on the market
Our reading of public product descriptions, November 2026. Awake Labs.
There is a regulatory precedent.
A wearable for a child that was sold as a consumer product and turned out to be a medical one: Owlet.
25 months
Oct 2021Nov 2023
From an FDA warning letter to De Novo clearance. The FDA fee for De Novo is now $191,020, or $47,755 for a small business (FY2027).
“Predicts a meltdown” can make a product a medical device. So we make no such claim today, and we will talk to the regulator before we ever do.
Method
The unit of data is a labeled episode, not an hour of recording.
A target of about 15 episodes per child, which at home means 6 to 8 weeks. The parent marks an episode with one tap. Every “what helped” mark is one more label.
- Wears the friendAt home, all day
- Signal is recordedHR, EDA, temperature, motion
- Parent marks itOne tap in the bot
- Window is cutThe minutes before
- Two modelsGeneral, plus 2 weeks of personal calibration
- Parent is warnedMinutes ahead, phase B only
“What helped” goes back into the data. The loop teaches the model this child.
The 8-week pilot
Draft protocolA · quiet recording
B · alerts on / off
Band
Parent marks
Video, with family consent
Personal calibration
Alerts
1
2
3
4
5
6
7
8 wk
The final protocol will be set with a clinical partner and an ethics committee, and pre-registered. Video labeling follows Imbiriba 2023, where raters agreed at κ 0.86 to 0.95.
What we measure
At 3, 5, and 10 minutes ahead:
- AUROC
- Sensitivity
- PPV
- False alarms per day
In phase B we compare how often and how long episodes last on “on” days and “off” days.
A labeling bot for parents is built and being tried out.
Sources
Every number on this site, and where it comes from.
Predicting episodes from a wearable
- Goodwin et al., 2019. Autism Research 12(8):1286–1296. Also: Northeastern.
- Imbiriba et al., 2023. JAMA Network Open 6(12):e2348898.
- Kartha et al., 2026. Preprint, arXiv 2605.17618.
- Bahrami Rad et al., 2025. Physiological Measurement 46(1):015004.
Where to measure
- Taylor & Machado-Moreira, 2013. Extreme Physiology & Medicine 2:4. Sweat gland map of the body.
- Payne, Schell & Dawson, 2016. Psychophysiology. Skin conductance across fingers, feet, forehead, wrist.
The problem
- Kanne & Mazurek, 2011. Aggression, 1,380 children. Summary by Kennedy Krieger.
- Steenfeldt-Kristensen et al., 2020. J Autism Dev Disord 50(11):3857–3873. Also: University of Birmingham.
- Anderson et al., 2012. Pediatrics. Running away, 1,218 children. Summary by Kennedy Krieger.
- Hayes & Watson, 2013. J Autism Dev Disord 43:629–642. Parenting stress, meta-analysis.
- Montaque, Dallos & McKenzie, 2018. Clinical Child Psychology and Psychiatry 23:125–139.
- CDC ADDM, MMWR 2025. 1 in 31 at age 8, 2022 data.
- Yao et al., 2022. Frontiers in Psychiatry. Sleep problems in 50 to 80% of autistic children.
- Wattegama et al., 2026. AMIA Annu Symp Proc 2025. Topics on r/Autism_Parenting, 1,216 posts.
Would families wear it
- Weber et al., 2025. Sensors 25(7):2009. 40 parents of nonverbal children.
- Koo et al., 2016. ITAA Proceedings. 16 interviews.
Devices, market, regulation
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