Wearable Solutions Using Physiological Signals for Stress Monitoring on Individuals with Autism Spectrum Disorder (ASD): A Systematic Literature Review

Some previous studies have focused on using physiological signals to detect stress in individuals with ASD through wearable devices, yet few have focused on how to design such solutions. Wearable technology may be a valuable tool to aid parents and caregivers in monitoring the emotional states of individuals with ASD who are at high risk of experiencing very stressful situations. However, effective wearable devices for individuals with ASD may need to differ from solutions for those without ASD. People with ASD often have sensory sensitivity and may, therefore, not tolerate certain types of accessories and experience discomfort when using them. We used the Scopus, PubMed, WoS, and IEEE-Xplore databases to search for studies published from 2014 to 2024 to answer four research questions related to wearable solutions for individuals with ASD, physiological parameters, and techniques/processes used for stress detection. Our review found 31 articles; not all studies considered individuals with ASD, and some were beyond the scope of this review. Most of the studies reviewed are based on cardiac activity for stress monitoring using photoplethysmography (PPG) and electrocardiography (ECG). However, limitations include small sample sizes, variability in study conditions, and the need for customization in stress detection algorithms. In addition, there is a need to customize the stress threshold due to the device's high individual variability and sensitivity. The potential of wearable solutions for stress monitoring in ASD is evident, but challenges include the need for user-friendly and unobtrusive designs and integrating these technologies into comprehensive care plans.