H-Behaviours
Children with neurodevelopmental and/or neuropsychiatric conditions often have a combination of voluntary and involuntary movements. These movements are associated with hyperactivity and hyper-/hypo-arousability (fight or flight/freeze responses) in the wake state, and hypermotor-restlessness in the sleep state, all summarized as H-Behaviours. H-Behaviours occur across a spectrum of the most frequent developmental, neurologic and mental health conditions such as ADHD, Restless Legs Syndrome (RLS) or Willis-Ekbom Disease, tics, Tourette syndrome, anxiety, ASD and FASD. While the H-Behaviour associated movement patterns are very well described in children with ADHD, tics and Tourette syndrome, they are less so in RLS. Additionally, they have not been clearly defined across age, different symptoms and presentations.
Targeting single aspects of such behaviours with pharmacological interventions (stimulants, anti-depressants, anti-psychotics) increases the likelihood for adverse drug reactions – usually these children/youth are trialed with multiple psychotropic substances. In order to reduce the epidemic of psychotropic substance use, we created an international clinical and technical research consortium. Clinician backgrounds include paediatrics, neurology, psychiatry, psychology, and occupational therapy, while technician backgrounds include computing, bio-mechanical engineering, and signal processing engineering, Most members joined at the 4th Conference of International Pediatric Sleep Association (IPSA - Taipei 2015) under the Video Working Group, which offers members a roof for collaborative action.
The Video Working Group developed a standardized framework for the analysis of video recordings of H-Behaviours (Regensburg 2017) and implements the use of pictograms. Members of the Video Working Group include our people and partners. The video recordings of H-Behaviours are captured during the SCIT/SIT (more info below).
Analysis of H-Behaviours will help to establish precision medicine: (1) children/youth with RLS will be identified by the family doctor/paediatrician/psychiatrist; (2) receive the most appropriate diagnosis without getting categorized with a neurodevelopmental and/or neuropsychiatric condition, due to unidentified sleep problems, and (3) receive, after treating restless legs, tailored treatment for their challenging/disruptive behaviours, which were caused and/or aggravated by sleep deprivation.
BBD – Catalyst Grant, BC Children’s Hospital Research Institute (2017); BC Children’s Hospital Foundation & Children’s Sleep Network (2013- ); Kids Brain Health Network (previously NeuroDevNet 2014/15); Treatable Intellectual Disability Endeavour, BC Children’s Hospital Research Institute (previously Child Family Research Institute, 2013-2015)
Project Leads: Osman Ipsiroglu (2013-Present) & HF Machiel Van der Loos (2016-Present) & Leonid Sigal (2018-Present) & Gerhard Klösch (2016-Present), Arthur Walters
Project Partners: Members of the H-Behaviours Group at BCCHR, Christine A. Loock, Suzanne Lewis, Gabriella Horvath, Alexander Rauscher, Sylvia Stockler; Members of the Vienna Research Hub, Georg Dorffner, Heinrich Garn, Bernhard Kohn; & Members of the Video Working Group of the International Pediatric Sleep Association: Catherine Hill (Southampton), Sue McCabe (Perth), Hans-Jürgen Kühle (Giessen), Barbara Schneider (Landshut), Rosalia Silvestri (Messina); Karen Spruyt (Lyon)
Research Assistants: Nadia Beyzaei (2014-Present); Emmanuel Tse (2016-18); Yi Jui Lee (2016-18); Mai Berger (2013-17); Alexandra Wagner (2014-15); Duncan Wong (2013-14); Hebah Hussaina (2017-18); Seraph Bao (2017-18), Khaola Safia Maher (2017-18), Mai Berger (2013-17); Kevin Xiao (2019-Present); Summer Students in 2017: Mackenzie Campbell, Natasha Carson, Jecika Jeyaratnam
Acknowledgements: Medical University of Vienna & Institute for Sleep-Wake Research Vienna, Austria; Austrian Institute of Technology, Vienna, Austria.