Using Wearable Technology to Predict the Occurrence of Severe Behavior Problems among Neurodiverse Individuals: A Systematic Review

Romani et al. (2026) hunted for papers that used smartwatches, chest bands, or other wearables to forecast severe behavior in neurodiverse people. They screened every study published up to 2026.

They kept 13 papers. The gadgets tracked heart rate, skin sweat, motion, or temperature. The goal was to see if the tech could give carers a few-second heads-up before a hit, bite, or scream.

The idea works in theory. Algorithms sometimes flagged rising stress a handful of seconds before the behavior.

But every study was tiny, used different cut-offs, and rarely checked if the alert was right outside the lab. The team calls the evidence 'early promise' only.

Liang et al. (2026) also used wearables on kids with NDDs, yet they measured movement, not behavior. They found the same weak spots: small samples and no two labs using the same recipe.

Kennedy (2025) showed sleep loss spikes challenging behavior in people with ID. That review is strong; Romani’s is shaky. The contrast warns us: wearables may predict, but fixing sleep gives faster, proven relief.

Mukherjee et al. (2021) reviewed infant wearables that predict cerebral palsy. Like Romani, they saw cool tech trapped by poor real-world tests. Together the three reviews say: hardware is ahead of validation.

Do not buy a smartwatch and assume it will keep your client safe. Use it as an extra probe, not a replacement for functional assessment. Track sleep first (H, 2025), then pilot wearables only if you can collect proof that the alerts match real outcomes.