Movement patterns during threat task associated with symptom profiles in young children

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medRxiv Published April 4, 2026 Medically reviewed April 26, 2026 Study authors: Cohen, J. G.; Mascia, G.; Loftness, B. C.; Bradshaw, M. C.; Halvorson-Phelan, J.; Cherian, J.; Kaira… DOI ↗ By Dr. Ji-eun Park, MD · Brain, Mind & Pain

Key Takeaway

Note: Laboratory movement patterns show symptom associations; clinical utility is not established.

This observational study examined threat response movement patterns in 91 children aged 4-8 years (48.4% with a mental health diagnosis) during a 30-second laboratory threat induction task using wearable inertial sensors. The task phases differed in potential threat intensity. The study assessed task validity (changes in stimuli response) and clinical validity (associations with symptom severity).

Main results showed that internalizing symptoms were associated with a smaller Turning Angle, which the authors suggest may indicate vigilance. This association was moderated by comorbid externalizing symptoms: children with high levels of both internalizing and externalizing symptoms exhibited larger Turning Angles, which the authors suggest may indicate avoidance. The study did not report effect sizes, p-values, confidence intervals, or absolute numbers for these associations. Turning Speed varied across task phases, but specific results were not reported.

Safety and tolerability data were not reported. Key limitations include the observational design, which cannot establish causation, and the laboratory setting, which may limit generalizability to real-world contexts. The lack of reported statistical precision (effect sizes, p-values) further limits interpretation. The findings suggest brief wearable-enabled tasks can capture objective behavioral markers and underscore the importance of considering comorbid symptom dimensions in early childhood mental health screening. However, clinical implications are not established.

Study Details

EvidenceLevel 5

PublishedApr 2026

View Original Abstract ↓

Early childhood mental health problems are common and difficult to detect due to reliance on caregiver reports of often unobservable symptoms. This study quantified threat response movement patterns during a 30-second laboratory threat induction task using wearable inertial sensors. Movement patterns were used to examine (1) changes in stimuli response across the task (task validity) and (2) associations with symptom severity (clinical validity). Sacral accelerometer and gyroscope data were analyzed from 91 children aged 4-8 years during the brief task, 48.4% of whom had a mental health diagnosis. Consistent with task validity, Turning Speed varied across task phases differing in potential threat intensity. Consistent with clinical validity, internalizing symptoms were associated with smaller Turning Angle, possibly indicating vigilance. This effect was moderated by comorbid externalizing symptoms, such that children with high internalizing and high externalizing symptoms exhibited larger Turning Angles, possibly indicating avoidance. Findings demonstrate that brief wearable-enabled tasks can capture subtle objective behavioral markers of threat responses and underscore the importance of considering comorbid symptom dimensions in early childhood mental health screening.