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A Brown University lab is analyzing the cries of infants for signs of opioid exposure

Barry Lester, director of the Center for the Study of Children at Risk at Brown University’s Warren Alpert Medical School.
Barry Lester, director of the Center for the Study of Children at Risk at Brown University’s Warren Alpert Medical School.Courtesy of Brown University

The Boston Globe’s weekly Ocean State Innovators column features a Q&A with Rhode Island innovators who are starting new businesses and nonprofits, conducting groundbreaking research, and reshaping the state’s economy. Send tips and suggestions to reporter Edward Fitzpatrick at edward.fitzpatrick@globe.com.

This week’s Ocean State Innovators conversation is with Barry Lester, director of the Center for the Study of Children at Risk at Brown University’s Warren Alpert Medical School.

Question: How and why is your lab analyzing the cries of babies?

Answer: The “how” is by extracting acoustic cry characteristics from a computer-based infant-cry analysis system that we developed a few years ago. The system has the potential to generate hundreds of measures of acoustic cry characteristics. Some are audible, such as pitch. Others are more subtle and not audible.


The “why” is to aid in the diagnosis of Neonatal Abstinence Syndrome, or NAS, which is the withdrawal that many opioid-exposed newborn babies go through. The diagnosis of NAS is based, in part, on cry characteristics.

Q: What is distinctive in the cry of an infant that would indicate opioid withdrawal? How do you distinguish it from the cries of any other infant?

A: We are working on an algorithm based on approximately 50 acoustic characteristics measured by our cry-analysis system. The algorithm was developed by identifying acoustic cry characteristics that distinguish the cries of babies with NAS from the cries of babies who do not have NAS.

When clinicians are examining a baby to diagnose NAS, they are listening for a high-pitched cry. But there are two problems with this.

First, high pitch alone is not characteristic of NAS cries. There are many medical conditions where babies have high-pitched cries, and there are babies without medical conditions who have high-pitched cries.


Second, determining high pitch in NAS is based on human judgment that is subjective. What is high pitch to one person is not necessarily high pitch to someone else.

The device that we are working on takes human subjective judgment out of the equation and measures all of the acoustic characteristics that are necessary to determine if a cry meets criteria for NAS.

Q: What kind of device is your research team developing and who would use it?

A: With my co-investigators, Steve Sheinkopf and Harvey Silverman, we are developing a handheld device that records a baby’s cry and provides an instantaneous readout of whether or not the cry is a characteristic NAS cry. It would be used by nurses and doctors who examine opioid-exposed babies to determine if they have NAS.

Q: What would be the benefits of broad application of this kind of technology?

A: The benefit is that it has the potential to help provide a more accurate diagnosis of NAS — which will determine what kind of treatment the baby gets and how long the baby will have to stay in the hospital, and it would lower costs.

Q: What is the scope of the opioid epidemic we are facing in the United States and here in Rhode Island, and how many newborns show signs of opioid exposure?

A: In the U.S., an opioid-exposed baby is born approximately every 15 minutes. This is a 240 percent increase over the last 10 years with an annual cost of $1.5 billion, most of which is hospital costs. In Rhode Island, we get approximately 100 babies per year born with prenatal opioid exposure.


Q: What is the Brown Biomedical Innovations to Impact Fund, and how is it supporting your work?

A: BBII, as it is known, is an initiative from Brown’s Division of Biology and Medicine and Brown Technology Innovations to help translate scientific discoveries into commercial products that can help patients. Mine was one of five projects that got about $100,000 in funding each, to help with the gap between the time when federal research funding ends and private investors are ready to invest for commercialization.

Q: What are some of the other projects that the Brown Biomedical Innovations to Impact program is supporting now?

A: This is the second set of annual awards. In the first year, there were also five projects that received awards, including one developing a new test for diagnosing lower back pain, another to optimize a new drug to treat pulmonary fibrosis, and one to advance lab-grown tissue to help repair the heart.

Edward Fitzpatrick can be reached at edward.fitzpatrick@globe.com. Follow him on Twitter @FitzProv.