Five Sleeping Children
Residency at Centre for Systems Modelling and Quantitative Biomedicine (SMQB), University of Birmingham

Epilepsy is a common brain disorder that causes repeated seizures. It can be very difficult to find out if a child has epilepsy, and when they have other conditions at the same time, this can be even harder. Two of the most common conditions that affect children with epilepsy are autism and ADHD. They also affect children's behaviour and brain function. When epilepsy, autism and ADHD are present, it can be very difficult to come to a clear diagnosis and to decide treatment.

This was a project about harvesting key elements in tests of electrical brain activity (electroencephalogram or EEG) and then developing algorithms to find commonalities that might indicate links within the diagnoses.

Although the outline doesn’t state it, this was a project also about sleep. Testing in sleep can be more likely to show abnormalities and that the change of state from wake to sleep will bring out the relationships between epilepsy, autism and ADHD more clearly. During sleep the brain is in a state that can provide additional and complementary information regarding those disorders But a child or young person presenting with epilepsy is invited in daytime, to a strange place that they might not have been to before (in this case Birmingham Children’s Hospital), to put on a strange and bulky head cap with lots of wires and 21 sensors that touch the scalp and asked to fall asleep. This is something that we all would find difficult to do. In a wider context, the quality of a child’s sleep has a direct effect on their epilepsy. Tired individuals with poor sleep patterns are more likely to have events or seizures.

The data from the EEGs is analysed by specialists and a 20 seconds long epoch to calculate the networks can be produced from each result. This shows the level of electrical activity in the brain picked up by the sensors. The network epoch looks like a decagon with a regular scattering of dots representing the sensors in relation to their placement on the head. The dots are interconnected to each other with a range of thin and thick lines. The denser the line the more correlated is the activity between two points in the brain. Some points remain unconnected. This information can then also be presented on a matrix of blocks of tone or colour illustrating the levels of activity between points. If these patterns are seen reliably, we may have a new way of identifying whether a child has epilepsy, and understanding how their brain activity is affected by symptoms of ADHD and autism’

I sought out textiles associated with children and sleep and have begun to embroider and overlay networks, matrices and code on children’s pyjamas and blankets.

As a research team we met most fortnights to discuss the progress of the project as a whole. It was interesting to hear the team talking of excitability and synchronicity, maximum cross correlation, frequencies and mean degrees. They sometimes talked with passion about things I didn’t understand; I didn’t have the Code of the Data, but that’s alright; they explained the important bits and always answered my questions.

When collaborating with scientists or clinicians I try and take a co-creation approach. I talk to specialists, making work on the basis of those conversations and then show the samples back to them to see if I am using the information correctly. I make work informed by the opinions of those ‘educated eyes’ but I am also interested in the lived experience. Now in the Age of Wikipedia everyone can look up information and try and understand.