JMIR Publications

ABSTRACT

Background:

Stress in childhood and adolescence can disrupt emotional, cognitive, and physiological development, with long-term health consequences. Conventional assessments (eg, cortisol sampling, retrospective questionnaires) are invasive, burdensome, and poorly suited for pediatric use. Advances in mobile health (mHealth), wearable devices, and non-contact sensing enable non-invasive, real-time monitoring of stress in children and adolescents.

Objective:

This scoping review synthesizes evidence on non-invasive technologies for pediatric stress detection and regulation, with particular attention to mobile, wearable, and ubiquitous health applications. It maps the technologies, protocols, and interventions reported to date and identifies gaps and future directions for research and practice.

Methods:

Following PRISMA-ScR guidelines, five databases (PubMed, Scopus, IEEE Xplore, ACM Digital Library, Google Scholar) were searched for peer-reviewed studies published between 2013 and June 2025. Eligible studies involved participants aged 0–18 years, used non-invasive technological methods for stress detection, monitoring, or mitigation, and reported empirical outcomes. Data were charted across seven dimensions: technology type, stress induction and validation, study context, age group, evaluation method, datasets, and intervention strategies.

Results:

Forty-nine studies were included. Most used wearable devices (84%), with limited exploration of non-contact (14%) or hybrid systems. Stress induction methods were heterogeneous, dominated by cognitive and academic tasks, with no standardized pediatric protocols. Adolescents were the most studied group, whereas children under 8 years were underrepresented. Evaluation approaches ranged from traditional statistics to supervised and deep learning models (accuracies 82%--95.6%), though reproducibility was constrained by small, homogeneous samples and a lack of open pediatric datasets. Only 9 studies integrated mitigation strategies (eg, biofeedback, serious games, caregiver-facing tools), typically in short-term deployments. Ethical and privacy considerations were acknowledged but rarely operationalized. While the review covers a broad spectrum of non-invasive approaches, the majority of included studies were delivered through mobile and wearable platforms, with fewer exploring ambient or ubiquitous sensing, aligning the field closely with mobile and ubiquitous health research.

Conclusions:

Non-invasive mobile and wearable technologies offer strong potential for scalable pediatric stress monitoring, yet the field remains fragmented. Priorities include developing age-appropriate stress protocols, creating diverse open datasets, evaluating systems in real-world and longitudinal contexts, and embedding closed-loop interventions. Stronger ethical, privacy, and equity safeguards are critical for translation into schools, telehealth, and everyday mHealth practice. Clinical Trial: Not Applicable