Temporal point process modeling of aggressive behavior onset in psychiatric inpatient youths with autism

Aggressive behavior, including aggression towards others and self-injury, occurs in up to 80% of children and adolescents with autism, making it a leading cause of behavioral health referrals and a major driver of healthcare costs. Predicting when autistic youth will exhibit aggression can be challenging due to their communication difficulties. Many are minimally verbal or have poor emotional insight. Recent advances in Machine Learning and wearable biosensing demonstrate the ability to predict aggression within a limited future window (typically one to three minutes) in autistic individuals. However, existing works do not estimate aggression onset probability or the expected number of aggression onsets over longer periods, nor do they provide interpretable insights into onset dynamics. To address these limitations, we apply Temporal Point Processes(TPPs), particularly self-exciting Hawkes processes, to model the timing of aggressive behavior onsets in psychiatric inpatient autistic youth. We benchmark several TPP models by evaluating their goodness-of-fit and predictive metrics. Our results demonstrate that self-exciting TPPs more accurately capture the irregular and clustered nature of aggression onsets, especially compared to traditional Poisson models. These incipient findings suggest that TPPs can provide interpretable, probabilistic forecasts of aggression onset along a time continuum, supporting future clinical decision-making and preemptive intervention.