Teenage innovator Karishma Muthukumar won a place on MI3’s internship programme and never looked back. Hazel Tang meets her.

Karishma Muthukumar has packed more into her teenage years than some do in a lifetime. When she was just 14, she earned a highly sought-after summer internship at the Sharon Disney Lund Medical Intelligence and Innovation Institute (MI3) at the Children’s Hospital of Orange County (CHOC).

Interns were able to meet regularly with mentors as well as shadow physicians on patient rounds. It was here she noticed how isolated patients with locked-in syndrome were mentally aware but unable to move or verbally communicate. Muthukumar was inspired to create a medical innovation, OutLoud – an emoji-based communi- cation board that enabled patients to express their needs and emotions through eye movements and EEG (electro- encephalography).

In 2016, when Muthukumar was just 15, OutLoud duly won the abstract competition for Artificial Intelligence and Big Data in the International Society of Pediatric Innovation’s annual Pediatrics 2040 conference, hosted by CHOC – making her the youngest ever winner.

Her innovation integrated a low-cost Brain-Computer Interface (BCI) system consisting of an EEG amplifier, LCD touchscreen, and electrodes, with a computerized emoji communication keyboard. Patients mentally visualize movements of their left arm to shift the cursors and select emoticons to express themselves effortlessly and relatively quickly. The technology
crosses cultural and language barriers with symbols enabling patients to express how they are feeling (happy emoticon), where they want to go (house emoticon), and even what they want to eat (burger emoticon).

Muthukumar’s ground-breaking work with OutLoud also led her to being named winner of 2018’s Young Innovators to Watch, a national scholarship program sponsored by Living in Digital Times and Lenovo. As a winner, she went on to present OutLoud at the world’s largest trade show – the Consumer Electronics Show in Las Vegas. But rather than bask in the glory of her awards and recognition, Muthukumar is inspired to continue to work towards greater achievements. “My favorite part was that after each presentation, there would always be physicians and nurses who’d come up to me and tell me how this could have an impact on their patients,” she says softly. “Just the simple conversations and seeing the small, tangible impacts continue to motivate and empower me today.”

Three years on and Muthukumar, 19, is now an under- graduate student at the University of California, Irvine (UCI), where she is also part of the university’s BCI lab member leading an IRB (Institutional Review Board) approved research study into her original innovation.
Muthukumar is keen to maintain the accuracy of OutLoud while reducing patient frustration levels. “The emojis we are using right now come from an open-source,” she explains. “But we want to further improve the time it takes for patients to express themselves with emojis and translate that into English content by caregivers. To that end, we want to incorporate health-specific emojis, redesign the layout of the computerized keyboard, and add in more BCI elements.”

Originally, Muthukumar had also made room for arti- ficial intelligence (AI) in her BCI system, where it deter- mines the overlapping data coming from EEG and eye movements, to quickly capture patients’ choice of emojis. Just how a normal human brain would. As the project evolves, the young innovator is now focusing on expanding it to broaden the study population, to include real patients and improve the emoji-based communication board. “As we go forward, I still believe AI could be inherited into the system to effectively address the inadequacies. But right now it’s not a mandatory aspect.”

Nevertheless, she believes AI is vitally important; “There’s so much development in AI and it has already become a huge field on its own. So, we need to make sure AI is sustainable and ethical and start thinking about the future right now.”

As well as becoming a pioneering innovator in her teens, Muthukumar has found the time to establish ‘Synapse’ a nonprofit organization which teaches neuroscience to
elementary school students. “There is just so much we don’t know about the brain,” she says excitedly. “So I thought neuroscience should not just be tackled at college level. It’s vital to start cultivating curiosity and inspiring interest at an even younger age.”

Through Synapse, Muthukumar and her team have organized neuroscience exhibits, bimonthly workshops and volunteer opportunities for younger students. It’s already proving a huge success with high school students teaching middle school and elementary school students, offering fun and interactive ways to learn about the brain. They also partner with a local brain injury center and an Alzheimer support group, to provide support to patients.

Juggling so many projects at such a young age, Muthukumar admits it can be challenging at times. But eschewing teenage pursuits, she prefers to find relaxation in her research and nonprofit commitments. “I think it’s just really exciting and fun to think about what could be next,” she laughs. “Textbooks can only teach you so much so there is a need to go beyond”.

Young and enthusiastic with a brilliant mind, Muthukumar is also humble enough to seek support and advice where she lacks the necessary technical skills. “When I arrive at something that I don’t know, I always ask for help and seek resources to help me find a new solution because I know I don’t yet have the requisite amount of knowledge and experience.”

She’s also gracious enough to acknowledge the support she’s received. “I truly believe it takes a community to support someone who wishes to innovate,” she says. “My family and friends are the ones who have been really sincere about my work. They tend to be the first to say, ‘I don’t think that idea would work’ or ‘Maybe it’s not good to start with this’. All these observations challenge me, allowing me to build on their feedback and create something even better than what I started with.”