Socially Assistive Robots as Mental Health Interventions for Children: A Scoping Review

Social robots in research on social and cognitive development in infants and toddlers: A scoping review

There is currently no systematic review of the growing body of literature on using social robots in early developmental research. Designing appropriate methods for early childhood research is crucial for broadening our understanding of young children's social and cognitive development. This scoping review systematically examines the existing literature on using social robots to study social and cognitive development in infants and toddlers aged between 2 and 35 months. Moreover, it aims to identify the research focus, findings, and reported gaps and challenges when using robots in research. We included empirical studies published between 1990 and May 29, 2023. We searched for literature in PsychINFO, ERIC, Web of Science, and PsyArXiv. Twenty-nine studies met the inclusion criteria and were mapped using the scoping review method. Our findings reveal that most studies were quantitative, with experimental designs conducted in a laboratory setting where children were exposed to physically present or virtual robots in a one-to-one situation. We found that robots were used to investigate four main concepts: animacy concept, action understanding, imitation, and early conversational skills. Many studies focused on whether young children regard robots as agents or social partners. The studies demonstrated that young children could learn from and understand social robots in some situations but not always. For instance, children's understanding of social robots was often facilitated by robots that behaved interactively and contingently. This scoping review highlights the need to design social robots that can engage in interactive and contingent social behaviors for early developmental research.

Use of automated conversational agents in improving young population mental health: a scoping review

Automated conversational agents (CAs) emerged as a promising solution in mental health interventions among young people. Therefore, the objective of this scoping review is to examine the current state of research into fully automated CAs mediated interventions for the emotional component of mental health among young people. Selected databases were searched in March 2023. Included studies were primary research, reporting on development, feasibility/usability, or evaluation of fully automated CAs as a tool to improve the emotional component of mental health among young population. Twenty-five studies were included (N = 1707). Most automated CAs applications were standalone preventions targeting anxiety and depression. Automated CAs were predominantly AI-based chatbots, using text as the main communication channel. Overall, the results of the current scoping review showed that automated CAs mediated interventions for emotional problems are acceptable, engaging and with high usability. However, the results for clinical efficacy are far less conclusive, since almost half of evaluation studies reported no significant effect on emotional mental health outcomes. Based on these findings, it can be concluded that there is a pressing need to improve the existing automated CAs applications to increase their efficacy as well as conducting more rigorous methodological research in this area.

Enhancing emotion regulation with an in situ socially assistive robot among LGBTQ+ youth with self-harm ideation: protocol for a randomised controlled trial

INTRODUCTION

Purrble, a socially assistive robot, was codesigned with children to support in situ emotion regulation. Preliminary evidence has found that LGBTQ+ youth are receptive to Purrble and find it to be an acceptable intervention to assist with emotion dysregulation and their experiences of self-harm. The present study is designed to evaluate the impact of access to Purrble among LGBTQ+ youth who have self-harmful thoughts, when compared with waitlist controls.

METHODS AND ANALYSIS

The study is a single-blind, randomised control trial comparing access to the Purrble robot with waitlist control. A total of 168 LGBTQ+ youth aged 16-25 years with current self-harmful ideation will be recruited, all based within the UK. The primary outcome is emotion dysregulation (Difficulties with Emotion Regulation Scale-8) measured weekly across a 13-week period, including three pre-deployment timepoints. Secondary outcomes include self-harm (Self-Harm Questionnaire), anxiety (Generalised Anxiety Disorder-7) and depression (Patient Health Questionnaire-9). We will conduct analyses using linear mixed models to assess primary and secondary hypotheses. Intervention participants will have unlimited access to Purrble over the deployment period, which can be used as much or as little as they like. After all assessments, control participants will receive their Purrble, with all participants keeping the robot after the end of the study. After the study has ended, a subset of participants will be invited to participate in semistructured interviews to explore engagement and appropriation of Purrble, considering the young people's own views of Purrble as an intervention device.

ETHICS AND DISSEMINATION

Ethical approval was received from King's College London (RESCM-22/23-34570). Findings will be disseminated in peer review open access journals and at academic conferences.

TRIAL REGISTRATION NUMBER

NCT06025942.

Social robotics for children: an investigation of manufacturers' claims

As the market for commercial children's social robots grows, manufacturers' claims around the functionality and outcomes of their products have the potential to impact consumer purchasing decisions. In this work, we qualitatively and quantitatively assess the content and scientific support for claims about social robots for children made on manufacturers' websites. A sample of 21 robot websites was obtained using location-independent keyword searches on Google, Yahoo, and Bing from April to July 2021. All claims made on manufacturers' websites about robot functionality and outcomes (n = 653 statements) were subjected to content analysis, and the quality of evidence for these claims was evaluated using a validated quality evaluation tool. Social robot manufacturers made clear claims about the impact of their products in the areas of interaction, education, emotion, and adaptivity. Claims tended to focus on the child rather than the parent or other users. Robots were primarily described in the context of interactive, educational, and emotional uses, rather than being for health, safety, or security. The quality of the information used to support these claims was highly variable and at times potentially misleading. Many websites used language implying that robots had interior thoughts and experiences; for example, that they would love the child. This study provides insight into the content and quality of parent-facing manufacturer claims regarding commercial social robots for children.

Research Hotspots and Trends of Social Robot Interaction Design: A Bibliometric Analysis

(1) Background: Social robot interaction design is crucial for determining user acceptance and experience. However, few studies have systematically discussed the current focus and future research directions of social robot interaction design from a bibliometric perspective. Therefore, we conducted this study in order to identify the latest research progress and evolution trajectory of research hotspots in social robot interaction design over the last decade. (2) Methods: We conducted a comprehensive review based on 2416 papers related to social robot interaction design obtained from the Web of Science (WOS) database. Our review utilized bibliometric techniques and integrated VOSviewer and CiteSpace to construct a knowledge map. (3) Conclusions: The current research hotspots of social robot interaction design mainly focus on #1 the study of human-robot relationships in social robots, #2 research on the emotional design of social robots, #3 research on social robots for children's psychotherapy, #4 research on companion robots for elderly rehabilitation, and #5 research on educational social robots. The reference co-citation analysis identifies the classic literature that forms the basis of the current research, which provides theoretical guidance and methods for the current research. Finally, we discuss several future research directions and challenges in this field.

Exploring the needs of children and caregivers to inform design of an artificial intelligence-enhanced social robot in the pediatric emergency department

Background & Objective

Socially assistive robots (SARs) are a promising tool to manage children's pain and distress related to medical procedures, but current options lack autonomous adaptability. The aim of this study was to understand children's and caregivers' perceptions surrounding the use of an artificial intelligence (AI)-enhanced SAR to provide personalized procedural support to children during intravenous insertion (IVI) to inform the design of such a system following a user-centric approach.

Methods

This study presents a descriptive qualitative needs assessment of children and caregivers. Data were collected via semi-structured individual interviews and focus groups. Participants were recruited from two Canadian pediatric emergency departments (EDs) between April 2021 and January 2022.

Results

Eleven caregivers and 19 children completed 27 individual interviews and one focus group. Three main themes were identified: A. Experience in the clinical setting, B. Acceptance of and concerns surrounding SARs, and C. Features that support child engagement with SARs. Most participants expressed comfort with robot technology, however, concerns were raised about sharing personal information, photographing/videotaping, and the possibility of technical failure. Suggestions for feature enhancements included increasing movement to engage a child's attention and tailoring language to developmental age. To enhance the overall ED experience, participants also identified a role for the SAR in the waiting room.

Conclusion

Artificial intelligence-enhanced SARs were perceived by children and caregivers as a promising tool for distraction during IVIs and to enhance the overall ED experience. Insights collected will be used to inform the design of an AI-enhanced SAR.

Hold My Hand: Development of a Force Controller and System Architecture for Joint Walking with a Companion Robot

In recent years, there has been a growing interest in the development of robotic systems for improving the quality of life of individuals of all ages. Specifically, humanoid robots offer advantages in terms of friendliness and ease of use in such applications. This article proposes a novel system architecture that enables a commercial humanoid robot, specifically the Pepper robot, to walk side-by-side while holding hands, and communicating by responding to the surrounding environment. To achieve this control, an observer is required to estimate the force applied to the robot. This was accomplished by comparing joint torques calculated from the dynamics model to actual current measurements. Additionally, object recognition was performed using Pepper's camera to facilitate communication in response to surrounding objects. By integrating these components, the system has demonstrated its capability to achieve its intended purpose.

Innovative protocol of an exploratory study evaluating the acceptability of a humanoid robot at home of deaf children with cochlear implants

The purpose of this paper is to introduce a research methodology for the assessment of the acceptability of a humanoid robot at home for children with cochlear implants (CI). The quality of audiology rehabilitation for cochlear implanted child administrated at the hospital with pluri-weekly sessions is a major prognostic factor in the outcome on communications abilities, but represents also a constraint for families related to the access to care that are more difficult. Further, home training with tools would balance the equitable distribution of care in the territory and promote the child's progress. The humanoid robot should allow an ecological approach to this complementary training. Before developing this approach, it is necessary to study the acceptability of the humanoid robot at home, both by cochlear implanted child and their families. Ten families were chosen to have a humanoid robot at home, to explore their acceptability of the humanoid robot Pepper. The study lasts for 1 month per participants (i.e. cochlear implemented children and parent). Participants were invited to use the robot at home as much as they want. The humanoid robot Pepper was able to communicate and proposed activities not related to rehabilitation. Once a week during the study, data were collected from participants (questionnaires and robot's logs) and the smooth running of the study was checked. Questionnaires are used to evaluate the acceptability of the robot by children and parents. User data from the robot's logs are used to quantify the time and the actual use of the robot over the period of the study. Results of the experimentation will be reported, once all 10 participants have completed their passation. The robot is anticipated to be used and accepted by children with cochlear implants and their families. Clinical trial registration: Clinical Trials ID: NCT04832373; https://clinicaltrials.gov/.

A protocol on the effects of interactive digital assistance on engagement and perceived quality of care of surgery patients and self-efficacy and workload of staff

Introduction

The workforce shortage in the healthcare context is a growing issue that exerts detrimental effects on employees (e.g., higher workload) and patients (e.g., suboptimal patient care). Since traditional approaches alone may not be enough to solve this problem, there is a need for complementary innovative digital health solutions, such as socially assistive robots. Hence, the proposed study aims to investigate the effects of gamified nursing education and physiotherapy delivered by a socially assistive robot on patient- (engagement, perceived quality of care) and employee-related outcomes (perceived self-efficacy, workload).

Methods and analysis

Approximately 90 vascular and thoracic surgery patients will receive either standard care or standard care with additional robot interactions over the course of 3–5 days. Additionally, approximately 34 nursing and physiotherapeutic employees will fill out self-report questionnaires after weeks of not using a social robot and weeks of using a social robot. The main hypotheses will be tested with mixed-design analyses of variance and paired-samples t-tests.

Discussion

While the proposed study has some limitations, the results will provide high-quality and comprehensive evidence on the effectiveness of socially assistive robots in healthcare.

Ethics and dissemination

The study was approved by the Medical Ethics Commission of the University Medical Center and registered in the ISRCTN registry (ISRCTN96689284). The study findings will be summarized in international peer-reviewed scientific journals and meetings and communicated to relevant stakeholders.

A Review on Human Comfort Factors, Measurements, and Improvements in Human-Robot Collaboration

As the development of robotics technologies for collaborative robots (COBOTs), the applications of human-robot collaboration (HRC) have been growing in the past decade. Despite the tremendous efforts from both academia and industry, the overall usage and acceptance of COBOTs are still not so high as expected. One of the major affecting factors is the comfort of humans in HRC, which is usually less emphasized in COBOT development; however, it is critical to the user acceptance during HRC. Therefore, this paper gives a review of human comfort in HRC including the influential factors of human comfort, measurement of human comfort in terms of subjective and objective manners, and human comfort improvement approaches in the context of HRC. Discussions on each topic are also conducted based on the review and analysis.

Getting acquainted: First steps for child-robot relationship formation

In this article we discuss two studies of children getting acquainted with an autonomous socially assistive robot. The success of the first encounter is key for a sustainable long-term supportive relationship. We provide four validated behavior design elements that enable the robot to robustly get acquainted with the child. The first are five conversational patterns that allow children to comfortably self-disclose to the robot. The second is a reciprocation strategy that enables the robot to adequately respond to the children’s self-disclosures. The third is a ‘how to talk to me’ tutorial. The fourth is a personality profile for the robot that creates more rapport and comfort between the child and the robot. The designs were validated with two user studies (N₁ = 30, N₂ = 75, 8–11 years. o. children). The results furthermore showed similarities between how children form relationships with people and how children form relationships with robots. Most importantly, self-disclosure, and specifically how intimate the self-disclosures are, is an important predictor for the success of child-robot relationship formation. Speech recognition errors reduces the intimacy and feeling similar to the robot increases the intimacy of self-disclosures.

A Survey on Recent Advances in Social Robotics

Over decades, social robotics has evolved as a concept that presently covers different areas of application, and interacts with different domains in technology, education, medicine and others. Today, it is possible to envision social robots in tasks that were not expected years ago, and that is not only due to the evolution of social robots, but also to the evolution of the vision humans have for them. This survey addresses recent advances in social robotics from different perspectives. Different contexts and areas of application of social robots are addressed, as well as modalities of interaction with humans. Different robotic platforms used in social contexts are shown and discussed. Relationships of social robotics with advances in other technological areas are surveyed, and methods and metrics used for the human evaluation of the interaction with robots are presented. The future of social robotics is also envisioned based on surveyed works and from different points of view.

Humanoid Robot Use in Cognitive Rehabilitation of Patients with Severe Brain Injury: A Pilot Study

Severe acquired brain injury (SABI) is a major global public health problem and a source of disability. A major contributor to disability after SABI is limited access to multidisciplinary rehabilitation, despite evidence of sustained functional gains, improved quality of life, increased return to work, and reduced need for long-term care. Twelve patients with a diagnosis of SABI were enrolled and equally divided into two groups: experimental and control. Patients in both groups underwent intensive neurorehabilitation according to the severity of their disabilities (motor, psycho-cognitive, and sensory deficits). However, in the experimental group, the treatment was performed by using a humanoid robot. At baseline, the two groups differed significantly only in Severe Impairment Battery (SIB) scores. Results showed that the experimental treatment had a higher effect than the traditional one on quality of life and mood. In conclusion, this pilot study provides evidence of the possible effects of relational and cognitive stimulation in more severely brain-injured patients.

What criteria are young people using to select mobile mental health applications? A nominal group study

Objective

The popularity of smartphone technology provides a unique opportunity to make mental health support widely accessible, especially among young people. Despite the promising results of some mobile mental health support applications, the overwhelming number of available applications (apps) on the market makes it difficult to make a choice that will be safe and effective. Currently, widely available tools are either developed by experts, without end user input or are solely based on usability rankings. Thus, it remains unclear what aspects of mental health apps are important for young people. The purpose of this study was to determine what criteria young adults use when they select mental health applications and what is the relative importance of these criteria to inform the development of a user-driven app-rating platform.

Methods

We conducted 4 group sessions with 47 youth and young adults aged 15-25 in British Columbia, Canada using a modified nominal group technique. This method allows for establishing the relative importance of criteria in a structured group discussion. We recorded, transcribed and analysed the resulting data using qualitative content analysis and quantitative methods.

Results

Criteria that are the most important to young adults when selecting mental health apps include accessibility, security and grounding in scientific evidence. We identified specific aspects of the discussed criteria which were ranked in the order of importance.

Conclusion

Consulting end users about their priorities when evaluating mental health apps ensures that their values and priorities are incorporated into future app-rating platforms, alongside expert opinions. The present study also outlines the common contexts in which apps are used as well as their desirable features to inform mental health app development.

A Review of Data Gathering Methods for Evaluating Socially Assistive Systems

Social interactions significantly impact the quality of life for people with special needs (e.g., older adults with dementia and children with autism). They may suffer loneliness and social isolation more often than people without disabilities. There is a growing demand for technologies to satisfy the social needs of such user groups. However, evaluating these systems can be challenging due to the extra difficulty of gathering data from people with special needs (e.g., communication barriers involving older adults with dementia and children with autism). Thus, in this systematic review, we focus on studying data gathering methods for evaluating socially assistive systems (SAS). Six academic databases (i.e., Scopus, Web of Science, ACM, Science Direct, PubMed, and IEEE Xplore) were searched, covering articles published from January 2000 to July 2021. A total of 65 articles met the inclusion criteria for this systematic review. The results showed that existing SASs most often targeted people with visual impairments, older adults, and children with autism. For instance, a common type of SASs aimed to help blind people perceive social signals (e.g., facial expressions). SASs were most commonly assessed with interviews, questionnaires, and observation data. Around half of the interview studies only involved target users, while the other half also included secondary users or stakeholders. Questionnaires were mostly used with older adults and people with visual impairments to measure their social interaction, emotional state, and system usability. A great majority of observational studies were carried out with users in special age groups, especially older adults and children with autism. We thereby contribute an overview of how different data gathering methods were used with various target users of SASs. Relevant insights are extracted to inform future development and research.

Experience with an Affective Robot Assistant for Children with Hearing Disabilities

This study presents an assistive robotic system enhanced with emotion recognition capabilities for children with hearing disabilities. The system is designed and developed for the audiometry tests and rehabilitation of children in a clinical setting and includes a social humanoid robot (Pepper), an interactive interface, gamified audiometry tests, sensory setup and a machine/deep learning based emotion recognition module. Three scenarios involving conventional setup, tablet setup and setup with the robot+tablet are evaluated with 16 children having cochlear implant or hearing aid. Several machine learning techniques and deep learning models are used for the classification of the three test setups and for the classification of the emotions (pleasant, neutral, unpleasant) of children using the recorded physiological signals by E4 wristband. The results show that the collected signals during the tests can be separated successfully and the positive and negative emotions of children can be better distinguished when they interact with the robot than in the other two setups. In addition, the children’s objective and subjective evaluations as well as their impressions about the robot and its emotional behaviors are analyzed and discussed extensively.

Investigating socially assistive systems from system design and evaluation: a systematic review

Purpose The development of assistive technologies that support people in social interactions has attracted increased attention in HCI. This paper presents a systematic review of studies of Socially Assistive Systems targeted at older adults and people with disabilities. The purpose is threefold: (1) Characterizing related assistive systems with a special focus on the system design, primarily including HCI technologies used and user-involvement approach taken; (2) Examining their ways of system evaluation; (3) Reflecting on insights for future design research. Methods A systematic literature search was conducted using the keywords "social interactions" and "assistive technologies" within the following databases: Scopus, Web of Science, ACM, Science Direct, PubMed, and IEEE Xplore. Results Sixty-five papers met the inclusion criteria and were further analyzed. Our results showed that there were 11 types of HCI technologies that supported social interactions for target users. The most common was cognitive and meaning understanding technologies, often applied with wearable devices for compensating users' sensory loss; 33.85% of studies involved end-users and stakeholders in the design phase; Four types of evaluation methods were identified. The majority of studies adopted laboratory experiments to measure user-system interaction and system validation. Proxy users were used in system evaluation, especially in initial experiments; 42.46% of evaluations were conducted in field settings, primarily including the participants' own homes and institutions. Conclusion We contribute an overview of Socially Assistive Systems that support social interactions for older adults and people with disabilities, as well as illustrate emerging technologies and research opportunities for future work.