Design, Development, and Evaluation of a Noninvasive Autonomous Robot-mediated Joint Attention Intervention System for Young Children with ASD

Enhancing social-emotional functioning in adolescents with developmental language disorder or deaf or hard of hearing through a Theory of Mind intervention

BACKGROUND

This study examines the effect of a Theory of Mind (ToM) intervention on ToM abilities and social-emotional functioning in adolescents with developmental language disorder (DLD) or who are deaf/hard of hearing (D/HH). It emphasizes the importance of self-reflection and measurement for personal growth. The research design incorporates both subjective and objective measures to evaluate the intervention's efficacy.

AIMS

To investigate the impact of the ToM intervention on ToM abilities and social-emotional functioning in adolescents with DLD or who are D/HH. It hypothesizes that participants in the intervention groups will show improved ToM and social-emotional functioning compared with those in the control groups.

METHODS & PROCEDURES

Adolescents with DLD or who are D/HH were recruited through collaboration with educational institutions. The study utilized a pre-/post-test design, assigning participants to either the intervention or the control group. The ToM intervention involved targeted activities to enhance ToM abilities. ToM abilities and social-emotional functioning were assessed using standardized tests and self-report questionnaires. Statistical analyses compared outcomes between the intervention and no intervention groups.

OUTCOMES & RESULTS

The findings reveal subjective improvements in social-emotional functioning among the D/HH intervention group. However, no significant effects on objective ToM measures were observed. These results highlight the need for further investigation and refinement of interventions in these areas. Future research should focus on improving intervention strategies and exploring additional objective measures to gain a comprehensive understanding of the intervention's impact on ToM and social-emotional functioning in this population.

CONCLUSIONS & IMPLICATIONS

The ToM intervention shows subjective benefits in improving social-emotional functioning among D/HH adolescents. However, it does not yield significant effects on objective ToM measures. These findings emphasize the ongoing need to refine interventions targeting ToM abilities and social-emotional functioning in this population. Future studies should explore alternative strategies and incorporate additional objective measures to enhance understanding and outcomes.

WHAT THIS PAPER ADDS

What is already known on this subject Before this study, it was known that ToM interventions have the potential to enhance ToM abilities. However, the specific effects of such interventions on subjective and objective measures for ToM and social-emotional functioning in adolescents with DLD or who are D/HH remained unclear, necessitating further research. What this paper adds to the existing knowledge This study adds to the existing knowledge by demonstrating subjective improvements in social-emotional functioning among adolescents who are D/HH and underwent a ToM intervention. However, no significant effects on objective ToM measures were observed. These findings highlight the need for refining interventions and exploring additional measures to better understand the intervention's impact. What are the potential or actual clinical implications of this work? The subjective improvements in social-emotional functioning observed in this study have important clinical implications. They suggest that ToM interventions can positively impact the social well-being of adolescents who are D/HH. However, the lack of significant effects on objective ToM measures emphasizes the need for further research and intervention refinement to address specific areas of improvement in this population.

Interactive mirrOring Games wIth sOCial rObot (IOGIOCO): a pilot study on the use of intransitive gestures in a sample of Italian preschool children with autism spectrum disorder

Background

Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication, social interaction, and restricted behaviors. The importance of early intervention has been widely demonstrated, and developmental trajectories in ASD emphasize the importance of nonverbal communication, such as intransitive gesture production, as a possible positive prognostic factor for language development. The use of technological tools in the therapy of individuals with ASD has also become increasingly important due to their higher engagement and responsiveness to technological objects, such as robots.

Materials and methods

We developed a training protocol using the humanoid robot NAO, called IOGIOCO (Interactive mirroring Games wIth sOCial rObot), based on the use of intransitive gestures embedded in naturalistic dialogues, stimulating a triadic interaction between child, robot and therapist. The training was divided into six levels; the first 2 levels were called "familiarization levels," and the other 4 were "training levels". The technological setup includes different complexity levels, from mirroring tasks to building spontaneous interactions. We tested the protocol on 10 preschool children with ASD (aged 2-6 years) for 14 weeks. We assessed them at recruitment (T0), at the end of training (T1), and after 6 months (T2).

Results

We demonstrated the tolerability of the protocol. We found that one group (n=4, males and 2 females) reached the training level, while another and group (n=6 males) remained at a familiarization level (mirroring), we analyzed the results for the two groups. In the group that reached the training levels, we found promising results, such as an improvement in the Social Adaptive Domain of the ABAS-II questionnaire between T0 and T2.

Conclusion

While current results will need a Randomized Controlled Trial to be confirmed, the present work sets an important milestone in using social robots for ASD treatment, aimed at impacting social and communication skills in everyday life.

Sharing Worlds: Design of a Real-Time Attention Classifier for Robotic Therapy of ASD Children. IEEE Int Conf Rehabil Robot 2022;2022:1-6. [PMID: 36176158 DOI: 10.1109/icorr55369.2022.9896506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0]

Joint attention is the capacity of sharing attention between two agents and an aspect of the environment, through the use of different cues, namely gaze. This capacity is of paramount importance for social skills. People with Autism Spectrum Disorder (ASD) present certain deficits in joint attention. Therefore, there is an increasing interest in finding therapies to improve this skill. Some of these therapies include robots since they are known to be attractive to people with autism due to their motivation ability and predictability when compared with humans. In this line, we have designed a real-time attention classifier for a triadic robotic therapy, using Gaze360 and geometrical considerations of the scene. We were able to classify the gaze of the therapist and the one of the child during the whole session, even in a highly unconstrained scenario with a single camera, achieving a mean accuracy of 59%. This classifier can be used for the measurement of joint attention, an important metric for the development of adaptive robotic therapies, where increasing levels of difficulty and engagement are provided dependent on the ASD children, who are characterised by high heterogeneity. Future work will pass by the calculation of this metric and integration on a robotic platform for ASD therapy to understand the impact of these robotic therapies in improving ASD symptoms, specifically on how ASD children share their attention with other people present in the rehabilitation scenarios.

A bibliometric analysis of research trends of artificial intelligence in the treatment of autistic spectrum disorders

OBJECTIVE

Autism Spectrum Disorder (ASD) is a serious neurodevelopmental disorder that has become the leading cause of disability in children. Artificial intelligence (AI) is a potential solution to this issue. This study objectively analyzes the global research situation of AI in the treatment of ASD from 1995 to 2022, aiming to explore the global research status and frontier trends in this field.

METHODS

Web of Science (WoS) and PubMed databese were searched for Literature related to AI on ASD from 1995 to April 2022. CiteSpace, VOSviewer, Pajek and Scimago Graphica were used to analyze the collaboration between countries/institutions/authors, clusters and bursts of keywords, as well as analyses on references.

RESULTS

A total of 448 literature were included, the total number of literature has shown an increasing trend. The most productive country and institution were the USA, and Vanderbilt University. The authors with the greatest contributions were Warren, Zachary, Sakar, Nilanjan and Swanson, Amy. the most prolific and cited journal is Journal of Autism and Developmental Disorders, the highest cited and co-cited articles were Dautenhahn (Socially intelligent robots: dimensions of human-robot interaction 2007) and Scassellati B (Robots for Use in Autism Research 2012). "Artificial Intelligence", "Brain Computer Interface" and "Humanoid Robot" were the hotspots and frontier trends of AI on ASD.

CONCLUSION

The application of AI in the treatment of ASD has attracted the attention of researchers all over the world. The education, social function and joint attention of children with ASD are the most concerned issues for global researchers. Robots shows gratifying advantages in these issues and have become the most commonly used technology. Wearable devices and brain-computer interface (BCI) were emerging AI technologies in recent years, which is the direction of further exploration. Restoring social function in individuals with ASD is the ultimate aim and driving force of research in the future.

C-Hg

Computer-assisted systems can provide efficient and engaging ASD intervention environments for children with Autism Spectrum Disorder (ASD). However, most existing computer-assisted systems target only one skill deficit (e.g., social conversation skills) and ignore the importance of other areas, such as motor skills, that could also impact social interaction. This focus on a single domain may hinder the generalizability of learned skills to real-world scenarios, because the targeted teaching strategies do not reflect that real-world tasks often involve more than one skill domain. The work presented in this article seeks to bridge this gap by developing a Collaborative Haptic-gripper virtual skill training system (C-Hg). This system includes individual and collaborative games that provide opportunities for simultaneously practicing both fine motor skills (hand movement and grip control skills) as well as social skills (communication and collaboration) and investigating how they relate to each other. We conducted a usability study with 10 children with ASD and 10 Typically Developing (TD) children (8–12 years), who used C-Hg to play a series of individual and collaborative games requiring differing levels of motor and communication skill. Results revealed that participant performance significantly improved in both individual and collaborative fine motor skill training tasks, including significant improvements in collaborative manipulations between partners. Participants with ASD were found to conduct more collaborative manipulations and initiate more conversations with their partners in the post collaborative tasks, suggesting more active collaboration and communication of participants with ASD in the collaborative tasks. Results support the potential of our C-Hg system for simultaneously improving fine motor and social skills, with implications for impacts of improved fine motor skills on social outcomes.

Social Robots in Special Education: A Systematic Review

In recent years, social robots have become part of a variety of human activities, especially in applications involving children, e.g., entertainment, education, companionship. The interest of this work lies in the interaction of social robots with children in the field of special education. This paper seeks to present a systematic review of the use of robots in special education, with the ultimate goal of highlighting the degree of integration of robots in this field worldwide. This work aims to explore the technologies of robots that are applied according to the impairment type of children. The study showed a large number of attempts to apply social robots to the special education of children with various impairments, especially in recent years, as well as a wide variety of social robots from the market involved in such activities. The main conclusion of this work is the finding that the specific field of application of social robots is at the first development step; however, it is expected to be of great concern to the research community in the coming years.

An Immersive Computer-Mediated Caregiver-Child Interaction System for Young Children With Autism Spectrum Disorder

Autism Spectrum Disorder (ASD) affects 1 in 54 children in the United States. A core social communication skill negatively impacted by ASD is joint attention (JA), which influences the development of language, cognitive, and social skills from infancy onward. Although several technology-based JA studies have shown potential, they primarily focus on response to joint attention (RJA). The other important component of JA, the initiation of joint attention (IJA), has received less attention from a technology-based intervention perspective. In this work, we present an immersive Computer-mediated Caregiver-Child Interaction (C3I) system to help children with ASD practice IJA skills. C3I is a novel computerized intervention system that integrates a caregiver in the teaching loop, thereby preserving the advantages of both human and computer-administered intervention. A feasibility study with 6 dyads (caregiver-child with ASD) was conducted. A near significant increase with medium effect size on IJA performance was observed. Meanwhile, physiology-based stress analysis showed that C3I did not increase stress of the caregivers over the course of the study. To the best of our knowledge, this is the first autonomous system designed for teaching IJA skills to children with ASD incorporating caregivers within the loop to enhance the potential for generalization in real-world.

Humanoid Robots and Autistic Children: A Review on Technological Tools to Assess Social Attention and Engagement

Recent studies suggest that robot-based interventions are potentially effective in diagnosis and therapy of autism spectrum disorder (ASD), demonstrating that robots can improve the engagement abilities and attention in autistic children. While methodological approaches vary significantly in these studies and are not unified yet, researchers often develop similar solutions based on similar conceptual and practical premises. We systematically review the latest robot-intervention techniques in ASD research (18 research papers), comparing multiple dimensions of technological and experimental implementation. In particular, we focus on sensor-based assessment systems for automated and unbiased quantitative assessments of children’s engagement and attention fluctuations during interaction with robots. We examine related technologies, experimental and methodological setups, and the empirical investigations they support. We aim to assess the strengths and limitations of such approaches in a diagnostic context and to evaluate their potential in increasing our knowledge of autism and in supporting the development of social skills and attentional dispositions in ASD children. Using our acquired results from the overview, we propose a set of social cues and interaction techniques that can be thought to be most beneficial in robot-related autism intervention.

An Open-Source Social Robot Based on Compliant Soft Robotics for Therapy with Children with ASD

Therapy with robotic tools is a promising way to help improve verbal and nonverbal communication in children. The robotic tools are able to increase aspects such as eye contact and the ability to follow instructions and to empathize with others. This work presents the design methodology, development, and experimental validation of a novel social robot based on CompliAnt SofT Robotics called the CASTOR robot, which intends to be used as an open-source platform for the long-term therapy of children with autism spectrum disorder (CwASD). CASTOR integrates the concepts of soft actuators and compliant mechanisms to create a replicable robotic platform aimed at real therapy scenarios involving physical interaction between the children and the robot. The validation shows promising results in terms of robustness and the safety of the user and robot. Likewise, mechanical tests assess the robot’s response to blocking conditions for two critical modules (i.e., neck and arm) in interaction scenarios. Future works should focus on the validation of the robot’s effectiveness in the therapy of CwASD.

Examining joint attention with the use of humanoid robots-A new approach to study fundamental mechanisms of social cognition

This article reviews methods to investigate joint attention and highlights the benefits of new methodological approaches that make use of the most recent technological developments, such as humanoid robots for studying social cognition. After reviewing classical approaches that address joint attention mechanisms with the use of controlled screen-based stimuli, we describe recent accounts that have proposed the need for more natural and interactive experimental protocols. Although the recent approaches allow for more ecological validity, they often face the challenges of experimental control in more natural social interaction protocols. In this context, we propose that the use of humanoid robots in interactive protocols is a particularly promising avenue for targeting the mechanisms of joint attention. Using humanoid robots to interact with humans in naturalistic experimental setups has the advantage of both excellent experimental control and ecological validity. In clinical applications, it offers new techniques for both diagnosis and therapy, especially for children with autism spectrum disorder. The review concludes with indications for future research, in the domains of healthcare applications and human-robot interaction in general.

ICT and autism care: state of the art

PURPOSE OF REVIEW

Over the past 10 years, the use of information and communication technologies (ICTs) has increased in regard to the treatment of individuals with autism spectrum disorders (ASDs). ICT support mechanisms (e.g. computers, laptops, robots) are particularly attractive and are adapted to children with ASD. In addition, ICT algorithms can offer new perspectives for clinicians, outside direct apps or gaming proposals. Here, we will focus on the use of serious games and robots because of their attractiveness and their value in working on social skills.

RECENT FINDINGS

The latest knowledge regarding the use of ICT in the forms of serious games and robotics applied to individuals with ASD shows that the field of serious games has already achieved interesting and promising results, although the clinical validations are not always complete. In the field of robotics, there are still many limitations on the use of ICT (e.g. most interaction are similar to the wizard of Oz), and questions remain concerning their eventual effectiveness.

SUMMARY

To describe the implications of the findings for clinical practice or research, we describe two large projects, namely, JEMImE and Michelangelo, as examples of current studies that are aimed at enhancing social skills in children with ASD by including novel algorithms with clinical insights in robots or serious games.