Pilot clinical application of an adaptive robotic system for young children with autism

People with Autism Spectrum Disorder Could Interact More Easily with a Robot than with a Human: Reasons and Limits

Individuals with Autism Spectrum Disorder show deficits in communication and social interaction, as well as repetitive behaviors and restricted interests. Interacting with robots could bring benefits to this population, notably by fostering communication and social interaction. Studies even suggest that people with Autism Spectrum Disorder could interact more easily with a robot partner rather than a human partner. We will be looking at the benefits of robots and the reasons put forward to explain these results. The interest regarding robots would mainly be due to three of their characteristics: they can act as motivational tools, and they are simplified agents whose behavior is more predictable than that of a human. Nevertheless, there are still many challenges to be met in specifying the optimum conditions for using robots with individuals with Autism Spectrum Disorder.

Effectiveness of a Robot-Assisted Psychological Intervention for Children with Autism Spectrum Disorder

Difficulties with social interaction characterise children with Autism Spectrum Disorders and have a negative impact in their everyday life. Integrating a social-humanoid robot within the standard clinical treatment has been proven promising. The main aim of this randomised controlled study was to evaluate the effectiveness of a robot-assisted psychosocial intervention and the secondary aim was to investigate potential differences between a robot-assisted intervention group and a control group receiving intervention by humans only. The analysis of the results showed that robot-assisted intervention could be beneficial by improving children's psychosocial skills. This improvement was highlighted by neuropsychological testing and parent reporting. Group comparison only presented minimal statistically significant differences. The study underpins the potential of robot-assisted interventions to augment standard care.

Effectiveness of Robotic Intervention on Improving Social Development and Participation of Children with Autism Spectrum Disorder - A Randomised Controlled Trial

Evidence-based robotic intervention programmes for children with autism spectrum disorder (ASD) have been limited. As yet, there is insufficient evidence to inform therapists, teachers, and service providers on effectiveness of robotic intervention to enhance social development and participation of children with ASD in a real context. This study used a randomised controlled trial to test the efficacy of robotic intervention programmes in enhancing the social development and participation of children with ASD. 60 children with ASD were included. The participants were randomly assigned to the following groups: (1) robotic intervention programme (n = 20), (2) human-instructed programme (n = 20), and (3) control group (n = 20). Both the performance-based behavioural change in social communication and parent-reported change in social responsiveness were evaluated. The participants in the robotic intervention group demonstrated statistically significant changes in both the performance-based assessment and parent-reported change in social participation. Significant differences were found in the communication and reciprocal social interactions scores between the experimental group and the control and comparison groups in the performance-based assessment (p < 0.01). The effectiveness of robotic intervention programme to enhance the social communication and participation was confirmed. Future studies may also consider adding a maintenance phase to document how the effects of the intervention carry over to the participants over a longer period. (Clinical trial number: NCT04879303; Date of registration: 10 May 2021).

Breaking Barriers-The Intersection of AI and Assistive Technology in Autism Care: A Narrative Review

(Background) Autism increasingly requires a multidisciplinary approach that can effectively harmonize the realms of diagnosis and therapy, tailoring both to the individual. Assistive technologies (ATs) play an important role in this context and hold significant potential when integrated with artificial intelligence (AI). (Objective) The objective of this study is to analyze the state of integration of AI with ATs in autism through a review. (Methods) A review was conducted on PubMed and Scopus, applying a standard checklist and a qualification process. The outcome reported 22 studies, including 7 reviews. (Key Content and Findings) The results reveal an early yet promising interest in integrating AI into autism assistive technologies. Exciting developments are currently underway at the intersection of AI and robotics, as well as in the creation of wearable automated devices like smart glasses. These innovations offer substantial potential for enhancing communication, interaction, and social engagement for individuals with autism. Presently, researchers are prioritizing innovation over establishing a solid presence within the healthcare domain, where issues such as regulation and acceptance demand increased attention. (Conclusions) As the field continues to evolve, it becomes increasingly clear that AI will play a pivotal role in bridging various domains, and integrated ATs with AI are positioned to act as crucial connectors.

A social robot connected with chatGPT to improve cognitive functioning in ASD subjects

Neurodevelopmental Disorders (NDDs) represent a significant healthcare and economic burden for families and society. Technology, including AI and digital technologies, offers potential solutions for the assessment, monitoring, and treatment of NDDs. However, further research is needed to determine the effectiveness, feasibility, and acceptability of these technologies in NDDs, and to address the challenges associated with their implementation. In this work, we present the application of social robotics using a Pepper robot connected to the OpenAI system (Chat-GPT) for real-time dialogue initiation with the robot. After describing the general architecture of the system, we present two possible simulated interaction scenarios of a subject with Autism Spectrum Disorder in two different situations. Limitations and future implementations are also provided to provide an overview of the potential developments of interconnected systems that could greatly contribute to technological advancements for Neurodevelopmental Disorders (NDD).

Motor differences in autism during a human-robot imitative gesturing task

BACKGROUND

Difficulty with imitative gesturing is frequently observed as a clinical feature of autism. Current practices for assessment of imitative gesturing ability-behavioral observation and parent report-do not allow precise measurement of specific components of imitative gesturing performance, instead relying on subjective judgments. Advances in technology allow researchers to objectively quantify the nature of these movement differences, and to use less socially stressful interaction partners (e.g., robots). In this study, we aimed to quantify differences in imitative gesturing between autistic and neurotypical development during human-robot interaction.

METHODS

Thirty-five autistic (n = 19) and neurotypical (n = 16) participants imitated social gestures of an interactive robot (e.g., wave). The movements of the participants and the robot were recorded using an infrared motion-capture system with reflective markers on corresponding head and body locations. We used dynamic time warping to quantify the degree to which the participant's and robot's movement were aligned across the movement cycle and work contribution to determine how each joint angle was producing the movements.

FINDINGS

Results revealed differences between autistic and neurotypical participants in imitative accuracy and work contribution, primarily in the movements requiring unilateral extension of the arm. Autistic individuals imitated the robot less accurately and used less work at the shoulder compared to neurotypical individuals.

INTERPRETATION

These findings indicate differences in autistic participants' ability to imitate an interactive robot. These findings build on our understanding of the underlying motor control and sensorimotor integration mechanisms that support imitative gesturing in autism which may aid in identifying appropriate intervention targets.

Assistive Technology to Improve Collaboration in Children with ASD: State-of-the-Art and Future Challenges in the Smart Products Sector

Within the field of products for autism spectrum disorder, one of the main research areas is focused on the development of assistive technology. Mid and high-tech products integrate interactive and smart functions with multisensory reinforcements, making the user experience more intuitive, adaptable, and dynamic. These products have a very significant impact on improving the skills of children with autism, including collaboration and social skills, which are essential for the integration of these children into society and, therefore, their well-being. This work carried out an exhaustive analysis of the scientific literature, as well as market research and trends, and patent analysis to explore the state-of-the-art of assistive technology and smart products for children with ASD, specifically those aimed at improving social and communication skills. The results show a reduced availability of products that act as facilitators of the special needs of children with ASD, which is even more evident for products aimed at improving collaboration skills. Products that allow the participation of several users simultaneously through multi-user interfaces are required. On top of this, the trend toward virtual environments is leading to a loss of material aspects in the design that are essential for the development of these children.

“Sequencing Matters”: Investigating Suitable Action Sequences in Robot-Assisted Autism Therapy

Social robots have been shown to be promising tools for delivering therapeutic tasks for children with Autism Spectrum Disorder (ASD). However, their efficacy is currently limited by a lack of flexibility of the robot’s social behavior to successfully meet therapeutic and interaction goals. Robot-assisted interventions are often based on structured tasks where the robot sequentially guides the child towards the task goal. Motivated by a need for personalization to accommodate a diverse set of children profiles, this paper investigates the effect of different robot action sequences in structured socially interactive tasks targeting attention skills in children with different ASD profiles. Based on an autism diagnostic tool, we devised a robotic prompting scheme on a NAO humanoid robot, aimed at eliciting goal behaviors from the child, and integrated it in a novel interactive storytelling scenario involving screens. We programmed the robot to operate in three different modes: diagnostic-inspired (Assess), personalized therapy-inspired (Therapy), and random (Explore). Our exploratory study with 11 young children with ASD highlights the usefulness and limitations of each mode according to different possible interaction goals, and paves the way towards more complex methods for balancing short-term and long-term goals in personalized robot-assisted therapy.

ASDesign: A User-Centered Method for the Design of Assistive Technology That Helps Children with Autism Spectrum Disorders Be More Independent in Their Daily Routines

COVID-19 has posed new physical and mental challenges for the population worldwide, establishing social and structural changes in the labor market that could be maintained and implemented permanently. This new reality will require new strategies to improve family and work conciliation, which is especially challenging for families with children suffering from psychological pathologies such as autism spectrum disorder (ASD). These changes have led to more frequent and intense behavioral problems, causing stress, anxiety, and confusion for these children and their families. Thus, the need to have tools that help parents reconcile work with the care of these children, who have low autonomy, is reinforced. This work develops a method for the design of assistive technology and smart products to support children with ASD in following a routine and managing tasks autonomously. In this way, the article analyzes the design problem including the needs and preferences of children with ASD and their parents during confinement in terms of dependence and adaptability; develops a design method for interactive and smart products focused on children with ASD in confinement situations; and validates this method in a case study, in which a robot is developed that makes it easier for children with ASD to follow a routine.

Human-robot interaction for social skill development in children with ASD: A literature review

Human-robot interaction has been demonstrated to be a promising methodology for developing socio-communicational skills of children and adolescents with autism spectrum disorder (ASD). This paper systematically reviews studies that report experimental results on this topic published in scientific journals between the years 2010 and2018. A total of 1805 articles from various literature were filtered based on relevance and transparency. In the first set of criteria, article titles are screened and in the second both titles and abstracts. The final number of articles which were subsequently thoroughly reviewed was 32 (N = 32). The findings suggest that there are benefits in using human-robot interaction to assist with the development of social skills for children with ASD. Specifically, it was found that the majority of studies used humanoid robots, 64% relied on a small number of participants and sessions, while few of the studies included a control group or follow-up sessions. Based on these findings, this paper tried to identify areas that have not been extensively addressed to propose several directions for future improvements for studies in this field, such as control groups with typical developmental children, minimum number of sessions and participants, as well as standardization of criteria for assessing the level of functionality for ASD children.

A win-win situation: Does familiarity with a social robot modulate feedback monitoring and learning?

Social species rely on the ability to modulate feedback-monitoring in social contexts to adjust one's actions and obtain desired outcomes. When being awarded positive outcomes during a gambling task, feedback-monitoring is attenuated when strangers are rewarded, as less value is assigned to the awarded outcome. This difference in feedback-monitoring can be indexed by an event-related potential (ERP) component known as the Reward Positivity (RewP), whose amplitude is enhanced when receiving positive feedback. While the degree of familiarity influences the RewP, little is known about how the RewP and reinforcement learning are affected when gambling on behalf of familiar versus nonfamiliar agents, such as robots. This question becomes increasingly important given that robots may be used as teachers and/or social companions in the near future, with whom children and adults will interact with for short or long periods of time. In the present study, we examined whether feedback-monitoring when gambling on behalf of oneself compared with a robot is impacted by whether participants have familiarized themselves with the robot before the task. We expected enhanced RewP amplitude for self versus other for those who did not familiarize with the robot and that self-other differences in the RewP would be attenuated for those who familiarized with the robot. Instead, we observed that the RewP was larger when familiarization with the robot occurred, which corresponded to overall worse learning outcomes. We additionally observed an enhanced P3 effect for the high-familiarity condition, which suggests an increased motivation to reward. These findings suggest that familiarization with robots may cause a positive motivational effect, which positively affects RewP amplitudes, but interferes with learning.

Examining Social Cognition with Embodied Robots: Does Prior Experience with a Robot Impact Feedback-associated Learning in a Gambling Task?

Social agents rely on the ability to use feedback to learn and modify their behavior. The extent to which this happens in social contexts depends on motivational, cognitive and/or affective parameters. For instance, feedback-associated learning occurs at different rates when the outcome of an action (e.g., winning or losing in a gambling task) affects oneself (“Self”) versus another human (“Other”). Here, we examine whether similar context effects on feedback-associated learning can also be observed when the “other” is a social robot (here: Cozmo). We additionally examine whether a “hybrid” version of the gambling paradigm, where participants are free to engage in a dynamic interaction with a robot, then move to a controlled screen-based experiment can be used to examine social cognition in human-robot interaction. This hybrid method is an alternative to current designs where researchers examine the effect of the interaction on social cognition during the interaction with the robot. For that purpose, three groups of participants (n total = 60) interacted with Cozmo over different time periods (no interaction vs. a single 20 minute interaction in the lab vs. daily 20 minute interactions over five consecutive days at home) before performing the gambling task in the lab. The results indicate that prior interactions impact the degree to which participants benefit from feedback during the gambling task, with overall worse learning immediately after short-term interactions with the robot and better learning in the “Self” versus “Other” condition after repeated interactions with the robot. These results indicate that “hybrid” paradigms are a suitable option to investigate social cognition in human-robot interaction when a fully dynamic implementation (i.e., interaction and measurement dynamic) is not feasible.

Optimal robot for intervention for individuals with autism spectrum disorders

With recent rapid advances in technology, human-like robots have begun functioning in a variety of ways. As increasing anecdotal evidence suggests, robots may offer many unique opportunities for helping individuals with autism spectrum disorders (ASD). Individuals with ASD often achieve a higher degree of task engagement through the interaction with robots than through interactions with human trainees. The type and form of robots to be used for individuals with ASD have been meticulously considered. Simple robots and animal robots are acceptable because of their simplicity and the ease of interesting and engaging interactions. Android robots have the benefit of the potential of generalization into daily life to some extent. Considering the affinity between robots and users is important to draw out the potential capabilities of robotic intervention to the fullest extent. In the robotic condition, factors such as the appearance, biological motion, clothes, hairstyle, and disposition are important. Many factors of a user, such as age, sex, and IQ, may also affect the affinity of individuals with ASD toward a robot. The potential end-users of this technology may be unaware or unconvinced of the potential roles of robots in ASD interventions. If trainers have extensive experience in using robots, they can identify many potential roles of robots based on their experience. To date, only a few studies have been conducted in the field of robotics for providing assistance to individuals with ASD, and future studies are needed to realize an optimal robot for this purpose.

A map of assistive technology educative instruments in neurodevelopmental disorders

PURPOSE

The use of assistive technology in mental health has gained an increased interest over the last decades. A growing number of studies have investigated diverse applications of technological interventions for rehabilitation of children with neurodevelopmental disorders. This article presents a map of the technological devises applied as therapeutic instruments.

METHODS

The research question of this review was which technological applications could be referred as an educational instrument for the management of children with autism spectrum disorders (ASDs), intellectual disability and attention deficit disorder. The articles included in this review were collected after a structured literature search in electronic databases using keywords such as "Assistive Technology", "technology devices", "robots", "Autism Disorder", "Intellectual Disabilities" and "Mental Retardation".

RESULTS

Assistive technology with the most up-to-date devices and applications helps children with intellectual disability and ASDs enhance cognitive skills and improve challenging behaviour, social communication and academic performance. Different technological tools are used to foster attention span and improve time management skills in children with attention deficit syndrome.

CONCLUSION

It is important that therapists choose the instrument that will offer the best approach towards the goal that is set. Future research could provide evidence based data, evaluating each specific methodology and tailoring each therapeutic approach specifically to a case.IMPLICATIONS FOR REHABILITATIONTechnology creates environments in which children could practice and learn in a safer, more predictable and pleasant manner.Assistive Technologies provide the opportunity for better acquisition of selfhelp skills and the power of social interaction for individuals with disabilities.By mapping out the wide array of Assistive Technology that is available today, future applications for rehabilitation of children with neurodevelopmental disorders could help extend therapeutic strategies out of the clinical and school settings and into the home, thereby incorporating the family and emphasizing personalization.Future studies could develop a model for the choice and use of each tool, tailoring each therapeutic approach specifically to each case.

Social Robots to Test Flexibility of Human Social Cognition

As the field of social robotics has been dynamically growing and expanding over various areas of research and application, in which robots can be of assistance and companionship for humans, this paper offers a different perspective on a role that social robots can also play, namely the role of informing us about flexibility of human mechanisms of social cognition. The paper focuses on studies in which robots have been used as a new type of "stimuli" in psychological experiments to examine whether similar mechanisms of social cognition would be activated in interaction with a robot, as would be elicited in interaction with another human. Analysing studies in which a direct comparison has been made between a robot and a human agent, the paper examines whether for robot agents, the brain re-uses the same mechanisms that have been developed for interaction with other humans in terms of perception, action representation, attention and higher-order social cognition. Based on this analysis, the paper concludes that the human socio-cognitive mechanisms, in adult brains, are sufficiently flexible to be re-used for robotic agents, at least for those that have some level of resemblance to humans.

Adherence and acceptability of a robot-assisted Pivotal Response Treatment protocol for children with autism spectrum disorder

The aim of this study is to present a robot-assisted therapy protocol for children with ASD based on the current state-of-the-art in both ASD intervention research and robotics research, and critically evaluate its adherence and acceptability based on child as well as parent ratings. The robot-assisted therapy was designed based on motivational components of Pivotal Response Treatment (PRT), a highly promising and feasible intervention focused at training “pivotal” (key) areas such as motivation for social interaction and self-initiations, with the goal of establishing collateral gains in untargeted areas of functioning and development, affected by autism spectrum disorders. Overall, children (3–8 y) could adhere to the robot-assisted therapy protocol (Mean percentage of treatment adherence 85.5%), showed positive affect ratings after therapy sessions (positive in 86.6% of sessions) and high robot likability scores (high in 79.4% of sessions). Positive likability ratings were mainly given by school-aged children (H(1) = 7.91, p = .005) and related to the movements, speech and game scenarios of the robot. Parent ratings on the added value of the robot were mainly positive (Mean of 84.8 on 0–100 scale), while lower parent ratings were related to inflexibility of robot behaviour.

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.

Differences in Spontaneous Interactions of Autistic Children in an Interaction With an Adult and Humanoid Robot

Robots are promising tools for promoting engagement of autistic children in interventions and thereby increasing the amount of learning opportunities. However, designing deliberate robot behavior aimed at engaging autistic children remains challenging. Our current understanding of what interactions with a robot, or facilitated by a robot, are particularly motivating to autistic children is limited to qualitative reports with small sample sizes. Translating insights from these reports to design is difficult due to the large individual differences among autistic children in their needs, interests, and abilities. To address these issues, we conducted a descriptive study and report on an analysis of how 31 autistic children spontaneously interacted with a humanoid robot and an adult within the context of a robot-assisted intervention, as well as which individual characteristics were associated with the observed interactions. For this analysis, we used video recordings of autistic children engaged in a robot-assisted intervention that were recorded as part of the DE-ENIGMA database. The results showed that the autistic children frequently engaged in exploratory and functional interactions with the robot spontaneously, as well as in interactions with the adult that were elicited by the robot. In particular, we observed autistic children frequently initiating interactions aimed at making the robot do a certain action. Autistic children with stronger language ability, social functioning, and fewer autism spectrum-related symptoms, initiated more functional interactions with the robot and more robot-elicited interactions with the adult. We conclude that the children's individual characteristics, in particular the child's language ability, can be indicative of which types of interaction they are more likely to find interesting. Taking these into account for the design of deliberate robot behavior, coupled with providing more autonomy over the robot's behavior to the autistic children, appears promising for promoting engagement and facilitating more learning opportunities.

Review of assistive technology in the training of children with autism spectrum disorders

The use of socially assistive robotics (SARs) is a promising method for improving the social skills of children with autism spectrum disorder (ASD). Studies conducted in this field in recent years show that the use of robots as collaborators may have positive effects on the development of social skills in children with ASD, especially in those areas where they reveal great deficits. In this literature review, we present, organize and evaluate the most important features and results of 13 relevant scientific articles. In analysis of the research findings we explored the documented effectiveness of robotics in enhancing the social skills of children with ASD in the areas of mutual attention, verbal communication and imitation skills, and also in the reduction of stereotypical behavior. Analysis of the results of the 13 studies confirmed that robots can have positive immediate effects on the communication skills of children with ASD, which holds promise for future intervention programs and relevant research.

Interactive video-player to improve social smile in individuals with autism spectrum disorder

Purpose

The purpose of this paper is to propose and develop a live interaction-based video player system named LIV4Smile for the improvement of the social smile in individuals with autism spectrum disorder (ASD).

Design/methodology/approach

The proposed LIV4Smile intervention was a video player that operated by detecting smile using a convolutional neural network (CNN)-based algorithm. To maintain a live interaction, a CNN-based smile detector was configured and used in this system. The statistical test was also conducted to validate the performance of the system.

Findings

The significant improvement was observed in smile responses of individuals with ASD with the utilization of the proposed LIV4Smile system in a real-time environment.

Research limitations/implications

A small sample size and clinical utilizing for validation and initial training of ASD individuals for LIV4Smile could be considered under implications.

Originality/value

The main aim of this study was to address the inclusive practices for children with autism. The proposed CNN algorithm-based LIV4Smile intervention resulted in high accuracy in facial smile detection.

Interaction With Social Robots: Improving Gaze Toward Face but Not Necessarily Joint Attention in Children With Autism Spectrum Disorder

It is widely recognized that robot-based interventions for autism spectrum disorders (ASD) hold promise, but the question remains as to whether social humanoid robots could facilitate joint attention performance in children with ASD. In this study, responsive joint attention was measured under two conditions in which different agents, a human and a robot, initiated joint attention via video. The participants were 15 children with ASD (mean age: 4.96 ± 1.10 years) and 15 typically developing (TD) children (mean age: 4.53 ± 0.90 years). In addition to analyses of fixation time and gaze transitions, a longest common subsequence approach (LCS) was employed to compare participants' eye movements to a predefined logical reference sequence. The fixation of TD toward agent's face was earlier and longer than children with ASD. Moreover, TD showed a greater number of gaze transitions between agent's face and target, and higher LCS scores than children with ASD. Both groups showed more interests in the robot's face, but the robot induced a lower proportion of fixation time on the target. Meanwhile participants showed similar gaze transitions and LCS results in both conditions, suggesting that they could follow the logic of the joint attention task induced by the robot as well as human. We have discussed the implications for the effects and applications of social humanoid robots in joint attention interventions.

High-functioning autistic children programming robotic behaviour

Purpose

The purpose of this paper is to examine the ability of high-functioning autistic (HFA) children to programme robotic behaviour and sought to elucidate how they describe and construct a robot’s behaviour using iconic programming software.

Design/methodology/approach

The robotic learning environment is based on the iPad, an iconic programming app (KinderBot), and EV3. Two case studies, of A. and N., both HFA children of average age 10.5, are the focus of this research.

Findings

The research revealed how the participants succeeded in programming the behaviour of an “other” at different programming complexity levels (from simple action to combinations of states of two binary sensors and rule with subroutine). A transformation from procedural to declarative description was also found.

Practical implications

This research on the ability of HFA children to programme robotic behaviour yielded results that can be implemented in K-12 education. Furthermore, learning to programme robots and understand how robotic technologies work may help HFA children to better understand other technology in their environment.

Originality/value

In this research, the authors present an innovative approach that for the first time enables HFA children to “design” the behaviour of smart artefacts to use their sensors to adapt in accordance with the environment. For most HFA children, this would be the first opportunity to “design” the behaviour of the other, as opposed to oneself, since in most of their experience they have been largely controlled by another person.

Brief Report: Evaluating the Utility of Varied Technological Agents to Elicit Social Attention from Children with Autism Spectrum Disorders

Technological agents could be effective tools to be used in interventions for enhancing social orienting for some young children with ASD. We examined response to social bids in preschool children with ASD and typical development (TD) at a very early age (i.e., around 3 years) using social prompts presented by technological agents of various forms and human comparisons. Children with ASD demonstrated less response overall to social bids compared to TD controls, across agents or human. They responded more often to a simple humanoid robot and the simple avatar compared to the human. These results support the potential utilization of specific robotic and technological agents for harnessing and potentially increasing motivation to socially-relevant behaviors in some young children with ASD.

Who is a better teacher for children with autism? Comparison of learning outcomes between robot-based and human-based interventions in gestural production and recognition

BACKGROUND

Individuals with autism spectrum disorder (ASD) tend to show deficits in engaging with humans. Previous findings have shown that robot-based training improves the gestural recognition and production of children with ASD. It is not known whether social robots perform better than human therapists in teaching children with ASD.

AIMS

The present study aims to compare the learning outcomes in children with ASD and intellectual disabilities from robot-based intervention on gestural use to those from human-based intervention.

METHODS AND PROCEDURES

Children aged six to 12 with low-functioning autism were randomly assigned to the robot group (N = 12) and human group (N = 11). In both groups, human experimenters or social robots engaged in daily life conversations and demonstrated to children 14 intransitive gestures in a highly-structured and standardized intervention protocol.

OUTCOMES AND RESULTS

Children with ASD in the human group were as likely to recognize gestures and produce them accurately as those in the robot group in both training and new conversations. Their learning outcomes maintained for at least two weeks.

CONCLUSIONS AND IMPLICATIONS

The social cues found in the human-based intervention might not influence gestural learning. It does not matter who serves as teaching agents when the lessons are highly structured.

Project INSIDE: towards autonomous semi-unstructured human-robot social interaction in autism therapy

This paper describes the INSIDE system, a networked robot system designed to allow the use of mobile robots as active players in the therapy of children with autism spectrum disorders (ASD). While a significant volume of work has explored the impact of robots in ASD therapy, most such work comprises remotely operated robots and/or well-structured interaction dynamics. In contrast, the INSIDE system allows for complex, semi-unstructured interaction in ASD therapy while featuring a fully autonomous robot. In this paper we describe the hardware and software infrastructure that supports such rich form of interaction, as well as the design methodology that guided the development of the INSIDE system. We also present some results on the use of our system both in pilot and in a long-term study comprising multiple therapy sessions with children at Hospital Garcia de Orta, in Portugal, highlighting the robustness and autonomy of the system as a whole.

The impact of robotic intervention on joint attention in children with autism spectrum disorders

Background

A growing body of anecdotal evidence indicates that the use of robots may provide unique opportunities for assisting children with autism spectrum disorders (ASD). However, previous studies investigating the effects of interventions using robots on joint attention (JA) in children with ASD have shown insufficient results. The robots used in these studies could not turn their eyes, which was a limitation preventing the robot from resembling a human agent.

Methods

We compared the behavior of children with ASD with that of children with typical development (TD) during a JA elicitation task while the children interacted with either a human or a robotic agent. We used the robot "CommU," which has clear eyes and can turn its eyes, for the robotic intervention. The age range of the participants was limited to 5-6 years.

Results

Sixty-eight participants participated in this study, including 30 (10 females and 20 males) children with ASD and 38 (13 females and 25 males) children with TD. The participants were randomly assigned to one of the following two groups: the robotic intervention group or the control group. JA in the children with ASD was better during the robotic intervention than during the human agent intervention. These children exhibited improved performance in the JA task with human after interacting with the robot CommU. JA was differentially facilitated by the human and robotic agents between the ASD and TD children.

Conclusions

The findings of this study significantly contribute to the literature on the impact of robots on JA and provide information regarding the suitability of specific robot types for therapeutic use.

A pilot study for robot appearance preferences among high-functioning individuals with autism spectrum disorder: Implications for therapeutic use

Recent rapid technological advances have enabled robots to fulfill a variety of human-like functions, leading researchers to propose the use of such technology for the development and subsequent validation of interventions for individuals with autism spectrum disorder (ASD). Although a variety of robots have been proposed as possible therapeutic tools, the physical appearances of humanoid robots currently used in therapy with these patients are highly varied. Very little is known about how these varied designs are experienced by individuals with ASD. In this study, we systematically evaluated preferences regarding robot appearance in a group of 16 individuals with ASD (ages 10–17). Our data suggest that there may be important differences in preference for different types of robots that vary according to interaction type for individuals with ASD. Specifically, within our pilot sample, children with higher-levels of reported ASD symptomatology reported a preference for specific humanoid robots to those perceived as more mechanical or mascot-like. The findings of this pilot study suggest that preferences and reactions to robotic interactions may vary tremendously across individuals with ASD. Future work should evaluate how such differences may be systematically measured and potentially harnessed to facilitate meaningful interactive and intervention paradigms.

Robots As Intentional Agents: Using Neuroscientific Methods to Make Robots Appear More Social

Robots are increasingly envisaged as our future cohabitants. However, while considerable progress has been made in recent years in terms of their technological realization, the ability of robots to interact with humans in an intuitive and social way is still quite limited. An important challenge for social robotics is to determine how to design robots that can perceive the user's needs, feelings, and intentions, and adapt to users over a broad range of cognitive abilities. It is conceivable that if robots were able to adequately demonstrate these skills, humans would eventually accept them as social companions. We argue that the best way to achieve this is using a systematic experimental approach based on behavioral and physiological neuroscience methods such as motion/eye-tracking, electroencephalography, or functional near-infrared spectroscopy embedded in interactive human-robot paradigms. This approach requires understanding how humans interact with each other, how they perform tasks together and how they develop feelings of social connection over time, and using these insights to formulate design principles that make social robots attuned to the workings of the human brain. In this review, we put forward the argument that the likelihood of artificial agents being perceived as social companions can be increased by designing them in a way that they are perceived as intentional agents that activate areas in the human brain involved in social-cognitive processing. We first review literature related to social-cognitive processes and mechanisms involved in human-human interactions, and highlight the importance of perceiving others as intentional agents to activate these social brain areas. We then discuss how attribution of intentionality can positively affect human-robot interaction by (a) fostering feelings of social connection, empathy and prosociality, and by (b) enhancing performance on joint human-robot tasks. Lastly, we describe circumstances under which attribution of intentionality to robot agents might be disadvantageous, and discuss challenges associated with designing social robots that are inspired by neuroscientific principles.

Embodied Conversational Agents in Clinical Psychology: A Scoping Review

Background

Embodied conversational agents (ECAs) are computer-generated characters that simulate key properties of human face-to-face conversation, such as verbal and nonverbal behavior. In Internet-based eHealth interventions, ECAs may be used for the delivery of automated human support factors.

Objective

We aim to provide an overview of the technological and clinical possibilities, as well as the evidence base for ECA applications in clinical psychology, to inform health professionals about the activity in this field of research.

Methods

Given the large variety of applied methodologies, types of applications, and scientific disciplines involved in ECA research, we conducted a systematic scoping review. Scoping reviews aim to map key concepts and types of evidence underlying an area of research, and answer less-specific questions than traditional systematic reviews. Systematic searches for ECA applications in the treatment of mood, anxiety, psychotic, autism spectrum, and substance use disorders were conducted in databases in the fields of psychology and computer science, as well as in interdisciplinary databases. Studies were included if they conveyed primary research findings on an ECA application that targeted one of the disorders. We mapped each study’s background information, how the different disorders were addressed, how ECAs and users could interact with one another, methodological aspects, and the study’s aims and outcomes.

Results

This study included N=54 publications (N=49 studies). More than half of the studies (n=26) focused on autism treatment, and ECAs were used most often for social skills training (n=23). Applications ranged from simple reinforcement of social behaviors through emotional expressions to sophisticated multimodal conversational systems. Most applications (n=43) were still in the development and piloting phase, that is, not yet ready for routine practice evaluation or application. Few studies conducted controlled research into clinical effects of ECAs, such as a reduction in symptom severity.

Conclusions

ECAs for mental disorders are emerging. State-of-the-art techniques, involving, for example, communication through natural language or nonverbal behavior, are increasingly being considered and adopted for psychotherapeutic interventions in ECA research with promising results. However, evidence on their clinical application remains scarce. At present, their value to clinical practice lies mostly in the experimental determination of critical human support factors. In the context of using ECAs as an adjunct to existing interventions with the aim of supporting users, important questions remain with regard to the personalization of ECAs’ interaction with users, and the optimal timing and manner of providing support. To increase the evidence base with regard to Internet interventions, we propose an additional focus on low-tech ECA solutions that can be rapidly developed, tested, and applied in routine practice.

The effects of embodied rhythm and robotic interventions on the spontaneous and responsive verbal communication skills of children with Autism Spectrum Disorder (ASD): A further outcome of a pilot randomized controlled trial

The current manuscript is the second in a mini-series of manuscripts reporting the effects of alternative, movement-based, rhythm and robotic interventions on the social communication skills of 36 school-age children with ASD. This pilot randomized controlled trial compared the effects of 8-weeks of rhythm and robotic interventions to those of a standard-of-care, comparison intervention. The first manuscript reported intervention effects on the spontaneous and responsive social attention skills of children. In this manuscript, we report intervention effects on the spontaneous and responsive verbal communication skills of children. Communication skills were assessed within a standardized test of responsive communication during the pretest and posttest as well as using training-specific measures of social verbalization during early, mid, and late training sessions. The rhythm and comparison groups improved on the standardized test in the posttest compared to the pretest. The rhythm and robot groups increased levels of social verbalization across training sessions. Movement-based and stationary contexts afforded different types and amounts of communication in children with ASD. Overall, movement-based interventions are a promising tool to enhance verbal and non-verbal communication skills in children with ASD.

Mapping Robots to Therapy and Educational Objectives for Children with Autism Spectrum Disorder

The aim of this study was to increase knowledge on therapy and educational objectives professionals work on with children with autism spectrum disorder (ASD) and to identify corresponding state of the art robots. Focus group sessions (n = 9) with ASD professionals (n = 53) from nine organisations were carried out to create an objectives overview, followed by a systematic literature study to identify state of the art robots matching these objectives. Professionals identified many ASD objectives (n = 74) in 9 different domains. State of the art robots addressed 24 of these objectives in 8 domains. Robots can potentially be applied to a large scope of objectives for children with ASD. This objectives overview functions as a base to guide development of robot interventions for these children.

Can Robotic Interaction Improve Joint Attention Skills?

Although it has often been argued that clinical applications of advanced technology may hold promise for addressing impairments associated with autism spectrum disorder (ASD), relatively few investigations have indexed the impact of intervention and feedback approaches. This pilot study investigated the application of a novel robotic interaction system capable of administering and adjusting joint attention prompts to a small group (n = 6) of children with ASD. Across a series of four sessions, children improved in their ability to orient to prompts administered by the robotic system and continued to display strong attention toward the humanoid robot over time. The results highlight both potential benefits of robotic systems for directed intervention approaches as well as potent limitations of existing humanoid robotic platforms.

Autism and social robotics: A systematic review

Social robotics could be a promising method for Autism Spectrum Disorders (ASD) treatment. The aim of this article is to carry out a systematic literature review of the studies on this topic that were published in the last 10 years. We tried to address the following questions: can social robots be a useful tool in autism therapy? We followed the PRISMA guidelines, and the protocol was registered within PROSPERO database (CRD42015016158). We found many positive implications in the use of social robots in therapy as for example: ASD subjects often performed better with a robot partner rather than a human partner; sometimes, ASD patients had, toward robots, behaviors that TD patients had toward human agents; ASDs had a lot of social behaviors toward robots; during robotic sessions, ASDs showed reduced repetitive and stereotyped behaviors and, social robots manage to improve spontaneous language during therapy sessions. Therefore, robots provide therapists and researchers a means to connect with autistic subjects in an easier way, but studies in this area are still insufficient. It is necessary to clarify whether sex, intelligence quotient, and age of participants affect the outcome of therapy and whether any beneficial effects only occur during the robotic session or if they are still observable outside the clinical/experimental context.

A comparison of the effects of rhythm and robotic interventions on repetitive behaviors and affective states of children with Autism Spectrum Disorder (ASD)

Repetitive behaviors and poor affect regulation are commonly seen in children with Autism Spectrum Disorder (ASD). We compared the effects of two novel interventions - rhythm and robotic therapies, with those of a standard-of-care intervention, on the repetitive behaviors and affective states of 36 children with ASD between 5 and 12 years using a randomized controlled trial design. We coded for frequencies of sensory, negative, and stereotyped behaviors and the duration of positive, negative, and interested affective states in children during early, mid, and late training sessions. In terms of repetitive behaviors, in the early session, the rhythm and robot groups engaged in greater negative behaviors, whereas the comparison group engaged in greater sensory behaviors. With training, the rhythm group reduced negative behaviors whereas there were no training-related changes in the other groups. In terms of affective states, the rhythm and robot groups showed greater negative affect, whereas the comparison group demonstrated greater interested affect across all sessions. With training, the rhythm group showed a reduction in negative affect and an increase in interested affect whereas the robot group showed a reduction in positive affect. Overall, it appears that rhythm-based interventions are socially engaging treatment tools to target core impairments in autism.

Impact of robot-mediated interaction system on joint attention skills for children with autism

With Centers for Disease Control and Prevention prevalence estimates for children with autism spectrum disorder 1 in 88, identification and effective treatment of autism spectrum disorder (ASD) is often characterized as a public health emergency. There is an urgent need for more efficacious treatments whose realistic application will yield more substantial impact on the neurodevelopmental trajectories of young children with ASD. Robotic technology appears particularly promising for potential application to ASD intervention. Initial results applying robotic technology to ASD intervention have consistently demonstrated a unique potential to elicit interest and attention in young children with ASD. As such, technologies capable of intelligently harnessing this potential, along with capabilities for detecting and meaningfully responding to young children's attention and behavior, may represent intervention platforms with substantial promise for impacting early symptoms of ASD. Our current work describes development and application of a novel adaptive robot-mediated interaction technology for facilitating early joint attention skills for children with ASD. The system is composed of a humanoid robot endowed with a prompt decision hierarchy to alter behavior in concert with reinforcing stimuli within an intervention environment to promote joint attention skills. Results of implementation of this system over time, including specific analyses of attentional bias and performance enhancement, with 6 young children with ASD are presented.