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Zhang X, Song XK, So WC. Examining Phenotypical Heterogeneity and its Underlying Factors in Gesture Skills of Chinese Autistic Children: Clustering Analysis. J Autism Dev Disord 2024; 54:3504-3515. [PMID: 37642873 DOI: 10.1007/s10803-023-06049-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2023] [Indexed: 08/31/2023]
Abstract
PURPOSE The heterogeneity of autism is well documented, but few studies have studied the heterogeneity of gesture production ability in autistic children. The present study aimed to identify subgroups of autistic children who displayed heterogeneous gesture production abilities and explore the underlying factors, including autism characteristics, intellectual ability, and language ability, that were associated with the heterogeneity. METHODS A total of 65 Chinese autistic children (mean age = 5;3) participated. Their autism characteristics and intellectual ability were assessed by standardized measurements. Language output and gesture production were captured from a parent-child interaction task. RESULTS We conducted a hierarchical cluster analysis and identified four distinct clusters. Cluster 1 and Cluster 2 both had low gesture production whereas Cluster 3 and Cluster 4 had high gesture production. Both Clusters 1 and 2 had relatively strong autism characteristics, in comparison to Clusters 3 and 4. CONCLUSIONS Our findings revealed that children with stronger autism characteristics may gesture less often than those with weaker characteristics. However, the relationship between language ability and intellectual ability and gesture production was not clear. These findings shed light on the directions of intervention on gesture production for autistic children, especially those with stronger autism characteristics.
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Affiliation(s)
- Xin Zhang
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, The People's Republic of China.
| | - Xue-Ke Song
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, The People's Republic of China
| | - Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin, NT, Hong Kong SAR, The People's Republic of China
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Zhang X, Song XK, So WC. The Development of Gesture Skills in Chinese Autistic Children: The Predictive Roles of Age and Language Ability. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2024; 67:2583-2599. [PMID: 39038241 DOI: 10.1044/2024_jslhr-23-00241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/24/2024]
Abstract
PURPOSE Gesture delay in autistic infants and toddlers has been widely reported. The developmental trajectory of gesture production during early childhood is understudied. Thus, little is known about the possible changes of gesture production over time. The present study aimed to document the development of gesture production in autistic children and examine whether child-based factors (chronological age and initial language skills) predicted gesture development. METHOD A total of 33 Chinese-speaking autistic children (Mage = 56.39 months, SD = 8.54 months) played with their parents at four time points over a 9-month period. Their speech was transcribed, and their gestures were coded from parent-child interaction. Multilevel modeling analysis was used to investigate the development of gesture and its associated factors. RESULTS The total number of gestures produced by autistic children decreased over time. Among different factors, children's initial age significantly and negatively predicted children's gesture production, while initial language positively predicted children's gesture production. CONCLUSIONS Gesture delay persists in preschool age. The decline in gesture production was associated with children's age and initial language ability. These findings shed light on the difficulties surrounding gesture use in autistic children.
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Affiliation(s)
- Xin Zhang
- Department of Educational Psychology, The Chinese University of Hong Kong, China
| | - Xue-Ke Song
- Department of Educational Psychology, The Chinese University of Hong Kong, China
| | - Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, China
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Gómez-Espinosa A, Moreno JC, Pérez-de la Cruz S. Assisted Robots in Therapies for Children with Autism in Early Childhood. SENSORS (BASEL, SWITZERLAND) 2024; 24:1503. [PMID: 38475039 PMCID: PMC10934187 DOI: 10.3390/s24051503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/31/2023] [Revised: 02/22/2024] [Accepted: 02/24/2024] [Indexed: 03/14/2024]
Abstract
Children with autism spectrum disorder (ASD) have deficits that affect their social relationships, communication, and flexibility in reasoning. There are different types of treatment (pharmacological, educational, psychological, and rehabilitative). Currently, one way to address this problem is by using robotic systems to address the abilities that are altered in these children. The aim of this review will be to analyse the effectiveness of the incorporation of the different robotic systems currently existing in the treatment of children up to 10 years of age diagnosed with autism. A systematic review has been carried out in the PubMed, Scopus, Web of Science, and Dialnet databases, with the following descriptors: child, autism, and robot. The search yielded 578 papers, and nine were selected after the application of the PRISMA guideline. The quality of the studies was analysed with the PEDRo scale, and only those with a score between four and six were selected. From this study, the conclusion is that the use of robots, in general, improves children's behaviour in the short term, but longer-term experiences are necessary to achieve more conclusive results.
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Affiliation(s)
- Ana Gómez-Espinosa
- Department of Informatics, University of Almería, ceiA3, CIESOL, 04120 Almería, Spain;
| | - José Carlos Moreno
- Department of Informatics, University of Almería, ceiA3, CIESOL, 04120 Almería, Spain;
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Dubois-Sage M, Jacquet B, Jamet F, Baratgin J. People with Autism Spectrum Disorder Could Interact More Easily with a Robot than with a Human: Reasons and Limits. Behav Sci (Basel) 2024; 14:131. [PMID: 38392485 PMCID: PMC10886012 DOI: 10.3390/bs14020131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2023] [Revised: 02/02/2024] [Accepted: 02/04/2024] [Indexed: 02/24/2024] Open
Abstract
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.
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Affiliation(s)
- Marion Dubois-Sage
- Laboratoire Cognitions Humaine et Artificielle, RNSR 200515259U, UFR de Psychologie, Université Paris 8, 93526 Saint-Denis, France
| | - Baptiste Jacquet
- Laboratoire Cognitions Humaine et Artificielle, RNSR 200515259U, UFR de Psychologie, Université Paris 8, 93526 Saint-Denis, France
- Association P-A-R-I-S, 75005 Paris, France
| | - Frank Jamet
- Laboratoire Cognitions Humaine et Artificielle, RNSR 200515259U, UFR de Psychologie, Université Paris 8, 93526 Saint-Denis, France
- Association P-A-R-I-S, 75005 Paris, France
- UFR d'Éducation, CY Cergy Paris Université, 95000 Cergy-Pontoise, France
| | - Jean Baratgin
- Laboratoire Cognitions Humaine et Artificielle, RNSR 200515259U, UFR de Psychologie, Université Paris 8, 93526 Saint-Denis, France
- Association P-A-R-I-S, 75005 Paris, France
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Kewalramani S, Allen KA, Leif E, Ng A. A Scoping Review of the Use of Robotics Technologies for Supporting Social-Emotional Learning in Children with Autism. J Autism Dev Disord 2023:10.1007/s10803-023-06193-2. [PMID: 38017310 DOI: 10.1007/s10803-023-06193-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
This scoping review synthesises the current research into robotics technologies for promoting social-emotional learning in children with autism spectrum disorder. It examines the types of robotics technologies employed, their applications, and the gaps in the existing literature. Our scoping review adhered to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) reporting guidelines. The systematic search of relevant databases allowed us to identify studies that use robotics technologies for fostering social, emotional, and cognitive skills in young children with autism. Our review has revealed that various robots, such as Nao, Kaspar, and Zeno, have been used to support the development of social and emotional skills through imitation games, turn-taking, joint attention, emotional recognition, and conversation. As most of these studies were conducted in clinical settings, there is a need for further research in classroom and community-based environments. Additionally, the literature calls for more high-quality longitudinal studies to assess the long-term effectiveness and sustainability of robot-assisted therapy and to assess adaptive and personalised interventions tailored to individual needs. More emphasis is recommended on professional development for educators, parents, and health professionals to incorporate robotics technologies as evidence-based interventions as a pathway for creating inclusive learning environments for children with autism.
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Affiliation(s)
- Sarika Kewalramani
- Department of Education, School of Social Sciences Media Film and Education, Swinburne University of Technology, Hawthorn, 3122, Australia.
| | - Kelly-Ann Allen
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
- Centre for Wellbeing Science, Melbourne Graduate School of Education, University of Melbourne, Melbourne, Australia
| | - Erin Leif
- School of Educational Psychology and Counselling, Faculty of Education, Monash University, Clayton, Australia
| | - Andrea Ng
- Department of Education, School of Social Sciences Media Film and Education, Swinburne University of Technology, Hawthorn, 3122, Australia
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Scarcella I, Marino F, Failla C, Doria G, Chilà P, Minutoli R, Vetrano N, Vagni D, Pignolo L, Di Cara M, Settimo C, Quartarone A, Cerasa A, Pioggia G. Information and communication technologies-based interventions for children with autism spectrum conditions: a systematic review of randomized control trials from a positive technology perspective. Front Psychiatry 2023; 14:1212522. [PMID: 37547218 PMCID: PMC10398379 DOI: 10.3389/fpsyt.2023.1212522] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2023] [Accepted: 07/07/2023] [Indexed: 08/08/2023] Open
Abstract
Information and communication technologies (ICTs) have become more widely used in the past years to help people with autism spectrum conditions (ASC). Serious games embedded into computers or tablets, as well as social robots, are the most employed ICT-related tools that are appealing to and appropriate for autistic children. The goal of ICT applications is to enhance behavioral abnormalities associated with ASC while also creating an interactive link between one person and one computer. Comparatively, to human-based therapy, ICT tools aid to inspire autistic children by providing predictability and regularity of tasks. Regaining social skills is the primary behavioral goal for which ICT tools have been designed and implemented. In the past several years, many studies have been created to show how effective it is at improving targeted behaviors. However, only a small number of researchers have used an RCT approach to evaluate its effectiveness. In this systematic review, we only included RCT studies where ICT technologies were used to help children with ASC in improving their social skills. Only 14 RCT studies satisfied the criteria and 12 described significant improvements, showing how the use of technology in educational contexts produced better improvement in developing several social skill facets with respect to the traditional face-to-face approach. Some studies used interventions and outcome measures focused on the core ASC symptoms, but many others addressed neurocognitive functions directly, like social cognition or emotional regulation, while other more general functions such as language or adaptive behaviors. We propose a classification based on processes and outcome measures to foster future research in this specific area of research. The behavioral intervention mediated by technological tools such as computer-based, tablet, and social robotics, undoubtedly provides a comfortable environment that promotes constant learning for people with ASC. Evidence provided in this review highlights the translational potential of this field of study in primary care practice and educational settings.
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Affiliation(s)
- Ileana Scarcella
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Flavia Marino
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | - Chiara Failla
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Kore University of Enna, Enna, Italy
| | - Germana Doria
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Paola Chilà
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Roberta Minutoli
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Faculty of Psychology, International Telematic University Uninettuno, Rome, Italy
| | - Noemi Vetrano
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- Department of Cognitive, Psychological Science and Cultural Studies, University of Messina, Messina, Italy
| | - David Vagni
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
| | | | | | | | | | - Antonio Cerasa
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
- S'Anna Institute, Crotone, Italy
- Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, Rende, Italy
| | - Giovanni Pioggia
- Institute for Biomedical Research and Innovation (IRIB), National Research Council of Italy (CNR), Messina, Italy
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So WC, Cheng CH, Law WW, Wong T, Lee C, Kwok FY, Lee SH, Lam KY. Robot dramas may improve joint attention of Chinese-speaking low-functioning children with autism: stepped wedge trials. Disabil Rehabil Assist Technol 2023; 18:195-204. [PMID: 33186058 DOI: 10.1080/17483107.2020.1841836] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
INTRODUCTION Children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention. Previous research has found that these children are interested in engaging with social robots. PURPOSE In the present study, we designed a robot drama intervention for promoting responses to joint attention abilities (RJA) of children with low-functioning autism (IQs < 70). MATERIALS AND METHODS Using a stepped wedge design, Chinese-speaking children aged six to eight were randomly assigned to three tiers (N = 18). Children of all three tiers had comparable autism severity, language and cognitive function, and joint attention abilities. Tier 1 first received intervention, followed by Tiers 2 and 3. They watched six dramas in which social robots demonstrated RJA behaviours. RESULTS The RJA of children of all tiers improved after intervention and such improvement was maintained over time. Despite initiation of joint attention (IJA) not being explicitly taught, IJA of all children was found to improve after intervention. CONCLUSIONS It was, therefore, concluded that a robot drama could enhance the joint attention of children with low-functioning ASD.Implications for rehabilitationIn comparison to typically developing children, children with autism spectrum disorder (ASD), especially those with low cognitive functioning, have deficits in joint attention.Robot-based drama intervention program was developed to promote responses to joint attention (RJA) abilities of children with low-functioning autism (IQs < 70).Modelling RJA in robot dramas can promote RJA abilities in these children.An improvement in RJA also yielded an increase in the initiation of joint attention (IJA) abilities.Children with low-functioning autism might be able to extract the initiation of joint attention skills from the drama, even though these behaviours were not explicitly taught.
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Affiliation(s)
- Wing-Chee So
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Chun-Ho Cheng
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Wing-Wun Law
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Tiffany Wong
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Cassandra Lee
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Fai-Yeung Kwok
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Shing-Hey Lee
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
| | - Ka-Yee Lam
- Department of Educational Psychology, Faculty of Education, The Chinese University of Hong Kong, New Territories, Hong Kong
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Huang Y, Wong MKY, Lam WY, Cheng CH, So WC. What affects gestural learning in children with and without Autism? The role of prior knowledge and imitation. RESEARCH IN DEVELOPMENTAL DISABILITIES 2022; 129:104305. [PMID: 35868200 DOI: 10.1016/j.ridd.2022.104305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/26/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
The present study examined whether prior knowledge to the learning target and imitation during learning affected learning outcomes in preschool children with autism spectrum disorder (ASD, N = 22) compared to their typically developing (TD, N = 15) peers. Children's gestural skills in recognizing and producing the target gestures before and after the training, as well as their imitative behavior during the training were coded. Results showed that consistent prior knowledge benefited gestural learning in both groups. Besides, only children with ASD were hindered by inconsistent prior knowledge. Notably, the effect of imitation was not significant in the ASD group. In conclusion, the learning process in children with ASD may differ from those with typical development, suggesting special-designed interventions are required.
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Affiliation(s)
- Ying Huang
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China.
| | - Miranda Kit-Yi Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Wan-Yi Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Chun-Ho Cheng
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
| | - Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region of China
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Huang Y, Cheng CH, Law WW, Wong T, Leung OK, So WC. Gesture Development in Chinese-Speaking Preschool Children With Autism and the Roles of Parental Input and Child-Based Factors. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:2309-2326. [PMID: 35617450 DOI: 10.1044/2022_jslhr-21-00494] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
PURPOSE Children with autism are found to have delayed and heterogeneous gesture abilities. It is important to understand the growth of gesture abilities and the underlying factors affecting its growth. Addressing these issues can help to design effective intervention programs. METHOD Thirty-five Chinese-speaking preschoolers with autism spectrum disorder (M age = 4.89 years, SD = 0.91; four girls) participated in four play sessions with their parents over 9 months. Their child-based factors including autism severity, intellectual functioning, and expressive language abilities were assessed. The gestures (deictic, iconic, and conventional) of the children and their parents were coded. Growth curve analyses were conducted to examine individual growth trajectories and the roles of child-based factors and parental input in shaping the children's gesture development. RESULTS Child-based factors and parental input predicted gesture development differently. Parents' gestures positively predicted their children's gestures of the same type. Autism severity negatively predicted iconic and conventional gestures. Overall growth was found in deictic rather than iconic and conventional gestures. Subgroup variation was also found. Specifically, children with better expressive language ability showed a decrease in deictic gestures. An increase in iconic and conventional gestures was found in children with more severe autism and those with poorer expressive language ability and intellectual functioning, respectively. CONCLUSIONS Different types of gestures may have different growth trajectories and be predicted by different child-based factors. Particular attention should be given to children who never produced iconic gestures, which is more challenging and may not develop over a short period, and hence require direct instruction.
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Affiliation(s)
- Ying Huang
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin
| | - Chun-Ho Cheng
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin
| | - Wing-Wun Law
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin
| | - Tiffany Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin
| | - Oi-Ki Leung
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin
| | - Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Shatin
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Raptopoulou A, Komnidis A, Bamidis PD, Astaras A. Human-robot interaction for social skill development in children with ASD: A literature review. Healthc Technol Lett 2021; 8:90-96. [PMID: 34295506 PMCID: PMC8284575 DOI: 10.1049/htl2.12013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Revised: 12/06/2020] [Accepted: 12/14/2020] [Indexed: 11/25/2022] Open
Abstract
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.
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Affiliation(s)
- Anastasia Raptopoulou
- Lab of Medical PhysicsSchool of MedicineAristotle University of ThessalonikiThessaloniki54124Greece
| | - Antonios Komnidis
- Lab of Medical PhysicsSchool of MedicineAristotle University of ThessalonikiThessaloniki54124Greece
| | - Panagiotis D. Bamidis
- Lab of Medical PhysicsSchool of MedicineAristotle University of ThessalonikiThessaloniki54124Greece
| | - Alexandros Astaras
- Lab of Medical PhysicsSchool of MedicineAristotle University of ThessalonikiThessaloniki54124Greece
- Computer ScienceAmerican College of ThessalonikiThessalonikiGreece
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Salimi Z, Jenabi E, Bashirian S. Are social robots ready yet to be used in care and therapy of autism spectrum disorder: A systematic review of randomized controlled trials. Neurosci Biobehav Rev 2021; 129:1-16. [PMID: 33862066 DOI: 10.1016/j.neubiorev.2021.04.009] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Revised: 04/11/2021] [Accepted: 04/11/2021] [Indexed: 11/19/2022]
Abstract
Autism is a neurodevelopmental disorder that affects the everyday life of people who have this lifelong condition. Robots hold great promise for uplifting therapy and care of the affected population. We searched Scopus, Medline, ScienceDirect, Web of Science, and PubMed databases for randomized controlled trials that had evaluated robot use in the therapy of people with autism, to see how effective social robots have been incorporated in autism care. Out of 240 papers initially identified, 19 satisfied the inclusion criteria and were fully evaluated. Overall, 10 different robots were utilized in the trials, out of which, four were non-humanoids. The number of papers with positive results for using robots on the main and secondary parameters was 11 and 5, respectively. Three papers reported that robot groups did not achieve better results than others. Robots in the papers included here were mainly added as the "entertainment agent" to elicit greater engagement from the participants, which is understandable, as robots at this stage might not be ready yet to deliver high-end care.
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Affiliation(s)
- Zohreh Salimi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Fahmideh St., Hamadan, 6517838678, Iran.
| | - Ensiyeh Jenabi
- Autism Spectrum Disorders Research Center, Hamadan University of Medical Sciences, Fahmideh St., Hamadan, 6517838678, Iran.
| | - Saeid Bashirian
- Social Determinants of Health Research Center, Hamadan University of Medical Sciences, Hamadan, 6517838678, Iran.
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Duville MM, Alonso-Valerdi LM, Ibarra-Zarate DI. Electroencephalographic Correlate of Mexican Spanish Emotional Speech Processing in Autism Spectrum Disorder: To a Social Story and Robot-Based Intervention. Front Hum Neurosci 2021; 15:626146. [PMID: 33716696 PMCID: PMC7952538 DOI: 10.3389/fnhum.2021.626146] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2020] [Accepted: 02/08/2021] [Indexed: 12/04/2022] Open
Abstract
Socio-emotional impairments are key symptoms of Autism Spectrum Disorders. This work proposes to analyze the neuronal activity related to the discrimination of emotional prosodies in autistic children (aged 9 to 11-year-old) as follows. Firstly, a database for single words uttered in Mexican Spanish by males, females, and children will be created. Then, optimal acoustic features for emotion characterization will be extracted, followed of a cubic kernel function Support Vector Machine (SVM) in order to validate the speech corpus. As a result, human-specific acoustic properties of emotional voice signals will be identified. Secondly, those identified acoustic properties will be modified to synthesize the recorded human emotional voices. Thirdly, both human and synthesized utterances will be used to study the electroencephalographic correlate of affective prosody processing in typically developed and autistic children. Finally, and on the basis of the outcomes, synthesized voice-enhanced environments will be created to develop an intervention based on social-robot and Social StoryTM for autistic children to improve affective prosodies discrimination. This protocol has been registered at BioMed Central under the following number: ISRCTN18117434.
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Affiliation(s)
- Mathilde Marie Duville
- Neuroengineering and Neuroacoustics Research Group, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Mexico
| | - Luz Maria Alonso-Valerdi
- Neuroengineering and Neuroacoustics Research Group, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Mexico
| | - David I Ibarra-Zarate
- Neuroengineering and Neuroacoustics Research Group, Tecnologico de Monterrey, Escuela de Ingeniería y Ciencias, Monterrey, Mexico
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Adamopoulou E, Moussiades L. Chatbots: History, technology, and applications. MACHINE LEARNING WITH APPLICATIONS 2020. [DOI: 10.1016/j.mlwa.2020.100006] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023] Open
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Huang Y, Wong MKY, Lam WY, Cheng CH, So WC. Gestures in Storytelling by Preschool Chinese-Speaking Children With and Without Autism. Front Psychol 2020; 11:573212. [PMID: 33013608 PMCID: PMC7506162 DOI: 10.3389/fpsyg.2020.573212] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 08/14/2020] [Indexed: 12/27/2022] Open
Abstract
Previous findings on gestural impairment in autism are inconsistent, while scant evidence came from Chinese-speaking individuals. In the present study, preschool Chinese-speaking children with typical development and with autism were asked to generate stories from a set of wordless Cartoon pictures. Two groups were matched in chronological age and language developmental age. Their speech and gestures were coded. Compared to children with typical development, children with autism produced fewer gestures and showed lower gesture rate. Besides, children with autism produced fewer emblems and fewer supplementary gestures compared to their TD peers. Unlike children with typical development, children with autism tend to produce emblems for reinforcing, rather than supplementing information not conveyed in speech. Results showed the impairments in integrating the cross-modal semantic information in children with autism.
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Affiliation(s)
- Ying Huang
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Miranda Kit-Yi Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wan-Yi Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Chun-Ho Cheng
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
| | - Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong, China
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Lau Y, Chee DGH, Chow XP, Wong SH, Cheng LJ, Lau ST. Humanoid robot-assisted interventions among children with diabetes: A systematic scoping review. Int J Nurs Stud 2020; 111:103749. [PMID: 32911362 DOI: 10.1016/j.ijnurstu.2020.103749] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 08/03/2020] [Accepted: 08/08/2020] [Indexed: 01/17/2023]
Abstract
BACKGROUND Although the humanoid robot is highly engaging for children, whether humanoid robot-assisted interventions could help in diabetes management is still unclear. OBJECTIVES This review aimed to elucidate the roles of humanoid robot in managing diabetes and observe the effects of humanoid robot-assisted interventions among children with type I diabetes mellitus. METHODS Arksey and O'Malley's methodological framework was used to conduct this scoping review. DATA RESOURCE We conducted a comprehensive search in 10 databases, including IEEE Xplore Digital Library, CINAHL, Cochrane Library, EMBASE, PubMed, Scopus, Web of Science, ProQuest, WanFang, and CNKI, from May 1, 1989 to February 1, 2020. The reference lists of key texts were examined and citation chaining was conducted. In addition, our team searched gray literature and relevant journals to maximise the searching. REVIEW METHODS Two independent reviewers examined all full articles for fitness with the eligibility criteria. Items of data extraction included the characteristics of articles, description of intervention, and mechanism of humanoid robot in improving the management of children with diabetes. RESULTS A total of 2,755 articles were retrieved, 22 of which were included from five countries across different ethnicities. Five roles of humanoid robots in managing diabetes among children with type I diabetes mellitus were identified: disease manager, educator, advocator, emotional supporter, and communicator. To some extent, effects seem to be related to the positive improvement of affective, experiential, relational, cognitive, and behavioral perspectives from humanoid robot-assisted intervention. CONCLUSIONS The roles of humanoids have been designed to perform their multidomain functionality. Although many positive effects were observed, the majority of selected articles have methodological issues. Future studies need an improved methodology for large-scale controlled trials.
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Affiliation(s)
- Ying Lau
- Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Level 2, Clinical Research Centre, Block MD11, 10 Medical Drive 117597, Singapore.
| | | | - Xue Ping Chow
- Staff Nurse I, Nursing Division, Singapore General Hospital, SingHealth, Singapore.
| | - Sai Ho Wong
- Nursing student, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
| | - Ling Jie Cheng
- Nursing Research Unit, Department of Nursing, Khoo Teck Puat Hospital, Yishun Health Campus, National Healthcare Group, Singapore.
| | - Siew Tiang Lau
- Associate Professor, Alice Lee Centre for Nursing Studies, Yong Loo Lin School of Medicine, National University of Singapore, Singapore.
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Syriopoulou-Delli CK, Gkiolnta E. Review of assistive technology in the training of children with autism spectrum disorders. INTERNATIONAL JOURNAL OF DEVELOPMENTAL DISABILITIES 2020; 68:73-85. [PMID: 35309695 PMCID: PMC8928843 DOI: 10.1080/20473869.2019.1706333] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 12/10/2019] [Accepted: 12/11/2019] [Indexed: 05/30/2023]
Abstract
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.
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Affiliation(s)
| | - Eleni Gkiolnta
- Department of Educational and Social Policy, University of Macedonia, Thessaloniki, Greece
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So WC, Cheng CH, Lam WY, Wong T, Law WW, Huang Y, Ng KC, Tung HC, Wong W. Robot-based play-drama intervention may improve the narrative abilities of Chinese-speaking preschoolers with autism spectrum disorder. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 95:103515. [PMID: 31670026 DOI: 10.1016/j.ridd.2019.103515] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2019] [Revised: 09/09/2019] [Accepted: 10/07/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Children with autism spectrum disorder (ASD) have deficits in their narrative skills and gestural communication. Very few intervention studies have been conducted with the aim of improving these skills. AIMS We examined whether children with ASD who received the robot-based drama intervention had better narrative abilities and gestured more often than their peers who did not receive the intervention. METHODS AND PROCEDURES Preschool children were randomly assigned to the intervention group (N = 13) and waitlist control group (N = 13). Children in the intervention group watched three robot dramas and engaged in roleplays with both robots and human experimenters. Children in both groups took the pre-tests, immediate post-tests, and, two week later, delayed post-tests, in which they narrated three stories. OUTCOMES AND RESULTS There were significant improvements in various narrative measures, including narrative length, syntactic complexity, narrative structure, and cognitive inferences, in the intervention group. There was also an improvement in the average number of overall gestures per clause in this condition. These learning outcomes were maintained in the delayed post-test. These patterns were not found in the waitlist control group. CONCLUSIONS AND IMPLICATIONS A robot-based play-drama intervention can enhance the narrative abilities and gestural communication of children with ASD.
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Affiliation(s)
- Wing-Chee So
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region.
| | - Chun-Ho Cheng
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Wan-Yi Lam
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Tiffany Wong
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Wing-Wun Law
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Ying Huang
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Ka-Ching Ng
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Hiu-Ching Tung
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
| | - Wing Wong
- Department of Educational Psychology Department, The Chinese University of Hong Kong, Shatin, Hong Kong Special Administrative Region
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A Robot-Based Play-Drama Intervention May Improve the Joint Attention and Functional Play Behaviors of Chinese-Speaking Preschoolers with Autism Spectrum Disorder: A Pilot Study. J Autism Dev Disord 2019; 50:467-481. [DOI: 10.1007/s10803-019-04270-z] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Computer- and Robot-Assisted Therapies to Aid Social and Intellectual Functioning of Children with Autism Spectrum Disorder. ACTA ACUST UNITED AC 2019; 55:medicina55080440. [PMID: 31387274 PMCID: PMC6724404 DOI: 10.3390/medicina55080440] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2019] [Revised: 08/01/2019] [Accepted: 08/02/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND AND OBJECTIVES Children with autism spectrum disorder (ASD) experience challenges with social interactions, a core feature of the disorder. Social skills therapy has been shown to be helpful. Over the past several years, computer-assisted and robot-assisted therapies have been infiltrating the social skills teaching environment. Rapid progress in the field of technology, especially in the robotics area, offers tremendous possibilities for innovation and treatment or even education for individuals with ASD. This paper's purpose is to drive awareness of these innovative interventions in order to support the social lives of children with ASD. The aims of the paper are identifying (1) the types of Information Technology platforms that are being evaluated in computer and robot-assisted therapies for children with ASD; (2) the various disciplines or professions studying and utilizing these computer and robot-assisted social skill therapies; (3) the outcomes being evaluated in each trial; and (4) if results demonstrate benefits to children with autism. MATERIALS AND METHODS PubMed, CINAHL, Science Direct, and Web of Science databases were searched for clinical trials published over the past five years. Search terms incorporated the subject intersection of autism, and computer or robot-assisted therapy. Results were mined for pediatric populations only and study designs establishing controlled comparisons. RESULTS Eighteen unique international studies were identified that utilize robot interventions (11 studies) and serious computer game interventions (seven studies). Most demonstrated promising results in improving outcomes for children with ASD. Study implications reveal a rapidly evolving assistive technology for ASD social skills therapy. CONCLUSIONS These interventions show considerable promise, but more effectiveness and cost effectiveness research of high quality should be carried out with larger numbers of children. Also, further studies are necessary to evaluate these technologies' effectiveness amongst adults with ASD and within unique subsets of the higher functioning autism population.
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Robinson NL, Cottier TV, Kavanagh DJ. Psychosocial Health Interventions by Social Robots: Systematic Review of Randomized Controlled Trials. J Med Internet Res 2019; 21:e13203. [PMID: 31094357 PMCID: PMC6533873 DOI: 10.2196/13203] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Revised: 03/22/2019] [Accepted: 04/09/2019] [Indexed: 01/06/2023] Open
Abstract
Background Social robots that can communicate and interact with people offer exciting opportunities for improved health care access and outcomes. However, evidence from randomized controlled trials (RCTs) on health or well-being outcomes has not yet been clearly synthesized across all health domains where social robots have been tested. Objective This study aimed to undertake a systematic review examining current evidence from RCTs on the effects of psychosocial interventions by social robots on health or well-being. Methods Medline, PsycInfo, ScienceDirect, Scopus, and Engineering Village searches across all years in the English language were conducted and supplemented by forward and backward searches. The included papers reported RCTs that assessed changes in health or well-being from interactions with a social robot across at least 2 measurement occasions. Results Out of 408 extracted records, 27 trials met the inclusion criteria: 6 in child health or well-being, 9 in children with autism spectrum disorder, and 12 with older adults. No trials on adolescents, young adults, or other problem areas were identified, and no studies had interventions where robots spontaneously modified verbal responses based on speech by participants. Most trials were small (total N=5 to 415; median=34), only 6 (22%) reported any follow-up outcomes (2 to 12 weeks; median=3.5) and a single-blind assessment was reported in 8 (31%). More recent trials tended to have greater methodological quality. All papers reported some positive outcomes from robotic interventions, although most trials had some measures that showed no difference or favored alternate treatments. Conclusions Controlled research on social robots is at an early stage, as is the current range of their applications to health care. Research on social robot interventions in clinical and health settings needs to transition from exploratory investigations to include large-scale controlled trials with sophisticated methodology, to increase confidence in their efficacy.
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Affiliation(s)
- Nicole Lee Robinson
- Australian Centre for Robotic Vision, Brisbane, Australia.,Queensland University of Technology, Brisbane, Australia
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So WC, Wong MKY, Lam WY, Cheng CH, Ku SY, Lam KY, Huang Y, Wong WL. 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. RESEARCH IN DEVELOPMENTAL DISABILITIES 2019; 86:62-75. [PMID: 30677695 DOI: 10.1016/j.ridd.2019.01.002] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Revised: 11/16/2018] [Accepted: 01/04/2019] [Indexed: 06/09/2023]
Abstract
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.
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Affiliation(s)
- Wing-Chee So
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Miranda Kit-Yi Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Wan-Yi Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Chun-Ho Cheng
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Sin-Ying Ku
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Ka-Yee Lam
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Ying Huang
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Wai-Leung Wong
- Department of Educational Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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Abstract
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.
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