Application of Robots in Autism Therapy

By Samudrapom DamReviewed by Susha Cheriyedath, M.Sc.Updated on Dec 1 2024

Robotics in medicine involves using robotic systems to assist in diagnosis, surgery, and rehabilitation. In autism therapy, robots are increasingly used to provide interactive, engaging, and consistent therapeutic interventions for individuals with autism.¹

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Emerging Role of Robots

Robotic therapies are increasingly receiving attention in the autism field to enhance conventional human interventions. Specifically, child autism has emerged as a promising field of research for robot-assisted autism therapy (RAAT). For instance, robotic therapies can be suitable for improving children’s social skills. Robots could reproduce consistent actions and experiences for children with communication capacity restrictions.¹

Moreover, children with autism spectrum disorder (ASD) often find engagement with robots stimulating as they offer simple, non-judgmental, predictable interactions, unlike complex human social interactions. Robots' non-intimidating nature and consistent behavior can make them more accessible and engaging for individuals with autism.¹

Types of Robots in Therapy

Different robots are increasingly used in autism therapy to address social and communication challenges. Social robots, such as humanoid robots like NAO provide opportunities for interaction and skill-building exercises, while assistive robots aid in communication and skill development.^2-4

Social Robots: In autism therapy, social robots like NAO and QTrobot act as efficient and reliable intervention mediators to increase skills and competence in children with ASD. NAO is characterized by a body in plastic with 25 degrees of freedom (DoF). This robot can speak and assures a degree of non-verbal communication, capturing a large amount of information about the environment using microphones and sensors.²

NAO is the commonly employed device for promoting cognitive and emotional rehabilitation in children with ASD. Many studies have reported its effectiveness as a behavioral intervention mediator. For instance, the first randomized controlled trial performed using NAO for children with ASD in a socio-emotional understanding protocol showed that NAO robot assistance significantly improves social skills and communication.²

QTrobot is a little expressive humanoid robot designed and developed to assist therapists in teaching new emotional, communication, social, and cognitive skills to children with autism/special educational needs. This recently developed social robot has a high motricity in the neck and hands with 12 DoF.²

The use of QTrobot could be suitable for long emotional-ability training for ASD. Studies investigating the usefulness of QTrobot by evaluating children’s imitation, attention, and presence of stereotyped and repetitive behaviors obtained significant positive results in all parameters.²

Kaspar, a humanoid social robot with 14 DoF and a silicon-rubber mask face that displays a range of simplified expressions. This robot can move its arms, head, and eyes, and respond to the touch of children. Kaspar is equipped with tactile sensors that allow the robot to react as defined by software programming.²

RAAT using Kaspar could be an effective intervention to improve visual perspective-taking and theory of mind in autism. Kaspar robot-mediated interventions also enhance communication, imitation, social skills, and psychomotor functions in children with ASD.²

Assistive Robots: Socially assistive robots (SARs) are specifically designed to assist in a therapeutic way to build social behavior skills. These robots have received significant attention in the diagnosis and treatment of ASD. The need for equitable and accessible applied behavior analysis (ABA) therapy services is increasing as rising numbers of individuals are diagnosed with ASD.³

The Penguin for Autism Behavioral Intervention (PABI), a relatively new SAR, is developed as a modular platform designed to assist in ABA therapy delivery. PABI can provide programming related to different skill sets using several empirically supported ABA therapy features like discrete trial training (DTT).³

This small-sized, non-anthropomorphic accessible robot is suitable for effective early interventions in children with autism. Similarly, Milo is another SAR that is effective in social and emotional development in autism therapy. Milo assists children in understanding and completing different exercises. It is more appropriate for younger children and those with a bit lower functioning and is a supplementary tool in the educational process.^3,4

Benefits of Robot-assisted Therapy

RAAT offers several benefits, including

• Providing engaging and tailored activities to individuals with autism
• Improving communication and social skills
• Developing sensitivity to physical contact
• Assisting children with ASD to understand and recognize emotions
• Performing therapeutic actions during emergencies like the coronavirus disease 2019 (COVID-19) pandemic when limiting direct interpersonal contact was essential
• Support for decision-making and advanced interaction with the environment
• Ensuring precise gestures and manipulation^1,2

Studies have also experimentally validated the benefits of RAAT. For instance, a facial automaton for conveying emotions (FACE), which is a social humanoid robot with a passive body and an active head, has been confirmed as a suitable device for improving imitative abilities, social communication skills, and shared attention in children with ASD.^1,2

Key Research Supporting Using RAAT

Autonomous robots possessing simplified mechanisms and functioning independently in several instances could be successfully deployed in home-based autism therapy. For instance, a work published at the 2019 28th IEEE International Conference on Robot and Human Interactive Communication (RO-MAN) developed an autonomous SAR system for eight children with ASD who performed various socially and educational diverse activities with a robot for one month.^5,6

The children sustained interest in the proposed SAR system and considered the robot as their friend due to its informal language use and animal-like appearance. Children and their parents positively perceived the system as they rated the robot to be applicable and friendly.^5,6

Robots have also displayed their effectiveness in play-based autism therapy. For instance, a longitudinal study was performed as part of the Aurora project to explore how repeated exposure benefits social behaviors in children with ASD aged between 5 and 10 years.^5,7

Robota, a doll-shaped robot consisting of LEGO parts and plastic components of a commercial doll with five DOF, was programmed throughout several months to play a decisive role in four behaviors, including eye gaze, imitation, child-robot proximity, and touch. The study found that Robota was successful in encouraging improvements in some of the targeted social behaviors.^5,7

Technological Features and Innovations

The integration of artificial intelligence (AI) and machine learning (ML) in autism therapy is revolutionizing personalized interventions, offering tailored support based on individual needs. Interactive features, such as facial recognition and adaptive behavior, enhance engagement and foster more effective communication for those with autism.^4,8

For instance, MILO could be more effective in detecting facial expressions for emotion identification through AI. This could improve the effectiveness of emotion learning and expression training.⁴

Similarly, a deep learning and reinforcement learning algorithm-based novel approach, supported by an ontological knowledge base containing important information and knowledge about screening tests, therapies, and patients, could be applied in social robot NAO to enable it to assist therapists in diagnosing children with ASD and prescribe a set of therapies based on their specific needs.⁸

Challenges and Limitations

Despite the potential of robots in autism therapy, challenges like high costs, accessibility issues, and ethical concerns requiring human oversight remain major obstacles to extensive adoption.²

Designing a child-size expressive humanoid robot with good verbal skills and mobility is a persistent challenge. Additionally, many robots do not possess an effective perception system, which is crucial to detect the child’s position and movements. Moreover, robots must be able to express complex and different emotions in addition to basic emotions. Currently, only QTrobot can express simple and complex emotions.²

Future Directions and Conclusion

In conclusion, the future of robot-assisted autism therapy (RAAT) holds exciting potential. With the integration of virtual reality and advancements in artificial intelligence, RAAT could offer even more personalized interventions. Efforts to increase accessibility and reduce costs will ensure wider adoption of robot-based therapies.

These innovations could transform autism therapy by enhancing communication, social skills, and emotional development. Continued research and development are essential to address current challenges and expand the capabilities of these robots. The ongoing evolution of RAAT promises to improve the lives of individuals with autism significantly.

References and Further Reading

1. Szymona, B., Maciejewski, M., Karpiński, R., Jonak, K., Niderla, K., Prokopiak, A. (2021). Robot-Assisted Autism Therapy (RAAT). Criteria and Types of Experiments Using Anthropomorphic and Zoomorphic Robots. Review of the Research. Sensors, 21(11), 3720. DOI: 10.3390/s21113720, https://www.mdpi.com/1424-8220/21/11/3720
2. Puglisi, A. et al. (2022). Social Humanoid Robots for Children with Autism Spectrum Disorders: A Review of Modalities, Indications, and Pitfalls. Children, 9(7), 953. DOI: 10.3390/children9070953, https://www.mdpi.com/2227-9067/9/7/953
3. Dickstein-Fischer, L. A., Crone-Todd, D. E., Chapman, I. M., Fathima, A. T., & Fischer, G. S. (2018). Socially assistive robots: current status and future prospects for autism interventions. Innovation and Entrepreneurship in Health, 15-25. DOI: 10.2147/IEH.S138753, https://www.tandfonline.com/doi/full/10.2147/IEH.S138753
4. Teixeira, V., Lai, M. (2021). The use Robotics in the intervention with children with ASD in Macao: An exploratory study with Milo. 1-26. DOI: 10.34632/investigacaoeducacional.2021.10041., https://www.researchgate.net/publication/362250025_The_use_Robotics_in_the_intervention_with_children_with_ASD_in_Macao_An_exploratory_study_with_Milo
5. Rakhymbayeva, N., Amirova, A., Sandygulova, A. (2021). A Long-Term Engagement with a Social Robot for Autism Therapy. Frontiers in Robotics and AI, 8, 669972. DOI: 10.3389/frobt.2021.669972, https://www.frontiersin.org/journals/robotics-and-ai/articles/10.3389/frobt.2021.669972/full
6. Pakkar, R., Clabaugh, C., Lee, R., Deng, E., & Mataricć, M. J. (2019). Designing a socially assistive robot for long-term in-home use for children with autism spectrum disorders. 2019 28th IEEE international conference on robot and human interactive communication (RO-MAN), 1-7. DOI: 10.1109/RO-MAN46459.2019.8956468, https://ieeexplore.ieee.org/abstract/document/8956468
7. Kumazaki, H. et al. (2020). Optimal robot for intervention for individuals with autism spectrum disorders. Psychiatry and Clinical Neurosciences, 74(11), 581-586. DOI: 10.1111/pcn.13132, https://onlinelibrary.wiley.com/doi/full/10.1111/pcn.13132
8. Salhi, I., Qbadou, M., Gouraguine, S., Mansouri, K., Lytridis, C., Kaburlasos, V. (2022). Towards Robot-Assisted Therapy for Children With Autism—The Ontological Knowledge Models and Reinforcement Learning-Based Algorithms. Frontiers in Robotics and AI, 9, 713964. DOI: 10.3389/frobt.2022.713964, https://www.frontiersin.org/journals/robotics-and-ai/articles/10.3389/frobt.2022.713964/full

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