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

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Iris van den Berk-Smeekens ◽  
Martine van Dongen-Boomsma ◽  
Manon W. P. De Korte ◽  
Jenny C. Den Boer ◽  
Iris J. Oosterling ◽  
...  
Autism ◽  
2020 ◽  
Vol 24 (8) ◽  
pp. 2117-2128 ◽  
Author(s):  
Manon WP De Korte ◽  
Iris van den Berk-Smeekens ◽  
Martine van Dongen-Boomsma ◽  
Iris J Oosterling ◽  
Jenny C Den Boer ◽  
...  

The aim of this study was to investigate the effect of Pivotal Response Treatment versus robot-assisted Pivotal Response Treatment on self-initiations of children with autism spectrum disorder and to explore the relation between self-initiations and collateral gains in general social-communicative skills. Forty-four participants with autism spectrum disorder aged 3–8 years (Pivotal Response Treatment: n = 20, Pivotal Response Treatment + robot: n = 24), who were recruited as part of a larger randomized controlled trial (number NL4487/NTR4712, https://www.trialregister.nl/trial/4487 ), were included. Self-initiations were blindly coded, assessing video probes of all parent–child sessions using an event-recording system. General social-communicative skills were assessed with the parent- and teacher-rated Social Responsiveness Scale during intervention and at 3-month follow-up. Results using linear mixed-effects models showed overall gains in self-initiations during both Pivotal Response Treatment intervention groups (estimate = 0.43(0.15), 95% confidence interval (CI): 0.13–0.73), with larger gains in functional self-initiations in children receiving robot-assisted Pivotal Response Treatment (estimate = −0.27(0.12), 95% confidence interval: −0.50 to −0.04). Growth in self-initiations was related to higher parent-rated social awareness at follow-up compared with baseline in the total sample ( r = −0.44, p = 0.011). The clinical implications of these findings, as well as directions for future research in the utility of Pivotal Response Treatment and robot assistance in autism spectrum disorder intervention, are discussed. Lay abstract The initiation of social interaction is often defined as a core deficit of autism spectrum disorder. Optimizing these self-initiations is therefore a key component of Pivotal Response Treatment, an established intervention for children with autism spectrum disorder. However, little is known about the development of self-initiations during intervention and whether this development can be facilitated by robot assistance within Pivotal Response Treatment. The aim of this study was to (1) investigate the effect of Pivotal Response Treatment and robot-assisted Pivotal Response Treatment on self-initiations (functional and social) of young children with autism spectrum disorder over the course of intervention and (2) explore the relation between development in self-initiations and additional gains in general social-communicative skills. Forty-four children with autism spectrum disorder (aged 3–8 years) were included in this study. Self-initiations were assessed during parent–child interaction videos of therapy sessions and coded by raters who did not know which treatment (Pivotal Response Treatment or robot-assisted Pivotal Response Treatment) the child received. General social-communicative skills were assessed before start of the treatment, after 10 and 20 weeks of intervention and 3 months after the treatment was finalized. Results showed that self-initiations increased in both treatment groups, with the largest improvements in functional self-initiations in the group that received robot-assisted Pivotal Response Treatment. Increased self-initiations were related to higher parent-rated social awareness 3 months after finalizing the treatment.


Autism ◽  
2020 ◽  
Vol 24 (6) ◽  
pp. 1566-1571
Author(s):  
Jena McDaniel ◽  
Paul Yoder ◽  
Madison Crandall ◽  
Maria Estefania Millan ◽  
Christina Mich Ardel ◽  
...  

A pivotal response treatment package consisting of clinician-delivered and parent-implemented strategies was recently found to be effective in improving language and social communication deficits in children with autism spectrum disorder. Reciprocal vocal contingency, an automated measure of vocal reciprocity, may provide stronger and complementary evidence of the effects of the pivotal response treatment package. Reciprocal vocal contingency is derived through an automated process from daylong audio samples from the child’s natural environment. Therefore, reciprocal vocal contingency is at lower risk for detection bias than parent report and brief parent–child interaction measures. Although differences were non-significant at baseline and after 12 weeks of intervention for the 48 children with autism spectrum disorder who were randomly assigned to the pivotal response treatment package or a delayed treatment control group, the pivotal response treatment package group had higher ranked reciprocal vocal contingency scores than the control group after 24 weeks ( U = 125, p = .04). These findings are consistent with results from parent report and parent–child interaction measures obtained during the trial. The participants in the pivotal response treatment package exhibited greater vocal responsiveness to adult vocal responses to their vocalizations than the control group. Findings support the effectiveness of the pivotal response treatment package on vocal reciprocity of children with autism spectrum disorder, which may be a pivotal skill for language development. Lay abstract A recent randomized controlled trial found that children with autism spectrum disorder who received a pivotal response treatment package showed improved language and social communication skills following the intervention. The pivotal response treatment package includes clinician-delivered and parent-implemented strategies. Reciprocal vocal contingency is an automated measure of vocal reciprocity derived from daylong audio samples from the child’s natural environment. It may provide stronger and complementary evidence of the effects of the pivotal response treatment package because it is at lower risk for detection bias than parent report and brief parent–child interaction measures. The current study compared reciprocal vocal contingency for 24 children with autism spectrum disorder in the pivotal response treatment package group and 24 children with autism spectrum disorder in the control group. The pivotal response treatment package group received 24 weeks of the pivotal response treatment package intervention. The control group received their usual intervention services during that time. The groups did not differ in reciprocal vocal contingency when the intervention started or after 12 weeks of intervention. However, after 24 weeks the pivotal response treatment package group had higher ranked reciprocal vocal contingency scores than the control group. These findings are consistent with results from parent report and parent–child interaction measures obtained during the trial. The participants in the pivotal response treatment package exhibited greater vocal responsiveness to adult vocal responses to their vocalizations than the control group. Findings support the effectiveness of the pivotal response treatment package on vocal reciprocity of children with autism spectrum disorder, which may be a pivotal skill for language development.


Medicina ◽  
2019 ◽  
Vol 55 (8) ◽  
pp. 440 ◽  
Author(s):  
Joan DiPietro ◽  
Arpad Kelemen ◽  
Yulan Liang ◽  
Cecilia Sik-Lanyi

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.


2017 ◽  
Vol 14 (5) ◽  
pp. 172988141773689 ◽  
Author(s):  
Jaishankar Bharatharaj ◽  
Loulin Huang ◽  
Ahmed Al-Jumaily ◽  
Rajesh Elara Mohan ◽  
Chris Krägeloh

This article reports our findings from a robot-assisted therapeutic study conducted over 49 days to investigate the sociopsychological and physiological effects in children with autism spectrum disorder using a parrot-inspired robot, KiliRo, that we developed to help in therapeutic settings. We investigated the frequency of participants’ interactions among each other and assessed any changes in interaction using social network analysis. Interactions were assessed through manual observation before and after exposure to the robot. Urinary and salivary tests were performed to obtain protein and α-amylase levels, respectively, to report the physiological changes in participating children with autism spectrum disorder before and after interacting with the robot. This is a pioneering human–robot interaction study to investigate changes in stress levels using salivary samples. Systolic and diastolic blood pressure, heart rate, and arterial oxygen saturation level in blood were also monitored to investigate the physiological changes in participating children before, during, and after interacting with our parrot-inspired robot, KiliRo. The results show that the robot can help increase social interaction among children with autism spectrum disorder and assist in learning tasks. Furthermore, the clinical biochemistry test report using urinary and salivary samples indicates that the stress levels of children with autism reduced notably after interacting with the robot. Nevertheless, blood pressure, heart rate, and oxygen levels in blood did not show positive change in all participants.


Author(s):  
Vasiliki Holeva ◽  
Vasiliki-Aliki Nikopoulou ◽  
Maria Papadopoulou ◽  
Eleni Vrochidou ◽  
George A. Papakostas ◽  
...  

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