About Jill Dosso

Jill Dosso, PhD is a Postdoctoral Fellow in the Neuroscience, Engagement, and Smart Tech (NEST) lab at the University of British Columbia and BC Children’s Hospital. In her work, she studies the perspectives of persons with lived experience on emerging technologies to support brain health across the lifespan.

Social Robots: What Are They and How Can They Help Children?

Post by Anna Riminchan

Consumer demand for social robots is increasing, particularly in response to the reduced amounts of social contact children that are getting because of school closures (1). Isolation due to the COVID-19 pandemic has accelerated people’s need for social interaction. Social robots have the ability to listen, emote, and sustain a verbal, or non-verbal conversation with others without spreading disease, making them an increasingly relevant solution to today’s problems. However, it is important to balance the growing excitement for social robots with a careful examination of the ethical issues they raise.

Socially assistive robots are devices intended to provide companionship, education, and healthcare assistance for diverse populations. Current research centers around the use of social robots for ageing populations and children. Social robots’ child-specific uses include support during hospitalization (2,3), support for distress during medical procedures (4), mitigation of the effects of a short-term stressor (5), intervention to improve social skills in children with autism spectrum disorder (6,7), and enhancement of education in the classroom (8).

In order to qualify as a social robot, a device must possess three elements: sensors to detect information, a physical form with actuators to manipulate the environment, and an interface that is able to interact with humans on a social level (9). Social robots’ interactions with humans also follow four key rules; (1) social robots have a physical presence, (2) social robots can flexibly react to novel events, (3) social robots are equipped to realize complex goals, and (4) social robots are capable of social interaction with humans in pursuit of their goals (definition adapted from 10).

Today’s social robotics scene contains robots that are available for research purposes as well as some that are sold commercially to children around the world. The present article will present examples of both types of social robots currently being used.

Huggable

Huggable is a blue and green, bear-shaped social robot created by MIT Media Lab in collaboration with Boston Children’s Hospital. An image of Huggable from MIT Media Lab’s website is shown. Its goal is to bridge the socio-emotional gap between child and parent stress and human resource supply in pediatric hospitals. Huggable wants to close this gap with its ability to “mitigate stress, anxiety, and pain in pediatric patients by engaging them in playful interactions”, as advertised on its website. It is meant to enhance social interactions between children and their teachers or healthcare providers through its fun communication abilities.

Research with Huggable also touched on the importance of the physical embodiment aspect of social robot interaction. An experiment was performed with children to compare the effects of the Huggable robot to a virtual character on a screen and a regular plush teddy bear. They showed that children are “more eager to emotionally connect with and be physically activated by a robot than a virtual character”(11). This is one of the first studies in 2012 to demonstrate the potential of social robots as opposed to other types of pediatric interventions.

Moxie

In terms of commercially available robots, Moxie is one of the newest social robots on the market. A picture of Moxie from the Embodied Inc’s website is included. Her teal colour, and animatronic face, as well as her teardrop-shaped head, give her a unique, yet modern look. According to the manufacturer’s website, Moxie is designed to “help autistic children learn the necessary social skills they need to thrive in the world and to provide them with understanding and engaging company.” Moxie is about 1500$ with a 40$ a monthly subscription after the first year of adoption. A highly expressive social robot, with an emotive electronic face, Moxie is designed to have large eyes, to promote eye contact in children. She presents the child with weekly missions to encourage learning and exploration of different topics related to human experiences, ideas, and life skills like kindness, empathy, and friendship. Guided meditations and breathing exercises can help children regulate their emotions and develop their self-expression in a positive way. The manufacturer’s website claims that children can read to Moxie to build confidence in their verbal ability and increase comprehension. Unstructured play can also help promote creativity and self-reflection. The website includes a page entitled “ The Science Behind Moxie”, which supports some claims made by manufacturers on Moxie’s abilities with other social robot studies. However, the only formal data available on Moxie’s effectiveness comes from a short, preliminary study done by the manufacturers, featuring a very small sample size. Although more research is needed on her effects on children, Moxie is a promising social robot for at-home use!

Researchers and manufacturers alike are continuing to acknowledge the growing potential of social robots for child wellbeing. With possible benefits like decreasing distress during hospitalization (2,3,4), enhancing interactions with others (6,7), and helping to promote healthy emotional regulation in response to stress (5), social robots have a unique set of capabilities to enhance children’s lives. However, more research is needed to establish the effectiveness of specific commercial social robots before manufacturers can soundly claim the benefits of well-researched robots as pertaining to their own product. Furthermore, the security of sensitive information a user shares with a social robot is currently evolving as consumers become more aware of ethical issues surrounding data privacy. Concerns about data security and sharing are being addressed by some, but not all social robot manufacturers. Of those which address data privacy, many statements are brief, and do not offer the consumer enough to make a fully informed, consenting decision on sharing their personal information. This information comes from an analysis performed in our yet unpublished paper, which addresses the greatly variable quality of claims made by social robot manufacturers. Although social robots show great potential for enhancing child well-being, further consideration of ethical issues, as well as re-evaluation of the quality of claims made by manufacturers is needed to enhance consumer’s experiences.


Anna Riminchan was born in Bulgaria, where she spent her early childhood before immigrating to Canada with her family. Anna is currently working towards a Bachelor of Science Degree, majoring in Behavioural Neuroscience and minoring in Visual Arts at the University of British Columbia. In the meantime, she is contributing to advancing research in neuroscience, after which, she plans to pursue a degree in medicine. In her spare time, you can find Anna working on her latest art piece!


References

1. Jargon J. Pandemic Tantrums? Enter the Robot Playmate for Kids [Internet]. WSJ. [cited 2021 Nov 10]. Available from: https://www.wsj.com/articles/pandemic-tantrums-enter-the-robot-playmate-for-kids-11596542401

2. Farrier CE, Pearson JD, Beran TN. Children’s fear and pain during medical procedures: A quality improvement study with a humanoid robot. Canadian Journal of Nursing Research. 2020 Dec;52(4):328-34.

3. Okita SY. Self–Other’s Perspective Taking: The use of therapeutic robot companions as social agents for reducing pain and anxiety in pediatric patients. Cyberpsychology, Behavior, and Social Networking. 2013 Jun 1;16(6):436-41.

4. Trost MJ, Ford AR, Kysh L, Gold JI, Matarić M. Socially assistive robots for helping pediatric distress and pain: a review of current evidence and recommendations for future research and practice. The Clinical journal of pain. 2019 May;35(5):451.

5. Crossman MK, Kazdin AE, Kitt ER. The influence of a socially assistive robot on mood, anxiety, and arousal in children. Professional Psychology: Research and Practice. 2018 Feb;49(1):48.

6. Diehl JJ, Schmitt LM, Villano M, Crowell CR. The clinical use of robots for individuals with autism spectrum disorders: A critical review. Research in autism spectrum disorders. 2012 Jan 1;6(1):249-62.

7. Pennisi P, Tonacci A, Tartarisco G, Billeci L, Ruta L, Gangemi S, Pioggia G. Autism and social robotics: A systematic review. Autism Research. 2016 Feb;9(2):165-83.

8. Belpaeme T, Kennedy J, Ramachandran A, Scassellati B, Tanaka F. Social robots for education: A review. Science robotics. 2018 Aug 15;3(21).

9. del Moral S, Pardo D, Angulo C. Social robot paradigms: An overview. In International Work-Conference on Artificial Neural Networks 2009 Jun 10 (pp. 773-780). Springer, Berlin, Heidelberg.

10. Duffy BR, Rooney C, O’Hare GM, O’Donoghue R. What is a social robot? In10th Irish Conference on Artificial Intelligence & Cognitive Science, University College Cork, Ireland, 1-3 September, 1999. 1999 Sep 1.

11. Jeong S, Breazeal C, Logan D, Weinstock P. Huggable: the Impact of Embodiment on Promoting Socio-Emotional Interactions for Young Pediatric Inpatients. In Proceedings of the 2018 CHI Conference on Human Factors in Computing Systems 2018 Apr;21:1-13.

12. Project Overview ‹ Huggable: A social robot for pediatric care [Internet]. MIT Media Lab. [cited 2021 Nov 29]. Available from: https://www.media.mit.edu/projects/huggable-a-social-robot-for-pediatric-care/overview/

13. Embodied Moxie [Internet]. Embodied, Inc. [cited 2021 Nov 29]. Available from: https://embodied.com/

Centering persons with lived experience in brain health technology research

What is the role of the persons with lived experience in research?

Researchers and research organizations in Canada are changing the way that they think about the role of persons with lived experience in research. There is a shift away from thinking about these groups as passive sources of data and towards meaningful collaboration with them at all stages of research (1). This can involve working collectively to set research priorities, select research designs, and interpret and share research findings. There are large potential benefits, even above and beyond the ethical imperative of “nothing about us without us”. Patient engagement in research can result in work that is better aligned with the actual goals of the population under study as well as improving study enrollment and decreasing participant drop-out (2). There are also potential benefits of the collaborative process for participants themselves. In one study, grandparents who acted as research advisors reported that the experience provided a sense of purpose and a feeling of connection (3). However, prioritizing a collaborative research approach does present unique challenges. It takes time and resources, there are a wide range of methodologies and large differences in how engagement is accomplished between research groups, and there is a potential for “tokenization”, which is the appearance of inclusiveness in the absence of true collaboration.

Incorporating patient engagement practices specifically in the technology research and development space has some unique additional challenges. Emerging technologies may not yet be ready for real-world deployment at the point of care, but engaging persons with lived experience in their early development is critical. It can be difficult to know how to ask participants the best way to study a set of devices that are still under development and part of a quickly-changing commercial landscape! For this reason, pathways to involve persons with lived experience in healthcare technology research are not yet well established.

The need to engage persons with lived experience in social robotics research

One example of a potential health technology that our group would like to study in a patient-centered way is social robotics. These interactive devices are intended to be effective social partners for a person. Their functions can include acting as a fun and entertaining companion, acting as a virtual assistant (e.g., setting up video calls, using the internet to answer questions), providing reminders to take medication, and monitoring the user for events like a fall, among other things. They are being trialled for applications like supporting children’s mental health, as supports for individuals for Autism Spectrum Disorder, and as companions for persons living with dementia (4-8). The COVID-19 pandemic is likely to further accelerate the adoption of social robotics as people seek to reduce live human contact without reducing social connectedness (9).

However, social robotics development priorities are largely driven by the market, engineering constraints, and the recommendations of healthcare experts, rather than by input from persons with lived experience (10). While technically advanced devices are coming to market and manufacturers are making strong claims about the usefulness of these objects, scientific evaluation of these claims is of poor quality and does not focus on the experiences and outcomes that are important to potential users and their families. Not including the voices of potential users can lead to the development of devices that ultimately fail to meet their needs.

Engagement at Neuroethics Canada: Lived Experience Expert Groups

Our research group is currently running a set of projects looking at robotic interventions for anxiety in children and teens. To engage members of these groups directly, we have developed a Lived Experience Expert Group (“LEEG” – we call this group our “League”) to advise on all aspects of our ongoing work on social robotics for children. The group includes a mix of children, teens, and parents/guardians with lived experiences of acute and chronic anxiety and a range of ages and diagnostic groups (e.g., social anxiety, generalized anxiety disorder). Involving young people themselves in patient experience research is critical as their reports on the quality of an interaction can differ from those of adults – even from their parents’ reports of the same event (11, 12). Involving an expert group, rather than a single token lived experience partner, tips the balance of our research team towards individuals with lived experience and away from researchers, as well as promoting a diversity of voices in the work. We are excited to work with the League to refine our research questions, design smart studies, and learn more about the experiences and priorities of young people living with anxiety.

This work is supported by BC Support Unit, the BC Children’s Hospital, and the Michael Smith Foundation for Health Research and is being done under the supervision of Dr. Julie Robillard, with team members Anna Riminchan, Jaya Kailley, Kat Kabacińska, and our generous persons with lived experience partners. 

References

  1. Robillard JK, Jordan I. Dialogue? Yes. Burden? No. Ethical challenges in engaging people with lived experience in health care research. Brainstorm, 32-35.
  2. Domecq JP, Prutsky G, Elraiyah T, Wang Z, Nabhan M, Shippee N, Brito JP, Boehmer K, Hasan R, Firwana B, Erwin P. Patient engagement in research: a systematic review. BMC health services research. 2014 Dec;14(1):1-9.
  3. Sheehan OC, Ritchie CS, Garrett SB, Harrison KL, Mickler A, AL EE, Garrigues SK, Leff B. Unanticipated Therapeutic Value of the Patient-Centered Outcomes Research Institute (PCORI) Stakeholder Engagement Project for Homebound Older Adults. Journal of the American Medical Directors Association. 2020 May 4;21(8):1172-3.
  4. Costescu CA, David DO. Attitudes toward Using Social Robots in Psychotherapy. Transylvanian Journal of Psychology. 2014 Mar 1;15(1).
  5. Dawe J, Sutherland C, Barco A, Broadbent E. Can social robots help children in healthcare contexts? A scoping review. BMJ paediatrics open. 2019;3(1).
  6. Hung L, Liu C, Woldum E, Au-Yeung A, Berndt A, Wallsworth C, Horne N, Gregorio M, Mann J, Chaudhury H. The benefits of and barriers to using a social robot PARO in care settings: a scoping review. BMC geriatrics. 2019 Dec;19(1):1-0.
  7. Kabacińska K, Prescott TJ, Robillard JM. Socially assistive robots as mental health interventions for children: a scoping review. International Journal of Social Robotics. 2021 Aug;13(5):919-35.
  8. Pennisi P, Tonacci A, Tartarisco G, Billeci L, Ruta L, Gangemi S, Pioggia G. Autism and social robotics: A systematic review. Autism Research. 2016 Feb;9(2):165-83.
  9. Ghafurian M, Ellard C, Dautenhahn K. Social companion robots to reduce isolation: A perception change due to COVID-19. In IFIP Conference on Human-Computer Interaction 2021 Aug 30 (pp. 43-63). Springer, Cham.
  10. Riek LD. Robotics technology in mental health care. In Artificial intelligence in behavioral and mental health care 2016 Jan 1 (pp. 185-203). Academic Press.
  11. Hargreaves DS, Sizmur S, Pitchforth J, Tallett A, Toomey SL, Hopwood B, Schuster MA, Viner RM. Children and young people’s versus parents’ responses in an English national inpatient survey. Archives of disease in childhood. 2018 May 1;103(5):486-91.
  12. Kerr C, Nixon A, Angalakuditi M. The impact of epilepsy on children and adult patients’ lives: development of a conceptual model from qualitative literature. Seizure. 2011 Dec 1;20(10):764-74.