Bonding with Robotic Pets. Children’s Cognitions, Emotions and Behaviors towards Pet-Robots. Applications in a Robot Assisted Quality of Life Intervention in a Pediatric Hospital

[eng] This dissertation addresses the emergence of emotional involvement in the interaction with social robots. More specifically, we investigate the dynamics of children bonding with robotic pets to design robot based programs to improve patients’ experience in pediatric hospitals. Pet-robots are robots that mimic real pets as dogs or cats, both in appearance and in behavior. We assume that gaining understanding of the emotional dimension of children/pet-robots interaction would contribute to evaluate the impact of pet-robots in children’s lives, and to inform both robots’ design and robot-based applications for health and wellbeing. First, this research presents a novel model of bonding with robotic pets inspired in the human-animal affiliation and particularly in child-dog relatedness, where bonding is envisaged as a process towards companionship that evolves through three stages –first impression, short-term interaction and lasting relationship- characterized by distinguishable patterns of behaviors, cognitions and feelings that can be identified and measured. Secondly, a behavioral analysis of children interacting with the Pleo robot -a robotic pet shaped as a baby dinosaur-, with an emphasis on the interactional surface and particularly on the sequences of dyad’s reciprocal exchange is presented. The outcomes are twofold: the ethograms and coding schemes of Pleo’s and children’s behaviors and a higher level categorization of behaviors involved in bond forming that can be applied to other platforms and users. Thirdly, a naturalistic study carried out in a pediatric hospital to observe the interactive practices with the Pleo robot in the wild and to evaluate the feasibility and effectiveness of a Pleo-based intervention to accompany children is analyzed and discussed. Inspired on the beneficial effects of real pets’ company, the study consisted in an intensive ethnography, a systematic observation of a group play session and a follow-up case study of an experience of adopting a Pleo. Our results show that the key mechanism driving bond forming is the robot’s capability to deploy credible attachment behaviors –proximity seeking and resource soliciting- that elicit complementary nurturing and play behaviors in children. Beyond the novelty effect, self-reinforcing processes as learning and evolution can keep children engaged in rewarding interaction with the robot over time. Moreover, Pleo’s versatility allows diverse modalities of interaction and individual and group play, satisfying different needs as company, technological curiosity, entertainment and social facilitation both for normatively developed children and for children with special needs and their families. In general, the introduction of robot-based play was regarded by the hospital professionals not only as compatible with their daily day practice but valuable as a regular resource to smooth children’s stay at the hospital.[cat] Aquesta tesi aborda el sorgiment de la implicació emocional en la interacció amb els robots socials. Més específicament, s'investiga la dinàmica de la afiliació dels nens amb les mascotes robòtiques – robots que evoquen els animals de companyia- per tal de dissenyar programes basats en robots per millorar l'experiència dels pacients en els hospitals pediàtrics. Considerem que investigar la dimensió emocional de la interacció nen/robots-mascota contribuirà a avaluar-ne el seu impacte en la vida del nens i nenes, i a informar el disseny d’aquests robots i de les aplicacions que se’n deriven per a la seva salut i benestar. A partir d’un model evolutiu original de vinculació nen-robot inspirat en la afiliació d'humans i animals - i més concretament, en la relació nen-gos- s’analitza el comportament de nens interactuant amb el robot Pleo –robot mascota en forma de nadó dinosaure-, amb un èmfasi en les seqüències d'intercanvi recíproc de la diada. Els resultats són de dos tipus: els etogrames del Pleo i dels nens, i una categorització conductual a més alt nivell, aplicables a altres plataformes i usuaris. A partir d’aquest estudi, s’analitza una experiència d’intervenció en un hospital pediàtric per observar les pràctiques interactives amb el robot Pleo, i per avaluar la viabilitat i l'eficàcia d'una intervenció basada en el Pleo per acompanyar els nens. Inspirat en els efectes beneficiosos de la companyia de mascotes reals, l'estudi va consistir en una etnografia, una anàlisi observacional d'una sessió de joc en grup amb el robot, i un estudi de cas longitudinal d'una experiència d’adopció d’un Pleo. Els resultats mostren que l’aspecte clau que impulsa la formació del vincle és la capacitat del robot per desplegar conductes d’aferrament creïbles –cerca de proximitat i sol·licitud de recursos- que provoquen comportaments complementaris de criança i joc en els nens, més enllà de l'efecte novetat. D'altra banda, la versatilitat de Pleo permet diverses modalitats d'interacció i joc, i satisfer diferents necessitats dels usuaris, com ara companyia, curiositat, entreteniment i facilitació social, també per nens i nenes amb necessitats especials i les seves famílies. En general, la introducció del joc basat en el robot va ser considerada pels professionals de l'hospital no només compatible amb la seva pràctica professional, sinó també com un recurs valuós per alleugerir l'estada dels nens a l'hospital

Social Robot Augmented Telepresence For Remote Assessment And Rehabilitation Of Patients With Upper Extremity Impairment

With the shortage of rehabilitation clinicians in rural areas and elsewhere, remote rehabilitation (telerehab) fills an important gap in access to rehabilitation. We have developed a first of its kind social robot augmented telepresence (SRAT) system --- Flo --- which consists of a humanoid robot mounted onto a mobile telepresence base, with the goal of improving the quality of telerehab. The humanoid has arms, a torso, and a face to play games with and guide patients under the supervision of a remote clinician. To understand the usability of this system, we conducted a survey of hundreds of rehab clinicians. We found that therapists in the United States believe Flo would improve communication, patient motivation, and patient compliance, compared to traditional telepresence for rehab. Therapists highlighted the importance of high-quality video to enable telerehab with their patients and were positive about the usefulness of features which make up the Flo system for enabling telerehab. To compare telepresence interactions with vs without the social robot, we conducted controlled studies, the first to rigorously compare SRAT to classical telepresence (CT). We found that for many SRAT is more enjoyable than and preferred over CT. The results varied by age, motor function, and cognitive function, a novel result. To understand how therapists and patients respond to and use SRAT in the wild over long-term use, we deployed Flo at an elder care facility. Therapists used Flo with their own patients however they deemed best. They developed new ways to use the system and highlighted challenges they faced. To ease the load of performing assessments via telepresence, I constructed a pipeline to predict the motor function of patients using RGBD video of them doing activities via telepresence. The pipeline extracts poses from the video, calculates kinematic features and reachable workspace, and predicts level of impairment using a random forest of decision trees. Finally, I have aggregated our findings over all these studies and provide a path forward to continue the evolution of SRAT

Social Touch

Interpersonal or social touch is an intuitive and powerful way to express and communicate emotions, comfort a friend, bond with teammates, comfort a child in pain, and soothe someone who is stressed. If there is one thing that the current pandemic is showing us, it is that social distancing can make some people crave physical interaction through social touch. The notion of “skin-hunger” has become tangible for many.Social touch differs at a functional and anatomical level from discriminative touch, and has clear effects at physiological, emotional, and behavioural levels. Social touch is a topic in psychology (perception, emotion, behaviour), neuroscience (neurophysiological pathways), computer science (mediated touch communication), engineering (haptic devices), robotics (social robots that can touch), humanities (science and technology studies), and sociology (the social implications of touch). Our current scientific knowledge of social touch is scattered across disciplines and not yet adequate for the purpose of meeting today's challenges of connecting human beings through the mediating channel of technology

Training Needs and Development of Online AT Training for Healthcare Professionals in UK and France

Background: Assistive Technology (AT) solutions for people with disabilities has become part of mainstream care provision. Despite advantages of AT on offer, abandonment and non-compliance are challenges for healthcare professionals (HCPs), introducing this technology to clients. Studies of abandonment reveal that 1/3 of all devices provided to service users end up stored unused. Key need is training to make informed decisions about AT tailored to individual needs and circumstances. In an online survey undertaken by the ADAPT project, HPCs identified AT training needs and barriers. Currently, a programme is being developed aimed at introducing AT concepts and enhancing practices to a wide range of HCPs. Method: Survey questions explored gaps, availability, qualifications and barriers to AT training in England and France. A series of consultation meetings with ADAPT partners took place. An advisory group consisting of longstanding AT users and their formal/informal carers and HCPs (occupational therapist, speech and language therapist, psychologist and biomedical engineer) contributed to the discussions on survey findings, development and evaluation of AT training for HCPs, key content areas and means of delivery. Key results: HCPs had no AT specific qualifications (UK 94.6%; FR 81.3%) nor in-service AT training (UK 65.1%; FR 66.4%). They either did not know of AT courses (UK 63.3%) or knew that none existed (FR 72.5%). Barriers to AT training were mainly local training (UK 62.7%, FR 50%) and funding (UK 62.7%, FR 55.7%). Some training priorities were clearer for French HCPs – overall knowledge of AT devices (82.1%, UK 45.8%), customization of AT (65.3%, UK 30.1%), assessing patient holistically (53.4%, UK 25.3%), educating patient/carers (56.5%, UK 28.3%) (p < 0.001). Variances may be due to differing country-specific HCP education approach. A third of both groups highlighted also abandonment, client follow-up, powered wheelchair training and prescribing AT. To bridge gaps in knowledge and identified training needs of HCPs, the online interactive training programme starts by introducing foundations of AT, including definitions, types/uses of AT, legislation/policies and AT in practice. More specialist units build and expand on specific areas, e.g. AT for mobility, communication, assessment and evidence-based practice. The biopsychosocial model of Health and World Health Organisation’s (WHO) International Classification of Functioning, Disability and Health (ICF) framework underpin development of content. ICF shifts focus from disability to health and functioning, in line with a social model of rehabilitation. E-learning comprises existing videos, AT textbook material and bespoke animated presentations. Selfassessment and evaluation of training are embedded and learners receive certificate of completion. Training was piloted to a group of HCPs trainees and postregistration HCPs who commented on relevance of AT content, clarity, accessibility of presentation, and usefulness. Users found training very useful, especially legislation/policies and AT literature. Conclusion: Overall, survey results suggest that both UK and French HCPs’ training on AT solutions is limited and highly variable. There is need for crosschannel AT professional competencies, availability of work-based training and funding support. Development of online, interactive training aims to increase professional confidence and competence in this area as well as the evidence base for AT

A Literature Review of the Challenges Encountered in the Adoption of Assistive Technology (AT) and Training of Healthcare Professionals

Background: Long-term disabilities often result in loss of autonomy and social interaction. Accordingly, there is a demand for Assistive Technology (AT) devices to enable individuals to live independently for as long as possible. However, many people experience difficulties in obtaining and using AT. This paper presents findings from a narrative literature review undertaken as part of the development of AT training for healthcare professionals, one of the work areas of the ADAPT project (Assistive Devices for Empowering Disabled People through Robotic Technologies), funded by EU INTERREG France (Channel) England. The results of the review informed the design of a survey of healthcare professionals regarding their views and experiences of AT and the development of AT training. Method: The review sought to understand challenges encountered in the adoption and use of AT as well as how training of healthcare professionals in AT takes place. A narrative approach was adopted as the most appropriate way to synthesise published literature on this topic and describe its current state-of-art. Narrative reviews are considered an important educational tool in continuing professional development. An initial search was conducted via databases in the UK and France, including CINAHL, Academic Search Index, Social Sciences Citation Index, BDSP (Base de données en Santé Publique), Documentation EHESP/MSSH (Ecole des Hautes Etudes en Santé Publique/Maison des Sciences Sociales et Handicap), Cairn, Google Scholar and Pubmed. Inclusion criteria for the review included: covering issues relating to AT provision and training, English or French language, and published from 1990 onwards. Application of these criteria elicited 79 sources, including journal papers (48), reports (11), online sources (11), books (6) and conference papers (3). Sources were thematically analysed to draw out key themes. Key results: The majority of papers were from USA and Canada (27), then UK (20) and France (19). Others were from Europe (7), Australia (3), country unknown (2), and one joint UK/France publication. The main source of literature was journal papers (48), of which the most common types were practice reports (18), evaluation surveys (10) and qualitative studies (9). The review uncovered a number of key challenges related to the adoption of devices, including: difficulty defining AT across disciplines, lack of knowledge of healthcare professionals and users, obtrusiveness and stigmatisation AT users can experience when using devices, and shortfalls in communication amongst professional groups and between professionals and users. These issues can lead to abandonment of AT devices. Furthermore, substantial barriers to healthcare professionals exist, including inconsistent provision and quality of training, lack of evaluation of training, lack of resources and funding, shortage of qualified professionals to teach, and the increasingly rapid development of the technologies. Conclusion: Support, training and education for prescribers, distributors, users, and their carers is vital in the adoption and use of AT. Evidence indicates a need for comprehensive education in the AT field, as well as ongoing assessment, updates and evaluation which is embedded in programmes

A Survey of Assistive Technology (AT) Knowledge and Experiences of Healthcare Professionals in the UK and France: Challenges and Opportunities for Workforce Development

Background: Assistive Technologies (AT) in healthcare can increase independence and quality of life for users. Concurrently, new AT devices offer opportunities for individualised care solutions. Nonetheless, AT remains under-utilised and is poorly integrated in practice by healthcare professionals (HCPs). Although occupational therapists (OTs), physiotherapists and speech and language therapists (SLTs) consider that AT solutions can offer problem-solving approaches to personalised care, they have a lesser understanding of application of AT in their practice. In this paper, we report findings of a survey on AT knowledge and experiences of HCPs in UK and France. Training needs also explored in the survey are presented in a separate paper on development of online training for the ADAPT project. Method: A survey of 37 closed/open questions was developed in English and French by a team of healthcare researchers. Content was informed by published surveys and studies. Email invitations were circulated to contacts in Health Trusts in UK and France ADAPT regions and the survey was hosted on an online platform. Knowledge questions addressed AT understanding and views of impact on user’s lives. Experience questions focussed on current practices, prescription, follow-up, abandonment and practice standards. 429 HCPs completed the survey (UK = 167; FR = 262) between June and November 2018. Key results: Participants were mainly female (UK 89.2%; FR 82.8%) and qualified 10+ years (UK 66.5%; FR 62.2%). A key group in both countries were OTs (UK 34.1%; FR 46.6%), with more physiotherapists and SLTs in UK (16.8%, 16.8%; vs. FR 6.5%, 2.3%), and more nurses in France (22.1% Vs. UK 10.8%). More HCPs were qualified to degree level in France (75.2%; UK 48.5%, p < 0.001). In terms of knowledge, all HCPs agreed that AT helps people complete otherwise difficult or impossible tasks (UK 86.2%; FR 94.3%) and that successful AT adoption always depends on support from carers, family and professionals (UK 52.7%; FR 66.2%). There were some notable differences between countries that require further exploration. For example, more French HCPs thought that AT is provided by trial and error (84.7%, UK 45.5%, p < 0.001), while more UK HCPs believed that AT promotes autonomous living (93.4%; FR 42.8%, p < 0.001). Also, more French HCPs considered that AT refers exclusively to technologically advanced electronic devices (71.8%, UK 28.8%, p <0.001). In both countries, top AT prescribers were OTs, physiotherapists and SLTs. Respondents had little/no knowledge in comparing/choosing AT (UK 86.8%; FR 76.7%) and stated they would benefit from interdisciplinary clinical standards (UK 80.8%; FR 77.1%). A third of HCPs did not know if AT users had access to adequate resources/support (UK 34.1%; FR 27.5%) and rated themselves as capable to monitor continued effective use of AT (UK 38.9%; FR 34.8%). Conclusion: Knowledge and application of AT was varied between the two countries due to differences in health care provision and support mechanisms. Survey findings suggest that HCPs recognised the value of AT for users’ improved care, but had low confidence in their ability to choose appropriate AT solutions and monitor continued use, and would welcome AT interdisciplinary clinical standards

Enhanced Living Environments

This open access book was prepared as a Final Publication of the COST Action IC1303 “Algorithms, Architectures and Platforms for Enhanced Living Environments (AAPELE)”. The concept of Enhanced Living Environments (ELE) refers to the area of Ambient Assisted Living (AAL) that is more related with Information and Communication Technologies (ICT). Effective ELE solutions require appropriate ICT algorithms, architectures, platforms, and systems, having in view the advance of science and technology in this area and the development of new and innovative solutions that can provide improvements in the quality of life for people in their homes and can reduce the financial burden on the budgets of the healthcare providers. The aim of this book is to become a state-of-the-art reference, discussing progress made, as well as prompting future directions on theories, practices, standards, and strategies related to the ELE area. The book contains 12 chapters and can serve as a valuable reference for undergraduate students, post-graduate students, educators, faculty members, researchers, engineers, medical doctors, healthcare organizations, insurance companies, and research strategists working in this area