Comparison of Goal Achievement When Transitioning from In-Person Therapy to Teletherapy in the Westchester County Early Intervention Program Due to the COVID-19 Pandemic

The sudden transition to virtual therapeutic services during the COVID-19 pandemic provided a unique opportunity to explore telehealth as a platform for delivering early intervention (EI) services. Through retrospective chart review of 93 children, we collected the following data: demographics, diagnosed conditions, therapy type, service format, and provider-reported participant goal achievement (1=no progress, 2=little progress, 3=moderate progress, 4=great deal of progress, 5=outcome achieved) over a six-month period before and after transitioning to telehealth. Pre- and post-transition progress scores were compared using the Wilcoxon signed-rank test. Results demonstrated maintained progress among children who transitioned from in-person to virtual services for similar therapy types. Children receiving speech therapy in-person and virtually demonstrated increased achievement (3.00 vs 3.33; p=0.032). Participants receiving a particular therapy post-transition but not in-person attained similar achievement as those who received the same therapy only in-person. Our research suggests that teletherapy may be a viable option for delivering EI services. &nbsp

The use of virtual reality in the treatment of eating disorders

A high percentage of patients with eating disorders (ED) respond to treatments such as cognitive-behavioural therapy. However, some patients do not progress significantly with these treatments, or suffer relapses. The incorporation of new technologies may help to increase the efficacy of standard treatments. Virtual reality has been successfully used to treat body image disturbances in ED patients and seems a suitable technology for cue exposure therapy in this setting. We review the published literature and discuss the results

Multimodal Interfaces to Improve Therapeutic Outcomes in Robot-Assisted Rehabilitation

The paper presents the developing of a new robotic system for the administration of a highly sophisticated therapy to stroke patients. This therapy is able to maximize patient motivation and involvement in the therapy and continuously assess the progress of the recovery from the functional viewpoint. Current robotic rehabilitation systems do not include patient information on the control loop. The main novelty of the presented approach is to close patient in the loop and use multisensory data (such as pulse, skin conductance, skin temperature, position, velocity, etc.) to adaptively and dynamically change complexity of the therapy and real-time displays of a virtual reality system in accordance with specific patient requirements. First, an analysis of subject’s physiological responses to different tasks is presented with the objective to select the best candidate of physiological signals to estimate the patient physiological state during the execution of a virtual rehabilitation task. Then, the design of a prototype of multimodal robotic platform is defined and developed to validate the scientific value of the proposed approach

Development and preliminary evaluation of a novel low cost VR-based upper limb stroke rehabilitation platform using Wii technology.

Abstract Purpose: This paper proposes a novel system (using the Nintendo Wii remote) that offers customised, non-immersive, virtual reality-based, upper-limb stroke rehabilitation and reports on promising preliminary findings with stroke survivors. Method: The system novelty lies in the high accuracy of the full kinematic tracking of the upper limb movement in real-time, offering strong personal connection between the stroke survivor and a virtual character when executing therapist prescribed adjustable exercises/games. It allows the therapist to monitor patient performance and to individually calibrate the system in terms of range of movement, speed and duration. Results: The system was tested for acceptability with three stroke survivors with differing levels of disability. Participants reported an overwhelming connection with the system and avatar. A two-week, single case study with a long-term stroke survivor showed positive changes in all four outcome measures employed, with the participant reporting better wrist control and greater functional use. Activities, which were deemed too challenging or too easy were associated with lower scores of enjoyment/motivation, highlighting the need for activities to be individually calibrated. Conclusions: Given the preliminary findings, it would be beneficial to extend the case study in terms of duration and participants and to conduct an acceptability and feasibility study with community dwelling survivors. Implications for Rehabilitation Low-cost, off-the-shelf game sensors, such as the Nintendo Wii remote, are acceptable by stroke survivors as an add-on to upper limb stroke rehabilitation but have to be bespoked to provide high-fidelity and real-time kinematic tracking of the arm movement. Providing therapists with real-time and remote monitoring of the quality of the movement and not just the amount of practice, is imperative and most critical for getting a better understanding of each patient and administering the right amount and type of exercise. The ability to translate therapeutic arm movement into individually calibrated exercises and games, allows accommodation of the wide range of movement difficulties seen after stroke and the ability to adjust these activities (in terms of speed, range of movement and duration) will aid motivation and adherence - key issues in rehabilitation. With increasing pressures on resources and the move to more community-based rehabilitation, the proposed system has the potential for promoting the intensity of practice necessary for recovery in both community and acute settings.The National Health Service (NHS) London Regional Innovation Fund

Externalising moods and psychological states in a cloud based system to enhance a pet-robot and child’s interaction

Background:This PATRICIA research project is about using pet robots to reduce pain and anxiety in hospitalized children. The study began 2 years ago and it is believed that the advances made in this project are significant. Patients, parents, nurses, psycholo- gists, and engineers have adopted the Pleo robot, a baby dinosaur robotic pet, which works in different ways to assist children during hospitalization. Methods: Focus is spent on creating a wireless communication system with the Pleo in order to help the coordinator, who conducts therapy with the child, monitor, under- stand, and control Pleo’s behavior at any moment. This article reports how this techno- logical function is being developed and tested. Results: Wireless communication between the Pleo and an Android device is achieved. The developed Android app allows the user to obtain any state of the robot without stopping its interaction with the patient. Moreover, information is sent to a cloud, so that robot moods, states and interactions can be shared among different robots. Conclusions: Pleo attachment was successful for more than 1 month, working with children in therapy, which makes the investment capable of positive therapeutic possibilities. This technical improvement in the Pleo addresses two key issues in social robotics: needing an enhanced response to maintain the attention and engagement of the child, and using the system as a platform to collect the states of the child’s progress for clinical purposes.Peer ReviewedPostprint (published version

A proposed framework of an interactive semi-virtual environment for enhanced education of children with autism spectrum disorders

Education of people with special needs has recently been considered as a key element in the field of medical education. Recent development in the area of information and communication technologies may enable development of collaborative interactive environments which facilitate early stage education and provide specialists with robust tools indicating the person's autism spectrum disorder level. Towards the goal of establishing an enhanced learning environment for children with autism this paper attempts to provide a framework of a semi-controlled real-world environment used for the daily education of an autistic person according to the scenarios selected by the specialists. The proposed framework employs both real-world objects and virtual environments equipped with humanoids able to provide emotional feedback and to demonstrate empathy. Potential examples and usage scenarios for such environments are also described