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Autism Therapy From a Robot?

— Augmenting, not replacing, human therapists.

MedpageToday
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The concept sounds a bit backwards -- a robot teaching a child how to get along in the world -- but the idea and a product based on it are gaining traction.

RoboKind, a Texas-based robotics company, has pioneered a new teaching tool designed to meet the needs of children with autism. Its name is Milo and it's a 22-inch, wide-eyed, walking, talking doll-like robot. Milo is intended to help children learn to express empathy, self-motivate, and navigate social situations.

"It's not like we're trying to take away their autism," said a company consultant and an associate professor of communication disorders at the University of Texas at Dallas. "We're just trying to have them function in an environment that they will typically need to go to because they're human beings."

, mostly boys, according to the CDC.

Researchers and representatives for the company say children on the autism spectrum engage more readily with robots than with people, and children who are more engaged learn more.

"This robot is built for bonding," said , RoboKind's CEO and founder.

Children on the autism spectrum are often more different from one another than people realize, Rollins said. Still, there are core characteristics common to most children on the spectrum. These include deficits in social communication and interaction.

"Children with autism don't share information," said Rollins. They can make requests, but they can't describe to their parents what they did in school or let their parents know when they're feeling sick, she continued.

Enter Milo. Along with his human-like face, spiky hair and child-like voice -- specifically chosen for its friendliness -- Milo has a video screen in his chest that displays symbols and keeps students eyes focused on the goals of a lesson when their ears tune out. Milo also has sensors, cameras, and facial recognition software to capture a child's responses and evaluate progress.

Milo's lessons are administered through two iPads, one for the (human) instructor and one for the student. The instructor decides, based on a student's response, whether to move forward or repeat a module.

All throughout these sessions, Milo is also actively monitoring the student, measuring the amount of eye contact it receives, the speed of answers, and the student's frustration and interest level, said Margolin.

Rollins has been researching autism and treating children on the spectrum for 30 years.

She helped design the teaching curriculum that Milo uses. The goal of each lesson is to deconstruct basic social situations in plain language and have the children model them. For example, Rollins said, "When you say hello to someone you look, smile and say hi."

The curriculum also includes modules for learning how to be a guest at a birthday party, interpret facial expressions and emotions, predict what others might feel, and "be a good friend."

Educating a child with autism can cost from $17,000 to $22,000 a year, according to the company. The cost for a Milo robot including the curriculum is $5,000. RoboKind's representative said that some insurance companies have helped reimburse the cost.

About 70 Milo robots are currently in use. The majority are located in Texas schools and treatment centers. The remaining "Milos" are supporting research at American and European universities and several have been purchased by families, a spokesperson for Robokind said in an email.

In research sponsored by RoboKind, Rollins found that Milo is best suited to work with children who have the following skills:

  • Picture symbol recognition
  • Ability to answer yes/no questions
  • Ability to understand cause and effect
  • Ability to use a tablet to communicate

, section head of developmental and behavioral pediatrics at Beaumont Children's Hospital and the assistant professor at the Oakland University William Beaumont School of Medicine in Michigan, said she supports the premise of robotic therapy.

"Sometimes children with autism can connect better to things other than human beings. Sometimes they connect better to animals. That's why we've been using pets and dogs for children with autism."

Using robots is one more way of reaching children that are difficult to engage socially, she said.

Asked whether robot therapy could replace developmental therapists in places where clinicians are scarce, Hines said, "I think it could help." However, she added, "if this was the only mode of therapy I would be a little bit concerned, because I think you really need to have that human component as well," she said.

, a retired associate professor emeritus in psychiatry and pediatrics at Oregon Health and Science University, said that robotic therapy has a lot of promise, but he's not certain that a robot could teach a child a complex feeling such as empathy.

"It's one thing to teach people emotions. This person's facial expression is sad, and this person is happy, and this one's angry," he said.

"But it's another thing to be able to put yourself in the other person's shoes -- how do you teach somebody to do that?"