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Outcomes of a Robot-Assisted Social-Emotional Understanding Intervention for Young Children with Autism Spectrum Disorders

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Abstract

This study is a randomized control trial aimed at testing the role of a human-assisted social robot as an intervention mediator in a socio-emotional understanding protocol for children with autism spectrum disorders (ASD). Fourteen children (4–8 years old) were randomly assigned to 10 sessions of a cognitive behavioural therapy (CBT) intervention implemented in a group setting either with or without the assistance of a social robot. The CBT protocol was based on Rational Emotive Behaviour Therapy (REBT) principles. Pre- and post-intervention assessments were conducted using the Test of Emotional Comprehension (TEC) and the Emotional Lexicon Test (ELT). Substantial improvements in contextualized emotion recognition, comprehension and emotional perspective-taking through the use of human-assisted social robots were attained.

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Data Availability

The datasets acquired, used and analyzed during the current study are reported in the Supplementary Materials.

Notes

  1. In this paper, we have chosen to use the expression “on the autism spectrum” to describe children with a diagnosis of autism spectrum disorder according to DSM-5 (American Psychiatric Association 2013). This expression is widely accepted by professionals and stakeholders (Kenny et al. 2016) and avoids the person-first (person with autism or ASD) versus identity-first debate (autistic or ASD person). The children involved in our study are too young to choose for themselves how to self-identify and we do not feel comfortable choosing for them. Unless otherwise specified, in the following we will focus on individuals without intellectual disability, with functional language and with a DSM-5 symptom severity level of 1 or 2 on both DSM-5 domains.

Abbreviations

ABC:

Antecedent-behaviour-consequence

ADOS-2:

Autism diagnostic observation schedule, second edition

ASD:

Autism spectrum disorders

CBT:

Cognitive behavioual therapy

CG:

Control group

CSS:

Comparative severity score

DQ:

Developmental quotient

EC:

Emotion comprehension

ELT:

Emotional Lexicon Test

GMDS-ER 2-8:

Griffiths Mental Development Scales, Extended Revised: 2 to 8 years

Mdn:

Median

RA-CBT:

Robot assisted therapy cognitive behavioural therapy

RAT:

Robot assisted therapy

RRB:

Repetitive and restricted behaviours

REBT:

Rational emotional behaviour therapy

RG:

Robot group

SA:

Social affect

SD:

Standard deviation

TEC:

Test of emotional comprehension

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Acknowledgments

We acknowledge all the children and their parents for their help and participation. A special thank you to the Municipality of Messina and our research assistants for their constant support.

Funding

This research has been fully supported by the grant from the Sicilian Region of Italy (Assessorato Regionale dell’Istruzione e della Formazione Professionale, Avviso 11/2017 Rafforzare l’occupabilità nel sistema R&S e la nascita di spin off di ricerca in Sicilia – P.O. FSE 2014/2020) project no. 2014.IT.05.SFOP.014/3/10.4/9.2.10/0011 - CUP G47B17000100009, entitled SANi.

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Author notes

  1. Liliana Ruta and Giovanni Pioggia contributed equally to the study.

Authors and Affiliations

  1. National Research Council of Italy (CNR) – Institute of Applied Sciences and Intelligent Systems “Eduardo Caianiello” (ISASI), via Torre Bianca snc, Istituto Marino di Mortelle, 98168, Messina, Italy

    Flavia Marino, Paola Chilà, Stefania Trusso Sfrazzetto, Cristina Carrozza, Ilaria Crimi, Chiara Failla, Mario Busà, Giuseppe Bernava, Gennaro Tartarisco, David Vagni, Liliana Ruta & Giovanni Pioggia

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  1. Flavia Marino
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Contributions

FM, LR, DV, PC, STS and GP designed the study. FM and LR performed the diagnostic and functional assessments of the participants. FM, PC and STS administered the protocol. CC, IC and CF administered the TEC and ELT tests as pre- and post-intervention assessments. LR, CC, IC and CF coded the data and reviewed the protocol adherence and fidelity. MB, GB, GT and GP realized the experimental set-up, developed the robot software and trained the therapists. DV, MB, GB, GT and GP processed the experimental data and performed the analysis. FM, LR, DV and GP wrote the manuscript. All authors provided critical feedback and helped shape the research, analysis and manuscript.

Corresponding author

Correspondence to Giovanni Pioggia.

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Ethics Approval

The study was conducted in accordance to the relevant guidelines and regulations for human subjects and the study design was approved by the Ethic Committee of the Research Ethics and Bioethics Committee (http://www.cnr.it/ethics) of the National Research Council of Italy (CNR). All the parents of the children who took part in the study gave their assent to participate in this study signing a written consent form.

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Marino, F., Chilà, P., Sfrazzetto, S.T. et al. Outcomes of a Robot-Assisted Social-Emotional Understanding Intervention for Young Children with Autism Spectrum Disorders. J Autism Dev Disord 50, 1973–1987 (2020). https://doi.org/10.1007/s10803-019-03953-x

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