Using assistive robots to promote inclusive education

Exploring new horizons: Emerging therapeutic strategies for pediatric stroke

Pediatric stroke presents unique challenges, and optimizing treatment strategies is essential for improving outcomes in this vulnerable population. This review aims to provide an overview of new, innovative, and potential treatments for pediatric stroke, with a primary objective to stimulate further research in this field. Our review highlights several promising approaches in the realm of pediatric stroke management, including but not limited to stem cell therapy and robotic rehabilitation. These innovative interventions offer new avenues for enhancing functional recovery, reducing long-term disability, and tailoring treatments to individual patient needs. The findings of this review underscore the importance of ongoing research and development of innovative treatments in pediatric stroke. These advancements hold significant clinical relevance, offering the potential to improve the lives of children affected by stroke by enhancing the precision, efficacy, and accessibility of therapeutic interventions. Embracing these innovations is essential in our pursuit of better outcomes and a brighter future for pediatric stroke care.

Exploring environmental factors affecting assistive technology strategies in mathematics learning for students with physical disabilities

PURPOSE

To explore the environmental facilitators and barriers affecting K-12 students with physical disabilities when using two assistive technology (AT) strategies, LEGO Mindstorms robots and a computer, in mathematics lessons.

MATERIALS AND METHODS

A qualitative multiple case study with three students with physical disabilities was conducted. The participants did five lessons in concepts they were studying in school with each AT strategy in a controlled environment. Observations of the lessons, and parent and teacher interviews after the last session were collected.

RESULTS

The AT strategies acted as facilitators because they were easy to use, participants could participate actively, and parents and school staff wanted to implement them. However, the strategies presented some barriers since the students required more time to complete the lessons with the robot, and some computer programs were not compatible with the students' skills. Also, barriers such as lack of technical knowledge on the part of parents and teachers, distractions in the environment, and funding issues were reported.

CONCLUSION

This study may be useful for rehabilitation staff and teachers who are considering implementing AT to support the participation of students with disabilities. Personnel needs to be trained to use the AT strategies, and several modifications may be necessary for the satisfactory use of the devices.IMPLICATIONS FOR REHABILITATIONHands-on manipulation promotes the active learning of early mathematical concepts. Students with disabilities may have the opportunity to participate in active learning through assistive technology (AT).Knowledge about environmental factors that may facilitate or limit the use of AT in the classroom will help teaching staff make decisions when implementing these strategies with students with disabilities.The use of an AT strategy may depend on the objectives the rehabilitation staff and teachers want to achieve during a task. For instance, the robot could be used for tailoring a task according to the student's needs and abilities. On the other hand, computer programs could be considered if time and ease of use are important factors.

The use of robots for augmentative manipulation during play activities among children with motor impairment: a scoping review

PURPOSE

To describe the extent, type, and quality of studies involving robots for augmentative manipulation during play by children with severe motor impairments (CwSMI), and to explore how they influenced children's cognitive skills and engagement.

METHODS

Web of Science, Scopus, PubMed & EBSCO were systematically searched for articles published until March 2021, that reported cognitive skills and/or engagement outcomes from interventions involving the use of robots in play activities, where participants included CwSMI, and full-text was available. Data extracted comprised characteristics of participants, study design, purpose of the study, outcomes assessed, collection methods, and intervention carried out (robot-environment interaction and robot used).

RESULTS

Eight mobile robots and five robotic arms were reported in the 17 included and reviewed articles. Most of them informed a positive impact on CwSMI's cognitive skills and/or engagement. However, the studies scored poorly on a five-criteria quality assessment, and only one single-case design proved strong evidence of treatment. None of the analysed interventions was an evidence-based practice.

CONCLUSION

The use of manipulative robots during play activities may have a positive impact on the CwSMI's cognitive skills and engagement in activities. However, further studies with higher internal and external validity are needed to support stronger evidence.Implications for rehabilitationThe use of robots for augmentative manipulation during play activities may have a positive influence on the cognitive functions and the engagement in activities of children with severe motor impairments.Through manipulative robots, this population could be able to show the abilities that are hidden due to their motor impairments, and subsequently, receive educational and physical training more aligned with their real capacities and potential.

Educational Robotics for Special Needs Students: Teachers’ Perspectives on Pre-service TrainingEducational Robotics for Special Needs Students: Teachers’ Perspectives on Pre-service Training

Since the introduction of LOGO by Seymour Papert in 1980 and the constructivist theories, after the teaching machines of Skinner, technology, robots and robotics activities have been viewed as effective educational tools. Multiple studies have demonstrated that robotics is a valuable device for special education students too. The present study is part of a particularly novel and challenging trend of research that intends to fill a knowledge gap regarding the perspectives and concerns of learning support teachers on educational robotics. Particularly by questioning teachers who have not received training in the use of educational robotics. In this exploratory study, 125 Italian pre-service learning support teachers were surveyed at the end or during their course specialization to determine their awareness and comprehension of educational robotics usage with students with special needs. The survey reveals that support teachers are not adequately trained to use educational robotics and that they are generally unfamiliar with it and they rarely employ it.

Preliminary testing of eye gaze interfaces for controlling a haptic system intended to support play in children with physical impairments: Attentive versus explicit interfaces

Introduction

Children with physical impairments may face challenges to play because of their motor impairments, which could lead to negative impacts in their development. The objective of this article was to compare two eye gaze interfaces that identified the desired toy a user wanted to reach with a haptic-enabled telerobotic system in a play activity.

Methods

One of the interfaces was an attentive user interface predicted the toy that children wanted to reach by observing where they incidentally focused their gaze. The other was an explicit eye input interface determined the toy after the child dwelled for 500 ms on a selection point. Five typically developing children, an adult with cerebral palsy (CP) and a child with CP participated in this study. They controlled the robotic system to play a whack-a-mole game.

Results

The prediction accuracy of the attentive interface was higher than 89% in average, for all participants. All participants did the activity faster with the attentive interface than with the explicit interface.

Conclusions

Overall, the attentive interface was faster and easier to use, especially for children. Children needed constant prompting and were not 100% successful at using the explicit interface.

Artificial Intelligence in Rehabilitation Targeting the Participation of Children and Youth With Disabilities: Scoping Review

BACKGROUND

In the last decade, there has been a rapid increase in research on the use of artificial intelligence (AI) to improve child and youth participation in daily life activities, which is a key rehabilitation outcome. However, existing reviews place variable focus on participation, are narrow in scope, and are restricted to select diagnoses, hindering interpretability regarding the existing scope of AI applications that target the participation of children and youth in a pediatric rehabilitation setting.

OBJECTIVE

The aim of this scoping review is to examine how AI is integrated into pediatric rehabilitation interventions targeting the participation of children and youth with disabilities or other diagnosed health conditions in valued activities.

METHODS

We conducted a comprehensive literature search using established Applied Health Sciences and Computer Science databases. Two independent researchers screened and selected the studies based on a systematic procedure. Inclusion criteria were as follows: participation was an explicit study aim or outcome or the targeted focus of the AI application; AI was applied as part of the provided and tested intervention; children or youth with a disability or other diagnosed health conditions were the focus of either the study or AI application or both; and the study was published in English. Data were mapped according to the types of AI, the mode of delivery, the type of personalization, and whether the intervention addressed individual goal-setting.

RESULTS

The literature search identified 3029 documents, of which 94 met the inclusion criteria. Most of the included studies used multiple applications of AI with the highest prevalence of robotics (72/94, 77%) and human-machine interaction (51/94, 54%). Regarding mode of delivery, most of the included studies described an intervention delivered in-person (84/94, 89%), and only 11% (10/94) were delivered remotely. Most interventions were tailored to groups of individuals (93/94, 99%). Only 1% (1/94) of interventions was tailored to patients' individually reported participation needs, and only one intervention (1/94, 1%) described individual goal-setting as part of their therapy process or intervention planning.

CONCLUSIONS

There is an increasing amount of research on interventions using AI to target the participation of children and youth with disabilities or other diagnosed health conditions, supporting the potential of using AI in pediatric rehabilitation. On the basis of our results, 3 major gaps for further research and development were identified: a lack of remotely delivered participation-focused interventions using AI; a lack of individual goal-setting integrated in interventions; and a lack of interventions tailored to individually reported participation needs of children, youth, or families.

Educational Robotics for children with neurodevelopmental disorders: A systematic review

This paper aims to provide a critical review of the studies dealing with Educational Robotics for children with Neurodevelopmental Disorders. We aimed to investigate whether in the literature there is a sound evidence that activities with robots improve the abilities and performances of children with special needs. This paper explores the methodological aspects as well as the outcomes of the selected studies to provide a clear picture of the state-of-the-art on this topic. After a systematic search in the online database via keyword searches, 15 scientific papers were included in this review. We applied strict selection criteria limiting our review only to papers reporting educational robotics activities with children (from 3 up to 19 years old) with a diagnosis of neurodevelopmental disorders, in which the children had the opportunity to somehow program the behaviours of real robots. The majority of experiences showed improvements in the participants' performance or abilities, their engagement and involvement, communication/interaction with peers, during robotics sessions. Some studies reported mixed results, calling for the need to carefully design the objective and the related activities of each experience.

Teachers’ Opinions towards Educational Robotics for Special Needs Students: An Exploratory Italian Study

Research reveals that robotics can be a valuable tool for school students with special needs (SNs). However, to our knowledge, empirical studies on teachers’ attitudes towards educational robotics for SNs students have been very limited and, in general, do not account for the great variability in the existent difficulties of school-aged children. Our aim is to fill this research gap. This post-test empirical study assessed Italian pre-service and in-service learning support teachers’ attitudes towards the application of Educational Robotics—ER with their students with SNs at the end of a 12-h training course. The results generally showed that most teachers perceived ER as a powerful tool for children with numerous SNs, particularly for Attention Deficit Hyperactivity Disorder—ADHD, Autism Spectrum Disorder—ASD, and Dyspraxia. Looking at the differences depending on the school level, kindergarten teachers perceived that ER is mostly helpful for ASD, ADHD, Down Syndrome—DS as well as with psychological or emotional distress or the needs of foreign students. For primary school teachers, ER was mostly helpful with ADHD, Dyspraxia and ASD. For both junior secondary school teachers and high school teachers, ER was mostly helpful with ASD, Dyspraxia, and ADHD.

Robotic Technology in Pediatric Neurorehabilitation. A Pilot Study of Human Factors in an Italian Pediatric Hospital

The introduction of robotic neurorehabilitation among the most recent technologies in pediatrics represents a new opportunity to treat pediatric patients. This study aims at evaluating the response of physiotherapists, patients and their parents to this new technology. The study considered the outcomes of technological innovation in physiotherapists (perception of the workload, satisfaction), as well as that in patients and their parents (quality of life, expectations, satisfaction) by comparing the answers to subjective questionnaires of those who made use of the new technology with those who used the traditional therapy. A total of 12 workers, 46 patients and 47 parents were enrolled in the study. Significant differences were recorded in the total workload score of physiotherapists who use the robotic technology compared with the traditional therapy (p < 0.001). Patients reported a higher quality of life and satisfaction after the use of the robotic neurorehabilitation therapy. The parents of patients undergoing the robotic therapy have moderately higher expectations and satisfaction than those undergoing the traditional therapy. In this pilot study, the robotic neurorehabilitation technique involved a significant increase in the patients’ and parents’ expectations. As it frequently happens in the introduction of new technologies, physiotherapists perceived a greater workload. Further studies are needed to verify the results achieved.

Effect of feedback and target size on eye gaze accuracy in an off-screen task

PURPOSE

Eye gaze interfaces have been used by people with severe physical impairment to interact with various assistive technologies. If used to control robots, it would be beneficial if individuals could gaze directly at targets in the physical environment rather than have to switch their gaze between a screen with representations of robot commands and the physical environment to see the response of their selection. By using a homogeneous transformation technique, eye gaze coordinates can be mapped between the reference coordinate frame of eye tracker and the coordinate frame of objects in the physical environment. Feedback about where the eye tracker has determined the eye gaze is fixated is needed so users can select targets more accurately. Screen-based assistive technologies can use visual feedback, but in a physical environment, other forms of feedback need to be examined.

MATERIALS AND METHODS

In this study, an eye gaze system with different feedback conditions (i.e., visual, auditory, vibrotactile, and no-feedback) was tested when participants received visual feedback on a display (on-screen) and when looking directly at the physical environment (off-screen). Target selection tasks in both screen conditions were performed by ten non-disabled adults, three non-disabled children, and two adults and one child with cerebral palsy.

RESULTS

Tasks performed with gaze fixation feedback modalities were accomplished faster and with higher success than tasks performed without feedback, and similar results were observed in both screen conditions. No significant difference was observed in performance across the feedback modalities, but participants had personal preferences.

CONCLUSION

The homogeneous transformation technique enabled the use of a stationary eye tracker to select target objects in the physical environment, and auditory and vibrotactile feedback enabled participants to be more accurate selecting targets than without it.Implications for RehabilitationBeing able to select target objects in the physical environment by eye gaze could make it easier for children with disabilities to control assistive robots, because in this way they do not have to change their focus between a computer screen with commands and the robot.Providing auditory or vibrotactile feedback when using an eye gaze system made it faster and easier to know if a target was being gazed upon.Being able to select targets in the environment using eye gaze could be beneficial for other assistive technology, too, such as destination selection for power wheelchairs.

A feasibility study of eye gaze with biofeedback in a human-robot interface

Play is a vital activity in which children learn skills and explore the environment through object manipulation. Assistive robots have been used to provide access to play, and Forbidden Region Virtual Fixture (FRVF) guidance at the user interface could help the users make the robot traverse the play environment more efficiently because it behaves like virtual walls to follow. Eye gaze was used to indicate the user's intended target and generate the location of the virtual walls in a card sorting task. We eliminated the typical computer screen required for visual feedback to confirm gaze location, and examined the use of alternative feedback. In this feasibility study, first a group of adults without physical impairment tested the system with auditory and vibrotactile feedback modalities for the gaze fixation and with the virtual walls on and off for robot movement. Then case studies with children and individuals with physical impairments were performed. Even though gaze fixation feedback and the virtual wall did not improve the performance of adult participants without impairment, the feedback increased the speed and accuracy of the gaze fixation and the virtual walls improved the movement efficiency for the participants with impairment and a 6-year-old child without impairment.

New technologies and future trends

Numerous technologies have been introduced for the diagnosis, treatment, and management of patients with neurologic disorders, offering the promise of early diagnosis, tailored and individualized interventions, improvement in quality of life, and restoration of neurologic function. Many of these technologies have become available commercially without having been evaluated by rigorous clinical trials and regulatory reviews, or at the least by peer review of results submitted for publication. A subset is intended to assess, assist, and monitor cognitive functions, motor skills, and autonomic functions and as such may be applicable to persons with developmental disabilities. Barriers that have previously limited the use of technologies by persons with neurodevelopmental disabilities are disappearing as new technologies that have the potential to substantially augment diagnosis and interventions to enhance the daily lives of persons with these disorders are emerging. While recent and future advances in technology have the potential to transform their lives, cautious and thoughtful evaluation is needed to ensure the technologies provide maximal value. As such, further work is needed to demonstrate feasibility, efficacy, and cost-effectiveness, and technologies should be designed to be optimized for individual use.