Annunziata Silvia, Santos Laura, Caglio Arianna, Geminiani Alice, Brazzoli Elena, Piazza Elena, Olivieri Ivana, Pedrocchi Alessandra, Cavallini Anna
IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy.
Front Psychiatry. 2024 Jun 28;15:1356331. doi: 10.3389/fpsyt.2024.1356331. eCollection 2024.
Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder characterized by persistent deficits in social communication, social interaction, and restricted behaviors. The importance of early intervention has been widely demonstrated, and developmental trajectories in ASD emphasize the importance of nonverbal communication, such as intransitive gesture production, as a possible positive prognostic factor for language development. The use of technological tools in the therapy of individuals with ASD has also become increasingly important due to their higher engagement and responsiveness to technological objects, such as robots.
We developed a training protocol using the humanoid robot NAO, called IOGIOCO (Interactive mirroring Games wIth sOCial rObot), based on the use of intransitive gestures embedded in naturalistic dialogues, stimulating a triadic interaction between child, robot and therapist. The training was divided into six levels; the first 2 levels were called "familiarization levels," and the other 4 were "training levels". The technological setup includes different complexity levels, from mirroring tasks to building spontaneous interactions. We tested the protocol on 10 preschool children with ASD (aged 2-6 years) for 14 weeks. We assessed them at recruitment (T0), at the end of training (T1), and after 6 months (T2).
We demonstrated the tolerability of the protocol. We found that one group (n=4, males and 2 females) reached the training level, while another and group (n=6 males) remained at a familiarization level (mirroring), we analyzed the results for the two groups. In the group that reached the training levels, we found promising results, such as an improvement in the Social Adaptive Domain of the ABAS-II questionnaire between T0 and T2.
While current results will need a Randomized Controlled Trial to be confirmed, the present work sets an important milestone in using social robots for ASD treatment, aimed at impacting social and communication skills in everyday life.
自闭症谱系障碍（ASD）是一种神经发育障碍，其特征是社交沟通、社交互动持续存在缺陷，以及行为受限。早期干预的重要性已得到广泛证实，ASD的发育轨迹强调非言语沟通的重要性，例如不及物手势的产生，这可能是语言发展的一个积极预后因素。由于自闭症患者对技术工具（如机器人）的参与度更高且反应更积极，因此技术工具在自闭症患者治疗中的应用也变得越来越重要。
我们开发了一种使用人形机器人NAO的训练方案，称为IOGIOCO（与社交机器人的互动镜像游戏），该方案基于在自然对话中嵌入不及物手势的使用，刺激儿童、机器人和治疗师之间的三元互动。训练分为六个级别；前两个级别称为“熟悉级别”，另外四个是“训练级别”。技术设置包括从镜像任务到建立自发互动的不同复杂程度。我们对10名患有ASD的学龄前儿童（年龄在2至6岁之间）进行了为期14周的该方案测试。我们在招募时（T0）、训练结束时（T1）和6个月后（T2）对他们进行了评估。
我们证明了该方案的耐受性。我们发现一组（n = 4，4名男性和2名女性）达到了训练级别，而另一组（n = 6名男性）仍处于熟悉级别（镜像），我们分析了两组的结果。在达到训练级别的组中，我们发现了有希望的结果，例如在T0和T2之间ABAS-II问卷的社会适应领域有所改善。
虽然目前的结果需要通过随机对照试验来证实，但目前的工作在使用社交机器人治疗ASD方面树立了一个重要的里程碑，旨在影响日常生活中的社交和沟通技能。
