Several hospitals that have paediatric units provide for children
specialised care that help them cope better with the situation. The process involves the use of a system of play and behavioural distraction. This prepares them better for the pre- and post-procedural steps in medical care. 

Therapeutic medical play is one such form of traditional intervention that aims to put children at ease in the hospital environment, and the situation they are in. It achieves this by the use of arts and crafts, games and other such activities.

To understand the therapeutic play better, researchers from Boston Children’s Hospital teamed up with MIT Media Lab and Northeastern University to conduct an experiment that used a robotic teddy bear called Huggable. More than 50 children at the hospital were part of the project, according to neurosciencenews.com. They were split into three groups: one used Huggable; another got a virtual Huggable (tablet based), and the third group was given a traditional teddy bear. 

The study, which was published in Pediatrics, found the group that used Huggable showed better results, including a more positive emotion. Children in this group were more than willing to get out of their bed to interact with the robot, including asking it personal questions, and also inviting Huggable to meet their families. “Such improved emotional, physical, and verbal outcomes are positive factors that could contribute to better and faster recovery in hospitalised children,” the researchers say.

This was a first-of-its-kind study that involved hospitalised children and social robotics in a live environment. Earlier, such studies were usually conducted in labs or had fewer children. 

Huggable, the robotic bear used, will help health care specialists, though it cannot replace them, the study adds. Co-author of the study Cynthia Breazeal, an associate professor of media arts and sciences, and founding director of the Personal Robots group, says: “It is a companion. Our group designs technologies with the mindset that they are teammates. We don’t just look at the child-robot interaction. It is about [helping] specialists and parents because we want technology to support everyone invested in the quality care of a child.”

Though the staff at paediatric wards try to put the children at ease, they might not be able to be with all the patients all the time, points out Deirdre Logan, a paediatric psychologist at Boston Children’s Hospital, who was also a part of the study. “There may also be kids who don’t always want to talk to people and respond better to having a robotic stuffed animal with them. It is exciting to know what types of support we can provide kids, who may feel isolated or scared about what they are going through.”

Other members on the research group were Brianna O’Connell, Duncan Smith-Freedman and Peter Weinstock from Boston Children’s Hospital; Matthew Goodwin and James Heathers from Northeastern University, and Sooyeon Jeong, a PhD student in the Personal Robots group.

Huggable is a plush teddy bear with digitally animated eyes. The first prototype came out in 2006. A specialist operates it remotely using a special software. The operator, sitting outside a patient’s room, can get the bear to change its expressions and look anywhere she wants. The specialist talks into a microphone and the voice comes out of a speaker on Huggable. But, the pitch is higher so that the child feels the bear also has a child’s voice. The interaction is monitored remotely using a camera. 

Huggable in this research

Children in the age group of 3 to 10 were part of this particular research. Huggable would introduce doctors before they entered a child’s room. It also helped specialists understand what the patient’s interests were. While playing with younger children, the specialist operating Huggable would sing nursery rhymes, moving the bear’s arms with the tune. While playing with older children, the bear would describe an object in the room and ask them to identify it. 

Researchers kept tabs on the interactions and, using questionnaires, recorded how patients and families interacted with the bear. They also recorded the patient’s moods and perceived pain levels. Cameras in the patient’s room captured speech patterns and a software analysed these to understand if they were happy or sad. 

It was found that a higher number of children and parents liked it when they were playing with Huggable than those playing with the virtual bear or even the traditional teddy bear. Speech analysis also confirmed this. Parents of these children also reported lower levels of perceived pain. A very large number, 93 per cent precisely, of patients in the Huggable group completed their interactions. 

The robot helped ensure greater involvement of the family in the process, said another paper based on this study. This improved the intervention. “Those are findings we didn’t necessarily expect in the beginning,” says Jeong, also a co-author on the previous paper. “We didn’t tell families to join any of the play sessions — it just happened naturally. When the robot came in, the child, robot and parents all interacted more.”

Another helpful outcome of the study was the researchers got some valuable inputs that can help them achieve their ultimate goal: make a fully autonomous robot. They were able to understand which gestures might be useful. 

“In these early studies, we captured data … to wrap our heads around an authentic use-case scenario where, if the bear was automated, what does it need to do to provide high-quality standard of care,” Breazeal says.

Such an automated robot would be useful to improve the quality of care given to a patient. It might even be possible to give a child an autonomous robot after discharge. This would help medical professionals keep tabs on how the patient is recuperating.

“We want to continue thinking about how robots can become a part of the whole clinical team and help everyone,” Jeong says. “When the robot goes home, we want to see the robot monitor a child’s progress. If there is something clinicians need to know earlier, the robot can let them know, so (they’re not) surprised at the next appointment to see the child hasn’t been doing well.”  For the researchers, the next step is trying to zero in on the type of patients who would benefit the most with Huggable’s interventions. “We want to find the sweet spot for the children who need this kind of extra support,” Logan adds.