Nao autism

Rob'autisme: When Nao helps young autistic people to communicate

Since November 2014, cultural workshops introducing young autistic people to the manipulation of Nao, the small humanoid robot, have been set up by the Samothrace Psychotherapy Centre (Nantes University Hospital), Stereolux and the Robots! association in partnership with the Ecole Centrale de Nantes. They have initiated an unprecedented and promising scientific experiment that will continue from January 2016 with new workshops to help communicate. This project is called Rob'autisme.
Rob'autism is the encounter between the world of psychotherapy, the world of robotics and the world of the arts.
For several years now, the Nantes University Hospital (and more precisely its day hospital, the Psychotherapeutic Centre for Older Children and Adolescents) has been offering an audio workshop for young autistic people led by speech therapist Rénald Gaboriau. In 2012, following the meeting with Stereolux, a creation and diffusion space for contemporary music and digital arts, this workshop has integrated the intervention of sound artist Cécile Liège.
The meeting with Sophie Sakka, a researcher and teacher at Centrale Nantes, has made it possible to amplify these sound workshops since November 2014, by offering teenagers a discovery of the world of robotics.
In charge of the association Robots! which aims to democratize robotics, Sophie Sakka leads the workshop around Nao, in close connection with the sound production work already started in previous years.
Centrale Nantes is a partner in this project, actively working for the past two years to offer its engineering skills in the service of health.
The team of the day hospital and Sophie Sakka meet every fortnight in Stereolux for these workshops aimed at initiating teenagers suffering from autistic disorders to the manipulation of the small French humanoid robot Nao. In six months, their progress has been spectacular and has exceeded the expectations of health professionals.

A new and promising experience

For six months, Sophie Sakka, a robotics researcher at Centrale Nantes and head of the Robots! association, taught six teenagers suffering from autism spectrum disorders how to use the software that manages the movements and voice of the little robot. The teenagers first learned to discover Nao and the possibilities it offers - making it talk, move around... - then programmed it themselves to make it express itself: "They took him in hand very quickly. At first, they made NAO say what they couldn't express. Little by little, they started to talk to each other through the robot. »
Known to the general public for its danced performances, the robot Nao is directly piloted by these teenagers. It draws them into a sensory and sound experience through play, music and dance. During this workshop, the children produced a show based on Anthony Browne's "A story for four voices": they recorded the voices they were going to lend to Nao and printed the corresponding movements.
This is the first time that a specific audience is an actor in the very process of robot creation and programming. The children program the robot themselves, decide what they are going to make it say, feel or do as a movement: "The playful side is important for these youngsters who don't necessarily play a lot. During the sessions, they communicate, they're present."

Nao : A mediation support in autism therapy

From the very first sessions, the medical team saw the impact on the teenager on several levels: his ability to experiment, to communicate within his group and the pride in being able to show off his skills. They also noted an evolution from session to session (every 15 days) and a clear and lasting improvement in the the autistic child's daily life, even outside of sessions. "The result was unexpected on them, phenomenal. There was an evolution from session to session on their ability to communicate. After six months, we were dealing with teenagers who were no longer screaming to be heard, were concentrating better and were able to communicate with each other", enthused Sophie Sakka.
The robot is a reassuring and playful support to carry the call to the other, to invest and develop it. The staff of the Nantes University Hospital, which has been following these children for years, is also pleasantly surprised by this result: "It worked on them because of the transfer phenomenon. The robot has become their extension, it speaks for them. Everybody looks at him when he speaks, not the person handling him. So they are 'hidden' behind it and can express things they wouldn't dare to say. They feel safe".
A real appetite for computers has long been observed in these young people with pervasive developmental disorders. It brings creativity, spontaneity and opens up new interactions in the group. The work is done in pairs around a computer and a robot, which requires listening to the other person, giving him or her a place, but also "taking care" of the tool itself.
Beyond a sophisticated toy, Nao could well be a valuable therapeutic support that facilitates language, dialogue and allows children to better take into account the other by making them aware that they need to collaborate to program the robot.

Action research in progress

After an observation work during the workshops conducted in 2014-2015, an action-research work has been launched during this new session which will take place between January and June 2016. Conducted by Dr Laura Sarfaty of the Nantes University Hospital, the purpose of this scientific study is to determine, beyond the team's initial observations The Nao robots are an interesting tool to work on communication and relational skills in adolescents with autism. Here are the principles of this ongoing action-research, whose protocol is constantly evolving to adapt as the experimentation progresses.
People with Autism Spectrum Disorders (ASD) have a disruption in their ability to imagine the thoughts and intentions of others. The manipulation and programming of the Nao robot seems to be adapted to work on improving their communication skills.
An overall assessment will be carried out with all partners at the beginning, halfway through and at the end of the experimental phase. An assessment of each adolescent's communication and relationship skills is conducted after each session, as well as outside the workshop time in interviews with adolescents and their families.
In addition, an improvisational sketch played by the robots and led by the teenagers will be filmed at the beginning and end of the experiment. This will make it possible to measure the integration dimension of the social skills acquired through Nao's programming and manipulation work.
The analysis of their drawings representing the robot at the beginning and end of the project will also allow a clinical insight on the evolution of their representations and projections of this tool.
For its part, Stereolux intends to pursue this cultural action in coordination with its Arts & Technologies Laboratory, dedicated to experimentation and aimed at the emergence of technological advances and innovative uses by bringing together artists, entrepreneurs and researchers.

Towards the creation of a network

Given the success of the experiment, the four partners wish to continue this experience, share it as a therapeutic innovation and extend the project to other communities, in order to develop a protocol and give it a broader dimension.
The aim of the research work is to prefigure the development of a protocol so that this collective project can be replicated in a network in other cities in France and on different approaches to skills.
The latest figures provided by Nancy's Autism Resource Centre (ARC) show that one child in 100 is affected by autism (four boys for every girl). This represents about 8,000 births per year, or 600,000 people today. In the United States, according to the latest figures from the Centers for Disease Control, the prevalence rate of autism has increased from 1 in 150 in 2000 to 1 in 68 in 2010.
For France, the High Authority for Health has set the figure of 1 newborn out of 150 affected by autism. But the specialists estimate this rate largely underestimated.
"Families are often disoriented, especially since some follow-ups are not taken care of. The syndrome has been difficult to recognize, and is not yet fully recognized. It can be ignored by professionals, sometimes worried about the announcement of the diagnosis and the repercussions that it generates, sometimes entangled in personal theoretical orientations".explains Corinne Krux, president of the Asperger Lorraine association, in an interview with the Républicain Lorraine on 1 February 2016.
The mobilization of parents, the various awareness campaigns, the involvement of public authorities (autism plan 3) and now entrepreneurship, all contribute to making autism a major issue. Nao could be a nice compromise to help children and families in the fight against this disease, because we know that emotional involvement in a child's development is essential. Creating bonds, leading to the acquisition of social skills while avoiding isolation and the communication problems that characterize this disease, ... "robot therapy" could be a very precise therapeutic objective. Provided that it is within everyone's reach ...

Read more: For the first time, scientists have established a link between autistic behaviour and a neurotransmitter.


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