Roles, Strengths and Challenges of Using Robots in Interventions for Children with Autism Spectrum Disorder

Roles, Strengths and Challenges of Using Robots in Interventions for Children with Autism Spectrum Disorder

Huijnen, C. A. G. J., Lexis, M. A. S., Jansens, R., & de Witte, L. P. (2019). Roles, strengths and challenges of using robots in interventions for children with autism spectrum disorder. Journal of Autism and Developmental Disorders, 49, 11-21. doi: 10.1007/s10803-018-3683-x


In the past decade, there has been an increase in studies researching the utility of incorporating life-like robots into treatment for children with Autism Spectrum Disorder (ASD). Robots have been proposed as helpful in several different ways, including diagnosis, treatment provider, and as a model for either desirable social behavior or for possible behavior of a peer. Despite emerging promising findings, robots are still rarely used within treatments for children with ASD.

KASPAR (“Kinesics and Synchronization in Personal Assistant Robotics”) is one type of life-like robot that is the size of a seated toddler and able to move its upper body (i.e., head, torso, arms, hands), make limited facial expressions, and speak. KASPAR is remote controlled by a professional to simulate that the robot is independently behaving. The present study was completed to get perspectives from professionals who work with individuals with ASD about what roles they saw KASPAR filling in treatment, as well as any strengths and challenges related to possible use.

Who was involved?

Seventy professionals working with children with ASD in the Netherlands were included in the study, including teachers and assistants at special needs schools, psychologists, speech therapists, occupational therapists, physiotherapists, psychomotor therapists, behavioral therapists, treatment coordinators, and people working in care management. On average, these professionals had served children with ASD for 14 years. None of these professionals had prior knowledge of or experience in using robots in treatment.

Each professional participated in one of 12 focus group sessions, during which the group was asked to discuss their opinions for potential uses of KASPAR and the strengths or challenges to incorporating KASPAR into treatment. Focus group sessions were audio recorded and transcribed later. Two researchers reviewed all transcriptions and developed themes from content.

What was the outcome?

The participants discussed six potential uses for KASPAR across the focus group sessions. These included “provoker” (spurs interest and might increase likelihood child would engage), “reinforcer” (providing praise when appropriate), “trainer” (literally takes over as interventionist), “mediator” (supporting interaction with child with ASD and another person), “prompter” (specific, concrete, clear guidance), and “diagnostic information provider”(gather information on child’s social strengths and weaknesses relevant to diagnostic status). Strengths highlighted by the focus groups included individualization, enjoyment by the child, predictability of responses, and generalization of treatment beyond an adult therapist. Challenges to using KASPAR included a limited range of social responses, lack of mobility, possible fearfulness of KASPAR for a child, and if successful a potential for poor generalization to other interactions beyond KASPAR.

What are the strengths and limitations of the study?

Strengths: Participants included a large group of professionals that actively served children with ASD at the time of the study and were from a variety of organizations with long-term service experience.

Limitations: The perspectives of caregivers were not examined. Findings represent the opinions of providers and do not necessarily reflect empirically-supported advantages and disadvantages of using KASPAR nor other robotic intervention systems. Also, since the study sample was from the Netherlands, it is unclear whether service professionals in other areas of the world would share these same views.

What are the implications?

Given the response from providers regarding acceptability of using robots in therapy, further research is warranted to assess possible roles KASPAR and other robots can serve in treatment to enhance outcomes for individuals with ASD. The same considerations that have to be made in all treatments (i.e., planning for maintenance and generalization, fading of prompts, transitioning roles, and promoting functional independence) will be applicable to investigations of robotic treatment supports.