THE FREE PLAY EXPERIENCE OF CHILDREN WITH SEVERE CEREBRAL PALSY - - PowerPoint PPT Presentation

THE EFFECT OF A ROBOTIC INTERVENTION ON THE FREE PLAY EXPERIENCE OF CHILDREN WITH SEVERE CEREBRAL PALSY

Adriana Maria Rios Rincon. PhD Supervisors: Al Cook PhD, Kim Adams PhD Faculty of Rehabilitation Medicine UofA Professor Occupational Therapy Universidad del Rosario Vilnius, Lithuania, October 27th, 2014

LUDI

Introduction - Elements of Playfulness

Elements of Playfulness. Adapted from: Skard, G., & Bundy, A. (2008). Test of Playfulness. In L. D. Parham, & L. S. Fazio, Play in occupational therapy for children (p. 73). St, Louis: Mosby Elsevier.

Play Nonplay

High Playfulness Low Playfulness Frame

Introduction - Elements of Playfulness

Elements of Playfulness. Adapted from: Skard, G., & Bundy, A. (2008). Test of Playfulness. In L. D. Parham, & L. S. Fazio, Play in occupational therapy for children (p. 73). St, Louis: Mosby Elsevier.

Play Nonplay

High Playfulness Low Playfulness Frame

• Mothers: more directive and less responsive
• Children: more passive, less responsive and

more compliant Introduction - CP – Mother-child play interaction

• Investigate the effect of a robot-based intervention

to promote free play, provided in the child’s natural environments, on

• Child’s playfulness
• Mother’s directiveness, responsiveness and

affect/animation

• Child’s play performance and satisfaction with the

performance

• Identify the mother’s satisfaction with the

intervention.

Objectives

Questions and hypothesis

Variable Intervention Follow-up Playfulness H1: ToP  ToP ? Maternal Directiveness H2: MBRS-D  MBRS-D ? Maternal Responsiveness H3: MBRS-R  MBRS-R ? Maternal Affect/Animation MBRS-AA ? MBRS-AA ? Occupational play performance COPM-P ? COPM-P ? Satisfaction with the occupational performance COPM-S ? COPM-S ? Satisfaction with the intervention ?

Baseline Intervention Follow-up

ToP - MBRS –COPM

Partially non-concurrent multiple baseline design

TRAINING

Methodology

2.5 - 4 weeks 5-8 sessions 5 - 6 weeks 10 sessions 4 weeks 3 sessions

Methodology - Participants GMFCS IV-V MACS IV-V

• 5 y/ 5 m
• PTI-2: Below average
• Good level of spoken

language

• 9 y/ 4 m
• PTI-2:Very poor
• Very limited spoken

language

• 6 y/ 4 m
• PTI-2: Poor
• Limited spoken

language

• 8 y/ 11 m
• PTI-2: Below average
• Very limited spoken

language P01 MP01 P02 MP02 P03 MP03 P04 MP04

30%

IRD=58% IRD=100%

Results – Children’s playfulness

0%

IRD=100% IRD=100%

0% 0% IRD=Improvement Rate Difference

IRD=100% IRD=60%

40%

Results: Mother’s Directiveness

IRD=100%

0% 0%

IRD= -40%

90% IRD=Improvement Rate Difference

Results: Mother’s Responsiveness

0% 0% 100% 100%

IRD= NA

Results

Hypotheses Intervention Supported? Evidence Playfulness  H1: ToP  YES Strong evidence Maternal Directiveness  H2: MBRS-D  3 mothers YES Moderate evidence Maternal Responsiveness  H3: MBRS-R  2 mothers No change 2 mothers (ceiling effect?) NO No evidence

Results

Questions Intervention Follow-up Playfulness ToP  3 children Maternal Directiveness MBRS-D  2 mothers Maternal Responsiveness MBRS-R  1 mother Maternal Affect/Animation No change No change Occupational play performance COPM-P  100% concerns COPM-P  36% concerns (2 ch) Satisfaction with the

• ccupational performance

COPM-S  81% concerns (3 ch) COPM-S  45% concerns (2 ch)  9% concerns (1 ch) Satisfaction with the intervention YES

Discussion – No Robot

Initiator Dominates the play Responder Distracted Passive Compliant Mom, tell me what to do I cannot play with my toys!

• I do not know how

you want to play

• You seem distracted
• I need to manipulate

your toys

• This is what your

therapist said to do Low Playfulness High Directiveness Minimal Responsiveness

child Mother

Video No Robot

Discussion - Robot

Initiator Lead the play Responder Follows the child play interests You can play with your toys! I am satisfied Go to explore! I am ready to help when needed

I can play with my toys!

Mom I need you help me. I want to do… Playfulness 

Sensitive adaptation

Directiveness  “what can I do with these objects using robot?”

Child Mother

Videos Robot

Discussion – HAAT Model

Natural Environment Child Switches Lego Robot Programs Robot’s movements Activity Free play Intrinsic Motivation  Internal Control 

Freedom to suspend reality 

Human Technology Physical Context: Toys Context Social Context: Mother Framing  Control self 

• Use of the robot have an impact on children’s

playfulness and can have an impact on mother’s behavior, perception and satisfaction

• AT can impact children’s social context
• Carryover of children’s playfulness. Tendency

towards the baseline levels Conclusions

• First study that investigates the effect of a

robotic intervention on free play of children with motor impairment.

• The intervention was child-oriented but still had

an effect on maternal directiveness and responsiveness for some mothers. Discussion - Novelty and contributions

Limitations

• Researcher not blinded
• Inexpensive technology
• MBRS Ceiling effect?
• Small sample of children

Discussion - Limitations a future research Future research

• Larger sample. Other

cultures

• Effects on:
• Mastery motivation, sense of

competence, and self-efficacy

• Coordination, manipulation,

posture, and communication

• Different playmates
• Pretend play
• Use of better robots

Advisor Committee Supervisor: Al Cook PhD Co-supervisor: Kim Adams PhD Joyce Magill-Evans PhD

Acknowledgements

Examiners Brenda Skrypnek PhD Robert Palisano PhD Additional Support

Anita Bundy PhD Patty Rigby PhD Rosario Laserna MSc Sharon Warren PhD Juan Forero PhD Monica Moreno PhD Claudia Castillo MSc student Fernanda Arbelaez FT Antonio Miguel Cruz PhD Johanna Darrah PhD Veronica Smith PhD Al Fleming Giselle Pelaez OT (Colombia) Paola Rocio Esquivel OT student (Colombia) Lina Maria Becerra OT student (Colombia) Asociación ACONINO (Colombia) Centro de Capacitación San Pedro Poveda (Colombia)

Participants

Thank you