Robotics Based Therapy in Chilean Children with Autism Spectrum Disorder (ASD)

Background: Technology appeals ASD children. The use of this interest to help them improve socialization skills has received increasing research attention in the last decade (Dautenhahn, K. et al, 2002). Furthermore, special interest of ASD children for LEGO toys has been observed because they are highly structured, systematic and predictable. Studies have shown their usefulness when applied in the appropriate therapeutic context; they can decrease disruptive behaviors and improve social skills in ASD children, in a spontaneous and entertaining way, being less exhausting for patients and therapists (Legoff et. al 2006; Owens et. al 2008). However no data or results has been reported in the Chilean context.

Objectives: To determine whether robotics based therapy improves social skills in a group of Chilean ASD children under treatment in a Child Neuropsychiatry Hospital Service, representative of Chile´s context, because of its national referral center condition.

Methods: Cases and controls, prospective longitudinal study. 3 groups of 4 children with ASD diagnosis, confirmed with Autism Diagnostic Observation Schedule (ADOS); age higher than 9 years, normal intellectual coefficient with WISC (Wechsler intelligence scale for children). A group participated in workshops of LEGO Robotics (LEGOr-w), the second in workshops of social skills (SS-w) and the last one was not intervened. Both workshops lasted 10 sessions, and were performed once every two weeks

Results: 4 children of male sex in each group, average age: 11 years. Comparable groups. Vineland: significant differences in categories: socialization (p=0.002) and communication (p=0.039) comparing initial and final average scores of the 3 groups. No differences between groups (p>0.05, confidence level of 95%). Video coding: Children that joined LEGOr-w improved the following behaviors: initiation of meaningful conversation, autonomy for resolution of problems; less disruption to other, less echolalia, fewer episodes of discouragement or abandonment of the activity, however, these changes did not have statistical significance. Surveys: Statistically non-significant difference between scores of satisfaction surveys comparing initial and final assessments of parents and children in both workshops. Workshop attendance: Statistically significant difference in the attendance between the LEGOr-w and the SS-w (p=0.009), being the LEGO robotics group the one with better participation.

Conclusions: Better adherence to LEGOr-w, no differences in Vineland between groups, while the three improved. Novel intervention oriented towards users of Chilean public health system with restricted access to technology and limited offer of therapeutic interventions. Therapy aimed towards an age group where indifference attitudes have negative impact on interventions, contrary to the observations of this study sample. Further research could measure social behavior using the Gilliam Autism Rating Scale-2 in Spanish version and increase the total number of sessions and participants to observe the likelihood of improved socialization, as reported in literature. Maternal interviews in LEGOr-w final session reported improvement in fine motor skills of children; this could be measured in further robotics-based therapy research.