There is a lot of research being done in the areas of learning and social interaction for both normal, developing children as well as children with special needs. Recently there has been promising results using simple robots as an aide to such development through solitary and collaborative play (AURORA project).
On the other hand, the history of use of robotic devices for rehabilitation of motor function in stroke patients is much longer, starting somewhere in the early 1960s. But the gains have not been dramatic and the continued usage by patients abysmal.
There is strong evidence that robotic rehabilitation devices have become merely “exoskeletons with / without bio-feedback” and in some cases “active orthoses”, rather than being designed as devices which enable self expression in learning and play. There is no doubt that the active orthoses and the bio-feedback have shown positive results but full recovery occurred largely in cases where the motivation levels of the patients were high.
Therapy with children struggling with Autism and a patient trying to come to terms with the aftermath of stroke may have common elements due to the following similarities:
1. In both children as well as adults who have recently suffered cerebral trauma, the brain is in an elevated level of neuroplasticity for a particular, limited time-window.
2. Both groups suffer from low self-image and low social interaction.
3. Both groups have very short attention spans and inability to hold focus (especially if the stroke patients have some aphasia)
4. Both groups may have related issues with motor function.
5. Motivation to change in both groups is largely low.
6. Among the normal population, both age groups find great pleasure, security and energy interacting with each other, across all cultures.
The emerging concept of “Collaborative therapy” where two patients collaborate with each other or with their care givers or friends or with growing children shows great promise, in that it re-introduces the patient ( who has felt isolated so far as an invalid ) into the social milieu. Using universal design principles in the design of such “Orthotic Play and Collaborative Devices” will enable the patient to interact with whosoever he or she pleases, be it an infant or an elderly friend, able bodied or physically/mentally challenged.
So far, the case of interactive play has been seriously addressed only by Virtual Reality, where a patient is able to respond to / elicit response from a virtual object or person. But the experience of interacting with a real person is far richer and more stimulating to the various senses. It also brings into play more hand movements and upper extremity manipulations rather than being restricted to a mouse or a joy stick, and a computer screen. The participants may also use more natural positions to re-learn, rather than get stuck with a “table top” mindset.
We feel the coming together of two disciplines, robotics/mechatronics and learning behaviour, can give a boost to the accelerated recovery of patients living sub-optimal and dependent lives due to stroke. Hence it may be worthwhile to explore a study where these two disciplines work together to identify which interactions are critical to the patients and then design and develop simple robotic toys / devices to easily enable these interactions. These simple, non-screen based devices will also hopefully address the problem of low levels of long term acceptability/ enjoyablity of solely screen based systems for the elderly age-group. Simple therapy and disability assessment aids like the 9 Peg Board, the Purdue Board, Finger Ladder,Weight Well, hand dynamometer or pinch gauge can also be converted to “active play” devices.
In the same way, researched data about children with special needs can be incorporated into robotic design, so that the device becomes a mode of self expression, learning and collaborative play, as has been already tested in the AURORA project. The key again is to enable both normal children as well as children with special needs to use such devices for interaction.
On the other hand, the history of use of robotic devices for rehabilitation of motor function in stroke patients is much longer, starting somewhere in the early 1960s. But the gains have not been dramatic and the continued usage by patients abysmal.
There is strong evidence that robotic rehabilitation devices have become merely “exoskeletons with / without bio-feedback” and in some cases “active orthoses”, rather than being designed as devices which enable self expression in learning and play. There is no doubt that the active orthoses and the bio-feedback have shown positive results but full recovery occurred largely in cases where the motivation levels of the patients were high.
Therapy with children struggling with Autism and a patient trying to come to terms with the aftermath of stroke may have common elements due to the following similarities:
1. In both children as well as adults who have recently suffered cerebral trauma, the brain is in an elevated level of neuroplasticity for a particular, limited time-window.
2. Both groups suffer from low self-image and low social interaction.
3. Both groups have very short attention spans and inability to hold focus (especially if the stroke patients have some aphasia)
4. Both groups may have related issues with motor function.
5. Motivation to change in both groups is largely low.
6. Among the normal population, both age groups find great pleasure, security and energy interacting with each other, across all cultures.
The emerging concept of “Collaborative therapy” where two patients collaborate with each other or with their care givers or friends or with growing children shows great promise, in that it re-introduces the patient ( who has felt isolated so far as an invalid ) into the social milieu. Using universal design principles in the design of such “Orthotic Play and Collaborative Devices” will enable the patient to interact with whosoever he or she pleases, be it an infant or an elderly friend, able bodied or physically/mentally challenged.
So far, the case of interactive play has been seriously addressed only by Virtual Reality, where a patient is able to respond to / elicit response from a virtual object or person. But the experience of interacting with a real person is far richer and more stimulating to the various senses. It also brings into play more hand movements and upper extremity manipulations rather than being restricted to a mouse or a joy stick, and a computer screen. The participants may also use more natural positions to re-learn, rather than get stuck with a “table top” mindset.
We feel the coming together of two disciplines, robotics/mechatronics and learning behaviour, can give a boost to the accelerated recovery of patients living sub-optimal and dependent lives due to stroke. Hence it may be worthwhile to explore a study where these two disciplines work together to identify which interactions are critical to the patients and then design and develop simple robotic toys / devices to easily enable these interactions. These simple, non-screen based devices will also hopefully address the problem of low levels of long term acceptability/ enjoyablity of solely screen based systems for the elderly age-group. Simple therapy and disability assessment aids like the 9 Peg Board, the Purdue Board, Finger Ladder,Weight Well, hand dynamometer or pinch gauge can also be converted to “active play” devices.
In the same way, researched data about children with special needs can be incorporated into robotic design, so that the device becomes a mode of self expression, learning and collaborative play, as has been already tested in the AURORA project. The key again is to enable both normal children as well as children with special needs to use such devices for interaction.
Visualise a scenario where a child with autism or ADHD interacts and plays with an elderly stroke patient through a device which bridges the generation gap and limits the social isolation of both these vulnerable populations, besides aiding rehabilitation in a significant manner. That's something worth a lifetime of research effort !
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