Advances in Mental Health Care: Five N = 1 Studies on the Effects of the Robot Seal Paro in Adults With Severe Intellectual Disabilities

Abstract

Background: The evidence base for psychological treatments for autism and mood disorders in people with moderate to severe intellectual disabilities (ID) is limited. Recent promising robot-based innovations in mental health care suggest that robot-based animal assisted therapy (AAT) could be useful to improve social skills and mood in people with moderate to severe ID. This study explores the efficacy of the innovative therapeutic robot seal Paro on alertness and mood in adults with moderate to severe ID. Method: Five N = 1 studies were performed in adults (59-70 years) with moderate to severe ID. During a control phase of four weeks, participants could interact with a plush seal, which was replaced by the robot seal Paro during an equally long treatment phase. Results: In one participant, alertness and mood, as rated by supervisors, improved during the treatment phase as compared to the baseline phase. The other four participants did not improve on either of the outcome measures. Conclusion: We conclude that robot-based AAT does not have clear beneficial effects on alertness and mood in adults with moderate to severe ID, but that positive interactions with the robot seal could be of therapeutic value in itself.

Friends from the Future: A Scoping Review of Research into Robots and Computer Agents to Combat Loneliness in Older People

“…85 In another study, Paro acted as a direct companion to five adults with severe intellectual disabilities who formed an emotional connection with the robot. 86 Similar results have been found with the Huggable Bear robot, which has been shown to serve a social catalyst role between hospitalized children and their parents, 87 and to provide direct companionship. 88 Robots may also be effective facilitators of social interaction for children; an AV1 telepresence robot was found to help hospitalized children with cancer connect with classmates during remote learning activities.…”

“…This has also been shown in children and adults with intellectual disabilities. 85,86 Paro acted as a catalyst for social interaction between hospitalized children and other patients or staff, and as a direct companion for these children. 85 In another study, Paro acted as a direct companion to five adults with severe intellectual disabilities who formed an emotional connection with the robot.…”

Robotic Psychology: A PRISMA Systematic Review on Social-Robot-Based Interventions in Psychological Domains

“…In general, PARO seems promising to improve positive affect in children [47], mood, and alertness in adults with moderate to severe intellectual disabilities, fostering an increase in activities and directness in the environment [48]. Moreover, findings also reported the promotion of positive behavioral states (e.g., calmness, sleep behaviors, conversing) and reduction of negative ones (e.g., sadness, yelling, and isolative behaviors) in veterans with and without dementia [49].…”

“…For example, some interventions are, again, based on the paradigms of animal-assisted therapy [48] or they sink the roots in a body of research showing how social robots can facilitate interventions [61] and convey a sense of presence while eliciting positive social responses [73,74]. In the selected studies, social robots showed the potential to improve mood in intellectual disabilities [48] and depression [67], foster positive behaviors in the elderly with dementia [49], increase sensory awareness and mood during meditation [60], and promote healthy eating behaviors [42]. Moreover, social robots were also able to create an amusing setting [63] and elicit self-disclosure, but less so than a human interaction partner [40].…”

“…In one study participants were unequally distributed between the experimental conditions due to the randomization process with a small sample size (law of large numbers) [31]. Moreover, two studies reported having missing data [32,48]. The lack of some data may have biased results.…”