Robots are increasingly being used as replacements for human contact. Researchers are proposing autonomous robots for providing therapy to autistic children. This may be causing more harm than good. Rather certain uses of robot could cause long term post-traumatic stress disorder.
At the University of Hertfordshire, a robot called Kaspar i, is used to teach social skills. The child sits in front of the robot and encouraged by researchers and carers to interact with the robot. For an autistic child, already struggling to cope with sensory stimulation, her anxiety is only increased to a point at which she hits out at the robot. ii
The European DREAM project iii promised to go further. The human therapist will be replaced by robots which will train autistic children to behave in a socially acceptable way. The child will spend hours alone with the robot practicing repetitive behaviour dictated by the robot which will adjust its responses based on sensors in a smart room which detect the child’s response.
The DREAM project uses a NAO robot to implement Applied Behavioural Analysis (ABA) iv, a controversial behavioural conditioning therapy which involve hours of repetition based on rewards and punishments. ABA seeks to shape external behaviour to be socially convenient. v It does not matter what is going on inside the child’s mind or what the cause of the distressing behaviour is.
In the 1930s BF Skinner developed operant conditioning vi, demonstrated in the behavioural conditioning of starved rats in cages. This radical behaviourism vii is based on the dated idea that the goal of psychology is to predict and control behaviour. The DREAM project aimed to predict and control the behaviour of autistic children. The cage is the smart room and the conditioning is rewards and punishments administered via a robot which called out instructions. viii
In the 1940s autistic children were locked up in institutions and fed and watered like animals. Autistic children exhibit repetitive self-stimulatory behaviour called stimming. This behaviour such as hand flapping is their attempt to manage the over-stimulation they feel in their sensory world. Children would gouge out their eyes, chew fingers off or chew arms down to the bone in an attempt to cope with the overwhelming distress caused from the sensory overload of a crowded institutional ward.
In the 1960s Ivor Lovaas ix tried to deal with this by applying operant conditioning hitting the child every time it attempted to stim. Instead of being chained in a ward, the child would endure forty hours or more a week of behavioural conditioning and repeating socially acceptable behaviour. The effect could be dramatic. The child would outwardly look normal and fit into what we expect. But it is the outward behaviour that has been controlled, just like a robot, by forcing the child to obey and stay in a situation which is overwhelming for them.
But since Lovaas viewed autistic child as non-human x – merely a physical human shell, but psychologically not human – the use of conditioning of the same type that was used to train monkeys
for space travel was quite acceptable. And 40 hours stressful conditioning, however inhuman, was better than being chained to a bed gnawing your finger off. The fact that ABA resulted in lifelong post-traumatic stress syndrome xi was neither here nor there.
Far from lacking in empathy and emotions, the autistic problem is more one of a flooding of the emotions and an over stimulation from more sensory input than the child can manage. The autistic child lacks the skills and brain pathways to manage the emotional and sensory input that a normal child can. xii
Autistic children feel their own emotions and others strongly, but the wiring between the emotional and cognitive parts of the brain is weak. Emotions are hard to label, difficult to source and extremely difficult to calm. This leads to anxiety, panic and a fight or flight response. Indeed the autistic child is the opposite of robotic. Overwhelmed by human emotion, he tries to shut down and manage his brain activity.
Social robots act on a limited set of social rules. Faced with the almost infinite variety of human social behaviour, the limited repertoire of a social robot, even if complemented with attempts at machine learning, will be unable to cope with the human’s social variety. For a successful social robot interaction the variety of social response exhibited by the robot must match that of the human.
If we perceive autistic children as having a limited social repertoire we can view them as robotic and as a suitable case for social robots. But treating a robot and an autistic child as equivalent demeans the humanity of the child who may have skills and insights beyond the neurotypical.
Isolating an autistic child in a smart room with an autonomous robot xiii, based on the excuse that autistic children prefer machines to people which is the ambition of the DREAM project can only succeed in dehumanising the child.
The child needs more sensitive and supportive human contact not none nor being treated like the husk of a machine. What is required is not a blanket treatment of autistic children as severely disabled, but a sensitive understanding of the sensory issues, preferences and problems of the individual child supported by gentle and patient human interaction. Of course, in a world where gentleness and patience are swamped by the need for efficiency and quick results, the temptation to adopt a mechanistic, industrial approach to autism is strong.
There may well be a role for robots in providing social distraction in the classroom and home and changing the social atmosphere to take the focus off the child. But the idea of replacing human contact with robots or attempting to programme human behaviour with a robot promises a questionable brave new world.
How to use robots with autistic children:
- Teach the child to do simple programming to make the robot say things or dance, thus giving the child a sense of control.
- Insert the robot in a discussion group with friends and therapists as a social discussion point. Such a distraction will reduce the social pressure and support interaction.
- Identify soothing movements and patterns which the child likes and program these into the robot to support the child in calming down and dampening meltdown.
- Deploy the robot as an option for time out in a classroom situation such that the child can go and sit with the robot for a while and hence avoid a meltdown.
- Develop programs for using the robot in music therapy.
- i https://www.herts.ac.uk/kaspar/meet-kaspar
- ii https://humanargument.wordpress.com/2018/07/27/robots-and-autism-is-kaspar-just-a-sophisticated-doll/
- iii https://www.dream2020.eu/
- iv https://www.bacb.com/about-behavior-analysis/
- v https://autisticuk.org/does-aba-harm-autistic-people/
- vi https://www.simplypsychology.org/operant-conditioning.html
- vii http://old.behavior.org/item.php?id=529
- viii https://www.degruyter.com/view/j/pjbr.2017.8.issue-1/pjbr-2017-0002/pjbr-2017-0002.xml?format=INT
- ix http://thelovaascenter.com/about-us/dr-ivar-lovaas/
- x http://neurodiversity.com/library_chance_1974.html
- xi https://www.emeraldinsight.com/doi/full/10.1108/AIA-08-2017-0016
- xii https://www.jkp.com/uk/the-autism-discussion-page-on-the-core-challenges-of-autism-2.html/
- xiii https://ieeexplore.ieee.org/document/8307127/