The effects of embodied rhythm and robotic interventions on the spontaneous and responsive verbal communication skills of children with Autism Spectrum Disorder (ASD): A further outcome of a pilot randomized controlled trial.

The current manuscript is the second in a mini-series of manuscripts reporting the effects of alternative, movement-based, rhythm and robotic interventions on the social communication skills of 36 school-age children with ASD. This pilot randomized controlled trial compared the effects of 8-weeks of rhythm and robotic interventions to those of a standard-of-care, comparison intervention. The first manuscript reported intervention effects on the spontaneous and responsive social attention skills of children. In this manuscript, we report intervention effects on the spontaneous and responsive verbal communication skills of children. Communication skills were assessed within a standardized test of responsive communication during the pretest and posttest as well as using training-specific measures of social verbalization during early, mid, and late training sessions. The rhythm and comparison groups improved on the standardized test in the posttest compared to the pretest. The rhythm and robot groups increased levels of social verbalization across training sessions. Movement-based and stationary contexts afforded different types and amounts of communication in children with ASD. Overall, movement-based interventions are a promising tool to enhance verbal and non-verbal communication skills in children with ASD.

The Effects of Rhythm and Robotic Interventions on the Imitation/Praxis, Interpersonal Synchrony, and Motor Performance of Children with Autism Spectrum Disorder (ASD): A Pilot Randomized Controlled Trial.

We assessed the effects of three interventions, rhythm, robotic, and standard-of-care, on the imitation/praxis, interpersonal synchrony, and overall motor performance of 36 children with Autism Spectrum Disorder (ASD) between 5 and 12 years of age. Children were matched on age, level of functioning, and services received, prior to random assignment to one of the three groups. Training was provided for 8 weeks with 4 sessions provided each week. We assessed generalized changes in motor skills from the pretest to the posttest using a standardized test of motor performance, the Bruininks-Oseretsky Test of Motor Proficiency, 2nd edition (BOT-2). We also assessed training-specific changes in imitation/praxis and interpersonal synchrony during an early and a late session. Consistent with the training activities practiced, the rhythm and robot groups improved on the body coordination composite of the BOT-2, whereas the comparison group improved on the fine manual control composite of the BOT-2. All three groups demonstrated improvements in imitation/praxis. The rhythm and robot groups also showed improved interpersonal synchrony performance from the early to the late session. Overall, socially embedded movement-based contexts are valuable in promoting imitation/praxis, interpersonal synchrony, and motor performance and should be included within the standard-of-care treatment for children with ASD.

Effect of a virtual pain coach on pain management discussions: a pilot study.

There is a need to enhance patient and practitioner pain communications. A pain communication plus virtual pain coach intervention was tested in the primary care setting for the effect on communication of osteoarthritis pain information by older adults aged ≥60 years, on practitioners' pain management changes, and on older adults' reduced pain and depressive symptoms 1 month later. A randomized controlled pilot study design was used. Twenty-three older adults with osteoarthritis pain were randomly assigned to the pain communication plus virtual pain coach group or the pain communication-only group. Pain communication consisted of a video of important osteoarthritis pain information. The coach consisted of practicing out loud with a virtual pain coach via laptop computer. Pain and depressive symptoms were measured with, respectively, the Brief Pain Inventory Short Form and the Beck Depression Inventory II before intervention and 1 month later. Immediately after the intervention, older adults had their primary care visits, which were audiotaped, transcribed, and content analyzed for older adults' communicated pain information and practitioners' pain management changes. Older adults in the pain communication plus virtual pain coach group described significantly more pain source information and were prescribed significantly more osteoarthritis pain treatments than older adults in the pain communication-only group. A nonsignificant trend in pain intensity and depressive symptoms reduction resulted for older adults in the pain communication plus virtual pain coach group 1 month later. The virtual pain coach presents a possible strategy for increasing pain management discussions between practitioners and older adults with persistent pain.

Effect of interactions between a child and a robot on the imitation and praxis performance of typically devloping children and a child with autism: a preliminary study.

Interactions between a robot and a child (robot-child interactions) provide a unique context to engage children in whole body movements through a reciprocal imitation game. The effects of a novel, 8-session, robot-child interaction protocol on the imitation and praxis skills of 15 typically developing children and one child with autism between 4 and 7 years of age were examined. A quasi-experimental observational comparison of pretest and posttest performance was conducted. A task-specific robot imitation test and a standardized praxis measure were coded for changes in imitation and praxis errors at pretest and posttest. All children showed improvements in task-specific imitation and generalized praxis. Interpretation is limited by the lack of a control group. These findings serve as a foundation for further investigation of robot-child interactions as a potential training tool for children with dyspraxia.

The effect of a Spanish virtual pain coach for older adults: a pilot study.

OBJECTIVE: To pilot test the effects of a virtual pain coach on ambulatory Spanish-speaking older adults with pain from osteoarthritis. METHODS: A randomized, controlled design was used. Eighteen Spanish-speaking older adults were randomly assigned to the virtual pain coach and pain communication education group, or to the pain communication education-only group. All participants viewed the pain communication videotape. Participants in the virtual pain coach group practiced talking about their osteoarthritis pain with the virtual pain coach. Immediately after the respective intervention, participants had their ambulatory medical visit. Pain intensity and pain interference with activities were measured with the Brief Pain Inventory, and depressive symptoms were measured with the Beck Depression Inventory II at baseline and 1 month later. RESULTS: No significant group difference emerged for pain intensity, pain interference with activities, or depressive symptoms 1 month later. More older adults in the virtual pain coach group reported a change from nonuse to use of opioids at 1 month, 50% vs 0% of the education only group, Fisher's exact test, P = 0.023. CONCLUSIONS: Preliminary data indicate that the Spanish virtual pain coach might assist Spanish-speaking older adults to talk with their practitioner about their osteoarthritis pain and obtain opioid treatment changes, but that pain and depressive symptoms continue unchanged 1 month later. Additional refinement and testing is required for the Spanish-speaking virtual pain coach to determine acceptability and outcomes for assisting Spanish-speaking older adults to communicate about their pain with their primary care practitioner.

Effect of a virtual pain coach on older adults' pain communication: a pilot study.

A randomized posttest-only double blind design was used to pilot test the effect of a virtual practitioner pain communication coach on older adults' communication of their osteoarthritis pain. Baseline pain intensity and pain interference with activities were measured using the Brief Pain Inventory Short Form. Thirty older adults watched a video of a practitioner describing important osteoarthritis pain information followed by either a virtual practitioner coach, a video practitioner coach, or no coach. Participants were next asked, via a videotaped health care practitioner, to orally describe their pain as if speaking to their own practitioner. The amount of important distinctive pain information described by the older adults was audiotaped, transcribed, content analyzed, and summed using a priori criteria from the American Pain Society osteoarthritis pain management guidelines. Older adults described M=6.3 (SD=3.17), M=3.0 (SD=2.08), and M=5.2 (SD=2.40) items of important pain information as a result of the virtual coach, video coach, and no coach conditions, respectively; F(2,25)=3.17, p=.06, η²=.01. Older adults who practiced talking with the virtual coach described more than one additional item of important pain information. The clinically significant group difference supports the need to test the intervention in a randomized clinical trial. The virtual coaching and education intervention might enable older adults to communicate their pain management information more effectively to their practitioners.