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Review of User Studies, Outcomes, and Clinical Evidence

Cognitive Assessment Outcomes of Cognitive Assessment Studies

Several studies have shown that children with disabilities are able to use a robotic system as a tool for augmentative manipulation. Children as young as 7 to 9 months old were able to use an industrial robotic manipulator to bring a cookie closer (Cook, Liu, and Hoseit 1990). Such a finding is consistent with the typical development literature, in which at approximately 9 months children can use objects as tools to retrieve other objects (Claxton, McCarty, and Keen 2009). Cook et al. (2000) reported that children who were unable to directly manipulate objects in their environment were able to use a robotic arm to handle and manipulate objects in a playful scenario. Besides tool use, robot-mediated activities have proven to be a means to demonstrate other cognitive skills, such as cause and effect, inhibition, laterality, and sequencing (Encarna^ao et al. 2014; Poletz et al. 2010); problem solving and spatial reasoning (Cook et al. 2007, 2011); or conservation (Mainela-Arnold, Evans, and Alibali 2006). These studies showed that cognitive skills revealed by robot use were correlated with the

CASE STUDY 7.1 (CONTINUED) JOSEPH’S COGNITIVE ASSESSMENT NEED

Joseph’s OT considers using a robot-adapted version of the conservation task mentioned previously to gain insight into Joseph’s current cognitive skills. His OT first considers the human component, as per the HAAT model (cf. Chapter 1). Due to his physical disability, Joseph cannot talk or manipulate objects independently, which limits his ability to make a selection. His nystagmus prevents him from using visual fixation as a reliable response. The OT carefully analyzes the activity and its demands. To participate in the conservation task, Joseph requires a means through which he can reliably and independently express his choice. In addition, his OT wonders whether the limited opportunities afforded to Joseph to independently interact with objects would have limited his ability to develop the cognitive skills required to succeed in the task in the first place. Thus, a gap exists between Joseph’s current skills and the demands of the activity, which restricts his participation in the conservation task. The OT concludes that a robotic system for augmentative manipulation could bridge that gap. The OT set up the Microbot TeachMover (as in Figure 7.2), adapted for switch control. The OT placed two switches, one to each side of Joseph’s headrest, as she has identified this to be the best site of motor control for Joseph. One switch causes the robot to reach for the container on the left and the other to the container on the right. The OT set up the conservation task and programmed the robot to reach toward the container after a switch selection is made. First, Joseph demonstrated that he understood the concept of laterality by performing the cognitive utilization protocol that required him to knock over stacks of blocks (described previously). After he demonstrated that he could use the appropriate switch to make choices on his left or right side, Joseph was presented with the conservation task. When asked to make a selection, he was able to press the left or right switch to turn the robot toward the response he believed to be the correct one. This provided the OT and parents with unprecedented insight into Joseph’s specific cognitive skills and unveiled further potential. Further, after the assessment, the robot could be used as an intervention strategy to help Joseph engage in activities that would increase his understanding of volume, such as pouring water into different size containers. Experiences like these could ultimately improve the mental representations that lead to fully developed conservation skills.

children’s developmental age, in line with cognitive development literature. This validates the use of robot-mediated activities as a proxy measure of cognitive development through the comparison of the performance of children with disabilities executing the tasks with that of typically developing children. These studies have also provided the first set of normative data in this regard.

 
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