Social Robots for the Therapy of Communication Disorders: History
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Contributor:
Galya Georgieva-Tsaneva
,
Anna Andreeva
,
Paulina Tsvetkova
,
Anna Lekova
,
Miglena Simonska
,
Vaska Stancheva-Popkostadinova
,
Georgi Dimitrov
,
Katia Rasheva-Yordanova
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Iva Kostadinova

There has been a growing interest in the use of innovative technology in Speech and Language Therapy (SLT). Socially Assistive Robots (SARs) have drawn significant attention in the field of speech and language therapy. While initial results have been promising, further exploration is needed to fully understand the potential and usefulness of SARs in the SLT. It has been observed that the robots provide effective and engaging therapy experiences for children and adolescents with different communication disorders. 

  • SLT
  • SARs
  • AI
  • speech disorders

1. Social Robots as ATs in the Rehabilitation of Communication Disorders

In the 2022 UNICEF report [1] on assistive technologies for children with neurodevelopmental disorders, socially assistive robots and virtual reality are identified as high-tech assistive technologies with the most promising results in promoting social interaction and communication. SARs have the greatest potential: robots can play the role of a friend in a game or a mediator in the interaction with other children or adults, promote social interaction, and change the role of the child from a spectator to an active participant. Research shows that Assistive Technologies (AT) improve the skills of children with CD [2][3]; however, their use is still limited, possibly due to a lack of methodological and ethical guidelines and instructions for their use. SARs must be “empathetic”, “digitally intelligent”, stable, and reliable so that they can be assistants in speech and language therapy work. Therefore, they need assistive technologies such as mobile platforms for telepresence, virtual reality, interfaces for tracking body behavior, user interfaces for interaction through gestures or emotions, natural language interfaces, etc.
There are very few scientific studies on the use of SAR in speech and language therapy practice [4][5][6][7][8][9][10][11][12][13][14][15]. The most frequently used robot is of the NAO type, which participates with children with CD in individual sessions. Reported results show that it increases motivation and enhances children’s attention [2][3][4][5][6][7]. In addition to making the intervention more engaging, the robot supports therapists and the child’s family. For example, NAO does not have a human mouth and does not allow lip reading, and this makes children use their hearing to hear what the robot says when it speaks [5]. As a result of experiments [7] on the use of NAO in speech therapy conducted by members of the project team, it was concluded that there was a need to expand the environment in which children and robots communicate by applying more innovative image recognition and improving verbal interactivity with the robots. For example, one of the favorite games of children is shopping and telling a story via a series of pictures, but actions based on pictures are difficult to be animated by NAO, while a 3D project offering shopping in a virtual grocery store would be more realistic and attractive. In addition,, NAO is not so engaging for children with CD in middle schools, so there is a need for different 3D applications as well as a more innovative SAR to be developed and used. Other robots used to improve the social and communication skills of children with CD are robots which change their emotional facial expression or have cloud-based chat services, such as iRobiQ [6] and QTrobot [8]. Unfortunately, their price is not affordable for home use.
Robot assistants using other innovative assistive technologies in speech therapy intervention and inclusive education are presented in [16][17]. They integrate intelligent ICT components and tools, robotic systems such as cloud services [17], expert systems with speech therapy purposes, and a database of knowledge, ontologies, and concepts from the language–speech field [16]. Assistive technologies such as virtual reality are used more among children with autism spectrum disorders [18][19][20][21][22]. The STAR [19] platform is oriented to speech and language therapy and integrates augmented reality for practicing communication skills and strategies for analyzing alternative communication and applied behavior analysis (ABA). Another platform suitable for speech therapy is the VRESS [21] platform for developing customized scenarios for virtual reality to support children who practice and develop their social skills by participating in selected social stories. The platform is integrated with sensors for heart rate detection and eye tracking, which provides important feedback for further customization of scenarios as well as their evaluation. In general, eye tracking technology has recently been widely used to assess engagement in intervention tasks. With the help of the new-generation Tobii eye-and head-tracking devices, not only the attention but also the emotions of the child can be assessed.
Although research on the use of social robots in communication disorders is limited, some studies have reported promising results. For example, in [23], children with special needs who interacted with social robots Nao and CommU showed increased verbal production and engagement in therapy sessions. Another study [24] found that the presence of two social robots in a disability unit for adolescents with special needs led to improvements in articulation, verbal participation, and spontaneous conversations over a two-year period. The robot Kaspar has also been used in a long-term study by caregivers in a nursery school for children with ASD and has shown beneficial outcomes for the participants [25], in some special moments children use phrases and show interactive behaviour that are learned during the interactions with Kaspar and apply them to situations outside of their play with the robot.. Additionally, the humanoid robot iRobi positively impacted communication skills in children with pervasive developmental disorders using augmentative and alternative communication strategies. A low-cost robot named SPELTRA was also used to support therapy sessions for children with neurodevelopmental disorders [26], resulting in improvements in phonological, morphosyntactical, and semantic communication measures. The work [27] designed a program for improving articulation in children with cleft lip and palate using a social robot named Buddy. Similarly, Castillo et al. [28] created an application utilizing a desktop social robot called Mini to support rehabilitation exercises for adults with apraxia. In addressing stuttering, Kwaśniewicz et al. [29] employed the social robot Nao to provide “echo” by combining delayed auditory feedback and choral speech while clients worked on improving their fluency.

2. Technical, Methodological, and Ethical Limitations and Challenges of Using SARs in Speech and Language Therapy

Technical limitations include the high cost of purchasing and maintaining SARs, potential technical malfunctions and limitations in their ability for speech recognition and natural language processing capabilities, and emotional and social intelligence. Methodological limitations include the lack of standardization in the use of SARs in speech and language therapy. Ethical concerns include issues related to privacy and data protection, as well as potential negative effects on the therapeutic relationship between the therapist and the patient. In addition, there is a risk that children may become overly dependent on SARs for communication, rather than developing their natural communication skills.
The use of SARs in speech and language therapy can presents several technical challenges and limitations, including:
  • Limited adaptability and personalization: Most SARs are pre-programmed with a fixed set of responses and behaviors, which may not be tailored to the individual needs and preferences of each patient.
  • Limited physical capabilities: SARs may have limited physical capabilities, such as the ability to manipulate objects or to move around in the environment, which may limit their effectiveness in certain therapy contexts.
  • Limited speech recognition and natural language processing capabilities: SARs may have difficulty accurately recognizing and understanding speech, especially in noisy environments or when dealing with non-standard dialects or accents, or in cases of speech and/or language disorders.
  • Limited emotional and social intelligence: Although SARs are designed to interact with humans, they may lack the emotional and social intelligence needed to provide appropriate responses to patients who are experiencing strong emotions or who have complex social communication needs.
  • Technical failures and maintenance issues: Like any technology, SARs may experience technical failures or require maintenance and updates, which can disrupt therapy sessions and create additional stress for patients and therapists.
  • Cost: The cost of SAR technology and maintenance may be prohibitively high for some healthcare organizations, limiting their opportunity to provide this type of therapy to patients who could benefit from it.
The use of SARs in speech and language therapy poses several methodological challenges, including:
  • Reliability and Validity: One of the main challenges is ensuring the reliability and validity of the results when using SARs in speech and language therapy. This requires careful control of the methods of study design and data collection methods to minimize sources of bias and error.
  • Usability and User Acceptance: SARs must be usable and acceptable to the target population, including children with communication disorders, to be effective. This may require significant efforts to design and refine the user interface and user experience of the robot.
  • Standardization: There is a lack of standardized protocols and assessment methods for using SARs in speech and language therapy, which can make it difficult to compare results across studies and determine the effectiveness of different approaches.
  • Evaluation: Assessing the effectiveness of SARs in speech and language therapy often requires multiple raters to evaluate the therapy sessions. Ensuring inter-rater reliability, or consistent long-term effectiveness: Another challenge is demonstrating the long-term effectiveness of SARs in speech and language therapy. Many studies have only measured short-term outcomes, so there is a need for longer-term studies to determine the sustainability of the benefits of using SARs in therapy.
  • A number of participants: Usually, the sample is small in most published research about children/adolescents with communication disorders who interact with the SARs. The study groups consist of heterogenous types of neurodevelopmental disorders and lack control groups; therefore, it is difficult to apply statistical analysis.
The use of SARs in speech and language therapy includes several ethical challenges, including:
  • Privacy and Confidentiality: SARs collect and store sensitive information about the users, such as their speech and language patterns, which can raise concerns about privacy and confidentiality. This requires appropriate data protection measures, such as encryption and secure storage, to prevent unauthorized access to the data.
  • Bias and Discrimination: SARs are designed and programmed by humans, which raises the possibility of unintended bias and discrimination in their behavior and interactions with users. This requires careful consideration of the design and programming of SARs to ensure that they do not perpetuate or amplify existing biases and discrimination.
  • Responsibility and Liability: SARs are increasingly being used in healthcare settings, which raises questions about who is responsible and liable for any harm caused by their use. This requires clear and well-defined policies and procedures for the use of SARs in healthcare and speech and language therapy, as well as appropriate insurance coverage and risk management strategies.
  • Interpersonal Relationships: SARs may have the potential to affect interpersonal relationships and human interactions, including the relationships between patients, therapists, and caregivers. This requires careful consideration of the design and use of SARs to ensure that they enhance, rather than undermine, existing relationships and interactions.
  • Dependence and Over-Reliance: There is a risk that users may become overly dependent on SARs and cease to engage in important interpersonal relationships and activities, which can have negative impacts on their health and well-being. This requires careful monitoring and evaluation of the use of SARs in speech and language therapy to ensure that they are not creating negative consequences for users.[30][30]

The researchers also reviewed articles which serve as models for future implications of different frameworks [31][32]. In the article [32], the authors offer possible employment of social robots as additional tools in stuttering intervention. The scientists describe eight scenarios with social robots which can be adjusted in therapies with children and adults. The authors emphasize that HRI (Human–Robot Interaction) can significantly aid people who stutter and argue that there is a need to explore the prospects of robotics via experiments and studies with relevant participants.

The paper [33] reports an application which provides an opportunity to use a humanoid robot as a stutterer’s aide and therapist. Visual and auditory feedback was applied during the
therapy with the robot. The major advantage of the suggested application is the possibility of using a humanoid robot in therapy sessions accompanied by the “echo” method and expanded by the visual feedback. The robot can substitute the therapist and can lead the treatment of the patient who performs different activities, such as conversing, reading, or running a monologue. Another advantage is the potential to remotely connect to the robot which removes external noise. The proposed scenario will be tested on a group of people
and more experiments are necessary to prove the successful relevance of this application.

The article [34] offers a systematic review of research on therapies assisted by robots for children with autism. The authors try to understand the tendencies in studies on this type of therapy so that they can propose probable prospects in the field. Thirty-eight articles were analyzed and it was concluded that there is a substantial number of publications on robot-assisted autism therapy (RAAT). This points to growing interest in the use of robots in logopedic sessions. The advances of artificial intelligence and machine learning have impacted that interest greatly. The above-mentioned data postulate that robot-assisted therapies are promising tools which can support and help cognitive, social, and emotional development of children with ASD. The authors hope that the challenges which people face at present will be addressed successfully via skilled interdisciplinary cooperation.

The scientific team in [35] compared two situations of storytelling to a diseased person with neurodevelopmental disorder: 1. human–human interaction and 2. robot–human interaction. Their results showed that the story told by the plush robot ELE is more engaging. The potential advantages of the presented social robot are: enhancing and encouraging
verbal communication in person with neurodevelopmental disorders; limited non-verbal characteristics of communication of the robot that make the playful situation predictable; monitoring, gathering, and analyzing the data of the client’s behavior from a distance; saving time and money, as it enables remote therapy. The future work is directed to the application of the social robot for a larger number of people with neurodevelopmental disorders. This study can be taken as a model for working with children with neurological disorders.

To summarize, the potential scenarios for using SARs in the rehabilitation of communication disorders in children and adolescents is huge. Social robots can assist in vocabulary and language development, articulation therapy, speech rate control, storytelling, and improvement in social skills. Through engaging and playful activities, social robots can offer real-time feedback and guidance to help individuals practice and enhance their communication skills.

The types of communication disorders indicated in the studies mentioned are few, such as dyslexia, dysgraphia, specific language impairment, and dyslalia. The number of articles where the participation of team speech therapists is included is small and for this reason, the authors have preferred to describe the primary disorder, for example, ASD, cerebral palsy, or hearing impairment. All these conditions have different kinds of communication disorders. They belong to the category of neurodevelopmental disorders; in most of them, the language acquisition is affected at different levels and it varies in severity.

Possible applications of SARs in the intervention of communication disorders in children and adolescents based on the reviewed papers are:

- Vocabulary and language development (verbal and sign language): Social robots can assist children in practicing and improving their language skills through playful and engaging activities, offering real-time feedback and encouragement. SARs are able to initiate and support communication and enrich child’s vocabulary. They also help therapists train and assess linguistic capabilities of children and adolescents with language impairments [6][22][31][32][33][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58].

- Articulation therapy: Social robots can help children with speech disorders practice pronunciation and articulation exercises. The youngsters are observed to show increased verbal production and participation via SARs. The latter contribute to improvements in articulation, and phonological, morphosyntactical, and semantic communication [31][41][45][46][49][50][55][59][60][61]. Auditory skills: Children learn and develop language through listening. Some SARs are used to develop auditory skills as well as verbal speech. Robots are able to offer sounds with different frequency. SARs can also repeat words and provide support when necessary. In addition, robots can give visual and auditory feedback which is essential for therapists [39][49][62]. 

- Speech rate control: Social robots can aid children in practicing speaking at a slower rate, offering real-time feedback to improve fluency gradually [32][33][63].

- Storytelling: Social robots can assist children in practicing storytelling and engaging in conversation. Stories told by robots are found to be more engaging and funnier forchildren. SARs encourage verbal communication and enhance cognitive abilities in youngsters. Robots can also monitor, gather, and analyze data from the child’s behavior [6][35][41][59].

- Social skills: Social robots can help children improve social skills, such as turn-taking, joint attention, emotion regulation, and eye contact through playful and engaging activities. During these activities, different participants, together with the robots, can take part—peers, therapists, or parents. Children are provided support and guidanceduring play. Youngsters learn to interact and cooperate with the others and robotbased therapies enhance their cognitive and emotional abilities [33][36][38][39][40][44][45][53][54][58][64].

- Transfer the skills in life: Some of the studies indicate that the skills acquired in playbased interaction between a child and the SAR are transferred to real life and applied in everyday situations [53][54][55][62].

- Personalization and adaptation: SARs have the ability to personalize the interactive scenarios by utilizing individual data, performance metrics, and individual progress  to adapt therapy exercises, content, and level of difficulty to the specific CD [39][43][46][48][50][55][59][60][64].

Possible applications of SARs in the intervention of communication disorders in children and adolescents based on the reviewed papers are:

• Vocabulary and language development (verbal and sign language): Social robots can assist children in practicing and improving their language skills through playful and engaging activities, offering real-time feedback and encouragement. SARs are able to initiate and support communication and enrich child’s vocabulary. They also help therapists train and assess linguistic capabilities of children and adolescents with language impairments [6][22][31][32][33][36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58].

• Articulation therapy: Social robots can help children with speech disorders practice pronunciation and articulation exercises. The youngsters are observed to show increased verbal production and participation via SARs. The latter contribute to improvements in articulation, and phonological, morphosyntactical, and semantic communication [31][41][45][46][49][50][55][59][60][61]. Auditory skills: Children learn and develop language through listening. Some SARs are used to develop auditory skills as well as verbal speech. Robots are able to offer sounds with different frequency. SARs can also repeat words and provide support when necessary. In addition, robots can give visual and auditory feedback which is essential for therapists [39][49][62].

• Speech rate control: Social robots can aid children in practicing speaking at a slower rate, offering real-time feedback to improve fluency gradually [32][33][63].

• Storytelling: Social robots can assist children in practicing storytelling and engaging in conversation. Stories told by robots are found to be more engaging and funnier for children. SARs encourage verbal communication and enhance cognitive abilities in youngsters. Robots can also monitor, gather, and analyze data from the child’s behavior [6][35][41][59].

• Social skills: Social robots can help children improve social skills, such as turn-taking, joint attention, emotion regulation, and eye contact through playful and engaging activities. During these activities, different participants, together with the robots, can take part—peers, therapists, or parents. Children are provided support and guidance during play. Youngsters learn to interact and cooperate with the others and robot-based therapies enhance their cognitive and emotional abilities [33][36][38][39][40][44][45][53][54][58][64].

• Transfer the skills in life: Some of the studies indicate that the skills acquired in playbased interaction between a child and the SAR are transferred to real life and applied in everyday situations [53][54][55][62].

• Personalization and adaptation: SARs have the ability to personalize the interactive scenarios by utilizing individual data, performance metrics, and individual progress to adapt therapy exercises, content, and level of difficulty to the specific CD [39][43][46][48][50][55][59][60][64]. Table 1 presents interactive scenarios with SARs described in pilot studies. They are ordered chronologically, with the most recent publications appearing first.

Table 1. Description of interactive scenarios with SARs (pilot studies).

Reference: [40], 2022

Name of Scenario: Farm Animals—Voices and Names

Objectives

Remote speech and language therapy; Enrich the child’s vocabulary.

Treatment domain, Type of CD

Language domain, Farm animals’ voices and names; children with neurodevelopmental disorders.

Treatment technique

Identification of farm animal voice. Identification and pronunciation of words for farm.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Child–robot interaction.

Age

Four years old.

Participants’ role and behavior

There are five participants in this scenario, a speech and language therapist (control the game) a social robot (instructor–Nao), a social robot EmoSan (playmate), parent (co-therapist), and a child with neurodevelopmental disorders (playmate).

Activity description

[40], page 123 (https://youtu.be/KpeQcIXG6cA, accessed on 16 April 2023).

Robot configuration and mission

A social robot NAO, a social robot EmoSan, pictures of farm animals, a tablet and a laptop, BigBlueButton platform for telepresence.

Used software

NAOqi software v.2.8.6.23, Python v.2.7, Node-RED v.2.1.3.

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The activity can also include more participants.

Reference: [40], 2022

Name of Scenario: Storytime

Objectives

Follow a story and representation of a story as a sequence of scenes in time.

Treatment domain, Type of CD

Language domain, children with neurodevelopmental disorders.

Treatment technique

Story as a sequence of scenes in time.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are four participants in this scenario, a speech and language therapist (control the game), a social robot (instructor-Nao), a social robot EmoSan (playmate), and a child with neurodevelopmental disorders (playmate).

Age

3–10 years old (15 children)

Activity description

[40], page 123 (https://youtu.be/AZhih7KlaPc, accessed on 16 April 2023)

Robot configuration and mode of operation

A social robot NAO, a social robot EmoSan was used with 3 pictures of story scenes and a whisk.

Used software

NAOqi software , v.2.8.6.23 Python 2.7, Node-RED v.2.1.3.

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The activity can also include more participants to promote cooperative play.

Variation

-

Reference: [64], 2021

Name of Scenario: Different interactive activities with a tablet; robots are expected to be used.

Objectives

To propose a conceptual framework for designing linguistic activities (for assessment and training), based on advances in psycholinguistics.

Treatment domain, Type of CD

Speech and language impairments—developmental language disorder, autism spectrum disorder.

Treatment technique

Interactive therapeutic activities.

Play type (social ∣ cognitive)

Social and cognitive.

Interaction technique

The child performs activities on a tablet.

Age

4–12 years old.

Participants’ role and behavior

The participants in this scenario are the children (30), performing activities via a tablet.

Activity description

[64], page 2–6.

Robot configuration and mission

Socially assistive robots/tablets with different modules for training and assessing linguistic capabilities of children with structural language impairments.

Used software

Socially assistive robot and/or mobile device.

Setting and time

This scenario has been carried out in clinical settings over multiple sessions, two groups have been included—a target and a control group.

Variation

There are different linguistic tasks which evaluate different linguistic skills. Activities can include more than one participant.

Reference: [48], 2021

Name of Scenario: Serious games conducted by a social robot via embedded mini-video projector

Objectives

To show the application of a robot, called MARIA T21 as a therapeutic tool.

Treatment domain, Type of CD

Autism spectrum disorder, Down syndrome.

Treatment technique

Interactive serious games.

Play type (social ∣ cognitive)

Social and cognitive.

Interaction technique

Robot–child interaction.

Age

4–9 years old.

Participants’ role and behavior

The participants in this scenario are the social robot and eight children, supervised by the therapist and a group of researchers.

Activity description

[48], page 6–14 (see in Section 5 Methodology)

Robot configuration and mission

 

A new socially assistive robot termed MARIA T21 which uses an innovative embedded mini-video projector able to project Serious Games on the floor or tables.

Used software

A set of libraries-PyGame, written in Python 2.7; an open-source robot operating system.

Setting and time

The tests were carried out partly in a countryside region and partly in a metropolitan area, in order to expand socioeconomic diversity.

Variation

The games were created with all their possible events, characters, awards, and stories and have included different types of serious games.

Reference: [65], 2021

Name of Scenario: Questions and Answering with NAO Robot

Objectives

Initiation of conversation.

Treatment domain, Type of CD

Language domain, Language disorder due to ASD.

Treatment technique

Asking and answering simple questions.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Age

5–24 years old (4 children).

Participants’ role and behavior

There are five participants in this scenario, two teachers, two researchers, social robot, and the child.

Activity description

[65], page 0357

Robot configuration and mission

A social robot NAO is talking with a child.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a classroom of special school, in 4 sessions.

Variation

-

Reference: [65], 2021

Name of Scenario: Physical Activities with NAO Robot.

Objectives

Initiation of physical movements.

Treatment domain, Type of CD

Basic communication domain, Social and communication interaction due to ASD.

Treatment technique

Provocation of imitation of physical movements.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Age

5–24 years old (4 children)

Participants’ role and behavior

There are five participants in this scenario, two teachers, two researchers, social robot, and the child.

Activity description

[65], page 0357

Robot configuration and mission

A social robot NAO is talking with a child.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a classroom of special school, in 4 sessions.

Variation

-

Reference: [52], 2021

Name of Scenario: I like to eat popcorn

Objectives

Learning Bulgarian Sign Language.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Demonstration of signs, video and pronunciation of words from Sign Language.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are two participants in this scenario social robot (instructor) and the typically developed toddler.

Age

5 years

Activity description

[52] page 72–73

Robot configuration and mode of operation

A social robot Pepper.

Used software

NAOqi v.2.8.6.23

Setting and time

This scenario has been carried out in a lab setting, in one session.

Variation

The activity can also include more participants to promote cooperative play.

Reference: [50], 2016

Name of Scenario: Different activities between a robot and children

Objectives

To present a robotic assistant which can provide support during therapy and can manage the information.

Treatment domain, Type of CD

Communication disorders.

Treatment technique

Tasks and exercises for language, pragmatics, phonetics, oral-motor, phonological, morphosyntactic, and semantic interventions.

Play type (social ∣ cognitive)

Social and cognitive.

Interaction technique

Robot–child interaction.

Age

-

Participants’ role and behavior

The participants in this scenario are the robot and 32 children of regular schools.

Activity description

[50], see pages 4–6

Robot configuration and mission

The robot was designed via 3D technology, and has a humanoid form with possibility to wear any costume representing animals (dogs, cats, etc.), children (boys or girls), or any other characters.

The main controller of the robot (brain).

Used software

A Raspberry PI 2 plate that contains the operative system (Raspbian-Raspberry Pi Model 2 B+).

Setting and time

The pilot experiment consists of two stages—lab tests to determine robot’s performance (over multiple activities) and analyses of patients’ responses to the robot’s appearance.

Variation

The robot offers different activities (playing, dancing, talking, walking, acting, singing, jumping, moving, and receiving voice commands. The system automates reports generation, monitoring of activities, patient’ data management, and others. The robot’s appearance can be customized according to the preferences of the patients.

Reference: [60], 2016

Name of Scenario: Therapy mode

Objectives

Development of phonological, morphological, and semantic areas.

Treatment domain, Type of CD

Language and speech domain; Children with Cerebral Palsy.

Treatment technique

The robot displays on its screen some activities related to speech therapy such as phonological, semantic, and morphosyntactic exercises.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Child–robot interaction.

Age

7 years

Participants’ role and behavior

There are three participants in this scenario, a speech and language therapist, social robot, and the child.

Activity description

[60], page 4

Robot configuration and mission

SPELTRA (Speech and Language Therapy Robotic Assistant) with a display,

Used software

a Raspberry Pi Model 2 B+ (2015); mobile application (Android-Raspberry Pi Model 2 B+,2015).

Setting and time

This scenario was carried out in a school setting, in three sessions

Variation

Generates a complete report of activities and areas of language which the child has worked; it could be used by parents and their children at home.

Reference: [53], 2016

Name of Scenario: Fruit Salad

Objectives

Assessment of nonverbal communication behavior and verbal utterances, transferring skills in life.

Treatment domain, Type of CD

Nonverbal behavior and Language domain, Children with ASD.

Treatment technique

The robot had the role of presenting each trial by following the same repetitive pattern of behaviors: calling the child’s name, looking at each fruit, expressing the pre-established facial expression, and providing an answer at the end after the child placed a fruit in the salad bowl.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Age

5–7 years

Participants’ role and behavior

There are three participants in this scenario, an adult, social robot, and the child.

Activity description

[53], page 118

Robot configuration and mission

Social robot Probo and plastic fruit toys.

Used software

Elan—Linguistic Annotator, version 4.5

Setting and time

This scenario has been carried out in the therapy rooms in three schools, in two sessions.

Variation

The game is played in child–adult condition or in child–robot condition.

Reference: [54], 2016

Name of Scenario: Shapes

Objectives

Assessment of decoding/understanding words.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Identification; listening and following spoken instructions; Sign Language interpreter helps with the instructions if the child needs it.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are three participants in this scenario, a speech and language therapist (mediator), social robot (instructor), and the child with hearing impairment.

Age

5–15 years old

Activity description

[54], page 257

Robot configuration and mode of operation

A social robot NAO was used with pictures of different shapes and colors.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a school setting, in one session.

Variation

The activity can also include more participants to promote cooperative play.

Reference: [54], 2016

Name of Scenario: Emotions

Objectives

Understanding emotion sounds and naming the emotion, transferring skills in life.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Identification of emotion sounds; Sign Language interpreter helps with the instructions if the child needs it.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Peer interaction.

Participants’ role and behavior

There are three participants in this scenario, a speech and language therapist (mediator), social robot (instructor), and the child with hearing impairment.

Age

5–15 years

Activity description

[54], page 257

Robot configuration and mode of operation

A social robot NAO was used with pictures of emotions.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a school setting, in one session.

Variation

The activity can also include more participants to promote cooperative play.

Reference: [54], 2016

Name of Scenario: Shopping_1

Objectives

Identification of environment sounds and words pronunciation, transferring skills in life.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Identification of environmental sounds; Demonstration of body movements; Sign Language interpreter helps with the instructions if the child needs it.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Peer interaction.

Participants’ role and behavior

There are three participants in this scenario, a speech and language therapist (mediator), social robot (instructor), and the child with hearing impairment.

Age

5–15 years

Activity description

[54], page 257

Robot configuration and mode of operation

A social robot NAO and hygienic products (soap, shampoo, sponge, toothpaste and etc.).

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario wascarried out in a school setting, in one session.

Variation

The activity can also include more participants to promote cooperative play.

Reference: [54], 2016

Name of Scenario: Shopping_2

Objectives

Identification of sentence and words pronunciation, transferring skills in life.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Identification of sentence; categorization of words according to a certain criterion; Sign Language interpreter helps with the instructions if the child need.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Peer interaction.

Participants’ role and behavior

There are three participants in this scenario, a speech and language therapist (mediator), social robot (instructor), and the child with hearing impairment.

Age

5–15 years

Activity description

[54], page 258

Robot configuration and mode of operation

A social robot NAO and toys.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a school setting, in one session.

Variation

The activity can also include more participants to promote cooperative play.

Reference: [55], 2016

Name of Scenario: Order a doughnut

Objectives

How to order a doughnut from a menu in a doughnut shop, transferring skills in life.

Treatment domain, Type of CD

Language domain, ASD.

Treatment technique

Imitation of actions and words.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

The child’s family, the robot programmer, the special education teacher, social robot NAO, and the child.

Age

6 years old

Activity description

[55], page 132–133

Robot configuration and mode of operation

A social robot NAO and a menu

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out at subject’s home, in two sessions.

Variation

-

Reference: [55], 2016

Name of Scenario: Joint Attention

Objectives

Joint attention skills

Treatment domain, Type of CD

Joint attention; Developmental Delay and Speech-Language Impairments.

Treatment technique

Understanding instructions.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

The robot programmer, the speech and language pathologist, social robot NAO, and two children.

Age

7 and 9 years old

Activity description

[55], page 135

Robot configuration and mode of operation

A social robot NAO and objects in speech and language pathologist’s office.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out at speech and language pathologist’s office in five sessions.

Variation

After each session, the modification of the robot behaviors were designed according to the child’s needs.

Reference: [55], 2016

Name of Scenario: Joint Attention, Turn-Taking, Initiative

Objectives

Joint attention, introduction of turn-taking and initiative skills

Treatment domain, Type of CD

Language domain, Speech-Language Impairment.

Treatment technique

Imitation of actions and sentences.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

The robot operator, the speech and language pathologist, social robot NAO, and a child

Age

7 years

Activity description

[55], page 136–137

Robot configuration and mode of operation

A social robot NAO and cue cards.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out at school’s playroom, in eight months, twice a week sessions.

 

Playing the game without the cue cards.

Reference: [49], 2015

Name of Scenario: Auditory Memory Stimulation, Comprehensive Reading, Visual Stimulation, Stimulation of Motor Skills

Objectives

To offer a robotic assistant able to provide support for Speech Language Practitioners.

Treatment domain, Type of CD

Autism spectrum disorder, Down syndrome, Cerebral Palsy, Mild and Moderate Intellectual Disability, Epilepsy, Unspecified intellectual disabilities, other disabilities.

Treatment technique

Interactive therapy exercises, assessment tasks.

Play type

Social and cognitive.

Interaction technique

Therapist–patient interaction via an intelligent integrative environment.

Age

-

Participants’ role and behavior

The participants in this scenario are the therapist, the children, the robotic assistant (the model can be used by relatives and students, too).

Activity description

[49], page 75

Robot configuration and mission

RAMSES (v.2)—an intelligent environment that uses mobile devices, embedded electronic systems, and a robotic assistant. The robotic assistant consists of a central processor (an Android smartphone or tablet, or an embedded electronic system) and a displacement.

Used software

Electronic platform.

Setting and time

This is a pilot study, conducted in clinical settings over multiple activities.

Variation

The proposed model relies on different ICT tools, knowledge structures, and functionalities.

Reference: [56], 2014

Name of Scenario: The impact of humanoid robots in teaching sign languages

Objectives

Teaching Sign Language

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Demonstration of sign language and special flashcards illustrating the signs.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Child–robot interaction.

Age

9–16 years (10 children hearing impairment).

Participants’ role and behavior

Individual and group sessions of a therapist in sign language, a social robot, and a child/ children.

Activity description

[56], page 1124–1125

Robot configuration and mission

A social robot Robovie R3 and pictures of sings.

Used software

Robovie Maker 2 software (v.1.4).

Setting and time

This scenario was carried out in a computer laboratory, in one session.

Variation

Individual or group sessions.

Reference: [57], 2014

Name of Scenario: Sign Language Game for Beginners

Objectives

Learning signs from Turkish Sign Language

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Identification of words in Turkish Sign Language for beginners’ level (children of early age group), most frequently used daily signs.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Child–robot interaction.

Age

Average age of 10:6 (years:months)

Participants’ role and behavior

There are two participants in this scenario, the typically developed child and a humanoid social robot (instructor).

Activity description

[57], page 523, 525

Robot configuration and mission

A social robot NAO H25 and a modified Robovie R3 robot.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario wa carried out in a university setting for one session.

Variation

The game can also be played with children with hearing impairment.

Table 2 presents interactive scenarios with SARs described in empirical use cases.

Table 2. Description of human–robot interactive scenarios—empirical.

Reference: 2022

Name of Scenario: Ling Six-Sound Test

Objectives

Assessment of auditory skills/identification.

Treatment domain, Type of CD

Frequency speech sounds, children with neurodevelopmental disorders.

Treatment technique

Discrimination and identification of speech sounds.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are four participants in this scenario, a speech and language therapist (control the game), a social robot (instructorNao), a social robot EmoSan (playmate), and a child with neurodevelopmental disorders (playmate).

Age

3–10 years old

Activity description

[62], page 491

Robot configuration and mode of operation

A social robot NAO; a social robot EmoSan was used with pictures of different speech sounds.

Used software

and Python 2.7.

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The instructions play in random order. The activity can also include more participants to promote cooperative play.

[60], 2022

Name of Scenario: Warming up

Objectives

Identification of speech.

Treatment domain, Type of CD

Common greeting and introduction of someone, children with neurodevelopmental disorders.

Treatment technique

Identification of speech.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are four participants in this scenario, a speech and language therapist (control the game), a social robot (instructor-Nao), a social robot EmoSan (playmate), and a child with neurodevelopmental disorders (playmate).

Age

3–10 years old

Activity description

[62], page 491

Robot configuration and mode of operation

A social robot NAO, a social robot EmoSan.

Used software

NAOqi software v.2.8.6.23 and Python 2.7.

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The activity can also include more participants to promote cooperative play.

Reference: [62], 2022

Name of Scenario: Farm animals—receptive vocabulary

Objectives

Receptive vocabulary of children for this particular closed set of words.

Treatment domain, Type of CD

Receptive vocabulary of closed set of words, children with neurodevelopmental disorders.

Treatment technique

Identification of vocabulary of closed set of words.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child-robot interaction.

Participants’ role and behavior

There are four participants in this scenario, a speech and language therapist (control the game) a social robot (instructor-Nao), a social robot EmoSan (playmate) and a child with neurodevelopmental disorders (playmate).

Age

3–10 years old

Activity description

[62], page 492

Robot configuration and mode of operation

A social robot NAO, a social robot EmoSan has been used with pictures of different farm animals.

Used software

NAOqi software v.2.8.6.23 and Python 2.7.

Setting and time

This scenario has been carried out in a clinical setting over multiple sessions.

Variation

The instructions are played in random order. The activity can also include more participants to promote cooperative play.

Reference: [62], 2022

Name of Scenario: Colors.

Objectives

Receptive vocabulary of children for this particular closed set of words.

Treatment domain, Type of CD

Receptive vocabulary of closed set of words, children with neurodevelopmental disorders.

Treatment technique

Identification of vocabulary of closed set of words.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are four participants in this scenario, a speech and language therapist (control the game), a social robot (instructor-Nao), a social robot EmoSan (playmate), and a child with neurodevelopmental disorders (playmate).

Age

3–10 years old

Activity description

[62], page 492

Robot configuration and mode of operation

A social robot NAO; a social robot EmoSan has been used with pictures of different colors.

Used software

NAOqi software v.2.8.6.23 and Python 2.7.

Setting and time

This scenario has been carried out in a clinical setting over multiple sessions.

Variation

The instructions are played in random order. The activity can also include more participants to promote cooperative play.

Reference: [62], 2022

Name of Scenario: Shopping game

Objectives

Identification of environmental sounds and expressive vocabulary of closed set of words, transferring skills in life.

Treatment domain, Type of CD

Identification of sounds and expressive vocabulary of closed set of words, children with neurodevelopmental disorders.

Treatment technique

Identification of sounds and words.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child-robot interaction.

Participants’ role and behavior

There are four participants in this scenario, a speech and language therapist (control the game), a social robot (instructor-Nao), a social robot EmoSan (playmate), and a child with neurodevelopmental disorders (playmate).

Age

3–10 years old

Activity description

[62], page 492

Robot configuration and mode of operation

A social robot NAO; a social robot EmoSan was used with pictures of different colors.

Used software

NAOqi software v.2.8.6.23 and Python 2.7.

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The instructions are played in random order. The activity can also include more participants to promote cooperative play.

Reference: [66], 2022

Name of Scenario: Imitation games and speech therapy sessions

Objectives

To compare the children’s engagement while playing a mimic game with the affective robot and the therapist; to assess the efficacy of the robot’s presence in the speech therapy sessions alongside the therapist.

Treatment domain, Type of CD

Language disorders.

Treatment technique

Mimic game; speech therapy sessions.

Play type

Social and cognitive play.

Interaction technique

Robot–child–therapist interaction.

Age

Average age of 6.4 years.

Participants’ role and behavior

The participants in the scenarios are the social robot (RASA), six children in the intervention group, six children in the control group, and the therapist.

Activity description

[66], pages 10–11

Robot configuration and mission

A humanoid Robot Assistant for Social Aims (RASA). Designed to be utilized primarily for teaching Persian Sign Language to children with hearing disabilities.

Used software

The robot is controlled by a central PC carrying out high level control, and two local controllers.

Setting and time

Scenarios have been carried out in a clinical setting over ten therapy sessions (one per week).

Variation

The robot uses external graphics processing unit to execute facial expression recognition due to the limited power of the robot’s onboard computer.

Reference: [67], 2022

Name of Scenario: Reading skills

Objectives

Social robots are used as the tutor with the assistance of a special educator.

Treatment domain, Type of CD

Special Learning Disorder (dyslexia, dysgraphia, dysorthography).

Treatment technique

Teaching cognitive and metacognitive strategies.

Play type

Cognitive play.

Interaction technique

Robot–child interaction enhanced by the special education teacher;

Age

mean age 8.58.

Participants’ role and behavior

All scenarios were similar in content; structure and succession for both the NAO and the control group with the only difference that the welcoming, the instructions, the support, and the feedback for the activities was delivered by the special educator for the control group.

Activity description

[67], pages 5–4

Robot configuration and mission

A humanoid robot Nao.

Used software

NAOqi software v.2.8.6.23 .

Setting and time

Interventions took place in a specially designed room in a center; 24 sessions with a frequency of two sessions per week

Variation

-

Reference: [68], 2021

Name of Scenario: Therapy session with EBA.

Objectives

Formulation of questions and answers, Comprehension and construction of sentences, Articulation and pronunciation, Voice volume, Dictations, Literacy, Reading comprehension

Treatment domain, Type of CD

Treatment domain—nasality, vocalization, language, attention, motivation, memory, calculation, visual perception; children with language disorders—cleft palate and cleft lip, ADHD, dyslexia, language development delay.

Treatment technique

Story-telling, making dictations to check the spelling, asking questions about the text that has been read or listened, ask the child for words starting with a letter or will ask the child to identify how many syllables are contained in a word told, to repeat more clearly everything the child does not say properly, give instructions to the child for all the activities defined.

Play type (social ∣ cognitive)

Social and cognitive play.

Interaction technique

Robot-child-therapist interaction.

Participants’ role and behavior

There are 3 participants in this scenario, a speech and language therapist (control the game) a social robot Nao and the child with language disorder.

Age

9–12 years old (five children)

Activity description

[68], page 8–9

Robot configuration and mode of

operation

A social robot NAO has been used, preprogrammed with the modules: reading comprehension; dictations, stories and vocabulary, improvement of oral comprehension; articulation and phonetic-phonological pronunciation; phonological awareness and phonetic segmentation; literacy skills.

Used software

NAOqi software v.2.8.6.23 and Python 2.7.

Setting and time

Thirty-minute sessions with children were conducted once a week for 30 weeks. The intervention was conducted during ordinary therapy sessions in a room at the speech therapist centre.

Variation

Possible software modifications for different behaviors and scenarios.

Reference: [46], 2020

Name of Scenario: Different scenarios for child–robot interaction

Objectives

To achieve significant changes in social interaction and communication.

Treatment domain, Type of CD

Different speech and language impairments—specific language impairment, ADHD, dyslexia, oppositional defiant disorder, misuse of oral language, dyslalia, ADD, problems with oral language, nasality, vocalization.

Treatment technique

Logopedic and pedagogical therapy.

Play type

Social and cognitive play.

Interaction technique

Robot–child–therapist interaction.

Age

9–12 years old (9,10,12)

Participants’ role and behavior

The participants in this scenario are the social robot (instructor), five children, the therapist, and a researcher-programmer.

Activity description

[46], page 564–565

Robot configuration and mission

A social robot NAO was used, preprogrammed with the modules: reading comprehension; dictations, stories and vocabulary, improvement of oral comprehension; articulation and phonetic-phonological pronunciation; phonological awareness and phonetic segmentation; literacy skills.

Used software

NAOqi v.2.8.6.23

Setting and time

This scenario was carried out in a clinical setting over multiple sessions—once a week for 30 weeks.

Variation

Possible software modifications for different behaviors, faster modules, and adaptation to unpredictable scenarios.

Reference: [41], 2020

Name of Scenario: Physically explore the robot

Objectives

Joint attention, identification of emotional expressions.

Treatment domain, Type of CD

Language disorders in children with complex social and communication conditions.

Treatment technique

Cause and effect game.

Play type

Social and cognitive play.

Interaction technique

Robot–child–therapist interaction.

Age

From 2 to 6 years.

Participants’ role and behavior

The participants in the scenarios are the social robot Kaspar, staff at the nursery, teachers and volunteers, children with complex social and communication conditions.

Activity description

[41], pages 306–307

Robot configuration and mission

A social robot Kaspar.

Used software

The robot is controlled by a specific Kaspar software that have been developed to facilitate semi-autonomous behavior and make it more user-friendly for non-technical users.

Setting and time

Scenarios were carried out in a nursery and the children interacted with the robot for as many sessions as were deemed meaningful within the day-to-day running of the nursery. Number of interactions with the robot per child was 27.37 and the standard deviation was 18.62.

Variation

The robot Kaspar can be used in different play scenarios.

Reference: [41], 2019

Name of Scenario: Ling sounds story

Objectives

Acquisition of hearing skills.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Ling sounds, auditory-verbal therapy method.

Play type (social/cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are two participants in this scenario, a social robot (instructor) and the individual who has hearing impairments (learner).

Age

3–4 years old

Activity description

[39], page 442

Robot configuration and mode of operation

A social robot NAO was used with toys correlated with the Ling sounds.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The level of difficulty can be adjusted. The activity can also include more participants to promote cooperative play.

Reference: [39], 2019

Name of Scenario: Music density

Objectives

Acquisition of hearing skills.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Listening of environmental sounds; discrimination and identification; sound intensity, auditory-verbal therapy method.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are two participants in this scenario, a social robot (instructor) and the individual who has hearing impairments (learner).

Age

3–4 years old

Activity description

[39], page 443

Robot configuration and mode of operation

A social robot NAO was used with toys correlated with musical instruments.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The level of difficulty can be adjusted. The activity can also include more participants to promote cooperative play.

Reference: [39], 2019

Name of Scenario: Farm animals—discrimination and identification of animal sounds

Objectives

Acquisition of hearing skills.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Discrimination and identification of animal sounds which are with different frequency (e.g., low frequency—cow sound, high frequency—cat sound); auditory-verbal therapy method.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are two participants in this scenario, a social robot (instructor) and the individual who has hearing impairments (learner).

Age

3–4 years old

Activity description

[39], page 443

Robot configuration and mode of operation

A social robot NAO has been used with toys correlated with farm animals.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a clinical setting over multiple sessions.

Variation

The instructions play in random order. The activity can also include more participants to promote cooperative play.

Reference: [39], 2019

Name of Scenario: Vegetables

Objectives

Acquisition of decoding of words/understanding.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Discrimination and identification of words; auditory-verbal therapy method.

Play type (social ∣ cognitive)

Cooperative and practice play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are two participants in this scenario, a social robot (instructor) and the individual who has hearing impairments (learner).

Age

3–4 years old

Activity description

[39], page 443

Robot configuration and mode of operation

A social robot NAO has been used with vegetable-toys and a basket.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario has been carried out in a clinical setting over multiple sessions.

Variation

The instructions play in random order. The activity can also include more participants to promote cooperative play.

Reference: [59], 2019

Name of Scenario: Responding to directives

Objectives

Language expansion.

Treatment domain, Type of CD

Language domain, autism spectrum.

Treatment technique

The robot tells the student what to do and initiates social engagement.

Play type

Cooperative and practice play.

Interaction technique

Teacher–robot–student.

Age

Eight-year-old student.

Participants’ role and behavior

There are three participants in this scenario, a social robot (instructor), a speech-language pathologist (a teacher) and the individual who has a communication disorder (learner).

Activity description

[59], page 5–6

Robot configuration and mission

A social robot NAO has been used with favorite toys of the learner

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario has been carried out in clinical settings over multiple sessions.

Variation

The level of difficulty can be adjusted. The activity can also include more participants to promote cooperative play.

Reference: [44], 2016

Name of Scenario: Teaching fundamentals of music

Objectives

Facilitation multisystem development in children with autism.

Treatment domain, Type of CD

Autism, fine movements, communication skills.

Treatment technique

Robot–Child or Robot–Child–Therapist/Parent imitation turn taking games and playing a Kinect based virtual xylophone on the screen.

Play type

Cooperative and practice play.

Interaction technique

Interaction between a robot, a child, and a therapist/parent.

Age

6-year-old children.

Participants’ role and behavior

There are four participants in this scenario, a social robot (instructor), and the individual who has autism (learner).

Activity description

[44], page 543

Robot configuration and mission

A social robot NAO has been used with drum and xylophone.

Used software

NAOqi v.2.8.6.23

Setting and time

This scenario has been carried out in a clinical settings over 11 sessions.

Variation

The design study contains a Baseline, pre-test, post-test, and a follow-up test. Each participant’s skill is compared with his previous skill based on assessment tools.

Reference: [45], 2016

Name of Scenario: Football game

Objectives

To achieve significant changes in social interaction and communication.

Treatment domain, Type of CD

ASD, communication, and social behavior.

Treatment technique

Play therapy.

Play type

Collaborative physical play.

Interaction technique

Interaction between a robot, a child, a therapist, and a parent.

Age

3–10 years old (5, 7, 3.5)

Participants’ role and behavior

The participants in this scenario are the social robot (instructor), the individual who has autism spectrum disorder, his parent, and trainer (teacher at the elementary school).

Activity description

[45], page 564–565

Robot configuration and mission

A social robot NAO uses a ball and participates in an interactive football game with the child.

Used software

NAOqi v.2.8.6.23

Setting and time

This scenario was carried out in clinical settings over four sessions.

Variation

There are various specific autonomous behaviors that may lead to cross-platform utility of socially assistive robots.

Reference: [58], 2016

Name of Scenario: Interactive play with a song

Objectives

Promoting foundational communication and socialization skills.

Treatment domain, Type of CD

To elicit child communication and socialization, Language disorder due to ASD.

Treatment technique

Playing a song and performing appropriate hand/arm motions.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

The participants in this scenario are a social robot, two researchers (a computer scientist and a clinical instructor), and a child.

Age

3–6 years (8 children)

Activity description

[58], page 643, 645

Robot configuration and mode of operation

A robot Probo, named CHARLIE.

Used software

New software was designed to promote two fundamental skills linked to communication—turn-taking and imitation.

Setting and time

This scenario was carried out in a university setting 2 times a week for 6 weeks.

Variation

The game could be played by one or more participants (the child with ASD + sibling/caregiver).

Reference: [58], 2016

Name of Scenario: The hat game

Objectives

Verbal utterances.

Treatment domain, Type of CD

To encourage eye contact, directed attention, speech, and social interaction by providing a positive sensory response to reinforce each child’s efforts to communicate. Language disorder due to ASD.

Treatment technique

Ask and answer to a simple question.

Play type (social ∣ cognitive)

Social play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

The participants in this scenario are a social robot, two researchers (a computer scientist and a clinical instructor), and the child.

Age

3–6 years (8 children)

Activity description

[58], page 645–646.

Robot configuration and mode of operation

A robot Probo, named CHARLIE.

Used software

New software was designed to promote two fundamental skills known to be closely linked to communication—turn-taking and imitation.

Setting and time

This scenario has been carried out in a university setting 2 times a week for 6 weeks.

Variation

The game could be played by one or more participants (the child with ASD + sibling/caregiver).

Reference: [43], 2015

Name of Scenario: Giving color responses

Objectives

Training joint attention skills.

Treatment domain, Type of CD

Joint attention skills, autism.

Treatment technique

The student is instructed to follow the robot’s head movement, to verbally (out-loud) name the color of the target, at which the robot is looking, and additionally press the corresponding button.

Play type

Cooperative and practice play.

Interaction technique

Robot–student (and a teacher in the pre- and post-tests).

Age

Mean age 4.6 (from 4 to 5)

Participants’ role and behavior

There are three participants in this scenario, a pet robot (instructor), a speech-language pathologist (a teacher), and the individual who has autism (learner).

Activity description

[43], page 3–5

Robot configuration and mission

A social robot, CuDDler (A*STAR), was used with 10 colorful line drawings of various objects in 4 colors.

Used software

Two Android phones execute software modules.

Setting and time

This scenario was carried out in a clinical settings over 3 sessions.

Variation

The level of difficulty can be adjusted. The activity can also include more participants.

Reference: [6], 2015

Name of Scenario: “Special Friend, iRobiQ”

Objectives

To promote of language interaction for children with speech-language disorders

Treatment domain, Type of CD

Speech and language disorders, emotional expression

Treatment technique

Scripts for practical language goals by robot as an interlocutor friend (turn-taking; functional communication)

Play type

Entertaining educational elements for initiated conversations with a robot

Interaction technique

Robot–child–therapist interaction.

Age

Four autism/MR (Mental Retardation) children who were 4–5 years old.

Participants’ role and behavior

The participants in this scenario are the social robot (instructor), four children, and the therapist.

Activity description

[6] Greetings and a birthday celebration script (cake, gift, song), with the theme of the practical language goals.

Robot configuration and mission

 

A humanoid robot iRobiQ with touch screen.

Used software

iRobiQ software v.2.8.6.23

Setting and time

This scenario was carried out in a clinical setting over eight sessions.

Variation

Variation of facial expressions (happy, surprised, neutral, disappointed and shy)

Reference: [47], 2014

Name of Scenario: Different interactive plays

Objectives

To achieve a positive impact on the communication skills of nonverbal children via robot-based augmentative and alternative communication.

Treatment domain, Type of CD

Communication disorders, language impairments—pervasive development disorder.

Treatment technique

Play therapy.

Play type

Social and cognitive play

Interaction technique

Robot–child–therapist interaction.

Age

From 2 years, 9 months to 5 years, 4 months old.

Participants’ role and behavior

The participants in this scenario are the social robot (instructor), four children, the therapist, and a researcher-programmer.

Activity description

[47], page 855–857

Robot configuration and mission

 

A humanoid robot iRobi with a robot-based augmentative and alternative programs.

Used software

Can be controlled by a smartphone through Wi-Fi.

Setting and time

This scenario was carried out in a clinical setting over multiple sessions in 3 phases for 6 months—three times a week.

Variation

Multi-functional sensors which can motivate children to initiate social communication.

Reference: [57], 2014

Name of Scenario: Sign Language Game for Advanced Users

Objectives

Recognition of signs from Turkish Sign Language.

Treatment domain, Type of CD

Language domain, Language disorder due to hearing impairment.

Treatment technique

Recognition of words in Turkish Sign Language for advanced level.

Play type (social ∣ cognitive)

Cognitive play.

Interaction technique

Child–robot interaction.

Participants’ role and behavior

There are two participants in this scenario, a humanoid social robot (instructor), and the child with hearing impairment.

Age

7–11 years (21 children) and 9–16 years (10 children).

Activity description

[57], page 525

Robot configuration and mode of operation

A social robot NAO H25 and a modified Robovie R3 robot.

Used software

NAOqi software v.2.8.6.23

Setting and time

This scenario was carried out in a university setting for 6–9 games with each robot.

Variation

The participants can randomly select a robot to play with.

A summary of the results is presented in Figure 1. In conclusion, over the years, empirical studies have increased, while the pilot studies have decreased. More experimental studies will facilitate the establishment of standards and common methodology on how to apply SARs in SLT. At the same time, there is an emerging trend in publications offering only models and interactive scenarios with SARs without experiments. This provides directions for future studies.

Figure 1. The number of published articles for the empirical vs. pilot studies for the last 15 years.

The types of communication disorders (Figure 2) indicated in the studies mentioned are few, such as dyslexia, dysgraphia, specific language impairment, and dyslalia. The number of articles where the participation of team speech therapists is included is small and for this reason, the authors have preferred to describe the primary disorder, for example, ASD, cerebral palsy, or hearing impairment. All these conditions have different kinds of communication disorders. They belong to the category of neurodevelopmental disorders; in most of them, the language acquisition is affected at different levels and it varies in severity.

Figure 2. Summary of types of disorders.

Figure 3 presents the age distribution of participants interacting with robots in the pilot and case (empirical) studies. There was a tendency of a larger and heterogeneous age range in the groups of children studied in the pilot studies, while in empirical studies, children interacting with robots have a small age difference. Sixty percent of them focused on a contingent between 2 and 6 years of age. The child develops rapidly in the first 5–6 years of age. This can be explained by the fact that this is the period of tremendous growth and change in language, cognition, adaptive skills, emotional intelligence, and social functioning. The evidence of many studies in neurolinguistics has shown that the critical and most sensitive period for language development is in the early years of life. After the end of this period, there is a reduction in the plasticity of the specific neural pathways responsible for language coding and decoding, and functional communication. This means that early intervention is crucial. Language exposure and multichannel stimulation (more senses—hear, watch, touch, experience) in the early years has a significant effect on the verbal skills of children. Child interaction with robots gives opportunities to play, and experience and repeat scenarios that copy everyday situations with communication models. This stimulation in the early age period will enhance the child development and will affect positively language, cognition, and behavior in later stages of life.

Figure 3. Age of the participants interacting with robots in the studies (A) in pilot studies (B) in case studies.

The scenarios described in Table 1 and Table 2 represent different studies of child–robot interaction. The main goal for all of them is the development of communication. Table 3 provides a summary of the objectives and different levels of communication, pre-verbal, non-verbal, and verbal, aimed at in the research.
Table 3. Description of communication objectives used in the research with scenarios for child–robot interaction.
Communication Objectives References Number of Articles
Joint attention [41][43][47][48][58] 6
Turn-taking [68][6][41][43][47][48][58] 8
Imitation/repetition [41][43][45][48][49][65][48][66][58] 9
Sign recognition/understanding/receptive vocabulary [52][54][56][57] 4
Sign production/expressive vocabulary [56] 1
Sound and speech sound recognition [68][39][40][44][48][49][54][62][66] 9
Speech recognition/receptive vocabulary [68][39][59][41][46][47][48][49][54][62][58] 13
Speech production/expressive vocabulary [68][40][41][60][43][46][47][49][50][52][54][62][66] 13
Morphosyntax skills [67][68][59][60][46][64][49][50][65][66] 10
Functional communication/maintain conversation/ pragmatic skills [68][6][60][46][49][50][65][55][62][66] 10
NAO is the most commonly utilized robot, as evidenced by the data presented in Table 4, which display the number of articles reporting the use of SAR-types in pilot or case studies. Our finding is in line with other studies about the children’s acceptance and perception of SARs [31]. The cost of the robots is indicated in the table, and in cases where it is not specified, the cost is considered to be moderate, neither low nor high. Due to the strong emphasis on communication and language skills in SLT, intensive practice of speaking and listening is crucial. As a result, it is important for robots utilized in SLT to have access to cloud-based chat services, such as iRobi [6] and QTrobot [8]. Unfortunately, the price of these robots is not affordable for home use.
Table 4. Distribution of SAR-types in pilot/case studies and the number of articles they are used in.
Socially Assistive Robot Articles
NAO 27
Custom made 3D-printed/Arduino-based robot (low cost) 8
Probo (low cost) 3
Robovie R3 (high cost) 2
iRobi (high cost) 2
Cozmo (low cost) 1
SPELTRA (low cost) 1
CuDDler (low cost) 1
CASPER 1
RASA 1
MARIA T21 1
QTrobot (high cost) 1
Pepper (high cost) 1

3. Conclusions

After conducting a thorough review and answering the research questions, despite the limited research on the use of social robots in communication disorders, certain studies have reported promising results for speech and language therapy. It is important to consider the methodological, technical, and ethical limitations and challenges associated with their use and to carefully evaluate their effectiveness before implementing them in clinical settings.
The use of assistive technologies can create a supportive and non-intrusive environment for children, leading to better outcomes in therapy. However, continuous exploration, evaluation, and monitoring of the effectiveness of these technologies is crucial to ensure that assistive integrating of ATs in SLT has a beneficial effect on children’s communication skills. Ethical and privacy concerns should also be taken into account when implementing ATs in speech and language therapy. It is necessary for scientists to conduct more comprehensive experimental studies before considering the widespread implementation of social robots as standard therapeutic interventions in speech and language therapy.

This entry is adapted from the peer-reviewed paper 10.3390/machines11070693

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