Comparing Imitation and Stereotyped Behaviors in Autistic Children: Robots vs. Human Operators

Study Overview
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Brief Summary
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Virtual QT is a social robot designed to interact with humans in social and educational contexts. Equipped with visual and vocal interfaces, the robot can recognize and respond to various human inputs, providing emotional support and social interaction. It uses facial expressions, gestures, and movements to communicate, encouraging engagement and supporting learning through playful and educational activities. Its ergonomic design and interactive approach make it suitable for both clinical and educational settings. The aim of this study is to examine the effectiveness of the QTrobot in interventions for children with Autism Spectrum Disorder (ASD) and to assess whether children's attention and imitation are equally effective with the QTrobot compared to interacting with a human being. Furthermore, the presence of significant differences between motor and expressive imitation, when interacting with the robot as opposed to a human interlocutor, will be investigated. A key aspect of this investigation is to assess whether the presence of the QTrobot can positively influence the repetitive or stereotyped behaviors exhibited by the children, compared to interaction with a person. Additionally, to further understanding, the children's heart rate will be monitored through the use of a sensor that will allow to evaluate how heart rate affects performance outcomes during interaction with the QTrobot and with a human being. In this study, children will be recruited to take part in two separate sessions, both involving the same task. During the first session, the task will be carried out between the child and the human operator. Subsequently, in the same task, the child will interact with the QT robot. Throughout both task administrations, the child will wear a sensor to detect their heart rate. Furthermore, all task sessions will be video-recorded to conduct subsequent video analysis and make notes on imitation behaviors and stereotypical actions relevant to the study.

Official Title
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Exploring Imitative Abilities and Stereotypies: Comparing Robots and Human Operators in Autistic Children

Conditions
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Autism, Autism Spectrum Disorder

Intervention / Treatment
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* Other: QT robot


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Diagnosis of Autism QI ≥ 75 Exclusion Criteria: Motor deficits due to another clinical condition

Ages Eligible for Study
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Minimum Age: 4 Years
Maximum Age: 13 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Children with autism spectrum condition<br>Thirty Autism Spectrum Disorder (ASD) children with medium-high functioning, aged 4 to 13 years, IQ > 75, in the absence of motor deficits due to another clinical condition. | Other: QT robot<br>* In a single session each child will be video-recorded while performing the task. The participant subjects will perform the same task at two different times, once with the human operator and once with the Qt robot. Both tasks will have a duration of approximately 4 minutes. During the first minute, both the operator and the Qt will introduce themselves and ask four questions to the child to deepen the acquaintance. In the second minute, the operator/Qt will tell a story. In the third minute, the operator/Qt will ask to imitate 4 motor movements, while in the fourth minute, the operator/Qt will ask to imitate 4 facial expressions.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Video analysis of performance | The videos of the interviews were analyzed by a single observer. For each child, the observer evaluated both the child's interactions, one with a person and another with the robot. The assessment included the child's attention, measured by the frequency and duration of the child's gazes towards the interaction partner. Additionally, the observer recorded the number of imitations of the partner's actions, limited to a maximum of four imitations. Finally, to evaluate repetitive and stereotyped behaviors, the observer counted the sequences of these behaviors and the number of repetitions within each sequence. A sequence was defined as a continuous repetition of the same behavior type, with pauses or interruptions considered as separate sequences. If the child paused and resumed the same or a different behavior, each restart was counted as a new sequence. | The video analysis needs approximately 15 minutes per child | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Heart rate | The polar sensor detects the electrical activity of the heart and calculates heart rate in beats per minute (bpm).Typically it is worn on the wrist or chest. | The test needs approximately 30 minutes | 
| Heart rate variability | The Polar sensor measures the time intervals between successive heart beats and calculates Heart Rate Variability (HRV) in milliseconds (ms). Typically it is worn on the wrist or chest. | The test needs approximately 30 minutes | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Autism, imitation, social robot, Stereotypies