The robot, named MEDi, is programmed to greet a child with a high-five, collect toys from a tray and ask questions like “Do you like movies?” Children who engaged with the robot while receiving a flu shot had much less pain and distress than children who got a shot the usual way, according to a study published in the June issue of Vaccine.
“It’s the first robot to help children manage painful medical procedures,” said Tanya Beran, a professor of community health sciences at the University of Calgary in Alberta and the principal investigator of the study, which was conducted at Alberta Children’s Hospital. Research suggests that children who experience distress in a medical setting at a young age are less likely to access health care in adulthood, so she says it’s important to find ways to reduce pain during pediatric care.
For the study, Dr. Beran and her team recruited 57 boys and girls, ages 4 to 9, who had a moderate to severe fear of needles. Many had chronic medical conditions and had been to the hospital before. And many had vomited, fainted, run out of a clinic or needed to be restrained by nurses or parents when undergoing shots or other medical procedures.
The researchers randomly assigned the children to one of two groups: one with routine vaccination protocol administered by a nurse, and the other with the addition of MEDi in the room. In the MEDi group, the robot would converse with the child and pick up a toy, noting that it was dusty. As the nurse rolled up the child’s sleeve and swabbed the arm, MEDi would have the youngster blow on the toy to help clean it, timing the request to exhale for the moment the nurse injected the needle.
“The robot was distracting the child during distress, but also giving instruction for how to cope,” said Dr. Beran. “Deep breathing relaxes the deltoid muscle.”
Children, parents, nurses and researchers who were in the room were asked to rate the child’s distress, and all indicated significantly decreased pain and distress among those in the robot group compared to those getting routine care. (Other studies that have looked at similar distraction techniques, like using party blowers, have reported reductions in pain, but overall results have been mixed.)
But Dr. Beran and her team found that the robot’s presence produced benefits beyond pain reduction. For one, children recovered more quickly, smiling and relaxing almost immediately after the needle was removed, unlike children in the control group, who remained upset and often would not speak with their parents or nurses afterward. This finding was so striking that the researchers began taking the children in the control group to see the robot after the standard vaccination to try to cheer them up.
In addition, the researchers were surprised to find that parents interacted with the robot, serving as “an assistant coach” and adding encouraging instructions like “O.K., sweetie, let’s blow on the duck.”
“It gave the parents something to do,” Dr. Beran said. “They know their child is nervous, which makes them nervous. They’re not sure what to do, and usually the nurse will just instruct the parent to hold the kid’s hand. Here the robot gave instructions that kind of joined parent and child together in a common action.”
Dr. Beran and her team are now beginning a study using the robot during a blood test, which many children find far more disturbing than a shot. They are also collaborating with colleagues in the computer science department to personalize the interactions. Since MEDi has facial recognition capabilities, for example, one idea is for the robot to greet children by name at subsequent visits, or to program in responses received from parents ahead of time about children’s favorite books.
The robot is made by a French company, Aldebaran Robotics, and is sold under the name NAO for about $15,000. The Calgary researchers called theirs MEDi, short for Medicine and Engineering Designing Intelligence. Other research teams have programmed the robot for such applications as elder care, providing reminders to take medications and demonstrating yoga poses; leading a classroom game to teach students multiplication tables; and, in one Milan hospital, serving as a companion to children with diabetes.
But as far as pain relief in pediatric patients, “no one in the world has done this before,” said Dr. Beran. “You’re creating a new area of research that people will start to work in.”