How a Robot Named Milo Helps Children With Autism Develop Social Skills

Thanks to films like the Terminator series or HBO’s Westworld, robots are often portrayed as antagonists for the human race. Often under-reported is the work being done with robots that can help children with autism, elderly patients with dementia or Alzheimer’s, or people with special needs with things such as social skills.

At CES 2019, a special panel of experts will discuss the issues around robotic caregivers. The panel is part of the RoboBusiness at CES event, produced by Robotics Business Review. The session, “Creating Tomorrow’s Robotic Caregivers,” will discuss advances in assistive technologies.

The panel will feature Vivian Chu, chief technology officer of Diligent Robotics, Rodolphe Hasselvander, CEO of Blue Frog Robotics; Thuc Vu, co-founder and CEO of OhmniLabs; Richard Margolin, CTO of RoboKind; and Michelle McFarlin, a certified clinical speech language pathologist, who co-developed the autism curriculum for RoboKind’s robot, Milo. The session will be held on Tuesday, Jan. 10, at 2:15 p.m. PT, in Las Vegas at CES.

Since 2011, RoboKind has created a series of robots that help children with autism develop essential social skills, working with educators and experts to create a curriculum based on proven therapy methods.

The facially expressive humanoid Milo robot is designed “to be interesting and approachable for learners with [Autism Spectrum Disorders (ASD)],” RoboKind said. As Milo speaks, icons are displayed on an LCD touchscreen on the robot’s chest that helps children better understand what he is saying.

In addition, video clips sent to a user’s iPad demonstrates target skills. They display skills and behaviors that are correct and incorrect, according to RoboKind, allowing the user to then answer yes or no questions “to test the learner’s understanding of the skills.”

Along with Pam Rollins, an associate professor and speech language pathologist at the University of Texas at Dallas, McFarlin helped develop the autism curriculum that Milo utilizes with students. Robotics Business Review recently spoke with McFarlin about her work with Milo, and how robots can help children with autism learn appropriate social skills.

Developing a curriculum for Milo

Q: How did you get involved with working with children with autism, and then with RoboKind on the curriculum for Milo?

McFarlin: Autism has been my professional passion since I first met an individual with autism, and I have been doing autism therapy and research since 1997. With my background in psychology and my speech-language pathology clinical practice, I love being able to understand how a given individual’s mind works, and to design a clinical program that is going to make a set of social expectations make sense to a child with autism.

Working with RoboKind was an exciting challenge to see how to take evidence-based practices that have been shown to be effective in working with children with autism to help them to learn social skills, and put systems together in a new way, with a humanoid robot as a delivery platform.

In my clinical practice, I had previously also done a lot of work in curriculum writing for individuals with autism, in learning language, social communication, and social skills. So the curriculum writing piece was right up my alley.

Also, along with my major in psychology, I was a math major and had done a lot of programming in college – so I was able to contribute from the speech pathology side the way the social skills curriculum should look, what it should do, and how it should be ordered, but I also knew how to write in a nested loop.

I also have a background in augmentative communication, which is helping individuals who can’t communicate conventionally using their mouths, to find alternative ways to make their voice heard. So I was able to incorporate a lot of that research-based learning and clinical practice into the development of the social skills curriculum.

Dr. Rollins and I wrote the curriculum together, and we looked at the 27 evidence-based practices that are shown to have sound scientific evidence for helping children with autism learn social skills. We took those practices and interwove as many of them as we could in a way we felt would optimize results and, by using Milo as the platform, standardize how those pieces of therapy were delivered to kids.

Q: What are the advantages of a robot like Milo delivering these lessons?

McFarlin: By using a robot, he can deliver it in the same way again and again and again. That kind of repetition and consistency is really important to the way that we know that children with autism learn.

Milo also has a touchscreen that shows visual icons. So when he’s talking, icons for core vocabulary are synchronized with his spoken words. We did this because we know that many children with autism have trouble with auditory processing and visual supports have been proven to help them to understand.

We also know that kids with autism love predictability, and by making it somewhat mechanical, we allow for that consistency. The curriculum also breaks down social expectations, systematically explaining the target to the individual in such a way that we giving them a system for understanding and demonstrating skills that might otherwise be a mystery to them.

Also, children with autism are very naturally prone to loving technology, so just by the virtue that it’s a robot, it’s already way cooler than I’ll ever be. The users also get to use an iPad – and we know all kids love tablets and watching videos.

Social skills training through narratives

Q: How does Milo teach a specific social skill to children with autism?

McFarlin: He teaches social skills in a social narrative format, where he is basically describing what a target skill should look like. For example, “When we greet a friend, we should try to look at the friend’s face, smile, and say hi.” Social narratives are proven, evidence-based practices that work with these kids, but we’re also able to give the visual support and have the icons appear on his chest screen that read “look, smile, and say hi.” As a human, that’s pretty hard to replicate.

Then the robot says, “Let’s watch some friends looking, smiling, and saying hi,” and then on the iPad the child is using to interface, we have three to five video models with actors demonstrating the target skills.

Then the kids are shown “test videos,” and Milo asks them questions about what they saw. The robot is able to collect data in the cloud for analysis. The professionals working with the kids are able to use that data to make judgements on how they’re learning and how progress aligns with an Individualized Education Program (IEP) or treatment plan.

Q: Why is it important that Milo has an expressive face?

McFarlin: For many kids with autism, looking at human faces is incredibly uncomfortable, there’s a social anxiety piece there. So being able to have a child look at the robot’s face and analyze the robot’s facial expression, as opposed to a therapist like myself saying, “Look at my face! How do I feel?” removes that level of social anxiety from the situation, and allows them to learn in a more discrete way.

Milo has an incredibly expressive face, which really distinguishes this robot from other robots that are endeavoring to do the same thing.

Dr. Rollins and I were able to sit in meetings with engineers and say, “He’s supposed to look bored, but he doesn’t look bored yet, so can you change the amplitude of this motor, or whatever, to better depict what facial expression went with what emotion.”

Q: Why are the video models helpful?

McFarlin: Parents of kids with autism — or any parent actually – will tell you they’re constantly trying to pull the kids off the iPad, YouTube, and all that. They love watching videos of things.

But we also know from the research that video models are an effective way to teach social skills to an individual with autism. Being able to use video models on the iPad with Milo to teach them certain social skills is a huge advantage. We’ve been able to design these videos in a way that we know what kids with autism are going to be looking at, and we’re able to control for that.

As a speech pathologist, many times I would say, ‘We need a video model for this, and we’d shoot it with grad students, but it definitely wasn’t the same quality as a paid actor and Emmy Award-winning director or producer shooting high-quality video.”

With these video models, we’re saving teachers and therapists the time and resources in developing their own, and providing them with the quality that would be difficult to replicate on their own.

Q: How much time does a child usually interact with Milo as part of the learning? Do they learn a module once and move on, or is it an ongoing process?

McFarlin: In general, we recommend using Milo two to three times per week for about 30 minutes. It is about the time needed to keep the novelty going for the kids, and keep them motivated and learning, and also able to receive other therapies that are more traditional.

We have two introductory modules that they go through before starting the official curriculum. One of them, which has been one of our more effective teaching modules, is called the “Calm Down” module. For many kids, no one has been able to teach them in a way where they could understand how to recognize their own emotions and how to calm down and not become upset. The module teaches them five different tools they could use if they become upset, and it teaches them systematically how to calm down.

That has been one of our most effective teaching modules, because for kids with language challenges, or for whom talking about things like emotions that are not concrete, it’s really hard for them to understand. But somehow when Milo magically delivers it in his way, they get it. It has been one of the modules that the kids get right away, and it has been incredibly impactful in being able to move kids from the self-contained autism unit into the mainstream classroom, because they’re finally able to understand their own emotions and manage their own reactions.

Figuring out bizarre rules

Q: Explain some other situations where children with autism would be exposed to something outside a clinical setting that you developed a Milo module for.

McFarlin: It’s already hard for these kids to try to figure out the general rules of common social situations, and then there are special situations sort of violate all these rules. We wrote the situational modules to address these kinds of special circumstances.

For example, a birthday party is the most bizarre thing: You go somewhere you’ve possibly never been before, and it’s super-crowded and loud, you may or may not know or even like everybody, it’s not your birthday, but you have purchased a gift that you like a lot, but you have to give it to someone else and leave it there.

And sometimes for a birthday party, you go to a roller rink, for example. You have to take off your shoes that you brought, and maybe even really love a lot because they feel good, and you have to be able to put on roller skates, which are very strange and tight and moving and they’re not yours, and they feel different and they smell funny, and all of those things.

So we say, “Yes, this is going to be a very different situation, but there are also very predictable rules to this,” and we break it down again using the social narratives and video modules with core vocabulary and visual supports to help them understand what to expect.

Q: Are you making updates to the curriculum, or is it set in stone?

McFarlin: New curriculum units are in the works. We are working with even more professionals in the field to design modules that are more specific – things like the social skills of field trips, of fire drills, or the lunch room or even walking down the hallway – simple things that kids with autism really struggle with – those things that have the super-bizarre rules.

Q: Can you give an example of how these lessons have translated into the real world, where students can react to other humans after working with Milo?

McFarlin: At an educational event, I was standing at a booth with Milo and doing demos, and a dad came up and said his son with autism had done the birthday party module, and that he had never successfully had or attended a birthday party or experienced one without getting extremely dysregulated.

He did the birthday party module right before his birthday, and the dad started crying, saying, “He’s never ever enjoyed his birthday party before, and we made it through without any meltdowns. He sat down, he allowed us to sing ‘Happy Birthday’ to him, he smiled. He did it.”

Q: What takeaway message do you want to give the CES audience about robots being used in these situations?

McFarlin: Across the country, autism is on the rise, and there’s a limited number of professionals out there with the expertise to be able to deliver these kinds of services with the kind of breadth and depth we need. We were able to design this curriculum after years and years of development, based on research and Dr. Rollins and my combined experience.

By putting this curriculum into a delivery platform with a robot, which obviously is novel and intrinsically motivating to these kids, we’re able to reach others who otherwise would not have access to highly skilled autism services.

As a professional who went into this career with the passion to serve this population, there’s no greater gift to be able to send out this robot ambassador to do what I would do if I were right in front of the child. I’ve seen videos of kids doing a module in Australia, and I go, “That’s my voice on the voiceover!” With Milo, I’m able to talk to all of these kids around the world and serve them in a way that maybe they wouldn’t otherwise have access to, and do it in the novel form of a robot that is naturally way cooler than I would be if I were there myself.

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