Abstract

COVID-19 has severely impacted mental health in vulnerable demographics, in particular older adults, who face unprecedented isolation. Consequences, while globally severe, are acutely pronounced in low- and middle-income countries (LMICs) confronting pronounced gaps in resources and clinician accessibility. Social robots are well-recognized for their potential to support mental health, yet user compliance (i.e., trust) demands seamless affective human-robot interactions; natural ‘human-like’ conversations are required in simple, inexpensive, deployable platforms. We present the design, development, and pilot testing of a multimodal robotic framework fusing verbal (contextual speech) and nonverbal (facial expressions) social cues, aimed to improve engagement in human-robot interaction and ultimately facilitate mental health telemedicine during and beyond the COVID-19 pandemic. We report the design optimization of a hybrid face robot, which combines digital facial expressions based on mathematical affect space mapping with static 3D facial features. We further introduce a contextual virtual assistant with integrated cloud-based AI coupled to the robot’s facial representation of emotions, such that the robot adapts its emotional response to users’ speech in real-time. Experiments with healthy participants demonstrate emotion recognition exceeding 90% for happy, tired, sad, angry, surprised and stern/disgusted robotic emotions. When separated, stern and disgusted are occasionally transposed (70%+ accuracy overall) but are easily distinguishable from other emotions. A qualitative user experience analysis indicates overall enthusiastic and engaging reception to human-robot multimodal interaction with the new framework. The robot has been modified to enable clinical telemedicine for cognitive engagement with older adults and people with dementia (PwD) in LMICs. The mechanically simple and low-cost social robot has been deployed in pilot tests to support older individuals and PwD at the Schizophrenia Research Foundation (SCARF) in Chennai, India. A procedure for deployment addressing challenges in cultural acceptance, end-user acclimatization and resource allocation is further introduced. Results indicate strong promise to stimulate human-robot psychosocial interaction through the hybrid-face robotic system. Future work is targeting deployment for telemedicine to mitigate the mental health impact of COVID-19 on older adults and PwD in both LMICs and higher income regions.

Highlights

  • Dementia is a leading cause for disability and dependence across the world

  • We qualitatively identified the benefits in user engagement of multimodal vs. pure voice communication. We modified this robot further to provide clinicians with a telemedicine interface to deliver regular cognitive engagement, which may be of great utility during and beyond the COVID-19 era

  • We followed a user-centred design of the robot to ensure it meets the cost constraints and ease of use demands for utility in LMICs, in addition to cultural acceptability

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Summary

Introduction

As a chronic neurodegenerative condition, demands for care increase over time. Many people with dementia require social support, day care or assisted residence facilities with advancing illness. A staggering one in four United Kingdom hospital admissions is due to a dementia-related condition (Alzheimer’s Research UK, 2020). Global care costs are projected to exceed $2 trillion/annum demanding 40 million new care workers, which could overwhelm medical and social care systems as they stand today (Alzheimer’s Research UK, 2020). In India, the treatment gap today is a staggering 90% (Dias and Patel, 2009). Migration, and urbanization in Asia have impacted traditional family structures such that older people face less family support and more isolation today than ever before (Dias and Patel, 2009)

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