Alexism: ALEXa supporting children with autism in their oral care at home

Oral health care can be a challenging experience for children with autism, for their parents and for dentists. Recently, some technology-enhanced systems have been proposed to help people with autism to cope with distressing situations originated by unknown social-life contexts, such as dental care settings with intense sound-visual stimulations. Results were positive in mitigating anxiety at the dental clinic but seem to fail in supporting proper oral hygiene at home. Thanks to the increasing spread of household Intelligent Personal Assistants (IPA) and Vocal Conversational Agents (VCAs), we envisage new opportunities considering the Voice-enabled IPAs not only as support on daily activities but also to enrich and simplify access to healthcare procedures from home. This work attempts to extend the use of technology-enhanced systems for dental care by exploiting the potential of the Vocal User Interface, Amazon Alexa, as an instructional agent with children on the spectrum. To this purpose, we developed a personalized Alexa Skill with two different functionalities: (i) support the child during the routine transition toward the target activity: move to the bathroom to brush their teeth; (ii) act as a persuader and a timer to guide the child during the procedure observing the proper brushing time. We conducted a three-week preliminary study with three children of different autistic profiles. The goal was to collect opportunities and issues deriving from the device introduction in the home context and test the device usage to favour dental care. Results and feedback were encouraging and gave insights to improve this approach.