Robotics, Artificial Intelligence (AI), and the Internet of Things (IoT) support various processes in many scenarios of modern life such as e-health and psychological treatments. This article presents the design, development, implementation, and assessment of a Robotic Assistant (RA), named “Atent@”, as a support tool in the homework activities of children with Attention Deficit Hyperactivity Disorder (ADHD). Interacting with the children the RA helps them correct their bad habits and misbehavior caused by the disorder. Its features and functionalities were designed by therapists, implementing AI algorithms to process information and make decisions in real-time to help children to be focused on their homework. This RA interacts with smart objects deployed at home, which are associated with the activity under observation (desk and chair). This solution allows therapists to receive more accurate information about the homework sessions inside the home. At the same time, remote interaction with the child is made possible (through the RA) to provide new instructions and support him/her along with the sessions. This RA is a significant evolution of an earlier version. All the improvements brought to the project by the modifications in technical and qualitative features are explained. Furthermore, the experiment and its results are presented to illustrate the clinical potential. This project shows that the RA can not only make observations with a high degree of precision like an expert (teacher/therapist) but also positively influences the homework performance of children with and without ADHD.

The Central Nervous System of humans continuously evolves when children engage in new activities. These activities are progressing from learning to eat as a baby over playing during childhood up to homework in all its dimensions. These activities, which are meaningful and relevant to everyone, constitute what occupational therapists call “occupations”. The successful execution of these occupations makes the development of new roles as well as the construction of a correct state of health possible. Due to these reasons, occupational performance is a fundamental part of development throughout childhood. Homework is complex and extends beyond the school context to the home. For many children, the performance of these homework items is a difficult challenge or even impossible to overcome without the help of an adult. This article presents the design, implementation, and functional validation of an intelligent home environment that uses homework activities as a support tool for children with or without attention disabilities. In this project, the Internet of Things (IoT) paradigm is combined with the development of robotic assistance to implement an intelligent home environment. In this environment, we have included intelligent things (where the usual study chairs and desks become smart objects) that determine in real-time the child’s behavior during the development of homework and a robotic assistant which interacts with the children providing the necessary accompaniment (supervision and guidelines) just as a therapist would do. This development has been functionally validated by tests on several school-aged children without pathologies. In a later phase of the study, the proposal will be validated with children with different pathologies with an impact on learning, including Attention Disorder Hyperactivity Disorder (ADHD). The goal is the generation of intelligent places for therapeutic purposes within the home as assistance for children having difficulties to work with their homework assignment due to ADHD.

Performance and perceived satisfaction of daily occupations in people with multiple sclerosis (MS) can affect the perception of their quality of life and be impacted by the level of fatigue. To describe the performance and occupational self-perception, as well as to analyze whether there is a relationship between the perception of occupational performance and the quality of life and perceived fatigue. A descriptive cross-sectional study. Participants were referred by the services of Neurology of the various hospitals in Madrid. The assessment process was performed either at the MS' associations, in the participants' home, or at the Laboratory of Cognitive Intervention of the Health Sciences Faculty of the University. A total sample of 30 people with MS (pwMS) selected by non-probabilistic consecutive sampling during a three-months uptake patient recruitment period. The outcome measures used were the Canadian Occupational Performance Measure (COPM), the Modified Fatigue Impact Scale (MFIS) and the Multiple Sclerosis Quality of Life 54 (MSQoL-54). Descriptive analysis, parametric and non-parametric tests and multiple linear regression models were used. A statistically significant positive correlation was found between occupational performance and physical and mental health. Also, high physical health scores were associated with high satisfaction scores. Multiple regression models indicated that high levels of satisfaction were associated with high levels of physical health (P= 0.013). The better the perception of the physical aspects that influence the quality of life, the better the perceived satisfaction of pwMS. Fatigue may not influence self-perceived satisfaction and performance. The physical factors affecting perceived satisfaction should be considered when planning interventions to promote quality of life in pwMS. Although fatigue associated with MS may influence perceived performance and satisfaction, no relevant associations were found between variables.

Animal-assisted therapies are an innovative strategy within health care humanization initiatives, and they could play a role in the reduction of pain or anxiety. The main objective of this work was to evaluate the feasibility of implementing animal-assisted therapy in a pediatric intensive care unit and its effectiveness for the reduction of pain, fear, and anxiety. A prospective, quasi-experimental study of animal-assisted therapy was designed in the pediatric intensive care unit of the Hospital Universitario 12 de Octubre of Madrid, from January 2019 to December 2019. The study sample included patients who had been admitted to the unit and were over 3 years old. Satisfaction surveys were collected from the patients, family, and health personnel involved. Physiological variables and the level of pain (visual analog scale or Wong-Baker scale), fear (Child Medical Fear Scale), and anxiety (modified Yale Preoperatory Anxiety Scale) were evaluated before and after each session. Any existence of adverse events was recorded. A total of 74 therapy sessions were performed on 61 patients. All sessions were completed without any adverse effects. A total of 164 surveys were collected, providing an overall project rating of 9.69 out of a possible 10. The survey comments were found to be positive in most cases. No differences were found in the physiological variables measured before and after each session. There was a statistically significant decrease in pain, fear, and anxiety levels (p < 0.01).   Conclusion: The implementation of an animal-assisted therapy project in a pediatric intensive care unit is feasible and safe and has a high degree of acceptance among both participants and healthcare staff. Animal-assisted therapy is effective for the reduction of pain, fear, and anxiety, and therefore, it could be considered an adjunct to non-pharmacological therapy. What is Known:• Animal assisted therapies (AAT) are an innovative strategy that could be beneficial to help pediatrics patients cope with admission difficulties and could even play a role in reducing pain, anxiety and/or delirium.• To date there are not studies to analyze the effectiveness of AAT in the field of Pediatric Intesive Care. What is New:• Our study confirms the feasibility and effectiveness of the implementation of an AAT in the field of Pediatric Intensive Care with a high degree of acceptance by participants, caregivers and healthcare personnel.• AAT demonstrated a reduction in pain, fear and anxiety in pediatrics patients admitted to Pediatric Intensive Care Unit.

The importance of an early rehabilitation process in children with cerebral palsy (CP) is widely recognized. On the one hand, new and useful treatment tools such as rehabilitation systems based on interactive technologies have appeared for rehabilitation of gross motor movements. On the other hand, from the therapeutic point of view, performing rehabilitation exercises with the facial muscles can improve the swallowing process, the facial expression through the management of muscles in the face, and even the speech of children with cerebral palsy. However, it is difficult to find interactive games to improve the detection and evaluation of oral-facial musculature dysfunctions in children with CP. This paper describes a framework based on strategies developed for interactive serious games that is created both for typically developed children and children with disabilities. Four interactive games are the core of a Virtual Environment called SONRIE. This paper demonstrates the benefits of SONRIE to monitor children’s oral-facial difficulties. The next steps will focus on the validation of SONRIE to carry out the rehabilitation process of oral-facial musculature in children with cerebral palsy.