This is part of CNET's "Tech Enabled" series about the role technology plays in helping the disability community.
A hospital room has an odd duality. When my mom occupied one, it was both the best place for her to get better and the last place she'd ever see. She spent months in that light-gray room battling complications from kidney and heart disease.
My family and I did everything we could to make her feel comfortable, but we couldn't bring her the thing she wanted most: our family cat Capucine.
My mom's desire for her cat when she was ill wasn't unusual. Stroking a pet stimulates hormones that help you relax. An animal's breath and heartbeat feel soothing. But furry friends have a lot of limitations when interacting with sick people in a hospital. If they're allowed at all, they have to supervised, need bathroom breaks and are limited to visits at certain times.
Robots called comfort companions can fill this void, by offering the benefits of therapy animals without the downsides of germs, allergies and cost. With names like , My Special Aflac Duck and Jerry the Bear, these comfort companions help kids and adults cope with cancer, Type 1 diabetes, dementia and depression.
Just so we're on the same page, I use the term comfort companions to describe a robot or toy aimed at improving health and comfort. Some of these, like Sproutel's Jerry the Bear, are stuffed animals designed to work with an augmented reality (AR) phone app.
Other companions are full-on robots like, also designed by Sproutel. Then, there's Paro, which is a robot seal and a Class II therapeutic medical device certified by the Food and Drug Administration.
Hasbro sells robotic cats and dogs that blur the line between toy and comfort companion.
Animals are cute
Lyn Belingheri, a volunteer at Stanford Health Care who coordinates the PAWS (Pet Assisted Wellness at Stanford) program, believes in the healing benefits that animals can bring. "An animal can provide a connection between people and be the conduit for interactions," she says. "I saw a person who was severely depressed relate to my dog, talk to my dog and eventually talk to me."
Like their living counterparts, comfort companions take many shapes and forms, but nearly all are based on a real animal. Since it's difficult to make a convincing humanoid robot, and many comfort companions are aimed at children, they look more akin to stuffed toys than robots.
"If you think about how kids play with stuffed animals, kids put their imaginations on what this plush personality is," says Hannah Chung, co-founder and chief creative officer at Sproutel. "We are very intentional about not over designing our features. We think about the minimal things we have to provide and how much room we want a kid to have to fuel their imagination."
A robot duck
Chung and her business partner Aaron Horowitz founded Sproutel in 2012 to help kids cope with and learn about illness. They created Jerry, a stuffed bear for kids diagnosed with Type 1 diabetes. The bear is meant to be both a friend and a support tool. Kids learn to monitor blood sugar levels and give insulin shots to Jerry via an AR phone app.
In 2016, the insurance company Aflac worked with Sproutel to develop a robot toy for children diagnosed with cancer. Sproutel spent the following year exploring the journey that children, families and medical professionals take during cancer treatment, all of which informed both the hardware and behavior design of the My Special Aflac Duck companion bot.
The duck is equipped with a microphone, touch sensors and a light sensor that adjusts its behavior depending on the environment. When you tickle its sides, it dances, nuzzles, quacks and waggles its head. It even has breath and a heartbeat. The duck's furry "skin" is removable and easy to wash (a side effect of chemotherapy is vomiting).
I got to hold the duck for just 15 minutes, but I didn't want to put the little guy down. It felt alive and made me feel relaxed. The duck also gives children a chance to have control during a time when they seemingly have none by becoming the duck's caretaker and simulating feeding and bathing it via an accompanying AR app.
On the duck's chest is a glowing E.T.-like light where kids can place "feeler cards" that show different emojis. The cards determine how the duck feels, which is usually a reflection of how the kids feel. When a sad card is touched to the duck's chest, it droops its head and quacks sadly. A happy card makes it quack cheerfully and dance.
The same chest sensor has an attachment that lets kids witness their friend get chemotherapy medicine. It's little things like this that can ease children's minds before they have to go through the real thing.
The duck has finished numerous early tests at the Aflac Cancer and Blood Disorders Center in Atlanta and will be offered to children newly diagnosed with cancer in the US starting this fall. The price for each duck is approximately $200, but Aflac is covering the costs.
Paro started in 1993 as a project in Japan and went into production in 2005. Now in its ninth design, it's used in over 30 countries to treat people with dementia, cancer, anxiety, autism and Down syndrome. Famously, it was parodied on "The Simpsons" in 2011 when Bart and Martin built a Robopet that made the residents in the Springfield Retirement Castle happier. In 2015, Paro was featured on the Netflix show Master of None.
Modeled after a harp seal and about the size of a human baby, Paro is packed with sensors and microphones that are used to initiate movements, make happy baby seal sounds and regulate its body temperature. Its eyes open and close, it can recognize faces and it reacts to being stroked or cuddled with noises. Oh, and did I mention it was cute?
In the US, Paro helps treat veterans with brain injuries and PTSD. Geoffrey Woodward Lane, a geropsychologist at the VA Hospital in Livermore, California, says Paro is more practical than volunteer animals. "We can leave a Paro in a resident's room, if need be; they don't require handlers," he says. "Paro basically delivers the benefits of animal therapy without the mess."
Lane is a psychologist who treats mental health disorders in older adults. He shared a story about a WWII Navy veteran named Ray who suffers from dementia and is a resident at the VA.
Ray typically became anxious in the late afternoon and his restlessness was only worsened by his back pain. But when Lane gave him the seal, his mood brightened immediately. "Ray talks to Paro, and often mimics the sounds."
Over the next two years, Ray spent time once a week holding and petting Paro. These visits made Ray more social with other residents and staff members and decreased his need for certain medications.
When I toured the VA Hospital with Lane and Paro, residents reacted to the robot seal like a visiting celebrity. I overheard residents say, "There's the seal" and "Oh, here comes Paro!" It was eye-opening to witness a resident's energy and behavior relax as they petted the cuddly robot. One of the veterans, John Wilson, couldn't stop smiling as he held it. Paro craned its neck, batted its large eyes and cooed in-response.
"Our demented residents will frequently mistake it for a real live animal," says Lane, "which I generally am happy to just let them think, as long as they like it."
Takanori Shibata, chief senior research scientist at the National Institute of Advanced Industrial Science and Technology (AIST) in Japan, is the man behind Paro. He has bigger dreams for the seal.
"I am proposing Paro to be a companion for astronauts for mental health in long-term missions such as a mission to Mars," says Shibata. "It is very difficult for them to take animals. Paro may reduce the stress of astronauts, and reduce the risk of human error."
A compassionate future
Comfort companions are designed to be, in effect, compassionate. They don't cure disease, but they do bring hope and empathy to a child or adult when it's needed most. They are a friend.
The future for these comfort companions looks positive. But, as with most breakthroughs, the long-term benefits remain to be seen. The potential to provide comfort seems obvious, but what are the ethical consequences of using robots for emotional support? Does that change the way our society approaches aging and elder care?
I think back to my mom in her hospital room and wonder if such a comfort companion could have been a surrogate for her cat. Ultimately, my brother helped by bringing her a printed picture of Capucine. When she saw the photo, my mom's eyes lit up and her face filled with a healthy color. I like that moment.
This story appears in the summer 2018 edition of CNET Magazine. Click here for more magazine stories.
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: CNET got to spend time with My Special Aflac Duck which was designed to help kids suffering from cancer.