Augmentative and Alternative Communication, 2015; 31(2): 108–123 © 2015 International Society for Augmentative and Alternative Communication ISSN 0743-4618 print/ISSN 1477-3848 online DOI: 10.3109/07434618.2015.1029141

RESEARCH ARTICLE

Participation and Enjoyment in Play with a Robot between Children with Cerebral Palsy who use AAC and their Peers ULRIKA M. FERM1, BRITT K. CLAESSON1, CAJSA OTTESJÖ2 & STINA ERICSSON3 1

DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Gothenburg, Sweden, Department of Philosophy, Theory of Science and Linguistics, University of Gothenburg, Gothenburg, Sweden, and 3Department of Swedish, Linnaeus University,Växjö, Sweden

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Abstract This study explores children with complex communication needs, their peers and adult support persons in play with the talking and moving robot LekBot. Two triads were filmed playing with LekBot at pre-school. LekBot was developed to facilitate independent and enjoyable play on equal terms for children with significant communication disabilities and their peers. Using Conversation Analysis, participatory symmetry and enjoyment were investigated in relation to spoken and gestural communication, embodied stance, gaze, and affective display. Data originated from three video-recorded sessions that were approximately 2 hours long. Four different interaction situations were identified and explored: Participatory Asymmetry, Adult Facilitation, Greater Participatory Symmetry and Creativity, and Turn-taking and Enjoyable Play with LekBot. Neither participatory symmetry nor enjoyment were easily achieved in the play sessions and may require considerable effort, including adult involvement, but creative, spontaneous and highly enjoyable play, correlating with participatory symmetry to various degrees, was observed in a few instances. The findings are discussed with regard to play, AAC and the future development of robots to facilitate play.

Keywords: Augmentative and alternative communication; Cerebral palsy; Children; Complex communication needs; Peers; Robotics; Play; Participation; Enjoyment

Interaction Between Children with Complex Communication Needs and their Peers

Introduction In this study, we examined interaction between two children with complex communication needs, their peers, and adult support persons during play with the talking and moving robot LekBot. The focus of the analysis was the participants’ participation and enjoyment. Children with complex communication needs depend on different kinds of support to be able to communicate. The support tools used are important, but the provision of communication aids alone will not automatically result in more or better interaction with others. If there are few opportunities for communication, and no partners for communication or play, the provision of a communication aid is unlikely to make the desired difference to the child’s participation. The presence of other children, relevant activities, and appropriate means to participate in the activities are important factors for facilitating communication and play between children with and without disabilities.

Interaction between children with complex communication needs and their peers is often asymmetrical (Buzolich & Lunger, 1995; Clarke & Kirton, 2003; Clarke & Wilkinson, 2007). Speaking children may dominate by taking more turns and making more initiations and requests than children who use AAC; the latter may primarily take roles as respondents to others (Clarke & Kirton, 2003). This type of interaction has often been deemed to be a negative feature of conversation involving people who use AAC. However, Clarke and Wilkinson (2007) have suggested that it may be advantageous for children without disabilities and those who use AAC if this asymmetry is characterized by speaking children arranging specific slots in the conversation for aided contributions (e.g., as answers to questions). This type of interaction may support AAC turns that are more easily produced and understood. Other analyses by Clarke and colleagues noted evidence

Correspondence: Ulrika M. Ferm, DART Centre for AAC and AT, Queen Silvia Children’s Hospital, Sahlgrenska University Hospital, Kruthusgatan 17, 411 04 Göteborg, Sweden. E-mail: [email protected] (Received 10 January 2014; revised 10 February 2015; accepted 3 March 2015)

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Play with the Robot LekBot of considerable competence and co-operation between children who use AAC and their speaking peers in making conversation relevant and understandable (Clarke & Wilkinson, 2008, 2009; Clarke, Bloch, & Wilkinson, 2013). Thus, the interpretation of symmetry and equality of conversational contribution is complex and, arguably, best explored through detailed qualitative analysis of children’s actual interactions. By approaching the interactions of children with complex communication needs through ethnomethodology (Garfinkel, 1967) and Conversation Analysis (CA; Schegloff, 2007), it is possible to explore the details of the means children use to create shared meaning and to make the ongoing interaction proceed. This work can contribute important insights for practitioners and developers within the field of AAC. Of particular relevance to the present study are interaction phenomena such as participation and embodied interaction (i.e., meaning making considered in relation to body posture and movement in a physical environment, for example); use of gaze in interaction, affective displays, and shared involvement; and turntaking (Clarke et al., 2013; Clarke & Wilkinson, 2013; C. Goodwin, 2007; M. H. Goodwin, 2007; Ruusuvuori & Peräkylä, 2009; Sacks, Schegloff, & Jefferson, 1974; Sigurd-Pilesjö, 2013; Stivers, 2008). Children with complex communication needs may experience restricted participation; they need natural places to meet for the development of social relationships and interaction with others to occur (Anderson, Balandin, & Clendon, 2011; Batorowicz, Campbell, von Tetzchner, King, & Missiuna, 2014; Thirumanickam, Raghavendra, & Olsson, 2011). In the interview study by Anderson et al. (2011), five of six friendships were described as spontaneous in the sense that the children shared common aspects of their lives (e.g., they were in the same class). Restricted possibilities for participation and interaction with peers may have negative effects on the child’s development of language, and social and communication skills and thus may further restrict his or her chances for inclusion. With this in mind, instructing and adapting environments and activities so that children with disabilities can be involved, interact, and play in ways similar to those of peers without disabilities should be a high priority for practitioners (Batorowicz et al., 2014; Batorowicz, McDougall, & Shepherd, 2006; Buzolich & Lunger, 1995; Hunt, Alwell, & Goetz, 1991; Light, 1997; Lilienfeld & Alant, 2005; Trembath, Balandin, Togher, & Stancliffe, 2009; Trottier, Kamp, & Mirenda, 2011; von Tetzchner, Brekke, Sjøthun, & Grindheim, 2005). Play Social interaction is central to human development, and play is a main form of interaction for children that allows them to explore the world and develop within physical, emotional, cognitive, linguistic, and social domains (Garvey, 1990; Gärdenfors, 2010; Johnson, Christie, & Wardle, 2005). The following points raised © 2015 International Society for Augmentative and Alternative Communication

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by Garvey (1990) as central for a play activity are relevant for the understanding of the current study. First, play is pleasurable. Even if there are no outward signs of enjoyment, there is reason to believe that a play activity is experienced as positive in some way or other. In addition, play is not primarily goal oriented. It is playing itself that is important and enjoyable, not the achievement of a specific outer goal. Finally, play is spontaneous and voluntary and depends on active engagement and participation by the children involved. Children and adults may have different ideas about the nature of play. In a study by Kärrby (1990), 15 5- and 6-year-old children were interviewed about play and explained that it involved fantasy and pretending, could be defined in terms of a theme, and had specific rules. Just having fun or experiencing things were examples of activities that were not considered play. As pointed out by Garvey (1990), young children also interact without playing. Another important aspect of play is the possibility for a child to assume a different role, that is, to “…put their own identity within parenthesis…” (Jensen, 2008, p. 9) for a certain period of time. This is particularly true for pretend play, which involves imagination, sometimes complicated roles, and rules for what to do and how. Pretend play involves opportunities to learn social communicative skills such as joint attention and following, adapting to, and steering other people’s actions and intentions, understanding others’ emotions, and finding solutions to problems. Children need to take each other into close consideration and take turns while playing. Play and Children with Complex Communication Needs. For children with complex communication needs, play requires environmental support (Light & Drager, 2007). There is little, if any, research literature concerning play interactions between children who use AAC and their peers, but clinical experience suggests that play, as described previously, is difficult for these children. They may have restricted access to spoken language (sometimes with regard to both expression and understanding), reduced mobility and fine motor skills, and limited experience with play and playing rules. It may be difficult for them to initiate and take the lead in play or to move around and manipulate toys in relevant ways. Keeping up with what is going on and being flexible are important skills for play, and many children with complex communication needs may lack these skills. Thus, it is often difficult for children with complex communication needs to participate in play on terms similar to those of their peers without disabilities. Research has suggested that children with complex communication needs and their peers can have fun while interacting; that play and humor are also important for children who use AAC; and that communication aids should include content that enables playing, telling jokes, teasing, and making fun comments (Clarke & Kirton, 2003; Clarke & Wilkinson, 2007, 2009; Light, Page, Curran, & Pitkin, 2007;

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Lilienfeld & Alant, 2005; O’Mara & Waller, 2003; Trottier et al., 2011). Yet, young children who use AAC may not get the support they need, in terms of vocabulary to initiate play, for example (Finke & Quinn, 2012). Increasing the possibilities for children with complex communication needs to participate in enjoyable play is an important goal of AAC intervention. It would seem essential, therefore, to learn more about when playing is fun and why, as well as how technology can support the participation of children with complex communication needs in play with peers. AAC Technology and Play. Technology and instructional strategies should be designed to meet the varying needs and roles of the people who use AAC and their partners (Blackstone, Williams, & Wilkins, 2007). Light and colleagues have investigated the design of AAC technologies and suggest that functions supporting play, literacy, and language learning should be integrated with AAC technology to a greater degree than is currently available (e.g., Light & Drager, 2002). Color, shape, movement and action, and voice and sound are some of the features identified by Light, Drager, and Nemser (2004) as significantly different in AAC systems than in toys used by young children. For example, while toys have many different colors and shapes and could represent living characters such as people and animals, AAC devices often are more neutral in color and box-like in shape. Moreover, AAC devices tend to be static and offer little variety with regard to physical manipulation and kinetic and auditory feedback. Apart from the fact that tablet computers are common today – a significant development indeed – it is still the case that AAC technology in general is not as innovative in offering different possibilities for play, interaction, and development as could be the case, considering the potential of today’s design and technology. In developing play technology for children with complex communication needs, the views and playing behaviors of peers without disabilities – the expected playmates – must be taken into consideration (Light et al., 2007). Children without disabilities in the study by Light et al. provided creative suggestions about desirable types of technology (e.g., reading and speaking robots) and stressed that playing and having fun is relevant. There are different ways of involving children in the design of technology, from joint idea elaboration to end user testing (Druin, 2010; Nesset & Large, 2004). With respect to children with complex communication needs, valuable information about how technology and different strategies either support or restrict meaningful communication may be evident in their actual interactions with other people (Blackstone et al., 2007; Clarke & Wilkinson, 2008; Ferm, Ahlsén, & Björck-Åkesson, 2013; Higginbotham & Engelke, 2013; Sigurd-Pilesjö, 2013). Therefore, this project focused on play between children with complex communication needs and their peers.

Using a Robot to Facilitate Play: The LekBot Project The LekBot project (2010–2011) was a collaboration between DART – Centre for AAC and AT, the software developer Talkamatic, and the University of Gothenburg (Ljunglöf, 2009; Ljunglöf et al., 2011). A multidisciplinary team of researchers and clinicians (speech and language therapists, educational consultants, linguists, and computational linguists) developed a prototype robot designed for interaction with children with complex communication needs. The purpose was to create a system that would be fun and easy to use, enable independent play, and enable children with complex communication needs to play on equal terms with peers. In line with the critique by Nesset and Large (2004) of traditional user-centered design, where users test a system or product at the very end, in the LekBot project, both children with complex communication needs and their peers, as well as adult support persons, were involved in the design process from the very beginning. The LekBot system included a touch-screen computer that controls a moving and talking robot. The touch-screen computer acted as a communication aid and produced synthetic Swedish speech1. The robot was built using LEGO® MINDSTORMS® NXT2 and was dressed as a bumblebee (see: http://www.dart-gbg.org/ lekbot). A wireless audio transmitter and a receiver were used to send audio data from the touch-screen computer to the bumblebee. The bumblebee communicated through spoken utterances (using another synthetic voice), various sounds, and physical movement. The interactional flow in the system – decisions regarding what was said, by whom, and when – was controlled by a dialogue manager, a piece of software originally developed by Larsson (2002). While the touch-screen computer generated synthesized speech, messages between the computer and the bumblebee, such as the instruction to “Go forward” were communicated using a wireless connection, allowing for (near) perfect communication with the robot. Several robots have been developed in research contexts for children with different disabilities (Arent & Wnuk, 2007; Dickerson, Robins, & Dautenhahn, 2013; Feil-Seifer & Matarić, 2012; Kozima, Nakagawa, & Yasuda, 2007; Lee, Kim, Breazeal, & Picard, 2008; Robins, Dautenhahn, te Boekhorst, & Nehaniv, 2008; Saldien, Goris, Verrelst, Van Ham, & Lefeber, 2006; Scassellati, Admoni, & Matarić, 2012). Some of the robots communicate through lights and sounds, facial expressions and gestures, and, more recently, speech. LekBot was unique in using multimodal bi-directional communication, that is, the child communicated with the bumblebee by activating spoken messages represented by pictures on the touch-screen computer, and the bumblebee communicated with the child by speaking, making noises, and moving. In contrast with robots designed to facilitate single-turn spoken responses to others (e.g., Dickerson et al. 2013), communication with LekBot also involved a facility for communication Augmentative and Alternative Communication

Play with the Robot LekBot about specific topics that could be developed over several turns (e.g., LekBot could respond to a command from the child by asking a question, subsequently moving, and then asking the child for an evaluation of the action). In addition, the bumblebee was colorful and aimed to be humorous and fun for children. Unlike tablet-computer applications for games and interactivity, the LekBot bumblebee was a physical agent with a position in time and space, which added another dimension to the interaction. Purpose and Research Questions The overall purpose of the study was to examine interaction between children with complex communication needs, their peers and adults during play with the talking and moving robot LekBot. Specifically, we investigated play with LekBot with regard to participation and enjoyment. Two questions were explored: (a) how is participatory symmetry between children with complex communication needs and their peers achieved in interaction with LekBot?, and (b) in what sequential contexts (specific points in the interactions) do the children display enjoyment when interacting with LekBot? The interactions were examined with regard to the concept of play. These questions were designed to inform clinical practice and further the development of robots such as LekBot.

Method Participants The project was vetted by and received approval from the regional ethical review board. The children with complex communication needs were recruited through the Habilitation and Health services of western Sweden and through ordinary pre-schools in the same region. Three triads, each composed of a child with complex communication needs, a peer, and a support adult, participated in the project; data from two triads that agreed to participate in dissemination of the results are examined in this study. The preschool staff invited peers to participate who knew the children with complex communication needs well; had shown an interest in these children’s communication; and probably would, according to the staff, enjoy participating in the project and being recorded while playing with LekBot. The project group used the Communication Function Classification System (CFCS; Hidecker et al., 2011) in collaboration with the pre-school staff to describe the main features of the children’s communication. Since LekBot was under development and could be prone to technical problems, adults and researchers were present during data collection. The first triad consisted of Axel and Anna (pseudonyms) and an adult support person. Axel had cerebral palsy and complex communication needs. He was 6;6 (years;months) old at the time of the first recording © 2015 International Society for Augmentative and Alternative Communication

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and at Level 3 according to the CFCS, that is, was an effective sender and receiver with familiar partners but not with unfamiliar partners. Axel communicated using sounds and a few spoken words, gestures, manual signs, and pictures. He had the Swedish standard Blissymbol board and the communication software Programsnickaren®3 which he used together with the Light Rolltalk®4. Gross motor ability, hand function, and fine motor skills were affected, but Axel managed to activate a touch-screen using his right index finger. Anna was 5;8. She had no disability and, according to the pre-school staff, followed a typical pattern of development in speech, language, and communication. At the time of the video recording, Axel and Anna had known each other for 4 years and 4 months. The adult support person was a 51-year-old woman at the pre-school who was educated in supporting children with disabilities and who knew Axel and Anna well. The second triad was comprised of Carin and Cecilia (pseudonyms) and an adult support person. Carin had cerebral palsy and complex communication needs. At the time of the study she was aged 4;5 and was at CFCS Level 4, which means that she inconsistently sent and⁄or received messages even with familiar partners (i.e., even though she knew a communication partner well she was sometimes, but not always, effective in sending and receiving a message). She communicated using facial gestures, vocalizations, and a few spoken words and manual signs. She had a beginner’s Blissymbol board and a couple of activity specific boards. In conversation, she mainly expressed one concept at a time, such that her oral and picture-based contributions were short. At the time of the study, she had started combining two Blissymbols and pictures on her boards. She used a wheel chair and had restricted hand motor skills. She accessed her communication boards and the computer using her left hand and index finger. Cecilia was aged 4;3. She had no disabilities and, according to the staff, she had typical development of speech, language, and communication. Carin and Cecilia had known each other for 2 years and 4 months. The adult support person was a 44-year-old woman at the pre-school who was educated in supporting children with disabilities. She had known Carin and Cecilia since they started at the pre-school. Materials The study involved the LekBot robot that was described earlier. Each triad and pre-school was given a LekBot system and instructions for its use. They were encouraged to use LekBot as much as possible with all children and to integrate it into routines and typical activities of the pre-school. The LekBot robot underwent iterative development over the course of this study based on the children’s interactions and feedback. Two versions of LekBot were used in the interaction excerpts that were analyzed in this study: Versions 4 and 6. Version 4 enabled the

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bumblebee to move in different directions and dance. The main menu on the touch-screen computer controlled by the children included five buttons with SymbolStix®5 and written words for the commands “Go forward,” “Go backward,” “Dance,” “Turn left,” and “Turn right.” When a button was selected and the corresponding instruction was spoken, the bee asked whether it should “Move/turn a lot” or “Move/turn a little,” and these options were shown on the touch-screen. When one option was selected and the corresponding message was spoken, the bee responded, with the speech output, for instance, “Okay I’ll move forward a lot,” and it moved accordingly. Due to technology constraints, there was a delay of 2 s and 5 s between taps on the touch-screen, spoken output, and the bee’s physical actions. After a completed interactional sequence, the computer returned to the main menu. When the dance button was selected the bee randomly produced one of six possible utterances for conveying that it would like to dance, then played music and danced by moving back and forth in different directions. The bee also randomly refused to do what it was asked, by saying “No, I don’t want to go forward” etc. After a refusal, the computer touch-screen returned to the main menu. Using sensors placed at the front of the bee, the bee could sense when it bumped into something. Doing so made the bee exclaim, for example, “Oops,” “Ouch,” or “Wow.” LekBot Version 6 included the same functionality as Version 4 but was also able to search for food, find food, eat food, and talk about food. The main menu replicated that of Version 4 with the addition of a button to represent looking for food. When this option was selected, the bee asked in which direction it should move to look for food (forward, backward, left, or right). Then, when the bee moved into something it asked what it was, allowing the child to choose from “Let’s pretend it’s ice cream/ an apple/a carrot/a hot dog/trash.” The bee simulated eating by producing eating sounds. When the bee finished eating, the child could either ask what the bee thought about the food (the bee could respond “Yummy” or “Delicious”), or return to the main menu. If the bee moved without bumping into something, it said, “I don’t find any food,” and the touch-screen showed the four options for movement again. The dance functionality was also extended in Version 6, so that the child could choose whether the bee should dance a lot or a little. After each dance, the bee automatically asked the child to evaluate its dancing as “Good” or “Bad” via the touch-screen. If the child chose the symbol GOOD, the bee responded, “Great” and if the child chose the symbol BAD, the bee responded, “I thought I was good at dancing.” Data Collection Procedures Engagement with LekBot was documented through: (a) video recordings by the research team, (b) recordings in written diaries by the pre-school staff, and (c) interviews that the researchers conducted with the pre-school staff and the children. The focus of the

current study was on the filmed play interactions. Each triad was filmed during play with LekBot on six different occasions over five months (January to May). Each recording was 20 min to 60 min long. Members of the research team made the recordings in the children’s natural play environments at their pre-schools. The camera was mounted on a tripod and positioned to capture the children and the play area, but was maneuvered by a researcher if needed. Prior to the first recordings, the adults were informed that they should not intervene in the children’s activities, but should let the children explore and create their own play spontaneously. It transpired that, to varying degrees, the children needed social interactive, physical, and technical support in their interactions with each other and LekBot. The amount and type of support needed varied between dyads and across the time of the recordings. Therefore, at an early stage during data collection, it was decided to encourage the adults to participate in a more active way and to model communication by naming and pointing to pictures on the board, that is, by point-talking as often as possible during daily interaction and play with and between the children (Jonsson, Kristoffersson, Ferm, & Thunberg, 2011). They were also told to let the children take the lead and play independently as much as possible. Data regarding the frequency of point-talking by the adults and extent of independent play between the children were not analyzed but, as will be shown in the present analysis, the adult support persons did orient to and use the children’s communication boards and, to varying degrees, they did stimulate independent play. In total, 12 recordings were made of the children’s play with LekBot; five did not include both children all of the time and were therefore excluded from analysis. The remaining seven recordings (Recordings 2, 4, 5, and 6 of Axel and Anna, and Recordings 3, 4, and 6 of Carin and Cecilia) were used for this analysis. The excerpts originated from three of the seven recordings (Recording 2 of Axel and Anna using LekBot Version 4, which was 54 min 20 s long; and Recordings 3 and 6 of Carin and Cecilia, which were 49 min 50 s and 28 min 29 s long and involved LekBot Versions 4 and 6, respectively). The selection of the excerpts is explained in the Data Analysis section below. Data Analysis The LekBot play interactions were analyzed using the principles of Conversation Analysis (CA) (Higginbotham & Engelke, 2013; Schegloff, 2007; Sidnell, 2010). CA has been used increasingly to investigate interactions involving children with disabilities and has contributed important insights into interpersonal communication at the local and sequential level. For example, CA has been used to address how meaning is co-constructed and made relevant by the participants’ use of different bodily and environmental resources: what is done, with what means and why (e.g., Brouwer et al., 2011; Clarke & Wilkinson, 2007; Dickerson et al., 2013; Gardner & Augmentative and Alternative Communication

Play with the Robot LekBot Forrester, 2010; Sigurd-Pilesjö, 2013). A basic assumption of CA, which is a data-driven approach, is that communication is orderly and sequential. The way people orient to each other and show their understanding and stance by talking and making use of body communication is systematic, relevant, and sequentially organized. The position and meaning of a specific communicative contribution depends on the preceding contribution and in itself constitutes the sequential context for the next contribution. This is why and how people understand each other as well as why and how communication can be studied and understood. CA is a highly inductive method in which patterns of interest are identified based on the data, as opposed to in relation to specific pre-formed hypotheses. Through repeated viewings of the recordings, the researchers identified four types of interaction situations relating to participation and enjoyment that were representative of different play scenarios in the data: participatory asymmetry, adult facilitation, a greater degree of participatory symmetry and creativity, and turn-taking and enjoyable play with LekBot. In relation to these four situations, eight sequences of interaction were chosen for a more detailed analysis of the children’s play. The sequences were transcribed according to the system described by von Tetzchner and Basil (2011) and conventions typically used for CA (see the Supplementary Appendix to be found online at http://informahealth care.com/doi/abs/10.3109/07434618.2015.1029141). In line with the ethnomethodological assumptions of CA, the analysis was based on what was observable

and made relevant by the children and the adults during play. Particular attention was paid to how the children participated in play with the LekBot system, with each other, and with the adult support person through body movements and with speech and language, as well as how and when affect was displayed. Smiles and laughter, in combination with body orientation and movements, gestures, and eye gaze (C. Goodwin, 2007; M. H. Goodwin, 2007; Ruusuvuori & Peräkylä, 2009; Sigurd-Pilesjö, 2013), were all explored in relation to enjoyment. Different facets of participatory symmetry and enjoyment during play with LekBot emerged and are presented in excerpts in the Results section below.

Results Interaction Situation 1: Participatory Asymmetry The first extract (see Table I) has a dual purpose. First, it shows a complete command cycle with LekBot, from a first command by the child to the robot making a physical move. Second, it illustrates the participatory asymmetry that occurred several times in the data, in both triads, where only one child interacts with LekBot. In this excerpt of interaction, Axel and Anna are playing with LekBot Version 4. Prior to the recording, but in the same room, the children and adult had built a pathway using wooden building bricks. At the start of the interaction, the adult suggests that Axel and Anna move the robot along the pathway. The children are encouraged to play together. Initially, they each separately make

Table I. Interaction Involving Axel, Anna and the LekBot Robot (Version 4) Illustrating Participatory Asymmetry.

Turn 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26

Participant Axel: Anna: Axel: Anna: Axel: Anna: Axel: Anna: Bee: Anna: Axel: Axel: Anna: Axel: Axel: Axel: Bee: Bee: Anna: Axel:

Observed behavior ⌈ ((clicks GO-BACKWARDS)) ⌉ ⌊((pulls up her jumper, turns towards the mirror))⌋ ⌈ ((turns gaze towards Bee)) ⌉ |((pulls jumper up and down facing the mirror))| ⌊ (2.4) ⌋ ⌈ “go backwards” ⌉ ⌊((pulls jumper up and down facing the mirror))⌋ ⌈ ((turns gaze from Bee to screen)) ⌉ |((pulls jumper down, still facing mirror))| ⌊ (4.8) ⌋ ⌈ “okay (.) should I go backwards a lot or a little” ⌉ ⌊((falls down on the floor and rolls over on her back))⌋ ⌈ e u:: ⌉ | ((clicks GO-BACKWARDS-A-LOT)) | ⌊((on her back, tilts head backwards, gaze towards Bee))⌋ ⌈((turns gaze first to Bee, then to the screen⌉ ⌊ (2.5) ⌋ “go backwards a lot” ⌈((turns gaze from screen to Bee))⌉ ⌊ (4.7) ⌋ “okay (.) I’ll go backwards a lot” (1.4) ⌈((moves))⌉ ⌊ (4.5) ⌋ ((tilts head down, no longer able to see Bee)) ((turns towards the screen))

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LekBot move (go forward and go left, respectively) and they briefly interact with each other. Anna then stops playing with the robot and for several minutes Axel interacts with LekBot alone (without moving the bee along the track). During this time, Anna is encouraged to interact with LekBot by the support person and the researchers. The excerpt in Table I illustrates Axel’s interaction with LekBot and Anna’s withdrawal. Axel is on his knees in front of the touch-screen, with his back to the camera. The touch-screen is mounted on a table, where it remains throughout the recording. At the start of Excerpt 1, the bee is on the floor, to the right of the children. The support person is facing the children. Anna is sitting slightly behind Axel, from Axel’s point of view. At the start of the excerpt in Table I, Axel orients to the touch-screen and the bee through his physical position, gesture (clicking, Line 1), synthesized speech output (Line 6), and gaze (Lines 3 and 8). Simultaneously, Anna physically distances herself from the LekBot activity with respect to her body position and her gaze, by fiddling with her jumper and looking at herself in the mirror in the room (Lines 2, 4, 7, 9). A sequentially relevant point for Anna to participate in the play interaction occurs after Line 11. Given that LekBot has asked a question, albeit directed at Axel as a consequence of his use of the touch-screen, this question provides an answer slot in the conversation for Anna to potentially make a contribution by offering an opinion or by approaching the touch-screen to make a selection. (Note that even though one child is sitting in front of the touch-screen, it is possible for another child to move close to the touch-screen as well and click. In fact, Anna is observed to use the touch-screen on several other occasions when Axel is in front of the touchscreen). However in this particular excerpt in Table I, Anna instead continues to distance herself bodily from the LekBot activity (Line 12). Throughout the remainder of the excerpt, Axel orients to the touch-screen and the bee through physical position, vocalization while clicking (Line 13), gesture (Line 14), synthesized speech output (Line 18), and gaze (Lines 16, 19, 26). In the meantime, Anna, while still on her back on the floor, tilts her head and turns her gaze towards the bee, as if in anticipation of its subsequent movement (Line 15). She keeps her gaze towards the bee throughout its movement, and averts her gaze as soon as the bee has stopped moving (Line 25). In terms of interaction with LekBot, the excerpt in Table I is an example of participatory asymmetry. Axel is engaged in the activity of controlling the bee, whereas Anna is not. Anna neither physically activates the touch-screen nor communicates with Axel. Anna’s embodied stance (C. Goodwin, 2007) towards LekBot, and perhaps in particular towards Axel’s activity, is one of disalignment, perhaps indicating boredom or a protest against Axel’s exclusive use of LekBot. However, Anna’s stance does not show complete disalignment with the LekBot activity, as she is seen to follow the

bee’s movements with her gaze. Axel is actively controlling the bee, whereas Anna is at most a passive onlooker. Regarding interaction with LekBot at a more basic level, in terms of system affordance (i.e., how LekBot affords the opportunity for the children to control the bee), the excerpt in Table I shows that Axel is able to interact with the system by clicking on the touch-screen (Anna’s ability to click on the touch-screen is shown in the excerpt in Table IV). In Table I, there are no instances of interaction between the children. As for displays of affect, outward expressions such as smiles or laughter are absent. The excerpt in Table I illustrates participatory asymmetry and the absence of affective involvement: Axel controls the bee, but there is very little in terms of actual play between the children. Interaction Situation 2: Adult Facilitation While episodes of participatory asymmetry (such as the excerpt in Table I) are observed for several minutes in the recorded interaction, the adults in the room are seen to encourage interpersonal interaction and play between the children. The excerpts of interaction in Tables II–IV illustrate different ways in which adults try to get Anna to participate. The excerpt in Table II shows the first instance where the support person addresses the participatory asymmetry and Anna’s disengagement from Axel and LekBot. At the start of this excerpt, participants are positioned as described previously. Just before the start of the excerpt, the bee has played music and danced, as instructed by Axel. The adult directs a seemingly general and open question to the children about how the game should continue saying How do we continue then? (Line 1). Use of the inclusive “we” is common in interactions involving caregivers and children with communicative disabilities (Ferm, 2006) and, in this particular context, may reflect the adult’s wish for shared management of the activity (cf. Ferm et al., 2013). The adult’s question may target both Anna’s lack of participation and the fact that the latest movements of the bee, as determined by Axel, have not involved the predetermined game of moving the bee along the track. Anna responds verbally with a soft Don’t know, and puts her finger against her head in what appears to be a thinking gesture (Lines 2–3). Axel clicks on DANCE (Line 4), which in one way provides a reply to the adult’s question, but is not a relevant next action in the game of moving the bee along the track. Axel orients to LekBot (Lines 4–6, 13–14), whereas Anna does not. Anna’s stance (C. Goodwin, 2007) towards the LekBot activity and Axel’s actions is embodied through her turning her back on Axel and the touch-screen and by her moving away from the bee (Line 9). Thus, her lack of participation is achieved both through her spoken comment (Line 2) and through embodiment. However, as with the bee’s movement in the excerpt in Table I, Anna shifts her attention to LekBot when the bee dances (Table II, Lines 10–12). In this, and the previous excerpt, Anna becomes an Augmentative and Alternative Communication

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Table II. Interaction Involving Axel, Anna, the Adult, and the LekBot Robot (Version 4) Illustrating Adult Facilitation.

Turn

Participant

1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17

Adult: Anna: Anna: Axel: Axel: Axel: Bee: Anna: Bee: Anna: Axel: Axel: Adult: Anna:

Observed behavior how do we continue then °don’t know° ⌈((puts her index finger against her head))⌉ ⌊ ((clicks DANCE)) ⌋ ((turns towards Bee)) “dance” (4.6) ⌈ “okay (.) I’d love to do that” ⌉ ⌊((falls down on the floor, away from Bee))⌋ ⌈ ((dances and plays music)) ⌉ |((moves to a sitting position, dances, gaze towards Bee))| ⌊ (11.0) ⌋ ⌈ ne:: ⌉ ⌊((points towards Bee))⌋ do you have a suggestion Anna no (2.6)

onlooker rather than completely disengaged. It should also be noted that Axel refuses a cooperative stance (see Goodwin, 2007) with regard to the adult’s suggestion of a joint game (Line 1) when he continues to click the touch-screen on his own (Line 4). After the dance, the adult addresses Anna directly with a question, Do you have a suggestion Anna? (Line 15). This question seems to be a more explicit strategy for getting Anna to participate. Anna replies by saying No (Line 16). Thus, in the excerpt in Table II, Anna is offered two sequentially relevant slots for joining the activity but refrains from doing so. Still within the same interaction, but a while after the excerpts in Tables I and II, the support person, following suggestions from the researchers, moves over to the children and brings with her a Blissymbol6 communication board. The excerpt of interaction in Table III shows how the adult continues to try to facilitate interaction

between the children and how she upgrades her attempts in several different ways. In Table III the adult sits on the floor with the children. At this point, Axel is still closest to the touch-screen. The Blissymbol board is on the floor in front of Anna and the support person, and to the right of Axel. The back of Anna’s head is towards the camera throughout the excerpt, so it is not possible to see her gaze or facial expressions. The adult addresses Anna verbally as well as through gaze and by pointing to the Blissymbol board (Lines 1–2, 5–7, 11–12, 15–16), in an apparent bid to encourage her to participate. Anna responds by shaking her head very slightly (Line 13), and then again in a bit more pronounced manner (Line 17). However, the adult may not have seen the second headshake because she was looking down at the Blissymbol board (Line 18). As in previous excerpts, Axel is involved in controlling and attending to the bee, which is achieved through gaze

Table III. Interaction Involving Axel, Anna, the Adult, and the LekBot Robot (Version 4) Illustrating Upgraded Adult Facilitation.

Turn 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18

Participant

Observed behavior

Adult: Adult: Bee: Axel: Adult: Adult: Adult: Bee: Axel: Adult: Adult: Adult: Anna: Axel: Adult: Adult: Anna: Adult:

⌈ do you want to click ⌉ |((points and looks at communication board))| | “will I turn” | ⌊ ((gazes towards Bee)) ⌋ ⌈ (.) mo- Anna ⌉ | ((keeps her finger on the communication board)) | |((looks at Anna and then at communication board again))| | “a lot or turn a little” | ⌊ ((gazes towards Bee)) ⌋ ((removes finger, turns gaze towards Bee and then back)) ⌈ hm? ⌉ | ((turns gaze to Anna)) | |((shakes her head with small movements))| ⌊ ((clicks TURN-A-LOT)) ⌋ ⌈ do you want to click Anna ⌉ ⌊((points and looks at communication board))⌋ ⌈ ((shakes her head)) ⌉ ⌊((gaze still towards communication board))⌋

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U. M. Ferm et al. Table IV. Interaction Involving Axel, Anna, the Adult, and the LekBot Robot (Version 4) Illustrating Explicitly Organized Turn-taking.

Turn 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22

Participant

Observed behavior

Adult: Adult: Anna: Axel: Adult: Adult: Anna: Axel:

⌈ now it can be (.) Anna’s turn ⌉ |((looks and points at communication board)) | | ((looks at communication board)) | ⌊ ((looks at communication board)) ⌋ ⌈ now it can be your turn Anna ⌉ | ((looks and points at communication board)) | | ((looks at communication board)) | ⌊((moves hand towards the screen, stops before clicking))⌋ (2.0) (to) click ⌈ (there) ⌉ ⌊((looks and points towards Adult))⌋ ⌈ yes (.) now it’s Anna’s turn ⌉ | ((looks at Axel)) | ⌊((looks at screen, moves up from sitting to kneeling))⌋ ⌈ now it’s (.) her turn to click ⌉ |((looks and points at communication board)) | | ((moves towards the screen on her knees)) | ⌊ ((looks at Anna)) ⌋ ⌈((clicks GO BACKWARDS)) ⌉ | ((looks at Anna)) | ⌊ ((looks at Anna)) ⌋

Adult: Axel: Axel: Adult: Adult: Anna: Adult: Adult: Anna: Axel: Anna: Axel: Adult:

(Lines 4 and 9) and gesture (Line 14). In comparison with the interaction in Table II, the adult’s efforts to get Anna to participate are here upgraded in several ways. First, the adult again addresses questions directly to Anna (Lines 1, 5, 11, 15). In contrast with the questions in Table II, which focused on suggestions and how to continue, the proposed activities in the excerpt in Table III are more explicit, focusing on whether Anna wants to click on the touch-screen (e.g., Do you want to click). Second, the adult is also communicating via multimodalities by pointing to the Blissymbol board as well as speaking (Lines 2, 6, 16). Besides her verbal and gestural communication, the adult also directs her gaze at Anna, alternating between Anna and the Blissymbol board (Line 7). Third, the adult has moved from the sidelines to sit by the children; her physical closeness is part of the upgraded focus on Anna’s disalignment from the ongoing activity. In Table IV, after several minutes of continued attention by the adult to the asymmetry between Axel and Anna, Anna eventually clicks on the touch-screen. The excerpt in Table IV illustrates a further upgrade in the adult’s efforts to encourage Anna’s participation, as well as the adult’s and Axel’s facilitative actions in relation to Anna’s participation. In this interaction, the participants are positioned as in the excerpt in Table III, but now the camera has moved in front of them. As illustrated in Table IV, the adult explicitly organizes the next turn with the LekBot robot to be Anna’s turn, saying Now it can be (.) Anna’s turn (Lines 1–2). Both children look at the Blissymbol board (Lines 3–4). The adult then apparently upgrades the relevance of Anna going next, saying Now it can be your turn Anna (Line 5), and Anna continues to look at the Blissymbol board

(Line 7). At the same time, Axel turns toward the touchscreen and moves as if to make a selection, similar to his previous behavior (see Tables I–III), but refrains from doing so (Table IV, Line 8). Axel and the adult then communicate about it being Anna’s turn (Lines 11–14, 16–17). Specifically, Axel’s coordination of gaze direction, vocalization, and pointing gesture (Lines 11–12) are ascribed meaning by the adult (see Sigurd-Pilesjö (2013) for further discussion of this phenomenon). The adult’s response (Line 13) indicates her treatment of Axel’s contribution as ascribing a turn to Anna and thus being in favor of Anna’s participation, that is, Axel’s and the adult’s timed actions work to design a sequential slot for Anna to join the activity. During this time, Anna attends to the LekBot touch-screen (Lines 15, 18). Axel directs his gaze towards Anna as she moves towards the touchscreen and clicks it, making a selection (Lines 19–21). Interaction and steps towards play are not achieved spontaneously. Rather, this excerpt shows how the adult and Axel collaborate in bringing about increased participatory symmetry, seen in the alignment and affiliation of both children with the LekBot activity. Anna’s participation is enabled by both the adult’s continued upgraded efforts over several minutes and Axel’s refraining from clicking at a critical point in the interaction. With respect to displays of affect, outward expressions such as smiles or laughter are not observed in the interactions in Tables II–IV, just as was the case for the interaction in Table I. Interaction Situation 3: Greater Participatory Symmetry and Creativity In contrast to the excerpts of interaction presented in Tables I–IV, there are also sequences of play that are Augmentative and Alternative Communication

Play with the Robot LekBot characterized by greater participatory symmetry, affective involvement, spontaneity, and creativity. The interaction in Table V is an example of such a sequence. In this interaction, Carin and Cecilia are using LekBot Version 4. Carin is sitting in her wheelchair with a Blissymbol board in her lap and the touch-screen in front of her. The adult support person sits on her right side. Cecilia sits on a chair on Carin’s left side, a bit away from the touch-screen. Carin touches the Blissymbol board and the adult asks her if she wants to say something to Cecilia (Line 1). This focus by the adult, on supporting interaction between Carin and Cecilia, is also evident in her subsequent contributions (Lines 5 and 10), and seems to stimulate an increased mutuality in the play. Carin responds to the adult’s question and indirect request and says Dance (Line 3). The fact that Carin first touches the board and then speaks, makes the adult orient to the vocabulary of the board and acknowledge that there is no Blissymbol for dance (Lines 5–6). This, in turn, is taken up by Cecilia who, using assertive play language (I know) suggests and asks if she should dance (Line 8). Following this, a response from Carin is due. Subsequently, there is an inter-turn pause of 1 s (Line 9), which provides a conversational slot during which Carin could respond to Cecilia (but presumably it was too short a slot for Carin to contribute). This space is entered by the adult who prompts Carin to respond to Cecilia, and thereby further contributes to Cecilia dancing as the next possible relevant event (Line 10). Carin responds vocally in Lines 11 and 12, but this is not treated by Cecilia as either a clear signal to go ahead or refrain from dancing. In Line 13, Cecilia repeats her question and thereby requests clarification and confirmation concerning her suggestion about dancing. It is not possible to observe Carin’s body at this point but Cecilia’s next turns and actions (Lines 15 and 16,

when she says Okay then and dances) suggest that Carin does contribute in some way and that Cecilia treats this contribution as an affirmation that she should dance. There is greater participatory symmetry between Carin and Cecilia in the sense that they both contribute and respond to each other in relation to a shared issue, that is, they orient to the topic of dancing and are creative and spontaneous in doing so. According to Ruusuvuori and Peräkylä (2009), the face is a main channel for the expression of emotion in interaction and is thus important in children’s co-construction of play activities such as these interactions with LekBot. Cecilia dances with her back towards the camera so we cannot observe her facial expression, but Carin and the adult, who have their bodies positioned towards Cecilia, look at her, and smile and laugh. Carin’s and the adult’s embodied stance suggest that they align with the dancing. They seem to find the situation pleasurable (Lines 18–19) (cf. C. Goodwin, 2007; M. H. Goodwin, 2007) and display shared affiliation with each other in relation to the activity. Evidently, play between Carin and Cecilia can involve different roles and doing different things. The play in Table V does not involve the touch-screen or the bee and in this sense can be seen as an interactional move away from LekBot. However, it relates to the content and functionality of the system as such. The children have pictures representing dance in front of them on the touch-screen; they are familiar with playing with LekBot and know that the bee can dance. Cecilia suggests that she assumes a more active role in the play but makes sure she gets Carin’s confirmation before she starts dancing. Thus, with adult support, the children use the bee as a resource for their playing and there is greater symmetry between the two of them in the sense that they collaborate in determining what and how to play.

Table V. Interaction Involving Carin, Cecilia, the Adult, and the Lekbot Robot (Version 4) Illustrating Greater Participatory Symmetry and Creativity.

Turn 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19

Participant

Observed behavior

Adult: Carin: Carin: Cecilia: Adult:

were you going to say something ⌈(.)⌉ to Cecilia (.) perhaps ⌊n: ⌋ n: (1.4) ⌈dance⌉ ⌊(xxx) ⌋ dance yes is that what you’re saying but (1.5) have no dance picture here (.) actually (.) ⌈unfortunately⌉ | no: | ⌊ I know ⌋ will I dance (1.0) Ca- Carin (.) ⌈Cecilia⌉ asked you ⌊ ha: ⌋ a:j? will I dance (0.8) okay then ⌈ ((dances in front of Carin and Adult)) ⌉ | (2.0) | | ((looks at adult and at Cecilia and smiles)) | ⌊ ((looks at Cecilia and laughs)) ⌋

Carin: Cecilia: Adult: Carin: Carin: Cecilia: Cecilia: Cecilia: Carin: Adult:

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U. M. Ferm et al. Table VI. Interaction Involving Carin, Cecilia, the Adult, and the LekBot Robot (Version 6) Illustrating Turntaking and Enjoyable Play.

Turn 1 2 3 4 5 6 7 8 9 10 11

Participant

Observed behavior

Cecilia: Carin: Carin: Bee: Bee: Adult: Carin: Carin: Adult: Adult: Cecilia:

⌈((clicks on the screen with her right index finger)) ⌉ | nn | | ((removes Cecilia’s hand from the screen)) | ⌊ “okay (.)” ⌋ “I’ll search ⌈ forwards” ⌉ ⌊did you click on Cecilia⌋ n ⌈ ((Carin clicks on the screen)) ⌉ ⌊no (x) now Cecilia can do (.) coz you clicked forwards⌋ ⌈ one has to take turns Carin ⌉ ⌊(( removes Carin’s hand from the screen))⌋

Interaction Situation 4: Turn-taking and Enjoyable Play with LekBot The excerpts presented in Tables VI, VII, and VIII include interaction between Carin and Cecilia when they use LekBot Version 6. The excerpts exemplify (a) how the children orient to turn-taking in relation to the touch-screen, (b) how they co-operate in setting up a new play project, and (c) how the two of them, with the adult support person and LekBot, bring about an episode of apparently genuinely fun play together. While the excerpts in Tables II, III, and IV include adult-guided turn-taking, the excerpt in Table VI includes explicit turn-taking between Carin and Cecilia that they themselves manage (cf. Clarke et al., 2013). As is evident from the children’s and the adult’s contributions, taking turns in activating the touch-screen is important and, of course, turn-taking is also a basic feature of communication (Sacks et al., 1974). Prior to the interaction in Table VI, Cecilia and the adult have both made comments regarding turn-taking (e.g., Now it is my turn, Now it was Cecilia’s turn I think). In Line 1 (Table VI), Cecilia orients to the touchscreen by pointing at it with her right index finger. Carin vocalizes (Line 2), and at the same time uses her left arm to push Cecilia’s hand away from the touch-screen (Line 3). The adult comments on this action (Lines 6 and 10) as an apparent arbitrator of the turn-taking; her action explains or validates Cecilia, removing Carin’s hand from the touch-screen (Line 11). The adult’s explicit management of the children’s turn-taking is, to some extent, intrusive with regard to the children’s spontaneous and independent way of organizing the

play. As such, it provides evidence of the manifestation of a relatively asymmetrical pattern of participation, as perceived by the adult, in which the child with complex communication needs is dominating use of LekBot. Apart from the fact that turn-taking becomes an issue (i.e., they negotiate about the turn physically), the LekBot system design enables participation by both of the children and together they make use of this possibility in order to interact physically and communicatively with LekBot. LekBot enables independent selection of buttons on the touch-screen and they both orient to the touch-screen and the activity of clicking (making selections); in this sense they co-operate in a collaborative engagement with the device. After the negotiation of turn-taking, illustrated in Table VI, Carin and Cecilia play the “find the food” game with the bee. After a couple of minutes, the adult walks away from the children and the touch-screen and towards the bee. In the excerpt in Table VII, the children are sitting (Carin) and standing (Cecilia) beside each other behind the touch-screen, and the bee and the adult are on the floor in front of them. The bee asks the children how to find food (Line 1). Cecilia, using the touch-screen, tells the bee to “Search to the left” (Line 2) and the following very brief but noteworthy interaction follows. In overlap with the synthesized speech output produced by Cecilia through the touch-screen (“Search to the left”), Carin and Cecilia both orient to the adult and the bee by looking at them and laughing (Lines 3–4). When the bee responds, “Okay I’ll search to the left” (Line 5), Carin and Cecilia turn and look at each other

Table VII. Interaction Involving Carin, Cecilia and the LekBot Robot (Version 6) Illustrating Agreement, Co-operation, Symmetry, and Enjoyable Play.

Turn 1 2 3 4 5 6 7

Participant Bee: Cecilia: Carin: Cecilia: Bee: Carin: Cecilia:

Observed behavior “how should I go to find food” ⌈ “search to the left” ⌉ | ((looks at Adult and Bee and laughs)) | ⌊((looks at Adult and Bee and laughs)) ⌋ ⌈ “okay I’ll search to the left” ⌉ |((turns and looks at Cecilia with a smile, laughs))| ⌊ ((turns and looks at Carin and smiles)) ⌋ Augmentative and Alternative Communication

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Table VIII. Interaction Involving Carin, Cecilia, the Adult and the LekBot Robot (Version 6) Illustrating a High Level of Engagement, Collaboration, and Affective Involvement.

Turn 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16

Participant Carin: Cecilia: Cecilia: Cecilia: Bee: Adult: Carin: Cecilia: Cecilia: Carin: Bee: Cecilia: Adult: Carin: Cecilia: Adult:

Observed behavior ⌈ ((looks at Adult and Bee, laughs loudly)) ⌉ | ((looks at Adult and Bee, laughs loudly)) | | ((lifts finger and points at Adult and Bee)) ⌈ what did it do ⌉| ⌊ ⌊((keeps pointing))⌋⌋ “what’s this” ⌈yes what am I ⌉ ⌊ ((laughs)) ⌋ “let’s pretend it’s ice cream” ⌈((laughs loudly))⌉ ((looks at Adult and Bee)) ⌊((laughs loudly))⌋ ((looks at screen)) “okay” ⌈ now you’re ice cream ⌉ |((makes eating sounds))| ⌊ n ⌋ you are an ice cream yeah

and smile and laugh (Table VII, Lines 6–7). The communication represents a very special moment within this particular sequence of interaction. The way the children orient to each other, the adult and the bee, as well as their display of affective involvement, suggest that there is agreement, co-operation, and symmetry between the two of them. They bodily align with each other and the activity (C. Goodwin, 2007) and their interaction is characterized by shared affiliation (Clarke & Wilkinson, 2013; Stivers, 2008). They appear excited and seem to welcome playing in this way together. The find-the-food game continues after the interaction in Table VII. In the excerpt in Table VIII, which illustrates a considerable level of engagement, the adult sits down on an indoor trampoline in front of the children and starts interacting with the bee. The adult and the bee are on one side of the touch-screen and Carin and Cecilia on the other side. All are engaged in pretend play together. In Lines 1 and 2, the children look at the adult and the bee and laugh loudly as the bee bumps into the adult. In Lines 3 and 4, Cecilia points at the adult and the bee and asks, What did it do? The bee asks, “What’s this?” (Line 5) and the adult responds by asking the children what she is (Line 6). Carin laughs (Line 7) and in Line 8, Cecilia answers the question by clicking on the touch-screen and saying, “Let’s pretend it’s ice cream.” Cecilia and Carin laugh loudly and while Cecilia looks at the adult and the bee (Line 9), Carin looks at the touch-screen (Line 10), an action that is indicative of planning a next interactional move. Lines 11 through 14 make up an important sequence of interaction, where both Carin and Cecilia orient to the bee and their shared pretend play. The bee acknowledges Cecilia’s suggestion about the adult being ice cream by saying “Okay” (Line 11). Thereafter, in overlap, Cecilia declares that the adult is an ice cream (Line 12), the adult makes eating sounds (Line 13), and Carin aligns by vocalizing (Line 14). In Line 15, Cecilia again states that the adult is ice cream and the adult agrees by saying Yeah (Line 16). © 2015 International Society for Augmentative and Alternative Communication

The interaction in Table VIII is different from all other play in the recorded data. There is a high level of engagement and affective involvement as Carin and Cecilia collaborate in steering the bee onto the adult’s body, pretending she is ice cream. The play is spontaneous, creative, and consensus driven. Cecilia is operating the system physically, but with support from Carin who laughs and vocalizes (Lines 1–2, 7–10). Maximal joint attention occurs between the children (i.e., they look very concentrated as they look at and orient their bodies to the adult and the bee). This joint attention and Cecilia’s pointing and intense loud laughter are signs of co-operation, alignment, and affiliation (cf. Clarke & Wilkinson, 2013; C. Goodwin, 2007) as well as participatory symmetry, eager expectation, and genuine pleasure in this play sequence. However, there is lack of symmetry in the interaction in Table VIII in the sense that Cecilia and Carin are doing different things. Cecilia is physically more active and, apart from using the computer to interact, she also speaks with the adult and the bee using her own voice. Although Carin vocalizes and laughs, using spoken language to interact with the bee is not an option for her.

Discussion The LekBot robot was built in order to enable easy, pleasurable, independent, and equal play between children with complex communication needs and their peers. Thus, the first question motivating the study concerned how children with complex communication needs and their peers achieved participatory symmetry in play with LekBot. Independent and symmetrical play with LekBot depends on a basic motivation and understanding of the situation and the system, as well as the children’s ability to manipulate LekBot physically. Participatory symmetry in play with LekBot appeared evident in a number of ways: First, all children in the study, independent of their speech and motor skills, activated buttons on the touch-screen at some point to interact with LekBot. Hence, this study

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showed that, from a technical and design point of view, LekBot afforded the children opportunities for shared engagement in play. Second, symmetry was evident with regard to the children’s participation in play with each other and the bee at some points during the interactions. Four interaction situations were used to illustrate different variants of participatory symmetry and enjoyment; these situations ranged from those that showed participatory asymmetry to those that showed greater symmetry and enjoyment. The excerpts in Tables V–VIII demonstrate that there can be participatory symmetry between children (in this case Carin and Cecilia) playing with LekBot. However, the adult was actively involved in these interactions. Evidently, participatory symmetry in play with LekBot is neither easy, nor absolute. Features of symmetry in the play sequences in Tables V–VIII related to the synchronization between Carin and Cecilia and the fact that they aligned their bodies, oriented to a shared play project, and collaborated in deciding what to do (C. Goodwin, 2007; M. H. Goodwin, 2007). In contrast, the interactions in Table I–IV demonstrate a lack of participatory symmetry in play between Axel and Anna. In these interactions, Axel mainly did his own activities (i.e., clicking on the touch-screen) and Anna was mainly a passive viewer. In many, but not all, ways, Anna disaligned with the activity in these interactions. The adult support person attempted to direct the turn-taking. This is both a sign of the existing asymmetry between the children and a method used by the adult to stimulate symmetry, which is partly successful. When all participants simultaneously oriented towards the Blissymbol board and communicated multimodally about whose turn it was to contribute, increased symmetry between Axel and Anna was locally achieved. Of relevance for the achievement of increased symmetry between Axel and Anna was his refraining from clicking on the touch-screen and leaving interactional space for Anna to participate, which she did. Other phenomena, such as the fact that Cecilia, but not Carin, can interact with the bee and the adult independently using spoken language, as well as the fact that the children can do different things and have different roles, are also signs of participatory asymmetry. However, these are not necessarily negative issues in relation to the children’s broader co-construction and enjoyment of the play (cf. Clarke & Wilkinson, 2007). Most play is pleasurable (Garvey, 1990), and creating fun and enjoyable activities is an important goal in the support of interaction, play, and friendships between children with complex communication needs and their peers (Batorowicz et al., 2014; Clarke & Kirton, 2003; Johnson et al., 2005; Light, 1997; Light et al., 2007; O’Mara & Waller, 2003). Hence, the second question addressed in the study concerned in what sequential contexts do children display enjoyment when interacting with LekBot. As evidence of enjoyment, we sought to identify displays of positive affect with LekBot. In the interactions involving Axel and Anna and LekBot (Tables I–IV), enjoyment/affective involvement was not observed. However, Carin and Cecilia did display heightened affect

and engagement through their body orientation and movement, facial expression, and gaze (Ruusuvuori & Peräkylä, 2009); as well as smiles and laughter, suggesting that they were enjoying playing together with LekBot. However, the relationship between affective involvement/ enjoyment and participatory symmetry in play with LekBot is complex because participatory symmetry does not equate directly with enjoyment. Although the interactions characterized by participatory asymmetry lacked obvious signs of enjoyment, there was also an absence of enjoyment in some exchanges that could be characterized as symmetrical. However, evidence of enjoyment was observed in some interactions characterized by partial symmetry. Defining symmetry in play interactions is a complex problem. There were play interactions that were characterized by symmetry in terms of joint attention, engagement, communication, and development of the game but were significantly unequal in terms of the physical handling of the touch-screen and the play functions and roles assumed. And yet, these interactions included an abundance of enjoyment and numerous displays of affective involvement. An important observation is that some kind of symmetry seems to be necessary, but is not enough for enjoyment to occur. An important finding of the study was that, in the situations where both children displayed affective involvement during play with LekBot, there was also some kind of communication between the children. This finding points to the relevance of supporting communication in children’s play. It is important to note that it is not appropriate to make comparisons across the triads and the individual children in this study. The triads started off with very different play situations and the adult support persons assumed very different roles during play; these factors may have influenced the play and enjoyment. It should also be noted that the version of the LekBot robot used in the interactions might also have impacted the play and enjoyment. Axel and Anna used LekBot Version 4; Carin and Cecilia used Version 4 in the interaction in Table V but used the more advanced Version 6 in the interactions in Tables VI, VII, and VIII. Play is important for children’s development (Garvey, 1990; Johnson et al., 2005) and “…should be taken seriously” (Gärdenfors, 2010, p. 201). For children with complex communication needs, play is often associated with training activities and the acquisition of new skills. If play is used as a training context, important aspects of play, such as its volitional nature and creativity, the idea of simply playing for the sake of playing without a specific goal, and the central concept of having fun, may be threatened. Therefore, a key question arising from the analysis is whether or not the interactions with LekBot represent real play. The interaction between Axel and Anna includes few elements typical of play as defined in this paper. There is no spontaneity or creativity, and no signs of them having fun or enjoying the situation.Yet, they do act in ways that are important for play to occur. For example, adapting to the situation and the playmate are necessary components of play (Garvey, 1990) as an extension of Augmentative and Alternative Communication

Play with the Robot LekBot everyday collaborative interaction. An excellent example of a contribution by a child with complex communication needs to increase participatory symmetry in interaction and potential play is seen in Table IV, Line 8, where Axel refrains from clicking on the touch-screen, leaving room for Anna to participate. It is possible to experience satisfaction without displaying it. Rather than concluding that the interaction between Axel and Anna is definitely not play, it may be more appropriate to conclude that play with LekBot may involve hard work and co-operation between all participants involved, including adults. Other situations in the interactions observed include elements described as central for play by Garvey (1990) and others (e.g., Gärdenfors, 2010; Kärrby, 1990; Jensen, 2008; Johnson et al., 2005). In particular, the interaction between Carin and Cecilia, which was characterized by greater participatory symmetry and enjoyment, included typical features of play such as spontaneity and creativity, pretending, different roles, and co-operation with regard to the development of shared play. Interactions involving children with complex communication needs and partners without disabilities of different ages may be asymmetrical (Buzolich & Lunger, 1995; Clarke & Kirton, 2003; Clarke & Wilkinson, 2007), and the observation that children with complex communication needs risk becoming passive is a relevant and often-raised issue. However, the present analysis of actual play between children with complex communication needs and their peers suggests that caution is required when discussing interaction and play in terms of passivity, asymmetry, inequality, and the consequences thereof (cf. Clarke & Wilkinson, 2007). Children’s play behaviors must be interpreted within the larger context of the play activity and the children’s collaborative agreement for how the play is to be organized. A behavior that at first glance could be interpreted as passive may be the result, for example, of an agreement between the children regarding who is responsible for a certain aspect of the play. Conforming to agreements and rules is a sign of competency in play. Whether agreed upon or not, children with disabilities may also take more observably dynamic and dominant roles than their peers. For example, in some of the interactions with Axel and Anna, it was the child with complex communication needs who was more active and engaged than the peer in relation to LekBot and the touch-screen. In addition, it cannot be disregarded that one of the play sequences, which seemed to be very joyful and highly appreciated by both children, was a situation in which the child with complex communication needs was not at all active in terms of spoken communication and physical management of the touch-screen, yet the children still appeared to enjoy the play enormously.

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needs and their peers – was partly fulfilled. The study was limited in terms of the number of children who participated, but the qualitative research method was designed to give in-depth results. Even so, there is a need for future research that involves more children, with different needs and skills, in more varied play situations. Indeed, there are perhaps other possibilities provided by the LekBot robot that were not considered previously by the research team. The children were creative in their ways of approaching the system. For example, their interactions with the computer and the bee through both spoken language and actions are play behaviors that will be further explored as LekBot is developed. The children’s play interactions in the present study were truly multimodal. Yet, an overall experience in the project was that LekBot could have included more functions apart from moving the bee around, dancing, playing music, and looking for food. Overall, LekBot needs to include play activities that more directly target co-operation between children. Examples would be hide and seek games, construction games, and the possibility to collect points and reach different levels of play activities together. The children might also have benefited from access to a greater play vocabulary, which would have enabled a more extensive repertoire of communicative functions such as commands, suggestions, refusals, questions, responses, funny and unexpected utterances, and feedback items. Future development should also consider the possibility of choosing to use one touch-screen and two bumblebees, which the children could make play with each other. In the current study, children with and without disabilities used both the Blissymbol boards and the computer touch-screen, suggesting that the communication boards should have been built into LekBot. Having access to the communication boards on the touch-screen (as well as in a low-tech format) could have stimulated even more communication and play between the children and LekBot and, most importantly, more independent use of speech output by Axel and Carin. The roles and functions of the adult support persons during play with LekBot should also be further examined. Independent play between children will continue to be the goal.

Notes 1. Speech synthesis Acapela (www.acapela-group.com). 2. LEGO® MINDSTORMS® NXT (www.lego.com). 3. The software Programsnickaren® is a product of Abilia (www.abilia.com/sv). 4. The computer Light Rolltalk® is a product of Abilia (www.abilia.com/sv). 5. The software SymbolStix® is a product of n2y (www. n2y.com). 6. Blissymbolics (www.blissymbolics.org).

Implications and Directions for Future Research and Development As evidenced in this study, the goal of the LekBot project – to design a robot that stimulates enjoyable play on equal terms between children with complex communication © 2015 International Society for Augmentative and Alternative Communication

Acknowledgements LekBot is a result of many peoples’ enthusiasm and work. Special thanks to the children and the adult

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support persons involved in this study. Thanks also to Acapela for providing the Swedish TTS voices for the touch-screen computer and the bumblebee. LekBot has been presented at the conference of the European Academy of Childhood Disability (EACD) in Rome, 2011; at the Swedish Language Technology Conference (SLTC) in Linköping, Sweden, 2010; and at the Workshop on Speech and Language Processing for Assistive Technologies SLPAT in Edinburgh, 2011. Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the writing and content of the paper. LekBot has received financial support from the Swedish Governmental Agency for Innovation Systems VINNOVA, The Promobilia Foundation, The Petter Silfverskiöld Foundation, and The Research Council of the Swedish National Association for Disabled Children and Young People.

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Supplementary material available online Supplementary Appendix to be found online at http://informahealthcare.com/doi/abs/10.3109/074346 18.2015.1029141

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Participation and Enjoyment in Play with a Robot between Children with Cerebral Palsy who use AAC and their Peers.

This study explores children with complex communication needs, their peers and adult support persons in play with the talking and moving robot LekBot...
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