Playful Tray Adopting Ubicomp and Persuasive Techniques into

Playful Tray : Adopting Ubicomp and Persuasive Techniques into Play-based Occupational Therapy for Correcting Eating Behaviors in Young Children Presenter : : Dori Tung-yun Lin Jin-Ling Lo, Tung-yun Lin, Jen-hao Chen, Hsi-Chin Chou, Hao-hua Chu, Jane Hsu National Taiwan University

Ubiquitous Computing integrates computing into everyday objects and activities

Lost ? http: //www. mtn sys. com/Imags/ frmain 1. jpg Object location tracker - Shin-jan Wu, NTU Ubicomp Lab

Smart Environment

Smarter users Dumb users?

Persuasive Smart people. Computing Smart homes?

Textrix VR Bike Tooth Tunes Baby think it over Persuasive Mirror Related Works

Persuasive Computing from a Computing Perspective not only sensing and tracking behaviors but also engaging people to change behaviors

Persuasive Computing from an Occupational Therapist Perspective extending therapists’ reach from treatment clinic into the actual living environment

the problem… Mealtime Behavior

u Nutritional concerns u Affect the participation of children in daily routines u Negative parent-child interaction Mealtime Behavior

Traditionally, eating behavior interventions depend heavily on parents. • non-compliance of mealtime related parenting skills • emotion

Play-based Feeding Behavior Intervention “ Play is a child’s way of learning and an outlet for his innate need of activity. ” -- N. Alessandrini, “A. Play—A child’s world”

Habitual behavior Partial reinforcement Active engagement Three primary elements of play ` Playfulness Intrinsic motivation Internal control Suspension of reality Play-based Feeding Behavior Intervention

Habitual behavior Partial reinforcement Active engagement Playful Tray Design Considerations (1/4) ` Playfulness Intrinsic motivation Attention Internal control Suspension of reality Ø to split between game playing and eating activities

Habitual behavior Partial reinforcement Active engagement Playful Tray Design Considerations (2/4) ` Playfulness Intrinsic motivation Internal control Enjoyment Suspension of reality Ø two kinds of enjoyment: perceptual arousal / accomplishment

Habitual behavior Partial reinforcement Active engagement Playful Tray Design Considerations (3/4) ` Playfulness Intrinsic motivation Internal control Suspension of reality Engagement Ø to connect digital playfulness to active participation in the target physical activity

Habitual behavior Partial reinforcement Active engagement Playful Tray Design Considerations (4/4) ` Playfulness Intrinsic motivation Control Internal control Suspension of reality Ø to give children choices in determining game outcome

Implementation

[ Implementation 1] Coloring Game

[ Implementation 1] Coloring Game frustration ─ Four Problems when the cartoon character did not look colorful and happy at the end of the game boring (decrease of enjoyment) attractive at the first few times, then became boring for the color mappings never changed disengagement grabbed too much attention that some children became distracted from eating properly gobbling (wrong attention target) Some children became impatient to see their favorite cartoon characters fully colored

[ Implementation 2] Racing Game Palm-top PC with touch screen For placing the bowl Weight sensor and sensing surface

[ Implementation 2] Racing Game Digital Playful Feedback LCD Display Racing Game Eating Events Weighing Sensing Surface Weight Change Detector Physical Eating Action

[ Implementation 2] Racing Game 1. Choose one favorite character and start to dine 2. One randomly chosen character would run forward with every bite of food 3. The racing game can proceed if and only if one eats 4. At the end of dining, the character in the front wins the game

[ Implementation 2] Racing Game • Control (choose the favorite character) • Enjoyment (vision / accomplishment)

[ Implementation 2] Racing Game • Engagement (Eating events as inputs) • Attention (low interactivity? )

User Study • Done by professional occupational therapist. (Prof. Lo and her student) • 4 children aged from 4 to 7 years old. • • A B C D – – 7 5 5 4 yrs yrs old, • Long meals Asperger’s Syndrome High function autism Asperger’s Syndrome No specific diagnosis • ranging from over 30 min. to over 1 hr.

User Study Procedures 1. 2. 3. 4. Children’s Mealtime Behavior Checklist Interview - to clarify behavioral details Record eating activities without the tray Record eating activities with the tray within 1 week

Evaluation Behavior Coding System • Use the taped video to identify positive and negative behaviors • active feeding / interaction / social behavior • The P/N ratio is used to measure behavioral improvement

(1) Self-feeding: a child place food into his/her own mouth Mother Child Positive: A mother allows or promotes self-feeding, Positive: A child attempts self-feeding, such as verbal encouragement, praises, etc. holding utensils, putting food into mouth, etc. Negative: A mother discourages, disallows, or interrupts self-feeding, such as pushing the Negative: A child rejects self-feeding, such as saying child’s hands away, telling the child that she will “no” or pushing away given food. feed the child, etc. (2) Interaction: Actively initiated behavior and the synchronous responsive behavior of the feeding partner Mother as the actor Child’s responsive behavior Positive: A child accepts food when it is offered, or Positive: A mother attempts to arouse a child’s self-feeds food. interest, such as talking about food, models, food games, etc. A mother refocuses the child’s Negative: A child ignores the mother’s cue, refuses, attention on food when the child is distracted. or walks away from the mother’s cue. Positive: A child responds by self-feeding. Negative: A mother intrusively attempts to direct feeding, such as force-feeding the child, holding Negative: A child ignores the mother’s attempts, a child’s head, body, or hand, and threatening refuses, or walks away from the mother’s the child. attempts. Mother’s responsive behavior Child as the actor Positive: A mother synchronously responds to promote continuous feeding, such as interpreting Positive: A child initiates an attempt to eat, such as a child feeding cues, responding to a child’s looking at food, talking about food, requesting needs, etc. food/drink, or touching food. Negative: A mother synchronously responds to interrupt the child’s feeding. Positive: A mother synchronously responds to promote continuous feeding, such as interpreting the child Negative: A child shows disinterest, feeding cues, responding to the child’s needs, etc. discouragement, or stops eating or chewing. Negative: A mother synchronously responds to interrupt the child’s feeding.

(1) Self-feeding: a child place food into his/her own mouth Mother Child Positive: A mother allows or Positive: A child attempts self promotes self-feeding, such as holding as verbal encouragement, utensils, putting food into praises, etc. mouth, etc. Negative: A mother discourages, disallows, or Negative: A child rejects selfinterrupts self-feeding, such as saying as pushing the child’s hands “no” or pushing away, telling the child that given food. she will feed the child, etc.

Results Mealtime duration with and without the playful tray for the four children subjects Avg. : 32 min. (23 -41 min. ) Avg. : 21 min. (7 -29 min. )

Results The child’s P/N ratio with and without the Playful Tray 0. 80~13. 33 6. 95~19. 00 different food types (rice/ dumpling→easy to eat → less self-feeding actions) ↑

Results The mother’s P/N ratio with and without the playful tray 0. 79~ 4. 00 4. 30~30. 00

Conclusion • Utilizing Ubicomp and persuasive technology extends the reach of occupational therapists from their treatment clinic into the actual living environment of a patient. • The Playful Tray can effectively improve child meal completion time by 35%. • The Playful Tray can also make change of parent behaviors.

Limitations • Lack pre-interview process • Identify the real needs of real users • Only informally talked to a parent and some young children • Lack long-term user studies evaluation • - Pre Intervention Post

Future Work • Long-term user study. • Understand users’ real needs. • Focus group or 1 -on-1 interview • Observe weight changes through dining to improve the eating behavior recognition.

Future Work Output Any Other Animated Racing Games!! Simulation Game Camera Weighing RFID Reader Sensor (teeth (eating (toys’brushing) location) event) Game Input

Accomplish smarter users Output via smart environment. Game Input

Publications u Jin-ling Lo, Tung-yun Lin, Jen-hao Chen, Hsi-Chin Chou, Hao-hua Chu, Jane Hsu, Playful tray: adopting Ubicomp and Persuasive Techniques into Play-based Occupational Therapy for Correcting Poor Eating Behaviors in Young Children, Pending for International Conference on Ubiquitous Computing (ACM UBICOMP) 2007 u Tung-yun Lin, Keng-hao Chang, Shih-yen Liu, Hao-hua Chu, A Persuasive Game to Encourage Healthy Dietary Behaviors of Young Children, Demo Paper & Adjunct Proceedings of the 8 th International Conference on Ubiquitous Computing (ACM Ubi. Comp 2006), California, September, 2006. u Keng-hao Chang, Shih-yen Liu, Hao-hua Chu, Jane Hsu, Cheryl Chen, Tung-yun Lin, Chieh-yu Chen, Polly Huang, Diet-Aware Dining Table: Observing Dietary Behaviors over Tabletop Surface, in Proceedings of the International conference on Pervasive Computing (Pervasive 2006), Dublin Ireland, May 2006, (Lecture Notes in Computer Science 3968, Pervasive Computing 4 th International Conference, PERVASIVE 2006, Springer), pages 366 -382. u Chon-in Wu, Chao-ming (James) Teng, Yi-chao Chen, Tung-yun Lin, Hao-hua Chu, Jane Yun-jen Hsu, Point-of-Capture Archiving and Editing of Personal Experiences from a Mobile Device, to appear in ACM/Springer Journal of Personal and Ubiquitous Computing (PUC), Special Issue on Memory and Sharing of Experiences, 2006.