playful tray :

Playful Tray :Adopting Ubicomp and Persuasive

Techniques into Play-based Occupational Therapy for Correcting Eating Behaviors

in Young ChildrenPresenter :: Dori Tung-yun Lin

Jin-Ling Lo, Tung-yun Lin, Jen-hao Chen, Hsi-Chin Chou, Hao-hua Chu, Jane HsuNational Taiwan University

UbiquitousComputingintegrates computing into everyday objects and activities

Object location tracker- Shin-jan Wu, NTU Ubicomp Lab

Lost ?

http://www.mtnsys.com/Imags/frmain1.jpg

SmartEnvironment

Dumb users?Smarter users

PersuasiveComputingSmart homes?

Smart people.

Baby think it overPersuasive Mirror

Related WorksTextrix VR BikeTooth Tunes

from a Computing Perspective

not only

engaging people to change behaviors

sensing and tracking behaviorsbut also

Persuasive Computing

Persuasive Computingfrom an Occupational Therapist Perspective

extending therapists’ reach from

the actual living environment

treatment clinicinto

the problem…

Mealtime Behavior

Mealtime Behavior Nutritional concerns Affect the participation of children

in daily routines Negative parent-child interaction

Traditionally, eating behavior interventionsdepend 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”

`Playfulness

Active engagement

Partial reinforcement

Habitual behavior

Intrinsic motivation

Internal control

Suspension of reality

Play-based Feeding Behavior Intervention

Three primary elements of play

Playful TrayDesign Considerations (1/4)

Attention to split between game playing and eating activities

Attention`Playfulness

Active engagement

Partial reinforcement

Habitual behavior

Intrinsic motivation

Internal control

Suspension of reality

Playful TrayDesign Considerations (2/4)

Enjoyment two kinds of enjoyment:

perceptual arousal / accomplishment

Enjoyment`Playfulness

Active engagement

Partial reinforcement

Habitual behavior

Intrinsic motivation

Internal control

Suspension of reality

Playful TrayDesign Considerations (3/4)

Engagement to connect digital playfulness to active participation in the target physical activity

Engagement`Playfulness

Active engagement

Partial reinforcement

Habitual behavior

Intrinsic motivation

Internal control

Suspension of reality

Playful TrayDesign Considerations (4/4)

Control to give children choices in determining game outcome

Control`Playfulness

Active engagement

Partial reinforcement

Habitual behavior

Intrinsic motivation

Internal control

Suspension of reality

Implementation

[ Implementation 1]Coloring Game

[ Implementation 1]Coloring Game─ Four Problems

frustrationwhen 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

disengagementgrabbed 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

For placing the bowl Weight sensor and sensing surface

Palm-top PC with touch screen

[ Implementation 2]Racing Game

LCD Display Racing Game

Weight Change DetectorWeighing Sensing Surface

Physical Eating Action

Eating Events

Digital Playful Feedback

[ Implementation 2]Racing Game

1. Choose one favorite character and start to dine2. One randomly chosen character would run forward with every

bite of food3. The racing game can proceed if and only if one eats4. 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 – 7 yrs old, Asperger’s Syndrome• B – 5 yrs old, High function autism• C – 5 yrs old, Asperger’s Syndrome• D – 4 yrs old, No specific diagnosis

• Long meals• ranging from over 30 min. to over 1 hr.

User Study1. Children’s Mealtime Behavior Checklist2. Interview - to clarify behavioral details3. Record eating activities without the tray4. Record eating activities with the tray

within 1 week

Procedures

EvaluationBehavior 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 mouthMother Child

Positive: A mother allows or promotes self-feeding, such as verbal encouragement, praises, etc.

Positive: A child attempts self-feeding, such as holding utensils, putting food into mouth, etc.

Negative: A mother discourages, disallows, or interrupts self-feeding, such as pushing the child’s hands away, telling the child that she will feed the child, etc.

Negative: A child rejects self-feeding, such as saying “no” or pushing away given food.

(2) Interaction: Actively initiated behavior and the synchronous responsive behavior of the feeding partnerMother as the actor Child’s responsive behavior

Positive: A mother attempts to arouse a child’s interest, such as talking about food, models, food games, etc. A mother refocuses the child’s attention on food when the child is distracted.

Positive: A child accepts food when it is offered, or self-feeds food.

Negative: A child ignores the mother’s cue, refuses, or walks away from the mother’s cue.

Negative: A mother intrusively attempts to direct feeding, such as force-feeding the child, holding a child’s head, body, or hand, and threatening the child.

Positive: A child responds by self-feeding.Negative: A child ignores the mother’s attempts,

refuses, or walks away from the mother’s attempts.

Mother’s responsive behavior Child as the actorPositive: A mother synchronously responds to

promote continuous feeding, such as interpreting a child feeding cues, responding to a child’s needs, etc.

Positive: A child initiates an attempt to eat, such as looking at food, talking about food, requesting 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 feeding cues, responding to the child’s needs, etc. Negative: A child shows disinterest,

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 promotes self-feeding, such as verbal encouragement, praises, etc.

Positive: A child attempts self-feeding, such as holding utensils, putting food into mouth, etc.

Negative: A mother discourages, disallows, or interrupts self-feeding, such as pushing the child’s hands away, telling the child that she will feed the child, etc.

Negative: A child rejects self-feeding, such as saying “no” or pushing away given food.

ResultsMealtime duration with and without the playful tray for

the four children subjects

Avg.: 32min.(23-41min.)

Avg.: 21min.(7-29 min.)

ResultsThe child’s P/N ratio with and without the Playful

Tray

0.80~13.33

6.95~19.00different food types (rice/ dumpling→easy to eat → less self-feeding actions) ↑

ResultsThe 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.

OutputFuture Work

GameInputWeighing Sensor

(eating event)

RacingGame

RFID Reader(toys’ location)

AnimatedSimulation

Camera(teeth brushing)

Any OtherGames!!

Accomplish smarter users via smart environment.Output

GameInput

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

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 8th International Conference on Ubiquitous Computing (ACM UbiComp 2006), California, September, 2006.

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 4th International Conference, PERVASIVE 2006, Springer), pages 366-382.

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.

Publications