1. 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

2. Ubiquitous Computing integrates computing into everyday objects and activities

3. Object location tracker - Shin-jan Wu, NTU Ubicomp Lab Lost ? http://www.mtn sys.com/Imags/ frmain1.jpg

4. Smart Environment

5. Dumb users? Smarter users

6. Persuasive Computing Smart homes? Smart people.

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

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

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

10. the problem… Mealtime Behavior

11.  Nutritional concerns  Affect the participation of children in daily routines  Negative parent-child interaction

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

13. 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”

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

15. Playful Tray Design 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

16. Playful Tray Design 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

17. Playful Tray Design 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

18. Playful Tray Design 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

19. Playful Tray Design Considerations Attention :: to split between game playing and eating activities Enjoyment :: to bring intrinsic motivation of children Engagement :: to connect digital playfulness to active participation in the target physical activity Control :: to give children choices in determining game outcome

20. Implementation

21. [ Implementation 1 ] Coloring Game

22. [ Implementation 1 ] Coloring Game ─ Four Problems frustration 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

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

24. [ Implementation 2 ] Racing Game LCD DisplayRacing Game Weight Change DetectorWeighing Sensing Surface Physical Eating Action Eating Events Digital Playful Feedback

25. [ 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

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

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

28. 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.

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

30. 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

31. (1) Self-feeding: a child place food into his/her own mouth MotherChild 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 partner Mother as the actorChild’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 behaviorChild as the actor Positive: 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.

32. (1) Self-feeding: a child place food into his/her own mouth MotherChild 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.

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

34. 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) ↑

35. Results The mother’s P/N ratio with and without the playful tray 0.79~ 4.00 4.30~30.00

36. 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.

37. 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 - PreInterventionPost

38. 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.

39. OutputOutput Future Work GameGame InputInput Weighing Sensor (eating event) RacingGame RFID Reader (toys’ location) AnimatedSimulation Camera (teeth brushing) Any Other Games!!

40. Accomplish smarter users via smart environment. OutputOutput GameGame InputInput

41.  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