Comparative Effectiveness of Human- and Robot-Based Interventions in Increasing Empathy Among Autistic Children

Methods: A total of 82 Chinese-speaking children with autism aged 4–9 years were assigned to an HBI or an RBI group through stratified randomization. Before the intervention, the children’s autism severity, verbal comprehension, and Theory of Mind skills were assessed. Each child received four 30-min training sessions over 4 weeks, during which they watched four dramas performed by human or robot actors, in which one character shared an event with another character, who then displayed an empathic response. Parents completed a questionnaire before, immediately after, and 1 month after the intervention, and children’s cognitive empathy (CE), affective empathy (AE), and prosocial behavior (PB) were evaluated in an experimental task. Results: Both RBI and HBI training promote empathy skills, specifically CE, AE, and PB, as evaluated through children’s verbal responses in story tasks. Conclusion: RBI empathy training demonstrates comparable reliability and effectiveness to human teaching, suggesting that RBIs can assist human therapists in promoting empathy in children with autism. Our randomized controlled trial was registered in the Chinese Clinical Trial Registry (no. ChiCTR2300077745, https://www.chictr.org.cn).