{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T15:56:07Z","timestamp":1780588567037,"version":"3.54.1"},"reference-count":55,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T00:00:00Z","timestamp":1702598400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC Convening and Collaborating Award","doi-asserted-by":"publisher","award":["C2-2020-1392"],"award-info":[{"award-number":["C2-2020-1392"]}],"id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000245","name":"Michael Smith Health Research BC Convening and Collaborating Award","doi-asserted-by":"publisher","award":["TIF102"],"award-info":[{"award-number":["TIF102"]}],"id":[{"id":"10.13039\/501100000245","id-type":"DOI","asserted-by":"publisher"}]},{"name":"BC Children\u2019s Hospital Research Institute\u2019s Evidence to Innovation Seed Grant","award":["C2-2020-1392"],"award-info":[{"award-number":["C2-2020-1392"]}]},{"name":"BC Children\u2019s Hospital Research Institute\u2019s Evidence to Innovation Seed Grant","award":["TIF102"],"award-info":[{"award-number":["TIF102"]}]},{"name":"BC Children\u2019s Hospital Foundation","award":["C2-2020-1392"],"award-info":[{"award-number":["C2-2020-1392"]}]},{"name":"BC Children\u2019s Hospital Foundation","award":["TIF102"],"award-info":[{"award-number":["TIF102"]}]},{"name":"BC SUPPORT Unit Training Innovation Fund","award":["C2-2020-1392"],"award-info":[{"award-number":["C2-2020-1392"]}]},{"name":"BC SUPPORT Unit Training Innovation Fund","award":["TIF102"],"award-info":[{"award-number":["TIF102"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["MTI"],"abstract":"<jats:p>Social robots have the potential to support health and quality of life for children experiencing anxiety. We engaged families with lived experiences of pediatric anxiety in social robot development to explore desired design features, application areas, and emotion functionalities of social robots in anxiety care. We conducted 10 online co-creation workshops with (1) children with anxiety aged 7\u201313 (n = 24) with their family members (n = 20), and (2) youth with anxiety aged 14\u201318 (n = 12). Workshop participation included a validated robot expectations scale, anonymous polls, and discussion. Transcripts and text responses were subjected to content analysis. A lived experience expert group provided feedback throughout the research. Participants desired a pet-like robot with a soft texture, expressive eyes, and emotion detection to support activities of daily living. Specific anxiety-related applications included breathing exercises, managing distressing thoughts, and encouragement. Emotional alignment, the design of a robot\u2019s emotional display, and the emotional impacts of an interaction were discussed. Privacy and the replacement of human interaction were concerns. We identify pediatric anxiety-specific design features, applications, and affective considerations for existing and future social robots. Our findings highlight the need for customizability and robust emotional functionality in social robot technologies intended to support the health and care of children living with anxiety.<\/jats:p>","DOI":"10.3390\/mti7120118","type":"journal-article","created":{"date-parts":[[2023,12,15]],"date-time":"2023-12-15T03:16:33Z","timestamp":1702610193000},"page":"118","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":14,"title":["\u201cA Safe Space for Sharing Feelings\u201d: Perspectives of Children with Lived Experiences of Anxiety on Social Robots"],"prefix":"10.3390","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1570-9496","authenticated-orcid":false,"given":"Jill A.","family":"Dosso","sequence":"first","affiliation":[{"name":"Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada"},{"name":"British Columbia Children & Women\u2019s Hospital, B402-4480 Oak St., Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaya N.","family":"Kailley","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada"},{"name":"British Columbia Children & Women\u2019s Hospital, B402-4480 Oak St., Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3934-7779","authenticated-orcid":false,"given":"Susanna E.","family":"Martin","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada"},{"name":"British Columbia Children & Women\u2019s Hospital, B402-4480 Oak St., Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie M.","family":"Robillard","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Neurology, The University of British Columbia, Vancouver, BC V6T 1Z3, Canada"},{"name":"British Columbia Children & Women\u2019s Hospital, B402-4480 Oak St., Vancouver, BC V6H 3N1, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,12,15]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"465","DOI":"10.1007\/s12369-015-0298-7","article-title":"Evaluating the Engagement with Social Robots","volume":"7","author":"Anzalone","year":"2015","journal-title":"Int. J. Soc. Robot."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1002\/aur.1527","article-title":"Autism and social robotics: A systematic review","volume":"9","author":"Pennisi","year":"2016","journal-title":"Autism Res."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"eaat5954","DOI":"10.1126\/scirobotics.aat5954","article-title":"Social robots for education: A review","volume":"3","author":"Belpaeme","year":"2018","journal-title":"Sci. Robot."},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Heerink, M., D\u00edaz, M., Albo-Canals, J., Angulo, C., Barco, A., Casacuberta, J., and Garriga, C. (2012, January 9\u201313). A field study with primary school children on perception of social presence and interactive behavior with a pet robot. Proceedings of the 2012 IEEE RO-MAN: The 21st IEEE International Symposium on Robot and Human Interactive Communication, Paris, France.","DOI":"10.1109\/ROMAN.2012.6343887"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"984","DOI":"10.1177\/1359105313504794","article-title":"Humanoid robotics in health care: An exploration of children\u2019s and parents\u2019 emotional reactions","volume":"20","author":"Beran","year":"2015","journal-title":"J. Health Psychol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"e000371","DOI":"10.1136\/bmjpo-2018-000371","article-title":"Can social robots help children in healthcare contexts? A scoping review","volume":"3","author":"Dawe","year":"2019","journal-title":"BMJ Paediatr. Open"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"e20181511","DOI":"10.1542\/peds.2018-1511","article-title":"Social Robots for Hospitalized Children","volume":"144","author":"Logan","year":"2019","journal-title":"Pediatrics"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"596","DOI":"10.1177\/1367493518803031","article-title":"Social robots to support children\u2019s well-being under medical treatment: A systematic state-of-the-art review","volume":"23","author":"Moerman","year":"2019","journal-title":"J. Child Health Care"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/AJP.0000000000000688","article-title":"Socially Assistive Robots for Helping Pediatric Distress and Pain","volume":"35","author":"Trost","year":"2019","journal-title":"Clin. J. Pain"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1177\/0844562119862742","article-title":"Children\u2019s Fear and Pain During Medical Procedures: A Quality Improvement Study With a Humanoid Robot","volume":"52","author":"Farrier","year":"2020","journal-title":"Can. J. Nurs. Res."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1080157","DOI":"10.3389\/frobt.2023.1080157","article-title":"Social robotics for children: An investigation of manufacturers\u2019 claims","volume":"10","author":"Dosso","year":"2023","journal-title":"Front. Robot. AI"},{"key":"ref_12","unstructured":"Lathan, C.E., and Ling, G. (2023, October 16). Social Robots Play Nicely with Others, Scientific American, Available online: https:\/\/www.scientificamerican.com\/article\/social-robots-play-nicely-with-others\/."},{"key":"ref_13","first-page":"3","article-title":"Attitudes toward using social robots in psychotherapy","volume":"15","author":"Costescu","year":"2014","journal-title":"Transylv. J. Psychol."},{"key":"ref_14","first-page":"20556683221108364","article-title":"User perspectives on emotionally aligned social robots for older adults and persons living with dementia","volume":"9","author":"Dosso","year":"2022","journal-title":"J. Rehabil. Assist. Technol. Eng."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1051750","DOI":"10.3389\/fpsyt.2022.1051750","article-title":"Older adult perspectives on emotion and stigma in social robots","volume":"13","author":"Dosso","year":"2023","journal-title":"Front. Psychiatry"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1111\/jcpp.12381","article-title":"Annual Research Review: A meta-analysis of the worldwide prevalence of mental disorders in children and adolescents","volume":"56","author":"Polanczyk","year":"2015","journal-title":"J. Child Psychol. Psychiatry"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1037\/0021-843X.107.1.109","article-title":"Gender differences in anxiety disorders and anxiety symptoms in adolescents","volume":"107","author":"Lewinsohn","year":"1998","journal-title":"J. Abnorm. Psychol."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1007\/s11920-010-0173-z","article-title":"Assessment and Treatment of Anxiety Disorders in Children and Adolescents, Curr","volume":"13","author":"Connolly","year":"2011","journal-title":"Psychiatry Rep."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"1107","DOI":"10.1016\/j.jaac.2020.05.005","article-title":"Clinical Practice Guideline for the Assessment and Treatment of Children and Adolescents With Anxiety Disorders","volume":"59","author":"Walter","year":"2020","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"e154","DOI":"10.3928\/19382359-20220317-01","article-title":"Pediatric Anxiety and Depression in the Time of COVID-19","volume":"51","author":"Beharry","year":"2022","journal-title":"Pediatr. Ann."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1177\/1077558713518347","article-title":"Episodes of Mental Health Treatment Among a Nationally Representative Sample of Children and Adolescents","volume":"71","author":"Saloner","year":"2014","journal-title":"Med. Care Res. Rev. MCRR"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1009","DOI":"10.1016\/j.jaac.2013.07.012","article-title":"Dissemination and Implementation of Evidence-Based Practices for Child and Adolescent Mental Health: A Systematic Review","volume":"52","author":"Novins","year":"2013","journal-title":"J. Am. Acad. Child Adolesc. Psychiatry"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"256","DOI":"10.1016\/j.jpeds.2018.09.021","article-title":"Prevalence and Treatment of Depression, Anxiety, and Conduct Problems in US Children","volume":"206","author":"Ghandour","year":"2019","journal-title":"J. Pediatr."},{"key":"ref_24","first-page":"919","article-title":"Socially Assistive Robots as Mental Health Interventions for Children: A Scoping Review","volume":"13","author":"Prescott","year":"2020","journal-title":"Int. J. Soc. Robot."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"743","DOI":"10.1007\/s12369-015-0294-y","article-title":"Clinical Application of a Humanoid Robot in Pediatric Cancer Interventions","volume":"8","author":"Alemi","year":"2016","journal-title":"Int. J. Soc. Robot."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1037\/pro0000177","article-title":"The influence of a socially assistive robot on mood, anxiety, and arousal in children","volume":"49","author":"Crossman","year":"2018","journal-title":"Prof. Psychol. Res. Pract."},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"e27242","DOI":"10.1002\/pbc.27242","article-title":"Using the MEDiPORT humanoid robot to reduce procedural pain and distress in children with cancer: A pilot randomized controlled trial","volume":"65","author":"Jibb","year":"2018","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1007\/s12369-019-00616-w","article-title":"Emotional and behavioural distraction by a social robot for children anxiety reduction during vaccination","volume":"12","author":"Rossi","year":"2020","journal-title":"Int. J. Soc. Robot."},{"key":"ref_29","doi-asserted-by":"crossref","unstructured":"Matheus, K., V\u00e1zquez, M., and Scassellati, B. (September, January 29). A Social Robot for Anxiety Reduction via Deep Breathing. Proceedings of the 2022 31st IEEE International Conference on Robot and Human Interactive Communication (RO-MAN), Napoli, Italy.","DOI":"10.1109\/RO-MAN53752.2022.9900638"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"5","DOI":"10.3389\/frobt.2020.00005","article-title":"Exploring teens as robot operators, users and witnesses in the wild","volume":"7","author":"Thomas","year":"2020","journal-title":"Front. Robot. AI"},{"key":"ref_31","unstructured":"Riek, L.D. (2016). Artificial Intelligence in Behavioral and Mental Health Care, Elsevier."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"720799","DOI":"10.3389\/frobt.2022.720799","article-title":"Connecting the dots of social robot design from interviews with robot creators","volume":"9","author":"Orr","year":"2022","journal-title":"Front. Robot. AI"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1136\/archdischild-2020-320721","article-title":"Reducing negative emotions in children using social robots: Systematic review","volume":"106","author":"Littler","year":"2021","journal-title":"Arch. Dis. Child."},{"key":"ref_34","doi-asserted-by":"crossref","unstructured":"Prescott, T.J., Mitchinson, B., and Conran, S. (2017, January 6\u20139). Miro: An animal-like companion robot with a biomimetic brain-based control system. Proceedings of the Companion of the 2017 ACM\/IEEE International Conference on Human-Robot Interaction, Vienna, Austria.","DOI":"10.1145\/3029798.3036660"},{"key":"ref_35","doi-asserted-by":"crossref","unstructured":"Wilson, S.P., Verschure, P.F.M.J., Mura, A., and Prescott, T.J. (2015). Biomimetic and Biohybrid Systems, Springer International Publishing.","DOI":"10.1007\/978-3-319-22979-9"},{"key":"ref_36","doi-asserted-by":"crossref","unstructured":"Maheux, M.-A., Caya, C., L\u00e9tourneau, D., and Michaud, F. (2022, January 7\u201310). T-Top, a SAR Experimental Platform. Proceedings of the 2022 ACM\/IEEE International Conference on Human-Robot Interaction, Sapporo, Japan.","DOI":"10.1109\/HRI53351.2022.9889346"},{"key":"ref_37","unstructured":"(2023, October 16). Sony Group Corporation, aibo. Available online: https:\/\/us.aibo.com."},{"key":"ref_38","unstructured":"(2023, October 16). Embodied, Inc., Moxie. Available online: https:\/\/moxierobot.com."},{"key":"ref_39","unstructured":"Alves-Oliveira, P., Ribeiro, T., Petisca, S., di Tullio, E., Melo, F.S., and Paiva, A. (2015). Social Robotics: 7th International Conference, ICSR 2015, Paris, France, 26\u201330 October 2015, Springer."},{"key":"ref_40","unstructured":"(2023, October 16). MAXQDA. VERBI Software. Available online: https:\/\/www.maxqda.com."},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"101993","DOI":"10.1016\/j.isci.2020.101993","article-title":"Are friends electric? The benefits and risks of human-robot relationships","volume":"24","author":"Prescott","year":"2021","journal-title":"iScience"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1007\/s12369-021-00802-9","article-title":"An Attachment Framework for Human-Robot Interaction","volume":"14","author":"Rabb","year":"2022","journal-title":"Int. J. Soc. Robot."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1007\/s12369-019-00539-6","article-title":"Can We Keep Him Forever? Teens\u2019 Engagement and Desire for Emotional Connection with a Social Robot","volume":"12","author":"Rose","year":"2020","journal-title":"Int. J. Soc. Robot."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"381","DOI":"10.1007\/s00146-019-00889-9","article-title":"Do people with social anxiety feel anxious about interacting with a robot?","volume":"35","author":"Nomura","year":"2020","journal-title":"AI Soc."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1080\/21507740.2021.2001078","article-title":"Translational Neuroethics: A Vision for a More Integrated, Inclusive, and Impactful Field","volume":"14","author":"Wexler","year":"2021","journal-title":"AJOB Neurosci."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"207","DOI":"10.1136\/jme.2009.029785","article-title":"Translational ethics? The theory\u2013practice gap in medical ethics","volume":"36","author":"Cribb","year":"2010","journal-title":"J. Med. Ethics"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"B\u00e6r\u00f8e, K. (2014). Translational ethics: An analytical framework of translational movements between theory and practice and a sketch of a comprehensive approach. BMC Med. Ethics, 15.","DOI":"10.1186\/1472-6939-15-71"},{"key":"ref_48","doi-asserted-by":"crossref","unstructured":"Bj\u00f6rling, E.A., Xu, W.M., Cabrera, M.E., and Cakmak, M. (2019, January 14\u201318). The Effect of Interaction and Design Participation on Teenagers\u2019 Attitudes towards Social Robots. Proceedings of the 2019 28th IEEE International Conference on Robot and Human Interactive Communication (RO-MAN), New Delhi, India.","DOI":"10.1109\/RO-MAN46459.2019.8956427"},{"key":"ref_49","doi-asserted-by":"crossref","first-page":"e30337","DOI":"10.2196\/30337","article-title":"User-Centered Design of Companion Robot Pets Involving Care Home Resident-Robot Interactions and Focus Groups with Residents, Staff, and Family: Qualitative Study","volume":"8","author":"Bradwell","year":"2021","journal-title":"JMIR Rehabil. Assist. Technol."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"Langer, A., Marshall, P.J., and Levy-Tzedek, S. (2023). Ethical considerations in child-robot interactions. Neurosci. Biobehav. Rev., 151.","DOI":"10.1016\/j.neubiorev.2023.105230"},{"key":"ref_51","doi-asserted-by":"crossref","unstructured":"Arnold, L. (2016, January 7\u201310). Emobie: A robot companion for children with anxiety. Proceedings of the 2016 11th ACM\/IEEE International Conference on Human-Robot Interaction (HRI), Christchurch, New Zealand.","DOI":"10.1109\/HRI.2016.7451782"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Mott, T., Bejarano, A., and Williams, T. (2022, January 7\u201310). Robot co-design can help us engage child stakeholders in ethical reflection. Proceedings of the 2022 17th ACM\/IEEE International Conference on Human-Robot Interaction (HRI), Sapporo, Japan.","DOI":"10.1109\/HRI53351.2022.9889430"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1080\/13645579.2020.1857969","article-title":"Reflecting on asynchronous internet mediated focus groups for researching culturally sensitive issues","volume":"24","author":"MacNamara","year":"2021","journal-title":"Int. J. Soc. Res. Methodol."},{"key":"ref_54","doi-asserted-by":"crossref","unstructured":"Tates, K., Zwaanswijk, M., Otten, R., Van Dulmen, S., Hoogerbrugge, P.M., Kamps, W.A., and Bensing, J.M. (2009). Online focus groups as a tool to collect data in hard-to-include populations: Examples from paediatric oncology. BMC Med. Res. Methodol., 9.","DOI":"10.1186\/1471-2288-9-15"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"3813820","DOI":"10.1155\/2022\/3813820","article-title":"British children\u2019s and adults\u2019 perceptions of robots","volume":"2022","author":"Burdett","year":"2022","journal-title":"Hum. Behav. Emerg. Technol."}],"container-title":["Multimodal Technologies and Interaction"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2414-4088\/7\/12\/118\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T21:39:09Z","timestamp":1760132349000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2414-4088\/7\/12\/118"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,15]]},"references-count":55,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["mti7120118"],"URL":"https:\/\/doi.org\/10.3390\/mti7120118","relation":{},"ISSN":["2414-4088"],"issn-type":[{"value":"2414-4088","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,15]]}}}