Exploring companion robots for children with autism spectrum disorder: a reflexive thematic analysis in specialist dental care.

Introduction: As robotic technologies become increasingly integrated into care settings, it is critical to assess their impact within the complexity of real-world contexts. This exploratory study examines the introduction of a robot cat for children with Autism Spectrum Disorder (ASD) in a specialist dental care unit. Children with ASD often face challenges in dental care, including anxiety, sensory sensitivities, and difficulty with collaboration. The study investigates if a robot cat can provide psychosocial support to the patients. Methods: Ten patients, aged 5-10, participated in the 12-months study, each undergoing one baseline session without the robot and 3-5 subsequent visits with the robot, yielding 37 sessions of video data. Results: Reflexive thematic analysis revealed three key themes: the robot cat can enhance training and treatment, robot cats can serve as a beneficial but a non-essential tool, and robot cats can sometimes hinder progress in training and treatment. These findings highlight significant individual variation in how the robot was experienced, shaped by context, timing, and emotional state. The robot's role was not universally positive or passive; its effectiveness depended on how it was integrated into personalised care strategies by the dental hygienist, guardians, and the patients themselves. Discussion: This study underscores the importance of tailoring technological interventions in care, advocating for cautious, context-sensitive use rather than one-size-fits-all solutions. Future work should further explore adaptive, individualised deployment.