Introduction

Many children and young people with cancer are unable to attend school, for example due to extended hospital stays and side effects from treatment.1 2 This can have a considerable impact on their quality of life, educational attainment and emotional and social wellbeing.1-3 AV1 is a telepresence robot that enables children and young people with long-term illness, including cancer, to attend school remotely.4 Its camera, microphone and speakers are accessible via an app so users can follow a livestream directly from their school and participate in lessons. As of January 2021, there are approximately 1,300 AV1s active across Europe.5 The impact of these robots on educational attainment and wellbeing is being evaluated through pilot studies and charity-led programmes, such as those in the United Kingdom (UK) and Sweden.6-9

Challenge

Every year, more than 26,000 children and young people in Europe are diagnosed with cancer.10 In addition to concerns about cancer treatment, many young people express worries about missing school and falling behind.3 Extended hospital stays, side effects from treatment and not feeling well enough to attend and participate in school can lead to educational gaps.1 2 Adolescents are particularly at risk, with an average of 40–60 school days missed in the year following a cancer diagnosis.3

Ongoing engagement with education and school life is essential for children and young people with cancer. It is linked to higher quality of life and self-worth,3 and can help reduce feelings of loneliness and social isolation during treatment.1 2 Young people with cancer are also more likely to report easy reintegration into school when they maintain consistent contact with their peers.3 While many centres in Europe offer some form of educational support for children and young people with cancer,1 the comprehensiveness of these services varies across the continent.3

Solution

No Isolation, a start-up company based in Norway and London, has developed AV1 – a telepresence robot that enables children and young people with long-term illnesses, including cancer, to attend school remotely.4 AV1 is a distance-learning avatar, meaning that it acts as a child’s ears, eyes and voice when they cannot be physically present in a classroom.

AV1’s camera and microphone livestream directly from the classroom to an app, which the child or young person with cancer can access on a tablet while at home or in hospital.4 They can control the robot’s movements to adjust their view, participate in lessons using the loudspeaker function, and raise their hand or express emotions (neutral, happy, confused or sad) using a built-in light display. AV1 operates on a 4G sim.7

AV1 was designed in collaboration with teachers, parents, children and healthcare professionals, with privacy and safeguarding at the centre of its development.7 Its livestream is end-to-end encrypted and recording and screenshots are disabled.4 7 Each AV1 is linked to a single app protected by a four-digit code. No Isolation has also developed an AV1 Assistant app to support teachers, IT officers and administrators managing the robots at school.7

What has been achieved

As of January 2021, there are approximately 1,300 AV1s active across Europe.5 No Isolation estimates that approximately 10% of these are deployed to children with cancer.

In the UK, AV1s are used in schools and more than 20 local authorities to support children absent from school due to long-term illness, including cancer.5 In 2018, an initiative led by Hospital and Outreach Education received £522,124 from the UK Department for Education to evaluate the impact of telepresence robots on children and young people’s educational attainment, reintegration into school, and social and emotional wellbeing.6 Interim data from all recipients of an AV1, including those with cancer, suggest that average school attendance has increased from 29% to 58%.7

No Isolation has also partnered with charities to distribute and evaluate the impact of AV1.5 For example, SpecialEffect is a UK-based charity that focuses on increasing the quality of life of people with physical challenges through access to specialised technology.8 It is distributing AV1s to children with immunodeficiency due to cancer to combat isolation and support access to education. Similarly, the Barncancer Fonden (Childhood Cancer Foundation) in Sweden has distributed four AV1s to complement education provided in hospital schools.9

Next Steps

The two-year project led by Hospital and Outreach Education and funded by the UK Department for Education finished at the end of 2020.5 However, The Skylark Partnership – an educational trust – has pledged to continue the study for at least another year.11

Further information

Contact

No Isolation, contact@noisolation.com

References:

  1. Children's Cancer and Leukaemia Group. 2014. Children and young people with cancer: a parent’s guide. Leicester: CCLG
  2. Pini S, Hugh-Jones S, Gardner PH. 2012. What effect does a cancer diagnosis have on the educational engagement and school life of teenagers? A systematic review. Psycho-oncology 21(7): 685-94
  3. Pini S, Gardner P, Hugh-Jones S. 2013. The impact of a cancer diagnosis on the education engagement of teenagers – Patient and staff perspective. European Journal of Oncology Nursing 17(3): 317-23
  4. No Isolation. AV1. Available here: https://www.noisolation.com/uk/av1/ [accessed: December 2020]
  5. Gridley H. 2021. Interview with Marissa Mes at The Health Policy Partnership [videoconference]. 07/01/21
  6. ICT for Education. 2019. Hospital and Outreach Education wins Alternative Provision Innovation Fund bid, providing AV1 telepresence robots to support children with long-term illness. Available here: https://www.ictforeducation.co.uk/news/hospital-and-outreach-education-wins-alternative-provision-innovation-fund-bid-providing-av1-telepresence-robots-to-support-children-with-long-term-illness.html [accessed: December 2020]
  7. No Isolation. 2019. AV1 Brochure. London: No Isolation
  8. SpecialEffect. BubbleBusters: Bringing children with immunodeficiency due to cancer and who are in long-term isolation back together with schools and friends. Available here: https://www.specialeffect.org.uk/bubblebusters [accessed: January 2021]
  9. Barncancer Fonden. Robot hjälper barn med cancer att delta i skolan. Available here: https://www.barncancerfonden.se/press/robot-hjalper-barn-med-cancer-att-delta-i-skolan/
  10. Global Cancer Observatory. Cancer Today: Estimated number of new cases in 2020, all cancers, both sexes, ages 0-19. Available here: https://gco.iarc.fr/ [accessed: January 2021]
  11. Hospital and Outreach Education. Using telepresence solutions to support pupil attendance. Available here: https://nhoe.org.uk/av1/ [accessed: December 2020]