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Artificial intelligence and cerebral palsy

The field of artificial intelligence (AI) was founded over sixty years ago, grounded in what was an already solid base of both bionics (biologically-inspired engineering) and biocybernetics (application of cybernetics to biological science). Yet it is still widely regarded as novel and aweinspiring; more geared to the future than the present and carrying fantastic hopes for a better life or threats of a dehumanized world, depending on one’s outlook. This may be because it is commonly held that ‘AI is whatever hasn’t been done yet’, excluding from the field whatever applications have already become routine in everyday life (e.g. text translation, image classification, speech recognition, vehicle navigation systems, etc.). AI can refer to a research field striving to understand cognitive processes (such as knowledge representation, planning, learning, problem-solving, adaptation, and interaction) in mathematical terms, and which will in turn operationalize these processes into a computer system. But the term can also refer to the methods that are required to realize this, i.e. algorithms and computational structures. Medical applications have been developed since the early 1970s, when the Mycin system could identify bacteria causing severe infections and recommend antibiotics with dosage adjusted for the patient’s weight. Numerous AI systems can assist with medical decision-based tasks, including diagnosis, therapy, prognosis, and monitoring based on medical and other types of information from different sources about the patient, other patients, and previous experience. These systems can manage uncertain, incomplete, or inconsistent information, and provide some reasoning with some resemblance to our own. Thus they can arguably produce results that we usually achieve through experience and intuition, sometimes with more accuracy. In terms of cerebral palsy (CP), AI approaches have shown encouraging results for diagnostic purposes based on parents’ reports. It is likely that the recent development of well-designed registries in many countries will improve this type of effort, refine prognosis, and assist in management selection, although limitations in the amount and quality of information (particularly critical regarding management) may remain problematic for efficacy. As more data eventually become available on big-data platforms, requalification of the CP concept into possibly more relevant entities, and categories based on presentation and outcome, may emerge from a shift from knowledge-intensive to data-intensive applications. These developments may rekindle old fears that AI could make human factors – indeed human beings – redundant. There is some interesting substance for debate here, though none of it is novel or specific to AI or CP. The objectivity of algorithms can be challenged as a chimera, as they are still reliant on human selection. Caution remains necessary, particularly in mistaking assumption for evidence, and correlation for causality. Moreover, it must be recognized that complex decisions often involve more than sets of objective data and are partly determined by unique personal elements. Finally, currently available AI systems have a limited focus, and even when this becomes wider, the systems should remain essentially assistive tools. The real danger would be to assign tasks to machines that are beyond their capacity. Other AI applications for the benefit of people with CP are closer at hand. AI can be meaningful to specific management approaches. For example, mobility devices can adapt navigation to types of terrain, obstacles, and traffic, and communication devices make the most of natural language interfaces for optimal speech generation. Rapid advances in hardware miniaturization, sophisticated embedded algorithms, and easy Internet access will increasingly allow wearability of the devices. These developments will also permit unprecedented progress in robotics and hybrid systems connecting artificial and biological neural networks. In the wider world of applied technology, CP is probably a modest niche. But the pace of progress in our field will directly benefit from the leaps made in consumer electronics like smart phones, cars, and homes. The future is always with us – whether we know it or not!