Parents and Caregivers Report a Reduction in Anxiety and Distress in Young Cancer Patients Using the My Special Aflac Duck

ATLANTA (April 8, 2024) – In a clinical trial led by researchers at Children’s Healthcare of Atlanta and Emory University School of Medicine parents and caregivers report a reduction in distress and anxiety among young children undergoing cancer treatment after playing with a robotic duck known as the My Special Aflac Duck®. Investigators shared preliminary findings of the research during a presentation at the American Society of Pediatric Hematology/Oncology (ASPHO) annual meeting in Seattle April 5.

“These early findings suggest that children who were randomized to the My Special Aflac Duck arm of the study experienced reductions in procedural and treatment related anxiety, along with overall distress,” said James Klosky, PhD, ABPP, senior author on the study, Director of Psychology and Neuropsychology at the Aflac Cancer and Blood Disorders Center, and Professor of Pediatrics at Emory University School of Medicine. “Current results show patients who interacted with My Special Aflac Duck experienced reductions in distress, nausea and pain as well as treatment and procedural anxiety compared to patients who did not.”

My Special Aflac Duck is an animatronic, plush duck designed to incorporate elements of medical play, distraction, and social robotics to provide comfort and distraction for children. Previous research has recommended multisensory, developmentally appropriate devices that engage a child’s audiovisual, kinesthetic, and tactile senses, and cognitive, motor, and visual skills, as active distraction techniques may result in the reduction of pain and anxiety. These devices are especially relevant to younger children whose ability to cope with difficult situations is limited by their level of cognitive development and varying ability to self-regulate emotions.

The longitudinal clinical trial testing the effectiveness of the My Special Aflac Duck took place at eight hospital locations across the nation and included 160 patients between ages three to 10 years who were randomly assigned to receive the My Special Aflac Duck or standard care based on the hospital where they were treated. Parents, child life specialists (pediatric health care professionals who work with children and families in hospitals to help them cope with the challenges of hospitalization, illness, and disability) and older patients completed questionnaires about patient distress, quality of life and adverse events at their first appointment, after one week, one month and three months. The preliminary findings suggest patients who interacted with the My Special Aflac Duck experienced reductions in distress, nausea and pain as well as treatment and procedural anxiety compared to patients who did not. The trial follows a feasibility pilot project also led by Children’s and Emory published in Pediatric Blood and Cancer in 2019 showing My Special Aflac Duck helped reduce distress while in the hospital in almost 70% of patients and that more than 90% were satisfied with My Special Aflac Duck overall.

“These results suggest that inclusion of the My Special Aflac Duck in a child life specialist’s toolbox as an evidence-based intervention can reduce adverse psychological outcomes among young children undergoing cancer therapy,” said Tamara Miller, MD, first author on the study, Pediatric Hematologist/Oncologist at the Aflac Cancer and Blood Disorders Center, and Associate Professor of Pediatrics at Emory University School of Medicine. “The benefits of the intervention may also extend beyond patients to their families, as parents reported improvements in their own mental health.”

Using feedback from pediatric cancer patients, My Special Aflac Duck was developed for young children with cancer ages three to 10 years. Children can trigger lifelike nuzzling movements, fun and playful movements, along with quacks by petting their My Special Aflac Duck. Seven different emoji accessory tokens (angry, calm, happy, sad, scared, sick and silly) allow children to communicate their feelings to caregivers and cause My Special Aflac Duck to act out feelings with different movements, dramatic and fun quacks, and colored light sequences. A port-a-cath attachment can be affixed to facilitate medical play as children pretend to administer medications.

Drs. Klosky and Miller also hold positions within Emory University Winship Cancer Institute. Both the randomized clinical trial and previous feasibility study were funded by Aflac, Inc., which also helps fund the Aflac Cancer and Blood Disorders Center. Drs. Miller and Klosky are in the process submitting the results of the clinical trial for publication in a peer-reviewed journal.