Co-design and development of an occupational therapy conversational AI system for neurodevelopmental care in Greece: A mixed-methods protocol

Authors

DOI:

https://doi.org/10.14295/bjs.v6i2.943

Keywords:

artificial intelligence, conversational AI, chatbot, occupational therapy, neurodevelopmental disorders

Abstract

Conversational artificial intelligence (AI) has shown potential to support knowledge translation, personalized education, and access to health-related information. However, applications in neurodevelopmental care remain largely focused on screening and assessment, while conversational systems tailored to occupational therapy are scarce. Moreover, general-purpose generative AI may produce inaccurate, insufficiently contextualized, or clinically inappropriate responses, highlighting the need for evidence-based, domain-specific systems with robust safety mechanisms. This study describes the protocol for the co-design, development, and preliminary evaluation of a conversational AI system designed to support occupational therapists and parents of children aged 5–12 years with neurodevelopmental disorders in Greece. The system is intended as an educational and decision-support resource and will not replace diagnosis, clinical judgment, or individualized intervention. A co-designed, multi-phase, mixed-methods proof-of-concept design will be adopted, informed by the Medical Research Council framework, Design Science Research, user-centered design principles, and the CeHRes Roadmap 2.0. Development will include evidence synthesis, stakeholder needs assessment, knowledge base construction, iterative prototype development, and expert, technical, safety, and user evaluation. The system will integrate a curated occupational therapy knowledge base, retrieval-augmented generation, role-specific prompting, source verification, and layered safety guardrails. Expected outputs include a stakeholder-informed Greek-language minimum viable product and a transparent framework linking evidence, user requirements, technical design, and evaluation criteria. Preliminary evaluation will assess factual accuracy, evidence concordance, occupational therapy relevance, clinical appropriateness, safety, usability, acceptability, and perceived usefulness. This protocol provides a reproducible foundation for developing clinically relevant conversational AI in occupational therapy and for future feasibility and effectiveness studies.

References

Bui, T. A., Pohl, M., Rosenfelt, C., Ogourtsova, T., Yousef, M., Whitlock, K., Majnemer, A., Nicholas, D., Demmans Epp, C., Zaiane, O., & Bolduc, F. V. (2022). Identifying potential gamification elements for a new chatbot for families with neurodevelopmental disorders: User-centered design approach. JMIR Human Factors, 9(3), e31991. https://doi.org/10.2196/31991

Bulan, P. M. P., Kuizon, D. A. Y., Casaña, R. S. E., Fuentes, C. G., Pestaño, N. Y., & Suerte, J. R. O. (2025). A scoping review on artificial intelligence in occupational therapy. OTJR: Occupation, Participation and Health. Advance Online Publication. https://doi.org/10.1177/15394492251379332

Busch, F., Hoffmann, L., Rueger, C., van Dijk, E. H. C., Kader, R., Ortiz-Prado, E., Makowski, M. R., Saba, L., Hadamitzky, M., Kather, J. N., Truhn, D., Cuocolo, R., Adams, L. C., & Bressem, K. K. (2025). Current applications and challenges in large language models for patient care: A systematic review. Communications Medicine, 5. https://doi.org/10.1038/s43856-024-00717-2

Değerli, Y., Özata Değerli, M. N., & Kars, S. (2026). Artificial intelligence in occupational therapy: Comparing ChatGPT and occupational therapist approaches in assessment and intervention. British Journal of Occupational Therapy, 89(1), 6-18. https://doi.org/10.1177/03080226251368231

Feng, F., Yang, Y., Cer, D., Arivazhagan, N., & Wang, W. (2022). Language-agnostic BERT sentence embedding. In: Proceedings of the 60th Annual Meeting of the Association for Computational Linguistics: Volume 1, Long Papers, 878-891 p. Association for Computational Linguistics. https://doi.org/10.18653/v1/2022.acl-long.62

Gale, N. K., Heath, G., Cameron, E., Rashid, S., & Redwood, S. (2013). Using the Framework Method for the analysis of qualitative data in multi-disciplinary health research. BMC Medical Research Methodology, 13. https://doi.org/10.1186/1471-2288-13-117

Haltaufderheide, J., & Ranisch, R. (2024). The ethics of ChatGPT in medicine and healthcare: A systematic review on large language models. NPJ Digital Medicine, 7. https://doi.org/10.1038/s41746-024-01157-x

Kaelin, V. C., Valizadeh, M., Salgado, Z., Parde, N., Khetani, M. A., & Foster, E. R. (2021). Artificial intelligence in rehabilitation targeting the participation of children and youth with disabilities: Scoping review. Journal of Medical Internet Research, 23(11), e25745. https://doi.org/10.2196/25745

Kip, H., Beerlage-de Jong, N., van Gemert-Pijnen, L. J. E. W. C., & Kelders, S. M. (2025). The CeHRes Roadmap 2.0: Update of a holistic framework for development, implementation, and evaluation of eHealth technologies. Journal of Medical Internet Research, 27, e59601. https://doi.org/10.2196/59601

Koo, T. K., & Li, M. Y. (2016). A guideline of selecting and reporting intraclass correlation coefficients for reliability research. Journal of Chiropractic Medicine, 15(2), 155-163. https://doi.org/10.1016/j.jcm.2016.02.012

Lewis, J. R. (2018). The System Usability Scale: Past, present, and future. International Journal of Human–Computer Interaction, 34(7), 577-590. https://doi.org/10.1080/10447318.2018.1455307

Lewis, P., Perez, E., Piktus, A., Petroni, F., Karpukhin, V., Goyal, N., Küttler, H., Lewis, M., Yih, W.-T., Rocktäschel, T., Riedel, S., & Kiela, D. (2020). Retrieval-augmented generation for knowledge-intensive NLP tasks. Advances in Neural Information Processing Systems, 33, 9459-9474.

Livermore, P., Kupiec, K., Wedderburn, L. R., Knight, A., Solebo, A. L., Shafran, R., Robert, G., Sebire, N. J., Gibson, F., & IMPACT Steering Group. (2024). Designing, developing, and testing a chatbot for parents and caregivers of children and young people with rheumatological conditions (the IMPACT study): Protocol for a co-designed proof-of-concept study. JMIR Research Protocols, 13, e57238. https://doi.org/10.2196/57238

Milne-Ives, M., de Cock, C., Lim, E., Harper Shehadeh, M., de Pennington, N., Mole, G., Normando, E., & Meinert, E. (2020). The effectiveness of artificial intelligence conversational agents in health care: Systematic review. Journal of Medical Internet Research, 22(10), e20346. https://doi.org/10.2196/20346

Onoufriou, A., Kargaki, I., Sfintsioti, P., Georgiou, K., Kalogirou, G., & Pergantis, P. (2027). Bibliometric and science mapping analysis of occupational therapy research in Greece (1977–2025). Brazilian Journal of Science, 6(1), 191-207. https://doi.org/10.14295/bjs.v6i1.931

Orfanou, K., Tselios, N., & Katsanos, C. (2015). Perceived usability evaluation of learning management systems: Empirical evaluation of the System Usability Scale. The International Review of Research in Open and Distributed Learning, 16(2), 227-246. https://doi.org/10.19173/irrodl.v16i2.1955

Peffers, K., Tuunanen, T., Rothenberger, M. A., & Chatterjee, S. (2007). A design science research methodology for information systems research. Journal of Management Information Systems, 24(3), 45-77. https://doi.org/10.2753/MIS0742-1222240302

Pergantis, P., Bamicha, V., Skianis, C., & Drigas, A. (2025a). AI chatbots and cognitive control: Enhancing executive functions through chatbot interactions: A systematic review. Brain Sciences, 15(1). https://doi.org/10.3390/brainsci15010047

Pergantis, P., Bamicha, V., Doulou, A., Christou, A. I., Bardis, N., Skianis, C., & Drigas, A. (2025b). Assistive and emerging technologies to detect and reduce neurophysiological stress and anxiety in children and adolescents with autism and sensory processing disorders: A systematic review. Technologies, 13(4). https://doi.org/10.3390/technologies13040144

Pergantis, P., Georgiou, K., Bardis, N., Skianis, C., & Drigas, A. (2026). Artificial intelligence in the evaluation and intervention of Developmental Coordination Disorder: A scoping review of methods, clinical purposes, and future directions. Children, 13(2). https://doi.org/10.3390/children13020161

Reimers, N., & Gurevych, I. (2019). Sentence-BERT: Sentence embeddings using Siamese BERT-networks. In Proceedings of the 2019 Conference on Empirical Methods in Natural Language Processing and the 9th International Joint Conference on Natural Language Processing, 3982-3992 p., Association for Computational Linguistics. https://doi.org/10.18653/v1/D19-1410

Singla, A., Khanna, R., Kaur, M., Kelm, K., Zaiane, O., Rosenfelt, C. S., Bui, T. A., Rezaei, N., Nicholas, D., Reformat, M. Z., Majnemer, A., Ogourtsova, T., & Bolduc, F. (2024). Developing a chatbot to support individuals with neurodevelopmental disorders: Tutorial. Journal of Medical Internet Research, 26, e50182. https://doi.org/10.2196/50182

Skivington, K., Matthews, L., Simpson, S. A., Craig, P., Baird, J., Blazeby, J. M., Boyd, K. A., Craig, N., French, D. P., McIntosh, E., Petticrew, M., Rycroft-Malone, J., White, M., & Moore, L. (2021). A new framework for developing and evaluating complex interventions: Update of Medical Research Council guidance. BMJ, 374. https://doi.org/10.1136/bmj.n2061

The CHART Collaborative. (2025). Reporting guideline for chatbot health advice studies: The CHART statement. JAMA Network Open, 8(8), e2530220. https://doi.org/10.1001/jamanetworkopen.2025.30220

Zhang, W., Leung, R. Y. F., Mak, K. K., Ge, H., Kwok, T. T. O., Tso, R. V. Y., Wang, A., Ma, H., & Wong, J. Y. H. (2026). GPT-powered chatbot-based positive psychology intervention for well-being among parents of children with autism spectrum disorder: Single-arm mixed methods study. JMIR Formative Research, 10, e85060. https://doi.org/10.2196/85060

Downloads

Published

2026-07-28

How to Cite

Pergantis, P., Bardis, N., Skianis, C., & Drigas, A. (2026). Co-design and development of an occupational therapy conversational AI system for neurodevelopmental care in Greece: A mixed-methods protocol. Brazilian Journal of Science, 6(2), 111–135. https://doi.org/10.14295/bjs.v6i2.943

Similar Articles

<< < 1 2 3 4 5 

You may also start an advanced similarity search for this article.