Hillary Frank writes:
Last year, I did a story, “And Baby Makes 0011,” for This American Life and my podcast, The Longest Shortest Time, about robot babies. Y’know, those electronic baby dolls that some schools use in health class to scare kids out of getting pregnant. The babies are programmed to mimic real babies, crying at seemingly random times all day and night. And if you can’t properly diagnose whether the baby needs to be fed, changed, or comforted, your grade drops. Realityworks, the company that makes the computerized babies, says that 67% of school districts in the United States use their simulators, and that the program is used in 89 countries worldwide.
In my story, my producer Joanna Solotaroff and I went to Glen Ridge, New Jersey, and followed Paige and Rachel, two Glen Ridge High School seniors, during their 48-hour stints with the babies. The students couldn’t have been more different. Paige was devoutly Christian, conservative, dreamed of meeting a man in college, getting married, and having kids young. Rachel identified as bisexual, liberal, and no way did she want kids until she’d started a fulfilling career and had plenty of adventures. Of course, I figured Paige would love playing mom, and Rachel would see it as … just another weird high school adventure.
Boy, was I wrong.
After two nights with her robot baby, Paige was a wreck. She said she couldn’t imagine ever doing this in real life. She still wanted to be a mom, but not for a looooong time. Rachel, though. She bonded with her baby. Sang to it. Like, tenderly. She was sad to give it back. She told me that her experience with this hunk of plastic actually made her feel more prepared for unintended pregnancy. “If I have a baby really young, I feel like I would keep the baby,” she told me. “Cause I kinda like the feeling of having a baby. I guess for some reason, the idea that someone or something needs you and only you makes you feel important... I never thought I’d want to have a kid younger but maybe I would.”
I was shocked. Rachel’s response to the robot baby was exactly the opposite of what you were supposed to have after going through this program. You were supposed to feel like Paige. I didn’t really know what to make of this. I just figured Rachel was a fluke. She made for a great story, but she was a fluke.
Well, maybe not.
Today, The Lancet published a study titled “Efficacy of infant simulator programmes to prevent teenage pregnancy.” It’s a controlled, randomized trial that was conducted in Australia, led by Dr. Sally Brinkman of the Telethon Kids Institute. The study looked at a total of 2,384 girls, ages 13-15. Yes, only girls. The researchers determined the number of teen pregnancies by following the girls’ health records through age 20. Health records for boys would not provide conclusive evidence of being responsible for a pregnancy. 1,267 of the girls participated in the infant simulator program (the intervention); 1,567 of the girls participated in the standard Western Australian school sex-ed curriculum, which does not include infant simulators (the control). Dr. Brinkman’s objective was to find out how effective the infant simulator program was in preventing teen pregnancy. And what she found, she said yesterday in a press briefing, is that "unfortunately and surprisingly, for us, the intervention definitely, we could say, didn't work."
Not only did it definitely not work, the infant simulator program seems to have increased the pregnancy rate in girls under 20 years old. “The program,” Brinkman added, “had the opposite effect we have hoped for.”
Here are the numbers:
17% of the intervention (robot babies) group had teen pregnancies; while 11% of the control group had teen pregnancies.
Thanks to the magic of the internet, I was able to listen in on Dr. Brinkman’s press briefing in Australia last night, and ask her a couple of questions.
The first thing I asked was, of course, motivated by my observations of Rachel: Was there evidence that the simulators made teens interested in becoming moms? Or less afraid of accidental pregnancy?
Brinkman said there was no way to know the answer to this question. The study was designed to track pregnancy, not whether the pregnancies were intended or unintended. But, she added, they did study the pregnancy termination rate in both groups. And the group that got the infant simulators had a 6% lower proportion of abortions, compared with the control group. But, of course, there’s no way to really know if that lower rate means the girls who experienced the infant simulators felt more comfortable with the idea of becoming moms.
The second thing I asked Dr. Brinkman was, Have you gotten a response from Realityworks on the study?
Brinkman said that while Realityworks was aware of the study, they had not yet seen the findings, and the study was on embargo until 3:00pm ET today. At the time of this posting, Realityworks had still not received the study. The company is aware, though, that the study contains surprising findings. And they sent me this statement:
“The study being released today by The Lancet was not a representation of our curriculum and simulator learning modality but the researchers “adaptation” and is consequently not reflective of our product nor its efficacy. The RealCare Program, is a combination of curriculum and hands-on aids, and if they are being tested and judged for effectiveness should be judged in their entirety.
The 'adaptation' that was used was developed by Australia’s Swan Hills Division of General Practice, the Coastal and Wheatbelt Public Health Unit and the North Metropolitan Population Health Unit. The class time designated for teaching the adaptation was a mere 2.5 hours.
The Realityworks program is 14 hours of class time, learning activities and a prolonged take home simulator experience.
This study is not measuring Realityworks Program but the program developed by the Australian agencies listed above and recklessly associating our product with their content.”
It’s fair to say that the Australian program is an adaptation of the Realityworks program. But the Australian study participants did take the babies home for 64 hours, which is 16 hours more than Rachel and Paige, the American girls that I followed.
I should note that I did interview Realityworks president Timm Boettcher for my This American Life story, and he insisted that the purpose of the Realityworks program is not to prevent teen pregnancy, just to give teens an idea of what early parenthood is like.