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Assistive Technology for Cognition:Practical Applications in the World of Work

VCU ‐ RRTC

Tony Gentry, PhD, OTR/L

Assist Prof, Dept. of OT 

Dir., AT for Cognition Lab

VCU, Richmond, VA

Logentry@vcu.edu

(804) 828‐2219

Assistive Technology for Cognition Laboratory

• Research

• Development

• Service

• Training

• VCU Dept. of OT

Prevalence

• 20 million Americans (7%) are afflicted with cognitive disability

• Yearly cost for support, care and lost productivity: $140 billion (2001)

Cognitive Rehabilitation

Emerged and developed alongside personal computing

Remedial vs. Compensatory Approaches

1980s

• Dawn of Cognitive Rehabilitation

P l• Personal computers

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Remedial Approaches

• Brain‐Train products

• Nintendo’s “Brain Age” game for DSAge  game for DS

• “Memory Works” simulation and training games

1990s• Calls for ecologically valid research

1990s

D kt• Desktop computers as reminder systems & task‐sequencing coaches

2000s

• Handheld compensatory  solutions

• Distributed‐cognition experiments

Functional Cognition

• Memory for names / faces, locales

• Task Sequencing

• Multi‐tasking

• Dealing with Distractions

• Remembering to do things (medications, appts)

Functional Cognition

• Adapting to transitions & changes in routines

• Dealing with frustration

• Impulsivity

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Low-Tech Cognitive Aids Low-Tech Cognitive Aids

Low-Tech Cognitive Aids Ways PDAs Work for Peoplewith Cognitive Impairment

• Planning and organization

• Task sequencing

Ways PDAs Work for Peoplewith Cognitive Impairment

• Way‐finding (GPS)

h l• Behavioral cueing

Ways PDAs Work for Peoplewith Cognitive Impairment

• Behavioral cueing

• Wireless 2‐way communicationcommunication and transfer of information

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Gilbertson at Work

• Wake‐up, medication, cooking and catch‐the‐bus reminder alarms

• Contact information

• To Do list for daily work tasks

• Pictorial directions to campus sites

• 50 participants

• Acquired Brain Injury or

DRS-CNI-VCU Project

• Autism Spectrum Disorder

• Can training in the use of a PDA improve functional performance in everyday tasks?

Recapping Noah’s Uses

• Reminder alarms linked to calendar

• Periodic vibrating alarm during tests

• IM with teachers (fellow students)

• Transfers homework to PDA from PC

Recapping Noah’s Uses

• Beams assignments to/from instructor

• Game playing teaches adaptive strategies

• Photo album as emotional aid

• Uses photos/memos to assist at grocery job

Qualitative Themes

• Gratitude: At last something helped me!

• Medication Management: I feel better!

• Organization: I can keep track of my day, regained control over my life.

• Self‐efficacy: Being able to do more makes me want to do more.

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Initial Lessons I Learned• You can’t throw these thingsat people and run

• You have to provide long‐term follow‐along

• People with some pc experience adopt PDAs faster

• The “nag factor” is huge

Qualitative Support

• “The most important thing ishaving someone understand what I was going through and then find a solution for it.”d a so ut o o t

• “Thank you so much for giving me back my memory, even if it is now located in a somewhat different place!”

Organization

BeforeBefore

AfterAfter

The Devices

• PDAs

• PDA watches• PDA watches

• Pill‐box reminders

• Low‐end laptops

• Cell phones

• Pagers

Handheld Computers

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Handheld Computers Palm PDAs

• Zire series

• Higher end T series and Life Drive with wi‐fi

• Treo/Centrino cellphones

• Alphasmart Dana laptop

Basic Palm Functions

• Calendar• Note Pad • To Do List

– All with reminder alarms• Address listAddress list• Memo• Backup to PC or Mac• Photo album• Audio playback/record• Wireless functions

MS Mobile/Pocket PC Devices

• Dell Axim series

• HP iPAQ series

• Many Smart cell phones

Key Pocket PC functions

• Same as Palm

• Media Player

• Native MS Office

• All have audio‐note function

• Nearly all add‐on disability software is written for Pocket PC

Timex Data Link Watch

• Type data on pc

• Wear on wrist

• Cheap ($US50 to 100)

• Small readout

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Camera & Video

• Name/Face Recognition• Where did I park?• Where did I park?• Directional Prompts• Behavioral Cues• Step-by-step therapy

routines• Photo Album

Stand‐alone GPS

• Pre‐loaded maps

• 2nd generation antenna sometimes works indoors

• Now map pedestrian routes

• Mp3 capable

Good Smart Phone Choices

• Apple iPhonepp

• Palm Treo 700p

• Palm Centro

Hearing Impaired

• RIM Blackberry

• Handspring Treo

• Other wireless paging devices

Vision‐Impaired

• Parrot Voice‐Mate OrganizerOrganizer 

• $350

• Voice recognition & voice output

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PEAT System

• Brainaid.com

• Simplified handheld software

D il ti it “ i t ”• Daily activity “scripts”

• Visual/audible cues

• Downloadable to Pocket PC

• Can change plans as needed

• Discovery Desktop

• Schedule Assistant

• Pocket Coach

• Visual Assistant

• Pocket Compass

• Task Builder

Service Provider’s Role

• Assess client needs, tasks & environment

• Learn the devicesLearn the devices

• Determine best device for client

• Train client & caregiver

Service Provider’s Role

• Include in daily organization routine

• Follow-up consultsFollow up consults

• Gradually diminish supports

Resources• www.vcu.edu/partnership/pda

– Consortium for Handheld Technology site, VCU

• www.biausa.orgb au a o g– Complete listing of electronic cognitive aids

• www.colemaninstitute.org– Coleman Institute for Cognitive Disabilities,

University of Colorado