Assistive Technology and Mental HealthMay 12, 2009
M.A., M.Sc. (O.T.—Post-Professional), Doctoral Candidate
Occupational TherapistProprietor, Compass Occupational Therapist Solutions,
Kingston, ON
Heidi Cramm
Heidi Cramm, May 12 2009
Objectives
To discuss the significance of mental health issues for students
To become familiar with executive functioning skill deficits and how they relate to mental health disorders
To describe assistive technology features and applications that may benefit students who have mental health disorders and experience executive dysfunction
Heidi Cramm, May 12 2009
Students and Mental Health
1 in 5 children and adolescents in Canada are affected by mental health issues.
80% NEVER get help Seventy per cent of adults living with a
mental health problem developed symptoms before they were 18.
(http://www.thespec.com/article/559061)
Heidi Cramm, May 12 2009
Students and Mental Health By the time many students enter post-
secondary institutions, their mental health status has already been affected Major life changes such as leaving home or
beginning post-secondary studies can place these students at further risk
Heidi Cramm, May 12 2009
Executive Functions
Capacities related to successful engagement in productive, independent, and constructive behaviours
Relate to: Planning tasks Initiating activity Self-monitoring of task performance Self-correcting of behaviour Anticipating outcomes Levels of motivation
Heidi Cramm, May 12 2009
Executive Functions are distinct from Cognitive Functions
How do you do something?
How do you do things?
PROCESS
How much do you know?
What can you do?
KNOWLEDGE
Executive Functions Cognitive Functions
Heidi Cramm, May 12 2009
…knowing what you need, how long it will take, how to start, how to keep going, how to know when you are finished, where you need to be, etc.
The executive assistant to your brain
EXECUTIVE FUNCTIONS
Heidi Cramm, May 12 2009
Executive Dysfunctions
Manifested in difficulties in Initiation
Identifying needs and wants Planning
Identifying the components of the task Sequencing the steps in an organized way
Purposive action Translating intentions into actions Requires maintaining efforts and switching between
steps Monitoring effectiveness of performance
Being able to monitor and adjust one’s performance
Heidi Cramm, May 12 2009
Executive Dysfunction Simulations Writing Reading
Heidi Cramm, May 12 2009
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Heidi Cramm, May 12 2009
Executive Dysfunction Simulations Attention:
http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp1a.html
Memory: http://www.pbs.org/wgbh/misunderstoodmi
nds/experiences/readexp2a.html
Heidi Cramm, May 12 2009
Relating Executive Functions to Mental Health
Heidi Cramm, May 12 2009
Learning Disability
Processing information can take longer, so individuals may persist at tasks and miss other information Individuals may also avoid tasks due to the
effort and energy required The mechanics of reading, writing,
spelling, and memorizing can hog cognitive resources, making it difficult to sequence and plan larger tasks
Heidi Cramm, May 12 2009
Attention Deficit Disorders
Inattention is a common difficulty Impulsivity associated with difficulties
with self-monitoring and self-regulation is common
Distractibility also occurs, and individuals may shift attention to novel stimuli as they are introduced
Heidi Cramm, May 12 2009
Comorbidity with LDs and ADHD LD and AHDH often comorbid May be comorbid with
Anxiety Mood Behavioural disorders
Heidi Cramm, May 12 2009
Bottom line:
If you are working with students with LD and/or ADHD, be prepared to see anxiety or mood issues
Heidi Cramm, May 12 2009
Anxiety Disorders
Difficulties with Maintaining concentration
Recurrent and persistent thoughts, images, and behaviours that create an experience of distress
Trying to control the worry Keeping oneself regulated in emotion,
thinking, and behaviour
Heidi Cramm, May 12 2009
Mood Disorders
Mood disorders can have powerful impacts on initiation of goal-directed behaviours
Sequencing tasks places a heavy demand on executive functions to prioritize, organize, and anticipate, posing a challenge for those with mood disorders
Heidi Cramm, May 12 2009
Asperger’s Syndrome
Shifting between tasks is difficult Can become “stuck” cognitively in rigid thought
patterns Shifting perspectives to see big picture and how
details are connected is extremely difficult “connecting the dots” problematic
Initiation of goal-directed behaviour may be difficult as identification of needs and wants may prove challenging
Decoding single constructs into an organized sequence is very difficult
Heidi Cramm, May 12 2009
Psychotic Disorders
Intrusive thoughts and sensations can impair an individual’s ability to maintain concentration
Vigilance required to maintain focus and actively disregard those intrusions is very energy demanding
Heidi Cramm, May 12 2009
Other factors
Pain Fatigue Medication effects
Heidi Cramm, May 12 2009
How can assistive technology help?
Heidi Cramm, May 12 2009
How?
Mechanical burden mitigated Expectation that student read, write, and memorize
to learn realized through the use of AT Lack of automatization accommodated for Discrete chunks of information more accessible in
clear sequence See how the pieces of information are linked, can
alternate between big picture and little picture Inefficiencies shored up through study skill tools Organizational supports provided Difficulty in switching between tasks supported
Heidi Cramm, May 12 2009
Kurzweil 3000
Reading features supports attention Study skill features can allow for effective and
efficient note taking Highlight and extract Extract to column notes Extract column notes to outline
Writing features allow for integration of reading and writing into one task
Supports for Commonly confused words Revision learning strategies Word lists
Heidi Cramm, May 12 2009
Dragon 10
Significantly improved from earlier versions
Those with experience using Dragon dictation software from 3 or 4 years ago or longer will not recognize the program as it currently works
Dictation that works well can be an incredible to support to individuals who can lose their train of thought or who would benefit from the efficiencies it offers doing written work
Integrates with the other AT for synergistic results
Heidi Cramm, May 12 2009
Inspiration
An incredible process support Visually allows individuals to
See the sequence Prioritize and sort the information Monitor their performance
Comprehension checking Connect big picture and details without losing
the thread Hyperlink series of documents
Heidi Cramm, May 12 2009
Microsoft OneNote
Acts like an electronic binder Customizable to suit need Automatically saves Offers a visible index of the material so it
can be found quickly
Heidi Cramm, May 12 2009
Email contact information
Please feel free to contact me at: [email protected]@queensu.ca
Heidi Cramm, May 12 2009
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