Tony Gentry, PhD, OTR/L Assist Prof, Dept. of OT Assistive Technology for Cognition: Dir., AT for Cognition Lab Practical Applications in the World of Work VCU, Richmond, VA VCU ‐ RRTC [email protected] (804) 828‐2219

Assistive Technology for Cognition Laboratory Prevalence • Research • 20 million Americans (7%) are afflicted with cognitive • Development disability • Service • Yearly cost for support, care and • Training lost productivity: $140 billion (2001) • VCU Dept. of OT

Cognitive Rehabilitation 1980s Emerged and developed • Dawn of Cognitive alongside personal Rehabilitation computing • PlPersonal Remedial vs. computers Compensatory Approaches

1 Remedial Approaches 1990s • Brain‐Train products • Calls for ecologically valid research

• Nintendo’s “Brain Age” game for DS

• “Memory Works” simulation and training games

1990s 2000s

• Handheld compensatory • DktDesktop solutions computers as reminder systems & task‐sequencing • Distributed‐cognition coaches experiments

Functional Cognition Functional Cognition • Memory for names / faces, locales • Adapting to transitions & • Task Sequencing changes in routines

• Multi‐tasking • Dealing with frustration

• Dealing with Distractions • Impulsivity

• Remembering to do things (medications, appts)

2 Low-Tech Cognitive Aids Low-Tech Cognitive Aids

Low-Tech Cognitive Aids Ways PDAs Work for People with Cognitive Impairment

• Planning and organization

• Task sequencing

Ways PDAs Work for People Ways PDAs Work for People with Cognitive Impairment with Cognitive Impairment • Behavioral cueing • Way‐finding (GPS) • Wireless 2‐way • Behlhavioral cueing communication and transfer of information

3 Gilbertson at Work DRS-CNI-VCU Project

• Wake‐up, medication, cooking and • 50 participants catch‐the‐bus reminder alarms • Acquired Brain Injury or • Contact information

• Autism Spectrum Disorder • To Do list for daily work tasks • Can training in the use of a PDA improve • Pictorial directions to functional performance in everyday tasks? campus sites

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 Qualitative Themes • Beams assignments to/from • Gratitude: At last something instructor helped me!

• Game playing teaches adaptive strategies • Medication Management: I feel better!

• Photo album as emotional aid • Organization: I can keep track of my day, regained control over my life.

• Uses photos/memos to assist at grocery job • Self‐efficacy: Being able to do more makes me want to do more.

4 Initial Lessons I Learned • You can’t throw these things at 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 Organization

• “The most important thing is having someone understand what I was going through and then find a sol uti on for it.”

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

After

The Devices Handheld Computers

• PDAs • PDA watches • Pill‐box reminders • Low‐end laptops • Cell phones • Pagers

5 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 MS Mobile/Pocket PC Devices • Calendar • Note Pad • To Do List – All with reminder alarms • Dell Axim series • Address list • Memo • HP iPAQ series • Backup to PC or Mac • Photo album • Audio playback/record • Many Smart cell • Wireless functions phones

Key Pocket PC functions Timex Data Link Watch

• Same as Palm • Type data on pc

• Media Player • Wear on wrist • Native MS Office • Cheap ($US50 to 100) • All have audio‐note function • Small readout • Nearly all add‐on disability software is written for Pocket PC

6 Camera & Video

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

Stand‐alone GPS Good Smart Phone Choices • Pre‐loaded maps

• 2nd generation antenna sometimes works indoors • Apple iPhone

• Now map pedestrian • Palm routes

• Mp3 capable • Palm Centro

Hearing Impaired Vision‐Impaired

• RIM Blackberry • Parrot Voice‐Mate Organizer • Treo • $350

• Other wireless • Voice recognition & paging devices voice output

7 PEAT System

• Brainaid.com

• Simplified handheld software • Discovery Desktop • Schedule Assistant • DilDaily acti tiit“vity “scri it”pts” • Pocket Coach • Visual/audible cues • Visual Assistant • Downloadable to Pocket PC • Pocket Compass

• Can change plans as needed • Task Builder

Service Provider’s Role Service Provider’s Role

• Assess client needs, tasks & • Include in daily organization environment routine

• Learn the devices • Follow-up consults

• Determine best device for client • Gradually diminish supports

• Train client & caregiver

Resources

• www.vcu.edu/partnership/pda – Consortium for Handheld Technology site, VCU

• www.bbauaogiausa.org – Complete listing of electronic cognitive aids

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

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