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 solut i 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 Treo 700p routes • Mp3 capable • Palm Centro Hearing Impaired Vision‐Impaired • RIM Blackberry • Parrot Voice‐Mate Organizer • Handspring 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 8.