Transcript PowerPoint Presentation - Cognitive Prosthetics: Practical

Cognitive Prosthetics:
Practical Applications
Tony Gentry, M.A. OTR/L
Project Director
Consortium for Handheld Technology
Partnership for People with Disabilities
Virginia Commonwealth University
Richmond, Virginia
[email protected]
(804) 828-7049
Cognitive Disability
 Acquired Brain Injury
 Autism and Pervasive Developmental
Disability
 Mental Retardation
 Degenerative Neurological Disease
 Diabetes and other System Disorders
 Mental Illness
Prevalence
 20 million Americans (7%) are afflicted
with cognitive disability
 Yearly cost for support, care and lost
productivity: $140 billion (2001)
Early Cognitive Aids
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Memory notebook
Day Planner
Sticky Notes
Wall signs
Environmental
management
Electronic Cognitive Prosthetics
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Reminder Alarms
Schedules
Calendars
Lists/Memos
To Do Lists
Money management
Addresses/maps
Vocal prompts
The Visions System
 Visions for
Independent Living,
Inc.
 Originally focused on
MR population
 Total task
management at home
ISAAC System
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Cogent Systems, Inc.
Portable, wearable
Download schedule from pc
ISAAC System
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Large screen
Graphics based
Touch screen
Alarm reminders
Sequencing cues
PEAT System
 Brainaid.com
 Simplified handheld
software
 Daily activity “scripts”
 Visual/audible cues
 Downloadable to Pocket
PC
 Can change plans when
needed
Pocket Coach
 Ablelinktech.net
 Pocket PC add-on
 Sequenced verbal
prompts
 Easily programmable
with graphics/audio
Fonix VoiceAlert
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Fonix.com
Pocket PC add-on
Alarm reminder
Auditory prompt
reads calendar
Consumer PDAs
 Timex Data Link
watch
 Palm Zire models
 Pocket PCs
 Alphasmart Dana
 Many others….
Wireless systems
 Portable
 Programmable
 Monthly user fee
Audio Recorders
 Digitally record
reminder alarms
 Tapes can playback at
varying speeds
 Good for note-taking
 Generally easy to use
 Various manufacturers
Multi-function Cell Phones
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Address Book
Reminder alarms
Emails
Paging system
To do list
Good ol’ telephone
GPS
EADL/Smart Homes
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Control appliances
Manage lighting
Distribute medicines
Automate bill-paying
Automate shopping
E-mail alerts to family
Vital statistics
Therapist/Instructor’s Role
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Learn the devices
Determine best prosthesis
for student
Train student and
caregiver
Include in daily
organization routine
Follow-up consults
Gradually diminish
supports
Assessment Tools
 Rivermead Behavioral Memory Test
 Canadian Occupational Performance
Measure (COPM)
 Device checklist
 Interview re: current task/time
management strategies
It’s A.T., After All…
 Does person have potential to use a device?
 Functional vision
 Hearing
 Dexterity
 Ability to respond to a prompt and perform
prompted task
 Frustration tolerance
 Awareness of need/Interest in using device
Training
 Introduce a good basic device
 Download software to person’s pc
 Introduce reminder alarm function for daily
schedule
 Train family caregiver to trouble-shoot
 Help person record 4-5 reminders each
day for first week
Support/Follow-Along
 On subsequent visits, reinforce reminder
alarm function
 Work through problems
 Introduce other features, as appropriate
 Memo pad
 Address book
 To do list, etc.
Fading Supports
 Is this the right device for this
person?
 Gradually hand-off trouble-shooting
to person and caregiver
 Consider EADL/smart home ideas
 Be aware that new abilities lead to
new opportunities
 Collaborate on new ideas
Post-Assessment
 Re-test COPM and RBMT
 How has A.T. reduced need for
supervision?
 What new goals might be pursued?
 What other technology may help?
 If it didn’t work, why didn’t it?
CNI-Partnership Project
Age 14 or over
Documented ABI or autism spectrum disorder
Measurable impairment in ADL performance
Functional vision and dexterity
Ability to follow one-step written or iconic
commands
 Caregiver available
 Live in Virginia
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Functional Change - COPM
Scores
n = 20
7
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Value
2
Pretest
1
Posttest
1
Performance
2
Satisfaction
Comments
“I am absolutely amazed at how that [Timex Data Link] watch is
working. It is incredible! The second it goes off, D___ jumps up and
completes his task. I am so excited about the possibilities for his
independence and responsibility level.”
(mother of 14 year old boy with autism)
“Before I got this PDA, I wouldn’t even remember to eat half the time.
Now I‘ve got alarms for my medicines and appointments, my emails,
my shopping list, even directions to places in town. It makes me feel
like maybe I can start doing things again.”
(35 year old with TBI)
Resources
 www.vcu.edu/partnership/pda
 Consortium for Handheld Technology site
 www.cerebreon.com
 How to use cognitive prosthetics website
 www.biausa.org
 Complete listing of electronic cognitive aids
Consortium for Handheld Technology
 Partnership for People with Disabilities
 Virginia Commonwealth University
 Funded by a grant from the Commonwealth
Neurotrauma Initiative Fund in Virginia
 Principal Investigator: Joseph Wallace, PhD
 Project Director: Tony Gentry, M.A. OTR/L