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Cognitive Prosthetics: Practical Applications

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 Logentry@vcu.edu (804) 828-7049. Cognitive Disability.

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Cognitive Prosthetics: Practical Applications

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  1. 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 Logentry@vcu.edu (804) 828-7049

  2. Cognitive Disability • Acquired Brain Injury • Autism and Pervasive Developmental Disability • Mental Retardation • Degenerative Neurological Disease • Diabetes and other System Disorders • Mental Illness

  3. Prevalence • 20 million Americans (7%) are afflicted with cognitive disability • Yearly cost for support, care and lost productivity: $140 billion (2001)

  4. Early Cognitive Aids • Memory notebook • Day Planner • Sticky Notes • Wall signs • Environmental management

  5. Electronic Cognitive Prosthetics • Reminder Alarms • Schedules • Calendars • Lists/Memos • To Do Lists • Money management • Addresses/maps • Vocal prompts

  6. The Visions System • Visions for Independent Living, Inc. • Originally focused on MR population • Total task management at home

  7. ISAAC System • Cogent Systems, Inc. • Portable, wearable • Download schedule from pc

  8. ISAAC System • Large screen • Graphics based • Touch screen • Alarm reminders • Sequencing cues

  9. PEAT System • Brainaid.com • Simplified handheld software • Daily activity “scripts” • Visual/audible cues • Downloadable to Pocket PC • Can change plans when needed

  10. Pocket Coach • Ablelinktech.net • Pocket PC add-on • Sequenced verbal prompts • Easily programmable with graphics/audio

  11. Fonix VoiceAlert • Fonix.com • Pocket PC add-on • Alarm reminder • Auditory prompt reads calendar

  12. Consumer PDAs • Timex Data Link watch • Palm Zire models • Pocket PCs • Alphasmart Dana • Many others….

  13. Wireless systems • Portable • Programmable • Monthly user fee

  14. Audio Recorders • Digitally record reminder alarms • Tapes can playback at varying speeds • Good for note-taking • Generally easy to use • Various manufacturers

  15. Multi-function Cell Phones • Address Book • Reminder alarms • Emails • Paging system • To do list • Good ol’ telephone • GPS

  16. EADL/Smart Homes • Control appliances • Manage lighting • Distribute medicines • Automate bill-paying • Automate shopping • E-mail alerts to family • Vital statistics

  17. Therapist/Instructor’s Role • Learn the devices • Determine best prosthesis for student • Train student and caregiver • Include in daily organization routine • Follow-up consults • Gradually diminish supports

  18. Assessment Tools • Rivermead Behavioral Memory Test • Canadian Occupational Performance Measure (COPM) • Device checklist • Interview re: current task/time management strategies

  19. 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

  20. 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

  21. 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.

  22. 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

  23. 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?

  24. 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

  25. Functional Change - COPM Scoresn = 20

  26. “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) Comments

  27. 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

  28. 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

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