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Cognitive Support Technologies:

What’s Now and What’s NextPresenter: Daniel K. DaviesAbleLink Technologies, Inc.

Living with a Cognitive Disability: How Technology Can Help

Introduction• Personal Background:

– Counselor/ Case Manager in ID/DD Adult Services Field– Human Factors Engineering for FAA’s next generation Air Traffic Controller Workstations– Master’s in Clinical/Applied Experimental Psychology, University of Colorado at Colorado Springs

• Began Research Specifically on Using Technology for Individuals with Intellectual Disabilities in 1991

• Founded AbleLink Technologies in 1997

• AbleLink’s Mission: Research, Development, and Delivery of Cognitive Technology addressing the Specific Needs of Individuals with Cognitive Disabilities

My Brother - John Roger Davies

Technology Use – Novelty to Necessity: No Longer Optional for Full Access to Society

Cognitive Technology: An Emerging Field• Many Assistive Technologies exist for mobility, sensory, and

communication disabilities • Augmentative Communication Device Industry Example

R & D of devices from 1960sCommercial Devices Introduced

- Efficacy studies conducted to demonstrate societal benefits - Outcome research effects funding legislation - Industry grows over four decades – now dozens of manufactures with over 250 communication devices and Apps

Field of Cognitive Technologies in its infancy - Industry is being established, but still only just over a decade old - Experimental studies of benefits of cognitive support technology exist, but scope is

limited - Very little evidence based research from longitudinal/ large sample size studies - Funding legislation has not been impacted - yet! - Increasing research focus from government and universities - Only a few companies focused on cognitive technology; more now with App world

Mobile Devices – The App RevolutionWide Range of Mostly “Single Purpose” AppsThe Good, the Bad, and the Ugly

Great Resources on Assistive Technologiesand Best Practices

Today’s Focus – Evidence Based Cognitive Technologies

Convergence of Events… Acceleration of Cognitive Technology

• Growing Research Focus on “Hidden” Cognitive Disabilities– no longer only accommodating what we see

• Increasing Cognitive Populations– vets with TBI, Prevalence of Autism Spectrum

Disorders• Rapidly Increasing Number of Seniors and

Need for New Aging Care Paradigms

The Rights of People with Cognitive Disabilities to Technology and Information Access

13th Annual Coleman Institute Conference - October 2, 2013

AbleLink’s Cognitive Technology Research & Development

• Small Business Innovation Research Funding – ED, ACL, NIH, DARPA

– 55+ Phase I Concept Validation Studies Completed– 15+ Phase II Development Projects Completed, 1 in progress (2 year projects)

• Collaboration with Universities and Other Disability Organizations– partnered on DRRP on Technology and Intellectual Disability (University of Kansas)– partnered with CU’s RERC on Advancing Cognitive Technologies (University of Colorado)– partnered with Westchester Institute for Human Development– Partnered with Council and Quality and Leadership (CQL-POST App)– partnered with CU and WIHD on two Joseph P. Kennedy, Jr. Foundation Technology

Projects

• Research Outcomes– 35+ peer-reviewed journal articles and book chapters on technology for persons with

cognitive disabilities– 25+ commercially available cognitive support technologies (accessible scheduling, email,

web-browsing, step-by-step task prompting as well as other products for independent living)

Putting Cognitive Technology into Context …

Basic Definition of Technology

the application of scientific advancesto benefit humanity

(The Franklin Institute - http://fi.edu.franklin.glossary.html)

Technology Paradox

Functionality

Usability“…the same technology that simplifies life by providing more functionality … also complicates life by making it hard to learn. This paradox of technology is often used by people as an excuse for poor design…”Donald A. Norman - The Design of Everyday Things, 1988 (pp. 30-31)

“…the same technology that simplifies life by providing more functionality …

also complicates life by making it hard to learn. This paradox of technology is often used by people as an excuse for poor

design…”

Donald A. Norman - The Design of Everyday Things, 1988 (pp. 30-31)

Functionality

Usability

Technology Paradox Functionality vs. Usability

Low Hi

Low

Hi

Technology Paradox

Functionality

Usability“…the same technology that simplifies life by providing more functionality … also complicates life by making it hard to learn. This paradox of technology is often used by people as an excuse for poor design…”Donald A. Norman - The Design of Everyday Things, 1988 (pp. 30-31)

Functionality

Usability

Early Mainstream Technologies

Core

Low Hi

Low

Hi

Example: Microwave Ovens

Example: Cell Phones

Problem: Many Barriers to Using Technology: Why?

Mainstream Technology Not Cognitively Accessible

Multitude of Emerging Technology PlatformsUser Interface is the Key (Software)

Solution: Cognitively Accessible TechnologiesNeeds-based, person centered interface design results

in two Types:

1) Everyday technologies that are cognitively accessible 2) Specialized technologies that augment cognitive ability

Picture Planner

Type 1: Cognitively Accessible Everyday Technologies

Needs-based, person centered design results in everyday technologies that are simpler to use

Purpose: access core functionality of a specific everyday technology

Technology Paradox

Functionality

Usability“…the same technology that simplifies life by providing more functionality … also complicates life by making it hard to learn. This paradox of technology is often used by people as an excuse for poor design…”Donald A. Norman - The Design of Everyday Things, 1988 (pp. 30-31)

Functionality

Usability

Accessible Everyday Technologies Functionality vs. Usability

e.g. cell phones, schedulers,

email, reading technologies, etc.

Core

Low Hi

Low

Hi

Example: Mainstream Scheduling Technologies, Too Often Reading is Required

SmartPhone/ Tablet-based reminder systems using picture and audio prompts to help individuals maintain personal schedules, e.g. catch the bus, manage work breaks, call home.

Visual/Audio Scheduling for Non-Readers

Interfaces Designed for Simplicity and Extensibility

Example: Media Players

Example: Video of Terri:

Increasingly Individuals with Cognitive Disabilities are Using Person-Centered Technologies to Live More Independently

“A Day in the Life” story of Rusty

https://www.youtube.com/watch?v=TuHLj2U0SMQ

Type 2: Cognitive Support Technologies (CST)

Specialized technologies to maximize functional outcomes (examples: activity scheduling and prompting technologies)

Purpose: cognitive ability + technology = improved task performance

Activity Scheduling

Activity Scheduling

Foundational Research on Visual Prompting Technologies

Picture Coach: Desktop prompting system for individuals with intellectual disabilities, providing step-by-step visual and verbal task prompting for individual or group living settings. Circa 1995.

Renamed Visual Impact in 1997Also includes video playback

Pocket Coach: Pre-PDA “PDA” for individuals with intellectual disabilities, providing step-by-step verbal task prompting.

Evolution of Mobile Cognitive Support Technologies

Cross-Platform, Cloud-supported Visual Task Prompting Technologies for Self-Direction, with Remote Notifications

Cloud-based Activity Support System for Self-Direction

Cloud-based Activity Support System for Self-Direction

Visual Impact – Step-by-step multimediatask instructions available in cloud-based Learning Library

Cloud-based Activity Support System for Self-Direction

Visual Impact – Step-by-step multimediatask instructions available in cloud-based Learning Library

Cloud-based Activity Support System for Self-Direction

Visual Impact – Step-by-step multimediatask instructions available in cloud-based Learning Library

Cloud-based Activity Support System for Self-Direction

Visual Impact – Step-by-step multimediatask instructions available in cloud-based Learning Library

Task Content Created with Wizard on Tablet/ Smartphone Using Visual Impact

Research-Based Self-Directed Learning Apps

Everyday Skills and Living SafelyiPad/Android Apps for Self-Directed Learning

Disability service agencies are alsointegrating Cognitive Support Technologies into their services

Research-Based Self-Directed Learning Apps

My Health, My Choice, My ResponsibilityiPad/Android Apps for Self-Directed Learning

Accessible Step-by-Step Task Instructions

http://rosesforautism.com/

http://rosesforautism.com

Cognitive Technologies Meet Needs Across Spectrum of Life

•“Having My Voice Heard”• Accessible Surveys for Promoting Self-Expression

•“Accessing My Community” • Personal GPS for Enabling Independent Bus Travel

•“Accessing My Everyday Technologies”• Communicating with email, accessing the web, playing music & movies

•“Knowing When and How to …”• Visual & Audio Task and Personal Scheduling Support

ATLAS: Cognitively Accessible Tests and SurveysSelf-directed, survey tools , such as consumer satisfaction surveys, using

multi-modal presentation and accessible design can increase independence and reduce staff time interviewing and entering/

aggregating data.

Cloud-based Data Collection and Reporting

ATLAS VantagePoint: Self-Directed Satisfaction Surveys

Accessible Self-Directed Satisfaction Surveys for DD Service Agencies (ATLAS VantagePoint)

Communicating Feedback Effectively Can Impact Future Quality of Life

Personal Outcome Screening Tool Results

WayFinder: An accessible SmartPhone program for providing multimedia prompts to individuals with cognitive disabilities for navigating public transit systems.

Cognitive Support Technologies for Community Access

Location Based Prompts and Visual and Audio Directions Help Individuals Take the Bus Independently

Laura and William’s Story

http://www.arcaopeningdoors.org/

Laura’s StoryA vehicle/pedestrian accident left Laura too scared to take the bus independently. After a few weeks of pedestrian safety training and re-acclimation to independent travel, she now takes the bus to/from work three times a week.

William’s Story

When he started a Day Hab program, William wanted to learn the bus system rather than rely on staff or paratransit. Thanks to SMART Travel, he knows how to get to/from work and is so excited that he shows up on his days off!

ARCA’s Smart Travel Program – “Wildly Successful”

“The STP program is wildly successful. We

trained two groups of ten individuals in the

first year of collaborations with our

governmental partners. The first group

increased their public rides by 110% and the

second group increased their rides by 84%.”http://www.arc-a.org/Services/smarttravelprogram.php

AbleLink’s You Tube Channel Example with Chad learning to ride the bus

https://youtu.be/iNYfFpzjqyU

More Success Stories

Barriers to Access Begin at the Operating System

Cognitively Accessible Windows or Macintosh Computing Environment

Simplified Access to Windows Computers

Desktops are Driven by Personal Interests and Needs

Accessibility Settings Applied to Each User via the Cloud

Same Visual Supports for Learning Introduced Earlier

Visual Media Player

Customizable Web Browser

Simplified Picture and Audio Email

Digital StoryTellerCognitively Accessible Tool for Creating Personal Stories with a Tablet

Matt’s Story ofSelf-Expression

Step-by-Step Story Building Program

Matt’s story included ocean creatures, giraffes, tigers and “the very awesome

birds” !

Accessible News and Picture Feeds

“She uses the Endeavor Desktop every day to practice relaxation exercises, and read her MPR newsfeed. This helps her cope”

Sarah

“It’s been a wonderful gift for her to manage a difficult and stressful situation without relapse into crisis. We are very grateful for this technology and the way it acts to support Sarah. It has improved her quality of life.”

Andy’s Audio Email Story

“Andy sometimes had a very hard time expressing himself and verbalizing his feelings. He began using audio email and his social skills began to blossom. At first He was hesitant to give it a try. For several weeks his mom would send him emails and he would listen to them, but wouldn’t respond. Eventually with help from staff he began emailing by deciding ahead of time what he wanted to say in his email. Once he got over the hump of sending the first couple of messages, he began sending emails completely independently.

Because of his difficulties expressing himself verbally, Andy had not said ‘I love you’ to his mom in years. One day, he was sending emails in the dining room. The staff person nearby in the kitchen overheard him signing off from his email by saying, “I love you, mom.” Within 24 hours, his mom called the staff in tears to express just how much that meant to her. She continued to tell how Andy’s communication skills had improved over the short time since he had begun emailing with her.”

I Love You Mom!

Social Technologies Offer Powerful Opportunities to Connect

Exploratory Research: Cognitively Accessible Interface to Facebook

Communication Coexisting with Computer Access

Endeavor Talker: Communication System

Engagement and Enjoyment Go Hand in Hand

Imagine! Colorado

TM

Bob and Judy Charles SmartHome, Boulder, CO

Charles Family SmartHome, Longmont, CO

Staff-centered Remote Monitoring

Traditional remote monitoring allows organizations or third party organizations to “watch over” residents with cameras and physical sensors. This can be a cost-effective way to reduce staff hours needed to monitor individuals vs. onsite staffing.

Example Remote Monitoring Organizations

From Today to Tomorrow . . .

What’s Needed for Moving Forward• Recognition of the Rights of Individuals with Cognitive Disabilities to Technology and Information Access

• Continued R & D Funding for Development and Longitudinal Testing of New Cognitive Technologies

• Overcoming Existing Funding Obstacles to Providing Cognitive Technologies to the Individuals that Need Them

• Greater Education and Awareness Regarding the Impact Cognitive Technologies have on Enhancing Quality of Life

•

Contact Info: AbleLink Technologies, Inc. Dan Davies 618 N. Nevada Avenue dan@ablelinktech.com

Colorado Springs, CO 80903 719-592-0347 ext 110 www.ablelinktech.com www.aimsxml.com

Changing Lives with Cognitive Support Technologies

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“Assistive and Instructional Technology Supporting Learners with Disabilities”