Town Hall Meeting Tuesday May 11, 2004 1:00pm2:15pm EST Assistive Technology R

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Town Hall Meeting Tuesday May 11,
2004 100pm-215pm ESTAssistive
Technology RD Collaborative on Cognitive
Disabilities

• Sponsor National Institute on Disabilities and
  Rehabilitation Research (NIDRR)
• Project Number H133A030810

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To Obtain CEUs

• The University of Akron will provide a
  certificate for CEUs. This certificate will apply
  for boards such as PT, OT, ST, nursing,
  psychology, RESNA, teachers (for LEAs),
  rehabilitation counselors, etc.
• Send a self addressed 8x11 envelope to
• Roberta DePompei, Ph.D.
• School of Speech-Language Pathology
• Polsky 188K
• University of Akron
• Akron, OH 44325-3001

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Grant Overview

• Presented by
• Allan Bergman
• CEO Brain Injury Association of America

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Technology Related Assistance Act (PL100-407)

• Assistive Technology Device
• Any item, piece of equipment or product system,
  whether acquired commercially off the shelf,
  modified or customized that is used to increase,
  maintain or enhance FUNCTIONAL capabilities of
  individuals with disabilities.
• 
  1988

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Assistive Technology Definition Repeated in

• Developmental Disabilities Assistance and Bill of
  Rights Act
• Individuals with Disabilities Education Act,
  Parts B and C
• Rehabilitation Act

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Title XIX Grants to States for Medical
Assistance Programs42 U.S.C. Sec. 1396

• Section 1901
• (2) Rehabilitation and other services to help
  such families and individuals attain or retain
  capability for independence or self care
• 
  1965

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Early and Periodic Screening, Diagnosis and
Treatment

• This act requires that any service which you are
  permitted to cover under Medicaid that is
  necessary to treat or ameliorate a
  defect,physical and mental illness, or a
  condition identified by a screen, must be
  provided to EPSDT participants regardless of
  whether the service or item is otherwise included
  in your Medicaid plan.

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The New Disability Paradigm (3) disability is a
natural part of the human experience and in no
way diminishes the right of individuals to (A)
live independently (B) enjoy
self-determination (C) make choices (D)
contribute to society (E) pursue meaningful
careers and (F) enjoy full inclusion and
integration in the economic, political, social,
cultural, and educational mainstream of American
society.
Rehab Act, 1992
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Americans With Disabilities Act
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Goals of the A D A

• Equality of Opportunity
• Independent Living
• Economic Self Sufficiency
• Full Participation

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Assistive Technology for Individuals with
Cognitive Impairments

• The Last Frontier

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Request for Proposals 2001

• The National Institute of Disability and
  Rehabilitation Research within the US Department
  of Education published its first ever request for
  proposals for applications from organizations to
  establish research and development projects
  specifically for individuals with cognitive
  impairments

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NIDRR Funded 3 Projects for 5 years each

• The Collaborative includes the University of
  Akron, the Spaulding Rehabilitation Hospital, the
  Institute on Disabilities at Temple University
  and the Brain Injury Association of America
• The Beach Center at the University of Kansas
• The University of Oregon
• The Coleman Center, Denver, CO
• The Shepherd Center, Atlanta, GA

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Temple University

• Institute on Disabilities
• Temple University
• 423 Ritter Hall Annex, 1301 Cecil B Moore Avenue
• Philadelphia, PA 19122-6091

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The University of Akron

• The University of Akron
• Speech Language Pathology Department
• Polsky Bldg. Rm. 181
• Akron, Ohio 44325

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Spaulding Rehabilitation Hospital

• Spaulding Rehabilitation Hospital
• 125 Nashua Street
• Boston, MA 02114

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Overview of Phase I Results and Plans for Phase II

• Presented by
• Roberta DePompei, Ph.D
• Professor of Speech-Language Pathology
• University of Akron

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Phase I Results and Plans for Phase II

• Brain Injury Association of America, Inc.
• Moss Rehabilitation Research Institute
• Temple University, Institute on Disabilities
• University of Akron, School of Speech-Language
  Pathology and Audiology
• Spaulding Rehabilitation Hospital

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Purpose of Collaborative

• Phase 1 Identify current trends in the use of
  electronic organizers by people with cognitive
  disability
• Phase 2 Conduct usage trials of electronic
  organizers with persons with cognitive disability
  to add to the knowledge base related to
  successful applications of electronic organizers
• Phase 1 and 2 Provide consumers and other
  stakeholders with information on electronic
  organizers as they relate to cognitive disability

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Participants Addressed

• Adults with traumatic brain injury
• Adults with intellectual disabilities
• Children and adolescents with cognitive
  disabilities
• Traumatic brain injury
• Intellectual disabilities
• Related diagnoses

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What are Electronic Organizers?

• PDAs (Personal Digital Assistantse.g., Palms and
  Pocket PCs)
• Other handheld computers
• Wearable computers including wrist watches
• Portable voice organizers
• Pagers
• Cell Phones and Smart Phones

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Why study electronic organizers?

• At school Improved independence, follow
  schedule, stay on task, and move between tasks
  (Epstein et al 2001)
• At work Increased accuracy and performance in
  complex tasks, improved scheduling and time
  management, decreased use of external prompts,
  and easily integrated into work place (Davies et
  al 2002 Furniss et al 1999)
• At home Independent living skills including
  medication and oral hygiene (Kim et al., 1999)

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Surveys Phase I

• Demographic Background
• Current organizational strategies and
  satisfaction
• Perceived abilities related to tech use
• Technology currently used
• Relationship between perceived abilities and s
  of technologies used

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Sample Temple

• Adults with intellectual disabilities
• Capable of communicating answers to simple
  multiple choice questions
• Non-random convenience sampling to maximize
  diversity as related to ability level, type and
  level of support, race and ethnicity and gender
• N83

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Sample Akron

• Children with traumatic brain injury,
  intellectual disabilities, and related diagnoses
• Identified by teachers or other professionals as
  needing intervention in memory and organization
• 6-21 years of age, enrolled in a school program
• Non-random convenience sampling
• N53 youths, 106 parents and teachers of
  identified children, for total N159

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Sample Moss

• Adults with traumatic brain injury
• Recruited from outpatient residential programs
  and research registries
• At least 3 months post moderate to severe
  mechanical TBI no pre-existing conditions
  affecting cognitive status
• Survey structured interview administered in
  person, with visual aids
• N80

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Top Important / Very Important Features
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Current Strategies Contact Information
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Technologies Used
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Phase II Usage Trials Step 1Device Pilots

• Purpose
• To test the usability of the different devices
• To assess which functions, features, and
  operating systems are easiest to use
• To determine which devices people with
  disabilities prefer

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Device Pilots

• Piloted 13 devices
• 3 Pocket PCs
• 5 Palm OS devices
• 1 Smart phone
• 1 low-end organizer

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PDAs Used

• Palm OS devices Pocket PC devices
• Palm M130 Ipaq 3950
• Palm M500 Dell Axium
• Palm Tungsten Toshiba e330
• Sony Clie
• Alphasmart Dana

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Voice Organizers and Other Devices Used

• Parrot Sharp Wizard
• Voice Diary Nokia 9290
• Voice organizer

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Protocol

• Find a pre-entered phone number and dial the
  phone
• Respond to a pre-set alarm
• Enter a task into the calendar
• Provided minimal training 5-10 minutes
• Each test used Pocket PC, Palm and Voice
  organizer.

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Promoters Barriers

• Promoters
• Phone numbers
• Brightest screens
• On-screen keyboard
• Strong desire for technology
• Comfort with technology
• Organization and efficiency

• Barriers
• Drop down menus
• Alarms
• Have to hold in hand
• Calendar AM/PM, minutes difficulty
• Recoverability
• Graffiti
• Setting time
• Expensive

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Critical Features

• Brightest colors and screens
• Larger screens
• Appearance
• Simple to learn

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Phase II Usage TrialsStep 2 Device Trials

• Collaborative Partners
• Temple University
• Spaulding Rehabilitation Hospital
• The University of Akron
• The Brain Injury Association of America, Inc.

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Device Trials

• Usage trials in progress
• Children and adolescents population school
• Adult ID population work or residential
• Adults TBI population work or residential
• Participants were asked to
• Respond to an alarm
• Respond to an appointment

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Device Trials

• Usage Conditions
• (1) Baseline-No memory aid (2) Paper-based
  calendar
• (3) Dell Axium 3 Pocket PC (4) Palm
  Zire 71

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Device Trials

• Conditions 2, 3, and 4 are assigned at random
• Each of the 4 conditions last one week
• Goal is to identify features and functions that
  are promoters or barriers to successful usage,
  not to compare specific devices.

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Future Directions

• Distribute results of situational device trials
• Website accessibility tool development
• Tip cards for families on device acquisition
• Technology Transfer Conference for stakeholders
  on the State of the Science
• White Paper summary of Conference findings for
  distribution to developers and manufacturers

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Web Catalog

• http//www.biausa.org/Pages/AT/

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Experiences of Consumers with PDAsTemple
Consumers ExperiencesPresented by Debbie
Robinson
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Whats Working Well

• Can store information and not lose it.
• I dont like paper cause I lose it all the time.
• I use my Palm Pilot to store dates, appointments,
  work schedule, important addresses and telephone
  numbers. And I use the calculator too. I use it
  to add up how much the telephone, cable or cell
  phone bill is. I can add up my expenses.

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What are the challenges?

• I have trouble spelling and the battery runs out
  quickly. You have to charge it up all the time
  and it runs out of power if you dont remember.

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Recommendations

• People need training on how to use it. You cant
  just give it to a person and expect them to know
  how to use it. You also need technical support.
  If I didnt have someone to help me with a
  technical background, I wouldnt know where to
  go.
• Word Prediction to make it easier to put in
  information correctly. It should have a feature
  to magnify the screen too.

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Akron Consumer Familys experience with PDAs

• Thomas J. Prebis
• Highland High School

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Advantages of PDA

• Improves my organization
• Alarm reminder for
• class schedules
• upcoming events
• Appointments
• medications

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Advantages of PDA

• PDA can be connected HotSync to my computer
• transfer screen names for Instant Messenger
• transfer word documents i.e. home work
• download software programs to my PDA

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Disadvantages of PDA

• Difficult to enter information using the
  Graffiti writing format
• Most people are unaware of all the potential
  benefits of the PDA in our daily activities

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Ways of Improving the PDA

• Enlarge the Graffiti writing area and improve the
  handwriting recognition
• Encourage teachers use of PDA e.g. beam class
  assignments

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Family Perspective

• Presentation by
• James W. Prebis, M.D.
• Toms father

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Advantages of PDA

• Convenience
• fits in your shirt or pants pocket
• no need to carry day planner, to do list,
• homework assignments, calculator

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Advantages of PDA

• Unlimited software programs can be added
• Shopping lists, home organizers
• Street maps and directions
• Download and read e-books
• Connect to internet and e-mail

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Disadvantages of PDA

• An individuals physical limitations can restrict
  the use of the PDA
• it can be difficult to hold PDA in one
  hand and write with the other
• navigation buttons at bottom and side of PDA are
  small
• size of letters on the screen are small and they
  can be difficult to read

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Ways of Improving the PDA

• Design a more stable means of holding PDA
• Enlarge navigation buttons and letter size

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Prebis Family Speech-Language Pathologists
Perspective on PDA

• Presented by
• Linda Ginesi, M.A, CCC-SLP
• Toms Speech-Language Pathologist

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Academic Strengths

• Organization
• Tom to organize his day with a schedule on the
  palm
• Tom keeps important contact information.
• Study Skills
• Reminds Tom to study for school tasks and testing
• Allows Tom to jot notes throughout the day for
  upcoming papers.
• Orientation
• Tom uses the device to daily orient him to
  time/place

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Academic Weaknesses

• Distractions
• Tom is easily distracted by the Palm Pilot.
• Fine motor involved adds time to the task
• Redirection takes time away from the academic
• activity.
• Technology Failure
• Loss of information due to technology failure
• Inability to use during testing

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Improvements

• Appropriate Use
• Time limits for interaction with Palm Pilot.
• Pragmatic skills involved with use of device.
• Fine Motor Skills
• The device needs adaptive measures appropriate
  for Toms fine motor skills.

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Responses from other AT Centers

• Daniel Davies, M.A.
• Beach Center, Univ. of Kansas
• McKay Sohlberg, Ph.D.
• University of Oregon
• Mary Kay Rizzolo. M.A.
• Coleman Center
• Vicki Haberman, M.A.
• Shepherd Center

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Beach Center Response

• Presented by
• Daniel Davies, M.A.

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Beach Center

• Celebrating 30 Years of Excellence Partner in the
  RERC on Augmentative Communication funded by
  NIDRR http//www.aac-rerc.com
• Member of the Association of University Centers
  on Disabilities (AUCD) http//www.aucd.org
                                      
• The vision of the Institute on Disabilities is
  that there will be a society where all people of
  diverse cultures and abilities are included,
  recognizing that we all are interdependent and
  bring gifts and talents.

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Beach Center

• Primary Investigator
• Michael Wehmeyer, Ph.D.
• Associate Director of the Beach Center on
  Disability, University of Kansas
• 785-864-0723 (voice)
• 785-864-3458 (fax)
• wehmeyer_at_ku.edu

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University of Oregon Response

• Presented by
• McKay Moore Sohlberg, Ph.D.
• University of Oregon

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Think and Link E-mail for Individuals with
Cognitive Disabilities

• Project Sponsor NIDDR
• Project Emphasis To develop and evaluate a
  simple email system for individuals with severe
  cognitive impairment.

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Project Contact Information

• Principal Investigators
• McKay Moore Sohlberg, Ph.D.
• Bonnie Todis, Ph.D.
• Steve Fickas, Ph.D.
• Website www.think-and-link.org
• Contact Information
• McKay Moore Sohlberg, Ph.D mckay_at_oregon.uoregon.
  ecu
• Laurie Ehlhardt, Ph.D., CCC-SLP
  lehlhart_at_oregon.uoregon.edu

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Coleman Institute for Cognitive Disabilities
Response

• Presented by
• Mary Kay Rizzolo
• Research Assistant

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• The Institutes mission is to catalyze and
  integrate advances in science, engineering and
  technology to promote the quality of life and
  independent living of people with cognitive
  disabilities.

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David Braddock, Ph.D. Coleman-Turner Professor
of Psychiatry Executive Director Coleman
Institute for Cognitive Disabilities University
of Colorado System (SYS 586) 4001 Discovery
Drive, Suite 210 Boulder, CO 80309 www.cu.edu/Co
lemanInstitute
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Shepherd Center Response

• Presented by
• Viki Haberman
• Research Project Coordinator
• Shepherd Center

The Rehabilitation Engineering Research Center on
Mobile Wireless Technologies for Persons with
Disabilities is funded by the National Institute
on Disability and Rehabilitation Research of the
U.S. Department of Education under grant number
H133EO10804.
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Mobile Wireless Technology as Cognitive
Prosthetics Goals

• Establish a method for determining who would
  benefit from the use of a mobile wireless
  device(s) and what customizations are needed
• Establish interface guidelines for cognitive
  prostheses that can be applied to different
  aids/technology
• Contact Information
• Mike Jones, Ph.D. Vicki Haberman
• Shepherd Center Research Project Coordinator
• 2020 Peachtree Rd., NW [phone]
• Atlanta, GA 30309 vicki_habernam_at_shepherd.org
• [phone]
• mike_jones_at_shepherd.org

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Spaulding Rehabilitation Hospital Comments

• Murdo Dowds, Ph.D.
• Spaulding Rehabilitation Hospital
• 125 Nashua Street
• Boston, MA 02114

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Questions and Observations from
Participants(200pm - 215pm)
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To Obtain CEUs

• The University of Akron will provide a
  certificate for CEUs. This certificate will apply
  for boards such as PT, OT, ST, nursing,
  pyschology, RESNA, teachers (for LEAs),
  rehabilitation counselors, etc
• Send a self addressed 8x11 envelope to
• Roberta DePompei, Ph.D.
• School of Speech-Language Pathology
• Polsky 188K
• University of Akron
• Akron, OH 44325-3001

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Thank you for your participation

• For further information, contact Roberta
  DePompei, Ph.D., School of Speech-Language
  Pathology
• University of Akron
• Phone number [phone]
• E-mail address rdepom1_at_uakron.edu

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References

• Epstein, J.N., Willis, M.G., Connors, C.K.,
  Johnson, D.R. (2001). Use of technological
  devices to aid a student with attention deficit
  hyperactivity disorder to initiate and complete
  daily tasks An exploratory study. Journal of
  Special Education Technology, 16 (1), 19-28.
• Davies, D.K., Stock, S.R., Wehmeyer, M.L.
  (2002). Enhancing independent time-management
  skills of individuals with mental retardation
  using a palmtop personal computer. Mental
  Retardation, 40(5), 358-365.
• Furniss, F. Ward, A. (1999). A palmtop-based
  job aid for workers with severe intellectual
  disabilities. Technology and disability, 10,
  53-67.