PDAs as Cognitive Aids for High School Students with Autism: Study Results and Implications - PowerPoint PPT Presentation

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PDAs as Cognitive Aids for High School Students with Autism: Study Results and Implications

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Title: PDAs as Cognitive Aids for High School Students with Autism: Study Results and Implications


1
PDAs as Cognitive Aids for High School Students
with Autism Study Results and Implications
  • Tony Gentry, Ph.D. OTR/L
  • Assistant Professor
  • Department of Occupational Therapy
  • Virginia Commonwealth University
  • Logentry_at_vcu.edu
  • Joey Wallace, PhD
  • Director
  • The NeWell Fund
  • Richmond, VA
  • Joey.wallace_at_atlfa.org

2
Consortium for Handheld Technology Partnership
for People with Disabilities, VCU
  • Bridge emerging technologies to the cognitive
    disability community to improve functional
    independence and quality of life.

3
Assistive Technology for Cognition LaboratoryVCU
  • Research
  • Development
  • Service

4
Current Projects
  • PDAs as Cognitive Aids for
  • Brain Injury
  • Autism
  • Multiple Sclerosis
  • PDA-Enabled Job Coaching for Autism
  • Super School computer game
  • Online courses
  • PDA-Enabled Job Coaching
  • Assistive Technology for Cognition
  • Behavior Management Software for PDA
  • Safe-Smart Home demo, VA DRS

5
Autism characteristics
  • Social skills and communication impairment
  • Sensory-perceptual irregularities
  • Unusual self-regulating behaviors
  • Rigid adherence to routine
  • Narrow areas of focused interest
  • Every person with autism is a universe of one

6
Low-Tech Cognitive Aids
7
Ways PDAs Work for People with Cognitive
Impairment
  • Planning and organization
  • Task sequencing
  • Way-finding (GPS)
  • Behavioral cueing
  • Wireless transfer of homework and other
    information

8
Studies on PDA and Autism
  • Single subject studies have shown improvements in
    on-task behaviors for several adolescents with
    Aspergers Syndrome

9
CNI-Partnership Project
  • 50 participants
  • Acquired Brain Injury or
  • Autism Spectrum Disorder
  • Can training in the use of a pda improve
    functional performance in everyday tasks?

10
Training
Pre-Test, Provide PDA, load Palm Desktop,
Introduction to Data Entry and Calendar
Week 1
  • Contacts, Note Pad,
  • Tasks, Memos

Trouble-shooting Auxiliary Programs
Trouble-shooting Post-test
Weeks 2 and 3
11
Palm Zire 31
  • Color-screen PDA
  • Calendar
  • Reminder Alarms
  • Note Pad (e-sticky note)
  • Contacts
  • Tasks (to do list)

12
Assessment Tools
  • ASD Diagnosis and IEP
  • Canadian Occupational Performance Measure (COPM)
  • Craig Handicap Assessment and Rating Technique -
    Revised (CHART-R)
  • Functional Assessment Tool for Cognitive
    Assistive Technology (FATCAT)

13
Typical cognitive problems
  • Memory for names/faces, locales
  • Task Sequencing
  • Multi-tasking
  • Dealing with Distractions
  • Remembering to do things (medications,
    appointments)
  • Adapting to transitions and changes in routines
  • Dealing with frustration

14
Training Method
  • Theory
  • Diffusion of Innovations
  • Instructional Design
  • Cognitive Rehabilitation
  • Build on Prior Familiarity
  • Repetition and Reinforcement
  • Multi-modal training tools
  • Focus on Real World Needs
  • Formative and Summative Assessment
  • Collaboration and Facilitation

15
Functional ChangeCOPM Mean Scores n 46
Autism Group N 22
TBI Group N 24
16
COPM Satisfaction Scores
17
CHART scores
18
The Cannons - One Year Trial with PDA
19
Recapping Noahs Uses
  • Reminder alarms linked to calendar
  • Periodic vibrating alarm during tests
  • IM with teachers
  • Transfers homework to PDA from PC
  • Beams assignments to/from instructor
  • Game playing teaches adaptive strategies
  • Photo album as emotional aid

20
FATCAT Themes
  • Gratitude At last something helped me!
  • Medication Management I feel better!
  • Organization I can keep track of my day,
    gaining control over my life.
  • Self-efficacy Being able to do more makes me
    want to do more.

21
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 wouldnt even remember
    to eat half the time. Now Ive got alarms for my
    medicines and appointments, my passwords, my
    homework, even directions to places in town. It
    makes me feel like maybe I can do things on my
    own at last.
  • (16 year old with Aspergers Syndrome)

22
Initial Lessons I Learned
  • You cant throw these things at people and run
  • You have to provide long-term follow-along
  • Students with autism may sometimes prefer
    computer interactions to human nagging

23
Implications - Clinical
  • A brief training intervention with PDAs works
  • Affordable, readily available device
  • No social stigma for user
  • Improves functional performance and self-efficacy
  • Not a one-size-fits all therapy
  • As computers evolve, their uses will too. Make
    them a part of your treatment arsenal.

24
The Devices
  • PDAs
  • PDA watches
  • Pill-box reminders
  • Low-end laptops
  • Cell phones
  • Pagers

25
Improved GPS
  • Pre-loaded maps
  • 2nd generation antenna sometimes works indoors
  • Now map pedestrian routes
  • Mp3 capable

26
Good Smart Phone Choices
  • Apple iPhone
  • Palm Treo 700p
  • Palm Centro

27
Hearing Impaired
  • RIM Blackberry
  • Handspring Treo
  • Other wireless paging devices

28
  • Discovery Desktop
  • Schedule Assistant
  • Pocket Coach
  • Visual Assistant
  • Pocket Compass
  • Task Builder

29
Service Providers Role
  • Assess client needs, tasks and environment
  • Learn the devices
  • Determine best device for client
  • Train client and caregiver
  • Include in daily organization routine
  • Follow-up consults
  • Gradually diminish supports

30
Like any other A.T., consider
  • Does client 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

31
Set-up Training
  • Introduce a good basic device
  • Download software to persons 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

32
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.

33
Fading Supports
  • Is this the right device for this person?
  • Gradually hand-off trouble-shooting to person and
    caregiver
  • Consider disability-specific software
  • Consider EADL/smart home ideas
  • How can the device be leveraged for increased
    independence at school or on the job?
  • Be aware that new abilities lead to new
    opportunities
  • Collaborate on new ideas

34
Post-Assessment
  • How has A.T. reduced need for supervision?
  • What new goals might be pursued?
  • What other technology may help?
  • If it didnt work, why didnt it?

35
EADL/Smart Homes
  • Organize environment
  • Control appliances
  • Task Reminders on pc
  • Distribute medicines
  • Automate bill-paying
  • Automate shopping
  • E-mail alerts to family

36
Safety
  • Stovetop monitor
  • Tub overflow monitor
  • Automatic coffeepot
  • Lighting linked to movement sensors
  • Window escape systems
  • Med-alert medallion
  • Automated bill-paying

37
Appliance Controls
X-10 is old standby Insteon is both wireless and
wired
38
Funding AT
  • IEP
  • State Vocational Rehab Programs
  • Armed Services - Veterans Admin.
  • Medicare
  • Private Payers
  • Loan Programs

39
The Near Future
  • GPS-enabled way-finding for the blind
  • Distributed cognition services for workers linked
    to employers
  • Robot-nurses and robot-attendants
  • Brain implant cognitive aids

40
Autominder Nurse-Bot
  • Mobile robot with interactive sensors to monitor
    activities
  • Computer adjusts schedule
  • Prompts are stated
  • Multi-university study

41
Clever Cognitive Levers Project
  • Memory Aiding Prompting System (MAPS)
  • University of Colorado
  • Coleman Institute

42
Resources
  • www.vcu.edu/partnership/pda
  • Consortium for Handheld Technology site
  • www.biausa.org
  • Complete listing of electronic cognitive aids
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