Title: PDAs as Cognitive Aids for High School Students with Autism: Study Results and Implications
1PDAs 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
2Consortium 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.
3Assistive Technology for Cognition LaboratoryVCU
- Research
- Development
- Service
4Current 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
5Autism 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
6Low-Tech Cognitive Aids
7Ways PDAs Work for People with Cognitive
Impairment
- Planning and organization
- Task sequencing
- Way-finding (GPS)
- Behavioral cueing
- Wireless transfer of homework and other
information
8Studies on PDA and Autism
- Single subject studies have shown improvements in
on-task behaviors for several adolescents with
Aspergers Syndrome
9CNI-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?
10Training
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
11Palm Zire 31
- Color-screen PDA
- Calendar
- Reminder Alarms
- Note Pad (e-sticky note)
- Contacts
- Tasks (to do list)
12Assessment 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)
13Typical 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
14Training 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
15Functional ChangeCOPM Mean Scores n 46
Autism Group N 22
TBI Group N 24
16COPM Satisfaction Scores
17CHART scores
18The Cannons - One Year Trial with PDA
19Recapping 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
20FATCAT 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.
21Comments
- 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)
22Initial 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
23Implications - 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.
24The Devices
- PDAs
- PDA watches
- Pill-box reminders
- Low-end laptops
- Cell phones
- Pagers
25Improved GPS
- Pre-loaded maps
- 2nd generation antenna sometimes works indoors
- Now map pedestrian routes
- Mp3 capable
26Good Smart Phone Choices
- Apple iPhone
- Palm Treo 700p
- Palm Centro
27Hearing Impaired
- RIM Blackberry
- Handspring Treo
- Other wireless paging devices
28- Discovery Desktop
- Schedule Assistant
- Pocket Coach
- Visual Assistant
- Pocket Compass
- Task Builder
29Service 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
30Like 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
31Set-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
32Support/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.
33Fading 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
34Post-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?
35EADL/Smart Homes
- Organize environment
- Control appliances
- Task Reminders on pc
- Distribute medicines
- Automate bill-paying
- Automate shopping
- E-mail alerts to family
36Safety
- Stovetop monitor
- Tub overflow monitor
- Automatic coffeepot
- Lighting linked to movement sensors
- Window escape systems
- Med-alert medallion
- Automated bill-paying
37Appliance Controls
X-10 is old standby Insteon is both wireless and
wired
38Funding AT
- IEP
- State Vocational Rehab Programs
- Armed Services - Veterans Admin.
- Medicare
- Private Payers
- Loan Programs
39The 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
40Autominder Nurse-Bot
- Mobile robot with interactive sensors to monitor
activities - Computer adjusts schedule
- Prompts are stated
- Multi-university study
41Clever Cognitive Levers Project
- Memory Aiding Prompting System (MAPS)
- University of Colorado
- Coleman Institute
42Resources
- www.vcu.edu/partnership/pda
- Consortium for Handheld Technology site
- www.biausa.org
- Complete listing of electronic cognitive aids