Cognitive Support
Technologies:
What’s Now and What’s Next
Presenter: Daniel K. Davies
AbleLink Technologies, Inc.
www.CTDInstitute.org
Living with a Cognitive Disability:
How Technology Can Help
Introduction
• Personal Background:
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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
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Many Assistive Technologies exist for mobility, sensory, and
communication disabilities
Augmentative Communication Device Industry Example
R & D of devices from 1960s
Commercial 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 Revolution
Wide Range of Mostly “Single Purpose” Apps
The Good, the Bad, and the Ugly
Great Resources on Assistive Technologies
and 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
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Small Business Innovation Research Funding – ED, ACL, NIH, DARPA
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Collaboration with Universities and Other Disability Organizations
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55+ Phase I Concept Validation Studies Completed
15+ Phase II Development Projects Completed, 1 in progress (2 year projects)
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
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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 advances
to benefit humanity
(The Franklin Institute - http://fi.edu.franklin.glossary.html)
Technology Paradox
Functionality vs. Usability
Technology Paradox
Functionali
ty
F
u
n Hi
c
t
i
o
n
a
li
t Low
y
Low
Usability
Hi
Usability
“…the same technology
that simplifies life by providing more
“…the same technology that simplifies life by providing more functionality …
functionality …
also complicates life by making it hard to learn.
also complicates life by making it hard to learn.
This paradox of technology is often used by people as an excuse for poor
This paradox of technology is often used by people as an excuse for poor
design…”
design…”
Donald A. Norman - The Design of Everyday Things, 1988 (pp. 30-31)
Early Mainstream Technologies
Technology Paradox
Functionali
ty
F
u Hi
n
c
t
i
Cor
o
e
n
a
li
t
y Low
Usability
Usability
Low that simplifies
Hi more functionality …
“…the same technology
life by providing
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)
Example: Microwave Ovens
Example: Cell Phones
Problem: Many Barriers to Using Technology:
Why?
Mainstream Technology Not Cognitively Accessible
Multitude of Emerging Technology Platforms
User Interface is the Key (Software)
Solution: Cognitively Accessible Technologies
Needs-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
Accessible Everyday Technologies
Functionality vs. Usability
Technology Paradox
Functionali
ty
F
u Hi
n
c
t
i
Cor
o
e
n
a
li
t
y Low
e.g. cell phones,
schedulers,
email, reading technologies,
etc.
Usability
Usability
Low that simplifies
Hi more functionality …
“…the same technology
life by providing
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)
Example: Mainstream Scheduling Technologies,
Too Often Reading is Required
Visual/Audio Scheduling for Non-Readers
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.
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 1997
Also includes video playback
Evolution of Mobile Cognitive Support Technologies
Pocket Coach: Pre-PDA “PDA” for individuals with
intellectual disabilities, providing step-by-step verbal task
prompting.
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 multimedia
task instructions available in cloud-based Learning Library
Cloud-based Activity Support System for Self-Direction
Visual Impact – Step-by-step multimedia
task instructions available in cloud-based Learning Library
Cloud-based Activity Support System for Self-Direction
Visual Impact – Step-by-step multimedia
task instructions available in cloud-based Learning Library
Cloud-based Activity Support System for Self-Direction
Visual Impact – Step-by-step multimedia
task instructions available in cloud-based Learning Library
Task Content Created with Wizard on Tablet/
Smartphone Using Visual Impact
Research-Based
Self-Directed Learning Apps
iPad/Android Apps for Self-Directed Learning
Everyday Skills and Living Safely
Disability service agencies are also
integrating Cognitive Support Technologies into their services
Research-Based
Self-Directed Learning Apps
iPad/Android Apps for Self-Directed Learning
My Health, My Choice, My Responsibility
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
Self-directed, survey tools , such as consumer satisfaction surveys, using
Surveys
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
Cognitive Support Technologies for Community Access
WayFinder: An accessible SmartPhone program for providing multimedia
prompts to individuals with cognitive disabilities for navigating public transit
systems.
Location Based Prompts and Visual and Audio Directions
Help Individuals Take the Bus Independently
Laura and William’s Story
http://www.arcaopeningdoors.
Laura’s Story
A vehicle/pedestrian accident
left Laura too scared to take
the bus independently. After a
few weeks of pedestrian
safety training and reacclimation 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
http://www.arc-a.org/Services/smarttravelprogram.php
their rides by 84%.”
AbleLink’s You Tube Channel
Example with Chad learning to ride the bus
https://youtu.
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
Matt’s Story of
Self-Expression
Digital StoryTeller
itively Accessible Tool for Creating Personal Stories with a Tablet
Step-by-Step Story Building Program
Matt’s story included ocean creatures,
giraffes, tigers and “the very awesome
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
I Love You Mom!
“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.”
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
T
M
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 costeffective way to reduce staff hours needed to monitor individuals vs. onsite
staffing.
Example Remote Monitoring Organizations
From Today to
Tomorrow . . .
• Recognition
of the
of Individuals
with
What’s
Needed
forRights
Moving
Forward
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
Changing Lives with Cognitive Support Technologies
Contact Info: AbleLink Technologies, Inc.
618 N. Nevada Avenue
Colorado Springs, CO 80903
www.ablelinktech.com
www.aimsxml.com
Dan Davies
[email protected]
719-592-0347 ext 110
“Assistive and Instructional Technology Supporting Learners
with Disabilities”
www.CTDInstitute.org