Assistive Technology For Cognition Research Articles

The impact of a training intervention on knowledge, confidence and attitudes of professionals in a Community Acquired Brain Injury Service about assistive technology for cognition: a before and after survey

ABSTRACT Assistive Technology for Cognition (ATC) can help people to compensate for cognitive impairments following Acquired Brain Injury (ABI). Examples include mainstream devices such as smartphones, watches and environmental controls, and bespoke devices such as medication devices or specific educational software. Evidence suggests that professional support is key to people successfully adopting ATC, yet low confidence amongst clinicians and perceptions about barriers are often cited as reasons for not recommending ATC in practice. The objectives of this service evaluation were to evaluate the impact of an ATC training opportunity on the knowledge and confidence of staff and to explore staff perspectives of the barriers and enablers to implementation of ATC in practice. A survey was completed by 21 members of a Community Acquired Brain Injury Service before and after participating in an ATC training workshop. Survey findings highlighted that attitudes toward, and confidence with ATC, showed positive change after the training, whilst perceptions about barriers to implementation in practice reduced. Responses also highlighted the perceived importance of education for health professionals, service users and families as key enablers to successful implementation. Multi-professional training is therefore an important part of an implementation strategy for ATC.

Prompting cognitive assistive technology for multistep tasks in dementia homecare: Testing of mode and sequencing options

AbstractFor people living with dementia, information‐processing capabilities and previously acquired knowledge is generally limited. Daily tasks such as making coffee or teeth brushing may become too difficult to complete independently. People with normal cognitive functioning learn about the environment as they move through it with spatial information obtained sequentially, requiring mental activity to process this successive input into a comprehensive understanding of a task. Without this ability, individuals with dementia in many cases then rely on repetitive cuing for tasks from their family member or caregiver. The approach for this project was the evaluation of task prompting for a wearable cognitive assistive technology for support in cueing on for multi‐step home tasks. Choosing meaningful tasks, and breaking them down in a way that a caregiver would usually provide prompting support is not trivial. The physical or environmental context of the task can also affect the flow of the task, and the personality of the person carrying out the task can influence how methodically the prompts are followed. The testing took place in a lab setting set up to represent a one‐bedroom apartment. A sample of older adults 65+ took part in a series of protocols for eight multi‐step tasks and for each task four delivery modes options (written text, audio, still photo, video) and four sequencing modes (auto‐generated, self‐request, one‐time, step by step) which included: kitchen‐ loading the dishwasher, setting the table and making coffee, bedroom‐ making the bed, folding clothes, bathroom‐ brushing teeth, hand washing and face washing. This pre‐testing of system components was performed in order to reduce marginal risks, increase effectiveness, and maximize benefits for the end‐user population of individuals with dementia who will test the device in future projects and the outcomes from this research will ultimately enable the mode and sequencing of task prompting for this populations' frequently changing needs.

Development of Assistive Technology for Instrumental Activities of Daily Living for Dementia Homecare Environments.

This presentation describes preliminary National Institute of Health (NIH) funded user-centered research into Cognitive Assistive Technology (CAT) for dementia homecare and the subsequent development of a lab for testing the CAT. Caregivers face on-going significant risk throughout the ebb and flow of providing care, as individuals with dementia may lose grasp of their understanding of their circumstances, relying heavily on caregivers for all aspects of their physical and emotional support, as well as prompting and cueing through the multi-step IADLs. Difficulty with IADL tasks such as cooking meals and housekeeping is one feature of early-stage dementia, as these tasks require complex cognitive processing and are cognitively demanding. The goal of this research is to improve caregiver resilience and sustainability of dementia homecare via a low-cost wearable CAT system which can support the IADL task cueing intervention for care recipients called IADL/CAT. IADLs are highly personalized set of needs, requiring a flexible and versatile approach that can be customized and adapted for each individual in a specific setting. Smart-home technologies and assistive technology tools of specific functionalities have been previously developed to partially address those challenges, however, there is currently a lack of low-cost, portable, versatile and programmable interventions that can relieve the physical and emotional burden from caregivers by automatically providing timely, needed and individualized IADL task cueing to care recipients Our working hypothesis is that environmental cueing for an individual with dementia can be recorded and replayed to enable timely feedback and assistance through a IADL/CAT wearable device. This presentation will describe the initial research conducted to not only develop an environmental testing lab for the IADL/CAT project, but the initial system navigation cueing through the 3D model retrieval. Through the development of a lab-based replication/mock-up of environmental relationships which would be found in a home (i.e. connection between a kitchen and dining room) we have been begun to evaluate the IADL/CAT programming features and system usability.

Assessment of Cognitive Assistive Technologies in Elderly Patients with Dementia Post-COVID-19 Infection: A Research Proposal

Introduction: SARS-CoV-2 infection is thought to be implicated in an increased risk for various neurodegenerative diseases given its role in neuroinflammation. As a result, cognitive assistive technologies to monitor the risk of neurodegenerative diseases in those with prior COVID-19 infection and the regular implementation of practices designed to promote synaptic plasticity may decrease the risk of dementia in susceptible populations. It is hypothesized that incorporating frequent use of a mobile application designed to improve memory five times per week in the daily routines of patients aged 65+ who have survived a COVID-19 infection may decrease the prevalence of subsequent dementia. Methods: The goal of this application would be to (i) deliver interventions related to long-term potentiation, and (ii) centralizing patient health data in a singular domain to improve ease of access for caregivers and medical staff. This may be investigated through a two-pronged randomized controlled trial aimed to compare neural and cognitive functioning through repeat neuropsychological exams, magnetic resonance imaging, and electroencephalogram tests over a 6-year timeframe between no-intervention and intervention groups while collecting caregiver and healthcare worker data regarding its efficacy in improving quality of life. Results: It is expected that patients consistently using cognitive assistive technologies in long-term care facilities will experience lower incidence of cognitive decline compared to the control group due to improved maintenance of mental health and the learning of new skills. In addition, with the use of technology, patients may experience increased autonomy and independence, improving their quality of life while simultaneously providing relief to their families and caregivers. Discussion: Some further considerations may include the degree of technological proficiency of the patients during the development process to ensure that patients reap the maximum benefits. Factors including rapid development and testing, funding, and strong technology support systems must be taken into consideration to ensure a seamless transition to increased reliance on technology in post-COVID-19 patients with dementia. Conclusion: Strong evidence indicates technology-based interventions can be used to by dementia patients and their caretakers overcome physical and environmental challenges normally and during future pandemic waves.

Examining the Effects of Cognitive Assistive Agents on Team Coordination in Manufacturing Teams

This article details the motivation and design of an experiment to investigate the effects of artificially intelligent cognitive assistive agents on coordination efforts in manufacturing teams. As automation solutions become more accessible and products rapidly grow in complexity, there are significant calls to leverage abilities of both artificial agents and human workers to maximize team functioning and product output. As such, we propose an experimental design where we introduce a cognitive agent with two levels of autonomy (low, and high) into a team of participants during an assembly task. We hypothesized that cognitive assistive technologies would enhance coordination within assembly teams, leading to higher productivity and reduced errors, with initial data suggesting trends in support of these hypotheses. We seek to demonstrate the value of cognitive agents in augmenting human workers, allowing manufacturers to see the benefit of increased productivity while retaining value and relevance of human labor in the face of technological development.

Development of an Assistive Technology for Cognition to Support Meal Preparation in Severe Traumatic Brain Injury: User-Centered Design Study.

BackgroundAlthough assistive technology for cognition (ATC) has enormous potential to help individuals who have sustained a severe traumatic brain injury (TBI) prepare meals safely, no ATC has yet been developed to assist in this activity for this specific population.ObjectiveThis study aims to conduct a needs analysis as a first step in the design of an ATC to support safe and independent meal preparation for persons with severe TBI. This included identifying cooking-related risks to depict future users’ profiles and establishing the clinical requirements of the ATC.MethodsIn a user-centered design study, the needs of 3 future users were evaluated in their real-world environments (supported-living residence) using an ecological assessment of everyday activities, a review of their medical files, a complete neuropsychological test battery, individual interviews, observational field notes, and log journals with the residents, their families, and other stakeholders from the residence (eg, staff and health professionals). The needs analysis was guided by the Disability Creation Process framework.ResultsThe results showed that many issues had to be considered for the development of the ATC for the 3 residents and other eventual users, including cognitive issues such as distractibility and difficulty remembering information over a short period of time and important safety issues, such as potential food poisoning and risk of fire. This led to the identification of 2 main clinical requirements for the ATC: providing cognitive support based on evidence-based cognitive rehabilitation to facilitate meal preparation and ensuring safety at each step of the meal preparation task.ConclusionsThis needs analysis identified the main requirements for an ATC designed to support meal preparation for persons with severe TBI. Future research will focus on implementing the ATC in the residence and evaluating its usability.

A Study Protocol for Persons With Neurological Diseases: Linking Rehabilitation Goals to the International Classification of Functioning, Disability and Health With a Focus on Assistive Technology for Cognition and Its Effects.

Persons with neurological diseases often have some degree of cognitive impairment. They are in need of assistive technology for cognition (ATC) to compensate for cognitive impairments that affect their daily functioning. Goal setting in relation to cognitive deficits using ATC are common in clinical practice, and therapists often set several rehabilitation goals together with a patient. However, these rehabilitation goals are usually phrased differently, which limit the comparison of ATC and rehabilitation goals. It is thus valuable to link the goals to some standardized terminologies, such as the International Classification of Functioning, Disability and Health (ICF). Furthermore, goal achievement is seldom used to evaluate long-term effects of ATC in persons with neurological diseases and limited attention has been paid to the factors that predict goal achievement in using the ATC as cognitive support in persons with neurological diseases. The aim of the project is 3-fold. Firstly, we will use the ICF to link rehabilitation goals regarding the use of ATC in adults with neurological diseases. Secondly, we will evaluate effects of the ATC using goal achievement over a 5-year period. Thirdly, we will explore the variables that predict goal achievement in relation to the effects of ATC.

How Implementation of Cognitive Assistive Technology in Home-Based Services for Young Adults with Intellectual Disabilities Influences Support Staff`s Professional Practice.

The implementation of technology in home-based services takes place in contextualised socio-material practices negotiated through interactions between a diversity of actors. Prerequisites for succeeding in this process are time and competence, and that use of the technology is experienced as meaningful, for both the support staff and the resident. In this article, we investigate how implementation of cognitive assistive technology (CAT) in home-based services for young adults with intellectual disabilities influences the support staff`s professional practice. The participants are eight support staff members, five women and three men. Data were collected through two group interviews, the second one 8months after the first one. The data were analysed according to a systematic text condensation (STC) approach. Implementation of CAT is a demanding process, revealing different perspectives on professionalism and changing power relations, and entails a new way of working for the support staff.

In-Lab Development of a Mobile Interface for Cognitive Assistive Technology to Support Instrumental Activities of Daily Living in Dementia Homecare

5.5 million Americans have Alzheimer’s disease or some form of dementia and by mid-century, the number of people living with dementia in the United States is projected to grow to 13.8 million. About half of the persons with dementia currently live at home, 43% require occasional support, 47% daily support, and 10% continuous support; with most of this support provided by informal family caregivers. Caregivers face on-going significant risk throughout the ebb and flow of providing care, as care recipients may lose grasp of their understanding of their circumstances, relying heavily on caregivers for all aspects of support. This support includes prompting and cueing through the multi-step instrumental activities of daily living (IADLs) such as meal preparation and house-keeping which require complex cognitive processing and are cognitively demanding. This paper describes the preliminary pilot study work laying the groundwork for ongoing development of a cognitive assistive technology (CAT) to support IADLs in dementia homecare. Through a user-centered design methodology, an online survey for caregivers identified areas of the home with the highest levels of IADL needs, aiding in the development of an 800 sq ft mock-up apartment for preliminary testing of the mobile interface for the CAT tool.

Are friends electric? The benefits and risks of human-robot relationships.

SummarySocial robots that can interact and communicate with people are growing in popularity for use at home and in customer-service, education, and healthcare settings. Although growing evidence suggests that co-operative and emotionally aligned social robots could benefit users across the lifespan, controversy continues about the ethical implications of these devices and their potential harms. In this perspective, we explore this balance between benefit and risk through the lens of human-robot relationships. We review the definitions and purposes of social robots, explore their philosophical and psychological status, and relate research on human-human and human-animal relationships to the emerging literature on human-robot relationships. Advocating a relational rather than essentialist view, we consider the balance of benefits and harms that can arise from different types of relationship with social robots and conclude by considering the role of researchers in understanding the ethical and societal impacts of social robotics.

Assistive Technology for Cognition to Support Executive Functions in Autism: a Scoping Review

Atypical executive functions (EF) have long been observed in individuals with autism spectrum disorders (ASD) of any age. To compensate for EF-related difficulties and to cope with the demands of daily life, assistive technology for cognition may represent a valid solution, but at present, no information is available on the range of accessible solutions nor on their effectiveness in ASD. This paper reports on a review conducted to identify assistive technologies that may compensate for EF-related difficulties in ASD. A systematic search was conducted following the PRISMA Extension for Scoping Reviews (PRISMA-ScR) reporting guideline recommendations. Fifteen studies met inclusion criteria, with most studies following a single-subject research design (n = 11). The assistive technologies identified were grouped into two categories (context-aware, mobile) addressing four EF-related cognitive processes classified according to the taxonomy proposed by the International Classification of Functioning (i.e., organization and planning, time management, cognitive flexibility, and insight). Insight (e.g., self-monitoring) resulted as the only intervention that may be considered evidence-based. This review highlights that assistive technology may be effective in compensating for specific EF-related difficulties in ASD, but more rigorous research involving (a) a wider range of EF-related skills, (b) older participants, and (c) diverse settings (e.g., workplaces) is necessary.

Summative evaluation of a sensor-based cognitive assistive technology: Impact on quality of life and perceived utility

Summative evaluation of a sensor-based cognitive assistive technology: Impact on quality of life and perceived utility

Summative evaluation of a sensor-based cognitive assistive technology: Impact on quality of life and perceived utility

Background Current research shows that perceived improvement of quality of life (QoL) is among the most important factors influencing acceptance of technology by older adults. Research Aim/question ...

Parents act as intermediary users for their children when using assistive technology for cognition in everyday planning: Results from a parental survey

ABSTRACT Assistive Technology for Cognition (ATC) is employed by children with and without disabilities. However, how the ATC is used in everyday life has not been studied. The current study investigated ATC-usage in everyday planning in three groups: 1) children qualifying for Swedish habilitation centers (ID/ASD), 2) children with disability not qualifying for habilitation service (ADHD), and 3) children with typical development (TD). A parental survey was conducted (n = 192) and answers were analyzed with statistical tests and inductive thematic text analysis. Results showed that all groups used ATC, most in the Habilitation group and least in the TD group. According to parents, ATC supported cognitive functions in all groups, but it became evident that the parents were responsible for planning by setting up the ATC, whilst the children merely executed the plans. This was linked to several limitations, for example the design was not appropriately adapted for these groups. The implications for the practitioners are 1) evaluate the users’ cognitive abilities and choose an ATC suitable for that individual rather focusing on the diagnosis, and 2) follow up usage to see if it is the parent or the child that are using the ATC.

Exploring verbal assistance used by occupational therapists to improve financial management skills after brain injury: A case study

Cognitive difficulties following a brain injury can impact an individual's capacity to complete activities of daily living (ADLs). Combining metacognitive strategies, such as those parts of the Cognitive Orientation to Daily Occupational Performance (CO-OP) approach and assistive technology for cognition (ATC) can facilitate financial management (Poncet, 2017). The objective of this study was to examine how the COOP approach was implemented by paying attention to the type of verbal assistance (VA) provided by the therapist throughout the intervention and how it affected the participant's process of taking ownership of the CO-OP approach and therefore improving his ability to manage his finances. Case study of a 41-year old man, XC, who suffered a moderate traumatic brain injury (TBI). He participated in 10 individual therapy sessions where he learned to use CO-OP in combination with ATC. Throughout the sessions, an emphasis was placed on his personal goal of managing his grocery expenses. A qualitative analysis of the verbatim of the therapist-client interactions was completed. Two (representative) extracts from sessions 6 (first independent use of CO-OP) and 9 were selected to illustrate how XC established a goal to improve the management of grocery expenses. The quantity and type of VA changed between sessions 6 and 9 (i.e. n = 8 VA to 2). In session 6, the therapist provided several restarting and scaffolding assistances in order for XC to formulate a goal (Le Dorze, 2014). However, in session 9, the therapist only used restarting and explicit advice to support XC in formulating a goal, indicating improvement. This study begins to fill a gap with regards to the use of CO-OP by examining how a therapist assisted an individual with TBI in taking ownership of cognitive strategies for managing expenses. A more in-depth understanding of the use of VA could benefit therapists in their clinical practice.

Emotion and Motivation in Cognitive Assistive Technologies for Dementia

The adoption and effectiveness of cognitive assistive technologies hinge on harnessing the dynamics of human emotion. The authors discuss seminal advances in the integration of emotions in assistive technologies for dementia and propose Bayesian Affect Control Theory (BayesACT), a quantitative social-psychological theory, to model behavior and emotion in such systems.

Semantic Interpretation of Multi-Modal Human-Behaviour Data

This special issue presents interdisciplinary research—at the interface of artificial intelligence, cognitive science, and human-computer interaction—focussing on the semantic interpretation of human behaviour. The special issue constitutes an attempt to highlight and steer foundational methods research in artificial intelligence, in particular knowledge representation and reasoning, for the development of human-centred cognitive assistive technologies. Of specific interest and focus have been application outlets for basic research in knowledge representation and reasoning and computer vision for the cognitive, behavioural, and social sciences.

Environmental barriers to participation and facilitators for use of three types of assistive technology devices

ABSTRACTThe aim was to compare the presence of environmental barriers to participation and facilitators for assistive technology (AT) use and study the relation between barriers and AT use in three different AT devices. A cross-sectional survey was conducted. Inclusion criteria were ≥one year of experience as a user of myoelectric prosthesis (MEP), powered mobility device (PMD), or assistive technology for cognition (ATC) and age 20-90 years. Overall, 156 participants answered the Swedish version of the Craig Hospital Inventory of Environmental Factors and a study-specific questionnaire on facilitating factors. Non-parametric tests were used for comparisons. Barriers to participation were lowest in MEP users (md=0.12; p>0.001), and highest in ATC users (md=1.56; p>0.001) with the least support for AT use (p>0.001 - p=0.048). A positive correlation between fewer barriers and higher use of MEP was seen (r=0.30, p=0.038). The greatest barriers to participation were Natural environment, Surroundings and Information, and the most support came from relatives and professionals. Support, training and education are vital in the use of AT. These factors may lead to a more sustained and prolonged use of AT and may enable increased participation. Future research should focus on interventions that meet the needs of people with cognitive disabilities.

Effectiveness of a metacognitive strategy combined with assistive technology to help individuals with traumatic brain injury manage their budgets

Cognitive deficits incurred subsequent to a traumatic brain injury (TBI) largely increase the risk of financial mismanagement. It is urgent that optimal therapeutic interventions be identified to optimize independence in the management of one's personal finances. Our research team has recently developed a novel specific intervention for the treatment of these deficits using emerging Assistive Technologies for Cognition (ATC) combined with the use of a metacognitive approach. Objectives: to explore the effects of this intervention on the ability to develop and manage a budget. Five individuals having sustained a severe TBI participated in the study (two female; average age: 45.6 ± 10.8 yrs; average time post injury: 7 ± 7.2 yrs). They received a 5-week training program consisting of 1-hour sessions twice per week. Treatment sessions: metacognitive procedure using the Cognitive Orientation to daily Occupational Performance (CO-OP) approach combined with the use of ATC via the Budget Alert application available on tablet or smartphone; participants had access to the ATC at home and used it between sessions. The Intervention consisted of 5 phases: goal formulation, plan identification, acquisition of ATC, application of ATC in a real-world setting (shopping center) and generalization of ATC use in subject’ s everyday life. Repeated measurements pre-program (T1 and T2) and post-program (T3, T4, up to 4 months) with 5 participants having sustained a severe TBI using the Instrumental Activities of Daily Living Profile (IADL Profile) and the Canadian Occupational Performance Measure (COPM). Using the two standard deviation band method for small n designs, significant differences in pre- and post-program measures were found for the need of assistance (IADL Profile) for 5 participants. The results of the COPM suggest an effect in improving the ability to manage a budget for 4/5 subjects. Between the post-follow-up period and the follow-up, 4/5 participants continued to use the ATC; these 4 participants declared that they would continue to use it afterwards. The combined results from the IADL Profile and the COPM suggest an overall improvement in the activity of “making a budget” post-intervention; this improvement maintained at 4 months.

Qualitative study of affective identities in dementia patients for the design of cognitive assistive technologies

Our overall aim is to develop an emotionally intelligent cognitive assistant (ICA) to help older adults with Alzheimer's disease (AD) to complete activities of daily living more independently. For improved adoption, such a system should take into account how individuals feel about who they are. This paper investigates different affective identities found in older care home residents with AD, leading to a computational characterization of these aspects and, thus, tailored prompts to each specific individual's identity in a way that potentially ensures smoother and more effective uptake and response. We report on a set of qualitative interviews with 12 older adult care home residents and caregivers. The interview covered life domains (family, origin, occupation, etc.), and feelings related to the ICA. All interviews were transcribed and analyzed to extract a set of affective identities, coded according to the social–psychological principles of affect control theory (ACT). Preliminary results show that a set of identities can be extracted for each participant (e.g. father, husband). Furthermore, our results provide support for the proposition that, while identities grounded in memories fade as a person loses their memory, habitual aspects of identity that reflect the overall “persona” may persist longer, even without situational context.