1	Enhancing the Quality of Life Through Technology A Response Addressing the Potential for Technology for Individuals with Cognitive Disabilities as a Result of a Traumatic Brain Injury; Coleman Institute; October 5,2004 Allan I. Bergman President & CEO Anixter Center Chicago, IL. abergman@anixter.org
2	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
3	Assistive Technology Definition Repeated in: Developmental Disabilities Assistance and Bill of Rights Act Individuals with Disabilities Education Act, Parts B and C Rehabilitation Act
4	Goals of the A D A Equality of Opportunity Independent Living Economic Self Sufficiency Full Participation
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10	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
11	Traumatic Brain Injury An insult to the brain, not of degenerative or congenital nature, caused by an external physical force that may produce a diminished or altered state of consciousness, which results in an impairment of cognitive abilities or physical functioning and/or a disturbance of behavioral or emotional functioning.
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16	“Traumatic Brain Injury and Concussion in Sports” “The terms concussion and mild TBI are used interchangeably as is consistent with the U.S. medical literature.” JAMA, September 8, 1999 James P. Kelly, M.D.
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22	"Brain Injury Association of America" Brain Injury Association of America Temple University University of Akron Spaulding Rehabilitation Moss Rehabilitation
23	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)
24	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 N=83
25	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 N=53 youths, 106 parents and teachers of identified children, for total N=159
26	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 N=80
27	Top “Important / Very Important” Features
28	Phase II: Usage Trials Step #1: Device 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
29	PDAs Used Palm OS devices Pocket PC devices Palm M130 Ipaq 3950 Palm M500 Dell Axium Palm Tungsten Toshiba e330 Sony Clie Alphasmart Dana
30	Voice Organizers and Other Devices Used Parrot Sharp Wizard Voice Diary Nokia 9290 Voice organizer
31	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.
32	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
33	Critical Features Brightest colors and screens Larger screens Appearance Simple to learn
34	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
35	Device Trials Usage Conditions: (1) Baseline-No memory aid (2) Paper-based calendar (3) Dell Axium 3 Pocket PC (4) Palm Zire 71
36	Web Catalog http://www.biausa.org/Pages/AT/
37	Experiences of Consumers with PDAs Temple Consumer’s Experiences Presented by: Debbie Robinson
38	What’s Working Well Can store information and not lose it. I don’t 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.
39	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 don’t remember.
40	Recommendations People need training on how to use it. You can’t just give it to a person and expect them to know how to use it. You also need technical support. If I didn’t have someone to help me with a technical background, I wouldn’t 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.
41	Akron Consumer Family’s experience with PDAs Thomas J. Prebis Highland High School
42	Advantages of PDA Improves my organization Alarm reminder for: class schedules upcoming events Appointments medications
43	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
44	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
45	Ways of Improving the PDA Enlarge the Graffiti writing area and improve the handwriting recognition Encourage teacher’s use of PDA e.g. “beam” class assignments
46	Family Perspective Presentation by: James W. Prebis, M.D. Tom’s father
47	Advantages of PDA Convenience: fits in your shirt or pants pocket no need to carry day planner, to do list, homework assignments, calculator
48	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
49	Disadvantages of PDA An individual’s 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
50	Ways of Improving the PDA Design a more stable means of holding PDA Enlarge navigation buttons and letter size
51	Prebis Family Speech-Language Pathologists Perspective on PDA Presented by: Linda Ginesi, M.A, CCC-SLP Tom’s Speech-Language Pathologist
52	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
53	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
54	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 Tom’s fine motor skills.
55	Self Determination 2001 People With Brain Injury Are “Speaking Out” About Quality in Services National Center on Outcomes Resources (410) 583-0060 Info@thecouncil.org
56	About Quality of Life “Quality of Life is freedom and independence.” “Quality of life is having the opportunity to wake up in the morning with a purpose and the ability to pursue it.” “Quality of life is having the opportunity and tools to achieve my goals.”