The document discusses assistive technology for cognition (ATC) that can be used in neurorehabilitation. It provides examples of off-the-shelf technologies like smartphones, tablets, and apps that can be used for tasks like memory aids, medication reminders, planning and organization. While off-the-shelf technologies are cheaper alternatives to specialized devices, care must be taken to tailor them to individual clients' needs, which may require simplifying the technology. The literature supports the use of ATC in rehabilitation.

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Aims
Thinking Outside the Box:
 To provide you with an appreciation of the range of
Using off-the-shelf technology technology now available to clients for rehab
 To consider the impact of a client’s cognitive
in neurorehabilitation impairments and the benefits of assistive technology
for cognition (ATC)
 To consider the impact of a client’s cognitive
Dr Clare Ramsden impairments and the barriers to using assistive
Consultant in Neuropsychology & Rehabilitation technology for cognition (ATC)
Brain Injury Rehabilitation Trust
ATC in Rehab Role of Technology
 “very little is known about the relationship Assistive technology for cognition as
between, on the one hand, the clinical extension of existing rehabilitation
characteristics of persons with cognitive principles:
impairments, and on the other hand, the  Compensatory: e.g., memory aids,
specific characteristics of ATC (Assistive reminders, pillbox devices, cues & prompts
Technology for Cognition) interventions  Risk Management: journey trackers, pillbox
that are most suitable for those individuals” devices, sensors
(LoPresti et al., 2004, p 25)
 Retraining: cognitive ‘retraining’ apps
Number of studies in each ISO category
ATC prescription published per year
Gillespie, Best & O’Neil (2011) suggest using
ICF framework, and categorising AT devices
in terms of function (e.g., alerting,
distracting, prompting, navigating,
reminding, storing, displaying). Can then
build up a template where you can input a
client’s ICF impairments and have this
matched with a relevant AT device.
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ATC: purpose built or off-the-shelf? Sensecam
 Neuropage, Sensecam (Vicon Revue),  Sold as Vicon Revue in UK.
AbleLink  Takes photos automatically either triggered by
internal sensor, or on timer (30 sec).
 Smart phones , tablets,
 Review images at end of day or event.
netbooks/notebooks, cameras, voice
 Can use for memory rehab (esp. autobiographical),
recorders, e-readers, speakers, pagers,
support with CBT after ABI, lifelogs/visual diary,
mobile connectivity, apps. cueing & recognition memory, monitoring (e.g.,
eating, meds, etc).
 Around £300 (ex VAT)
Sensecam AbleLink
 Range of software options that sit on a smartphone
(e.g., HTC).
 Simplified desktop software that sits on top of the
existing operating system (Endeavour Desktop)
 Simplified mobile phone device (Pocket Ace)
AbleLink Visual Assistant AbleLink Pocket Endeavour
 Task prompting  “…an integrated, discreet,
and portable solution for
programme, with
managing time,
customised audio & sequential and non-
visual display (can sequential tasks, lists,
be pictures or video notes, instructions,
footage). Fairly easy classroom lectures, and
more”
to set up, very easy
 Memory & Executive
to use Function
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Able Link Portable Tablet PC AbleLink WayFinder
 Picture and vocal memory GPS-based personalized
aid audio and visual cues to
 One-off and recurring support independent
appointments can be travel via bus systems and
recorded on foot. Can create specific
 Tasks such as how to put
travel routes, activated
on the dishwasher or from the GPS location.
make a sandwich can be Users receive customized
broken down to easy step audio and visual
stages with vocal and instructions to prompt
picture prompts them through route
navigation.
Pagers & alerting systems Smartphones & iPads/Tablets
 Neuropage – well known & documented  Socially acceptable
 Findings may be generalised to other alerting &  Increasing pre-injury familiarity
messaging programmes, e.g., on a smartphone.
 Some degree of intuitive interface, even for ABI.
 Context-free cuing (text of ‘stop’) – cue to reflect on
 Touchscreens can be easier for some with physical
internal goal states, resulted in better performance on
scheduled tasks (Fish et al., 2007) impairments
 Neuropage costs £89 deposit + £60 per month  Introduction of apps specifically focused on
cognitive/language impairments & needs (e.g., Its
Done!, Proloquo2go, etc).
iPad 3 - £399; iPod touch - £170; Samsung Galaxy ~£200
Mobile ATC? Memory
 Can I use a smartphone, iPad or tablet as a useful,  Task managers/schedulers: AA Task, DoIt
meaningful ATC device? (tomorrow), ToDo
 What apps are out there that are useful in rehab?  Memoires: The diary; Day One – Journal:
 What apps are beneficial to those with cognitive Journal/ lifebooks combining a number of
impairments? smartphone functions such as text, images, video,
 Are there apps specifically for people with
GPS links, etc.
cognitive impairments?
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DoIt (Tomorrow) Tasks n Todos
Memoires: The Diary Day One - Journal
Benefit of text plus video/image record. However, typing on
smartphone screen can be frustrating!
Medication reminders Pillboxie
 Visual Pill Reminders (Android)
 Pillboxie (Apple)
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Visual Pill Reminders Daily Planning & Organising
 Google calendar
 Pocket Informant (Apple) – more like a diary, can
schedule tasks & events, colour-code, organise.
 Corkulous (Apple): visual virtual corkboard. Can add
notes, labels, photos, contacts & tasks. Pinterest
(web-based)
 Wallet Advanced (Apple): for managing passwords,
pins, numbers, etc.
 AA Task: Schedule & memo App (Android)
Pocket Informant AA Task
CalenGoo Its Done!
 App devised
specifically for ABI or
memory
impairment/executive
dysfunction.
Schedules, reminds, &
ticks off and sends
completion notices
(email or SMS)
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Corkulous Pinterest
Communication Proloquo2go
 Proloquo2go ($190 USD, Apple): Assistive
communication device for those with problems
speaking.
 Answers: YesNo (Apple): Choice of 2 answers. Comes
with Yes/No, also customisable.
 iCommunicate for iPad: story boards, flash cards,
choice boards, etc.
 Dragon Dictation (Apple): Voice recognition
software that translates into text.
 iBooks with Voiceover: Apple eReader
Proloquo2go Answers: YesNo
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iCommunicate for iPad Community Access & Safety
 Navigation: Google Maps & Navigation. Using
Google Street View as quasi-virtual reality for off-
escort training.
 Location: GPS tracker, Life360, SafeJourney,
Google
Life360 Finances & Shopping
 Find family & friends  Expense Manager, Money Manager (Android); Piggie
with GPS (Apple)
 Check in function  Lemon Receipts (Apple or Android): photo paper receipts,
email electronic receipts – collated into useful info.
 ‘Safe place’ ID – police
stations, hospitals.  Easy Shopping Calculator (Android): simple shopping
calculator
 Food Planner (Android): meal planning, shopping,
recipes, stock management, etc.
 Snap n Draw (Apple): Visual shopping list
 The Valuator (Apple): Calculates best value between offers
Snap n Draw Lemon Receipts
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Emotional management T2 Mood Tracker
 T2 Mood Tracker: Mood rating & monitoring on
6 pre-set scales, also customisable scales.
Stress Management What next?
 Breathe to Relax, Tactical Breather (Apple):  Visual recognition systems (e.g., Google Goggles)
cued breathing exercises to manage stress.  Voice to text to voice systems (Siri, Dragon)
 Stress Tracker: Records and tracks stress levels,  Biofeedback linked devices
moods, sources of stress, symptoms, and
behaviours.
 Biofeedback devices – heart rate monitors that can
both cue to elevated heart rate and record heart
rate over periods of time for review.
Tech downsides Tech upsides
 Complex – devices such as Ablelink’s Discovery  Can increase independence in some areas,
Desktop can help with this (overlay simple allowing staff time to be spent elsewhere
presentation on top of PC/PDA screen). Often  Can encourage positive feelings of control,
requires language skills & manual dexterity engagement in normal life activities, age-
 Can be visually complex – small devices can be appropriate behaviour
problematic to see, larger devices to carry around  Increasingly, people are coming to rehab with tech
 Requires person to do something – to follow the knowledge & understanding.
prompt, to recognise the cue, etc.  Tech partners, like communication partners
 May require some new learning  Reduce reliance on others, or need for prompts
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Off the shelf? Literature
 Increasing number of devices & apps that appear  Current literature supports use of ATC in
to be useful for the rehab population. rehabilitation
 Need to be carefully tailored to the individual  Don’t need to do research on every device, but rather
on the mechanism the device uses (e.g., prompting
 Person may need a simplified version. Now some
devices can look to the neuropage literature).
simplified devices that look similar to standard
 Gillespie, Best & O’Neill (2011): ATC prescription &
devices – person feels engaged with them, but they
classify ATC based on cognitive function.
are appropriate to needs.
 Off the shelf can be cheaper than specialised
devices
Useful resources
 Gillespie, A., Best, C., & O’Neill, B. (2011). Cognitive
Function and Assistive Technology for Cognition: A
Systematic Review.
 Technology for Psychologists blog:
http://sylvainroy.blogspot.com/
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