Team TBI proposes to conduct qualitative research to examine the use of assistive technologies to aid memory for people who have experienced traumatic brain injury (TBI) resulting in permanent brain damage and memory loss. They will focus on one adolescent participant, ages 14-18, recruited with Amy LaBay of Anixter Center. The goal is to define the design requirements of an artificial memory aid by understanding the participant's distributed cognition network and identifying their needs and the needs of their support system. Methods will include interviews with the participant, family, and others in their network to understand the impacts of memory loss and evaluate existing assistive technologies.

1. Quarter Project Proposal
HCI 511
Spring Quarter 2012
Team TBI
Joseph Howerton
Jessica LoPresti
Carlyn Porter
Submitted on May 5th
, 2012

2. Project Type
Team TBI is proposing to engage in a pre-design, qualitative research study that will
examine the use of assistive technologies to aid memory for people who have
experienced a Traumatic Brain Injury (TBI), with associated permanent brain damage
and memory loss.
Target Population
We will focus our research on the support needs of one person between the ages of 14
and 18 years old. Ideally, our participant will be an adolescent who has experienced a
significant TBI, permanent brain damage, and is affected by short-term memory loss. To
recruit our participant, we will be reaching out to Amy LaBay of Anixter Center to
identify a candidate and their family.
The Problem
With any TBI - whether mild, moderate, or severe - there is a considerable chance for
permanent brain damage. One of the most common factors associated with permanent
brain damage is some form of memory loss. This loss of memory can be connected to a
diminished ability for the person to perform even the easiest of daily tasks without help
from another person, which leads to an increased interdependency on their support
system. Inherent in the spectrum of frustrations are anxiety, decreased sense of self and a
lack of overall autonomy.
Project Summary
Team TBI intends to explore and discover the impact of Traumatic Brain Injury (TBI) on
human memory. We understand that there are two primary forms of memory loss - short
term and long term. Our focus will be on short-term memory (STM) loss and working
memory (WM) limitations. We will study the impact this has on independence by
understanding the constructs of their Distributed Cognition Network, or scaffolding.
The goal of this research is to define the design of a memory aid, otherwise known as an
artificial agent. In order to ascertain what is required of such a device, we plan to identify
one candidate and the people that constitute their support environment, which we will call
stakeholders. The stakeholders are the scaffolding, or the human agents that make up the
distributed cognition network, for one member of the target population.
To better understand the user needs of the target population, we will perform a discovery
phase and a process of requirements analysis. These efforts will incorporate the feedback
of a diverse group of stakeholders, as well as the evaluation of existing assistive
technologies also known as artificial agents.

3. Research Question(s)
What are the impacts of a TBI, permanent brain damage and memory loss on the support
system of the individual?
What makes up the complete support system of the individual, both in terms of human
and artificial agents, or assistive technologies?
Methods
The approach we will take to conducting our research study will include, exploratory
interviews, observations and participatory design. In the exploratory interview phase, we
will conduct in-person interviews with the participant and his or her family members. If
possible, we may also interview other significant individuals in his or her network such
as caretakers, teachers and doctors in order to understand the impact of the injury on the
participant’s memory.
Sample Interview Questions
• What is the impact of memory loss on study habits and overall learning?
• What assistive technology, if any, does the participant use to aid memory?
• What are the pros and cons of this particular device?
• What type of preferred features would the participant (and others in his or her
network) like to see in an assistive device?
• What are the main sources of frustration for the participant? For the family?

4. Annotated Bibliography
Boussemart, B. & Giroux, S. (2007). Tangible user interfaces for cognitive assistance. 21st
International Conference on Advanced Information Networking and Applications
Workshops. doi:10.1109/ainaw.2007.3
The authors, researchers at Laboratoire DOMUS, explored tangible user interface
as assistive cognitive aids. This research proposes a new approach to computer
interaction. These researchers discuss design of an interactive table to support cognitive
assistance in household kitchen activities. This research suggests an alternative approach
to traditional HCI when tackling assistant aids in contrast to traditional devices discussed
in articles mentioned below.
Burdea, G., Rabin, B., Chaperon, A. & Hundal, J. (year). Emotive, cognitive and motor
rehabilitation post severe traumatic brain injury: A new convergent approach. Virtual
Rehabilitation ICVR), 2011 International Conference. dol:10.1109/ICVR.2011.5971817
The authors, researchers at the Tele-Rehabilitation Institute at Rutgers University
and Center for Head Injuries at the JFK Johnson Rehabilitation Institute, studied the
effects of gaming on cognitive and motor abilities and depression. The study found
improvement in each of these areas, most notably in level of depression. Participants
showed improvements in their day-to-day lives having less difficulty performing tasks,
for example, preparing food and walking the dog.
Dawe, M. (2006). Desperately Seeking Simplicity: How Young Adults with Cognitive
Disabilities and Their Families Adopt Assistive Technologies. Paper presented at the
Conference on Human Factors in Computing Systems, CHI '06 Montréal, Québec,
Canada.
The author, a researcher at the Center for LifeLong Learning and Design,
conducted research to understand the usage of technology and how they benefit both the
individual with disabilities and also their families. This research found that use of
technology increased independence, safety and social interactions.
Doherty, A. & Smeaton, A. (2008). Combining face detection and novelty to identify important
events in a visual lifelog. IEEE 8th International Conference on Computer and
Information Technology Workshops, 31, 348-353. doi:10.1109/cit.2008.Workshops.31
The authors, researchers at Centre for Digital Video Processing and Adaptive Information
Cluster, discuss improvements in a visual lifelog through enhanced functionality of
detecting and logging important events in the user’s day-to-day life. This article is offers
a device that could take the place of taking physical pictures by caretakers as discussed in
the article above (Dawe 2006).

5. Gentry, T., Wallace, J. Kvarfordt, C. & Lynch, K.B. (2008). Personal digital assistants as
cognitive aids for individuals with severe traumatic brain injury: A community-based
trial. Brain Injury, 22(1), 19-24.
The authors, researchers at Virginia Commonwealth University, the Assistive
Technology Loan Fund Authority and the University of Windsor, examine the
effectiveness of personal digital assistants (PDAs) as cognitive aids for people with
severe traumatic brain injury. They discovered statistically significant improvement
regarding satisfaction and self-ratings of performance in everyday tasks. In contrast, an
earlier study by Stapleton, Adams and Atterton cited below did not see improvements in
memory of individuals with a severe traumatic brain injury who used a mobile phone as a
cognitive aid.
Hart, T., Buchhofer, R. & Vaccaro, M. (2004). Portable electronic devices as memory and
organizational aids after traumatic brain injury: A consumer survey study. Journal of
Head Trauma Rehabilitation, 19(5), 351-363.
The authors, researchers at the Moss Rehabilitation Research Institute and the
Department of Rehabilitation Medicine at Thomas Jefferson University, investigate
attitudes and experiences regarding the use of portable electronic memory aids by
individuals with a moderate to severe traumatic brain injury. Participants expressed
preferences for devices that are easy to use, that provide technical support and have long-
lasting battery power. These devices were mainly used to monitor spending,
remembering things to do and remembering what other people say. Our research group
will be able to compare these findings with what we discover in our interviews for our
project.
Hutchins, E. (2000). Distributed Cognition. Retrieved May 2, 2012 from http://www.artmap-
research.com/wp-content/uploads/2009/11/Hutchins_DistributedCognition.pdf
The psychological theory of Socially Distributed Cognition was first developed by
Hutchins in the 1980s. The framework draws from the disciplines of sociology,
psychology, and cognitive science. At its core, it posits that cognitive processes may be
distributed across the members of a social group. Applied to cognitive rehabilitation
therapy, the concept provides a foundation for creating an understanding of the
requirements of a support system around a person after Traumatic Brain Injury.
Jorgensen, M. & Togher, L. (2009). Narrative after traumatic brain injury: A comparison of
monologic and jointly-produced discourse. Brain Injury, 23(9), 727-740.
This article represents a culmination of research into the communications of a person
after they have experienced a Traumatic Brain Injury (TBI). It explores the effects of TBI
on the individual’s ability to communicate a narrative on their own which has been called
Monologic in this study. Further, the researchers assessed the effectiveness of the
person’s communication abilities while forming a jointly produced narrative of an event
with a partner. The bases for measurement were narrative cohesion, grammar,

6. information units, and exchange structure. The research offers meaningful insights into
the nature of scaffolding around a person with a TBI, the effectiveness of those
communications, and how to form effective support structures to aid in their recovery.
Kim, H., Burke, D., Dowds, M., Boone, K. & Parks, G. (2000). Electronic memory aids for
outpatient brain injury: follow-up findings. Brain Injury, 14(2), 187-196.
The authors, researchers at Harvard Medical School Spaulding Rehabilitation Hospital,
Emerson College and the State University of New York Health Science Center, examine
if individuals with a brain injury, who are in outpatient care, benefit from the use of
palmtop computers to assist with daily memory-related activities. During a follow-up
period ranging from 2 months to 4 years, the majority of the patients continued to use
assistive technologies to aid memory. This research may assist in determining helpful
features in the development of a new memory aid.
Stapleton, S., Adams, M. & Atterton, L. (2007). A mobile phone as a memory aid for individuals
with traumatic brain injury: A preliminary investigation. Brain Injury, 21(4), 401-411.
The authors, researchers at Julian Hospital, Colman Hospital and the University of East
Anglia, investigate the use of setting reminders on a mobile phone as a memory aid for
people with a traumatic brain injury. Their preliminary investigation with five
participants suggests that this memory aid works best for individuals who do not have
severe memory impairment or who require 24-hour care. The use of the phone assisted
two participants in learning and remembering their routines, which improved target
behaviors after removal of the phone. This work provides support to our research project,
which examines how individuals with a TBI use assistive technologies as a memory aid.
This article may also be helpful in determining the design requirements of a new memory
system.
Wilson, B., Emslie, H., Quirk, K., Evans, J. & Watson, P. (2005). A randomized control trial to
evaluate a paging system for people with traumatic brain injury. Brain Injury, 19(11),
891-894.
The authors, researchers at Addenbrooke’s Hospital in Cambridge, conducted a
randomized control trial to see if a paging system could reduce memory and planning
issues for people with traumatic brain injury. The researchers concluded that this
particular paging system is a useful memory aid due to the statistically significant
increase in task achievement and level of independence for people with TBI. This is
another study that can assist in determining the requirements for the development of a
new memory aid for our research project.
Wisconsin’s Traumatic Brain Injury (TBI) Statewide Task Force/Network. (2007). Memory
Module. Retrieved May 2, 2012 from from http://dpi.wi.gov/sped/pdf/tbi-
memoryguide.pdf.

7. This guide is the result of an extensive study that was put together by the Wisconsin TBI
Initiative through research grants that they received. The article explores the constructs of
memory and memory loss as a by-product of TBI and provides a comprehensive
overview on the subject(s). The target audience is essentially parents who are dealing
with a child who has experienced a Traumatic Brain Injury (TBI), as well as educators.
This work effectively underpins our research and helps us to form the basis of our
understanding of the physical repercussions of TBI and associated permanent brain
damage on learning and memory. It includes several valuable checklists that assist in
creating a complete understanding of the effects of TBI and associated permanent brain
damage.