Please listen to the presentation, read detailed slides and return to first post to make your comments below the corresponding paper author's post. Session Chair: Shun Okuhara Session Theme: Education and Support Session Number: 5 Paper No: 5 Session and Talk No: TS5-4 Type: Short Co-authors: Ming Yi, Kecheng Lai and Yukari Nagai Title: Using Symbol Designs for a Cooking Puzzle Game as Training Material for Error-less Learning for MCI

1. Using Symbol Designs for a Cooking
Puzzle Game as Training Material for
Error-less Learning for MCI
YI Ming
LAI Kecheng
Nagai Yukari

2. Overview
INTRODUCTION
EL training can improve people
with mild cognitive impairment
(MCI) and those in the early stages
of dementia (PwD). Error-less
learning (EL) refers to a kind of
learning that does not make any
mistakes in the learning process
method
ORIGINALITY
Let the EL training
method turn be combined
with fun puzzle games, it is
more immersive and allows
participants to be more
interested in the experiment
METHOD
We design the graphic
symbols and combine the
Error-less learning method as a
cooking puzzle game,
composed of creative symbols,
to carry out the cooking
process.
DISSCUSSION
In this study, we examined how
people with cognitive
impairments learn to use
puzzle games through errorless
learning techniques and how
the application of these
techniques’ change over time.

3. INTRODUCTION
Literature review：
1. Japan is renowned worldwide as an aging society and thus the
problems caused by aging have also attracted more and more
attention within the country. The cognitive function of the elderly
declines with age, and ones with mild cognitive impairment (from
now on referred to as MCI) diseases are gradually increasing. It is
also noted that the early symptoms of dementia often include MCI
(Nordlund) Et al., 2005).
2. Other studies have pointed out that the likelihood of
people with MCI developing dementia in the future is as
high as 16% to 41% (Petersen, 2011; Gauthier et al.,
2008).

4. INTRODUCTION
3. Most research results indicate that cognitive training is the best
way to improve cognitive dysfunction or MCI in the elderly. Some
studies have found that Error-less learning (from now referred to
as EL) can help them improve their usual memory and cognitive
functions. This method is more effective than other types of
learning methods, such as error learning (Hyer et al., 2015;
Roberts et al. 2016).

5. 5
INTRODUCTION
4. In addition to drug treatment, nostalgia therapy has also been
proven to be an effective way to exercise the cognitive function of
the elderly and improve their physical and psychological
conditions. The elderly who often play with educational toys can
delay thinking degradation; enhance concentration, cognition and
memory. Daily activities such as shopping, cooking, and
housework has also been seen to help prevent Alzheimer’s (Zhang
Wei et al., 2012 ).

6. Participants
65-85 years old elderly Japanese people
Selected 8 elderly people from Japanese society who do not attend a facility for the aged
24 food and condiment samples which we narrowed down
24 graphic symbols were first used for recognition and memory target training and were
divided into 6 different training questionnaires (Figure 1) and 3 puzzle games
EXPERIMENTAL METHOD

7. EXPERIMENTAL METHOD
Fig. 1 ‘Example of training questionnaires’

8. EXPERIMENTAL METHOD
The questions in the interview after
the test are about the evaluation of
the test. The questions posed are:
"Please briefly talk about your views
on this graphic symbol recognition
test"; "Do you think these graphic
symbols are easy or difficult to
recognize?"; "Do you think you can
still benefit from Error-less learning
methods even if you don’t know or
are unsure?”
Procedures

9. EXPERIMENTAL METHOD
After we conducted a recognition test of graphic symbols on the subjects, based on the
graphic symbols that the subjects already knew, we designed three puzzle games with
recipes as the theme. All had ranging and differing levels of difficulty and adopted a
method of Error-less learning.
Procedures

10. EXPERIMENTAL METHOD
Procedures
Fig. 2 ‘Example of puzzle game’

11. EXPERIMENTAL METHOD
Procedures
1. Partial training of the game
We started the training from the ‘A’ puzzle which has the lowest difficulty out of the three puzzles. Each
puzzle was used 4 times in total during the training. Each time the puzzle was changed in a clockwise
direction to ensure that the subject trained with different parts. During the training test, if a subject could not
recognize a graphic symbol, we gave them hints. Each subject conducted the partial training individually
without their fellow group members.

12. EXPERIMENTAL METHOD
Procedures
2. The overall training of the game
After the subjects had participated individually in the partial training test, they immediately conduct the main
training test of the puzzle together as a group (Figure 3). In the overall training test of the puzzle, as also
seen in the partial training, if the experimental subjects struggle to recognize a graphic symbol, we will also
give them prompts.

13. DISCUSSION
DATA
The data is collected in the following way.
First, we recorded the time taken for each subject to complete the
puzzle game test, which includes both the partial training test time and the
test time of the overall training.
Second, we recorded the number of hints required by the subjects
during each training and testing session. Once again, we observed and
recorded the completion of each link in the training test.
Finally, we collected interviews afterwards, about the participants’
attitudes towards the experiment.

14. DISCUSSION
1.Graphic symbol test results
We evaluated the results of the
graphic symbol test on four subjects.
In the connection test of the graphic
symbols to physical photos and the
graphic symbols to text interpretation
of physical objects, they were all
successful and accurate. No errors
were found in their test results, which
shows that the subjects can correctly
recognize the graphic symbols in the
puzzle experiment, and our graphic
symbol design is effective.
2. Game training test results
In this part of the training test, we
recorded their completion time and the
number of hints they required during
the completion of part of the puzzle test
and the overall test of the puzzle. First
of all, whether it was a partial training
test or an overall training test, the four
test subjects were successful and able
to complete each of the food puzzles
individually and as a group. Secondly,
when they completed the three puzzles
of ‘A’, ‘B’ and ‘C’, there was a
correlation that as the difficulty of the
puzzle increased, the time required for
them to complete the puzzle alone also
increased. However, in the overall
training test of the ‘A’, ‘B’ and ‘C’
puzzles, where subjects participated
together as a group, the time required
for each part showed a decreasing
characteristic.
3. Summary
In this study, we examined how
people with cognitive impairments
learn to use puzzle games through
errorless learning techniques and
how the application of these
techniques’ change over time. With
longitudinal application of errorless
learning techniques to teach people
with cognitive impairments to play
puzzle game tasks we would see a
decrease in the need for the games
over time which would be indicated
by the following: if participants are
able to play with fewer prompts from
the experiment instructor, if
participants complete more turns
independently, and if there is a
shorter duration of turns(i.e., play
becomes quicker)

15. DISCUSSION
Limitations
This experiment is based on the selection of participants for the training process. It is necessary to
screen and separate the participants who usually cook and those who do not often cook. That is, the
accuracy and completion speed of the experiment is strongly related to whether the participants have
cooking experience. Also when the participants were doing the symbol recognition questionnaires and
training, it can be questioned whether they recognized them according to our training methods, or if they
used some exclusion methods; even though the graphic symbols we used were all derived from the
cognitive category of the respondents. However, it is possible that the subjects obtained the result
through conjecture during the experiment. This complicated and long process also requires later
experiments and data to prove and elaborate such issue, such as whether eye tracker test data is
needed to determine the accuracy of the participants' recognition of food graphic symbols. Since during
the training and testing and through the questionnaire, we concluded that all participants have a
corresponding increase in interest in this experiment. Can we seek more experimental people to
participate in this design and entertaining cooking? Puzzle games can produce such products for
society. At the same time, we need to seek a degradable, environmentally friendly, non-toxic and
harmless printing ink and paper medium that can be cooked with to further allow participants to enjoy
Error-less learning methods.

16. DISCUSSION
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