Abstract
Assistive Technology for Cognition (ATC) is the use of technology to extend human mental capacity. The present chapter reviews the use of assistive technology in health and social care for people with cognitive impairment. The review conceptualizes ATC in terms of function (reminding, alerting, micro prompting, distracting, storing and displaying, navigating, and biofeedback), as opposed to the type of technology (mobile phone, desk-top computer, etc.). This is necessary as many modern devices can perform multiple functions. Some important distinctions are revealed by this new way of looking at assistive technology. Of particular significance is whether the ATC intervention is enabling the external control of action or whether it prompts internal self-regulation.
TopBackground
Ever since personal computers became mainstream technology more than thirty years ago, researchers and clinicians have seen the potential for Information and Communication Technology (ICT) to assist people with cognitive impairments. Computer functions, such as ‘memory,’ are the very ones that are lost when people have a brain injury. Therefore it was a short step to try and employ ICT to replace or augment impaired cognitive functions.
In cognitive rehabilitation technology has been employed in two distinct ways:
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In a Restorative Capacity: That is, training exercises and other therapies designed to restore lost or damaged cognitive functions. For example memory drills performed on a computer.
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As Compensation: That is, rather than altering the individual, compensatory strategies change the environment to facilitate task performance. For example someone with a prospective memory impairment listening to prerecorded, time-activated voice messages to remind them to perform activities of daily living is a method of compensation.
ATC is compensatory. It is technology that enables someone to perform a cognitive tasks that they would not be able to perform unassisted.
It is important the researchers and clinicians to have up-to-date information on the efficacy of these devices in order to firstly match potential users to effective assistive technology devices and secondly, to identify gaps in the evidence base, that is, areas for future research and device development. For this reason we conducted a systematic review of assistive technology for cognition (Gillespie, Best and O’Neill, in press).
TopReview Of Assistive Technology For Cognition
Search Criteria and Strategy
We conducted a search of medical (Medline, AMED, EMBASE) and psychology (PsychINFO) literature databases for terms associated with cognitive impairment e.g. attention, or memory, or executive function, combined with cognitive rehabilitation plus a technology term. The databases were searched from earliest to April 2011. Studies where the intervention primarily supported language, reading or writing were excluded. We then searched the reference lists of included papers and reviews in the field. .
Results
The review found a total of 89 publications describing 91 studies.
Participants
The 91 included studies included participants with cognitive impairment of diverse etiology: Traumatic brain injury, dementia, intellectual disability, neurodevelopmental disorder, and mental health problems. The majority of studies were of people with acquired brain injury.
Key Terms in this Chapter
Distracting ATC: Distracting devices are those which distract users from anxiety provoking stimuli.
Cognition: Thinking, remembering, and knowing.
Biofeedback ATC: Provide the user with information about their own bodies.
Reminding ATC: Those devices providing a one-way, usually one-off, time-dependent reminder about something not in the immediate environment which is intended to be an impetus to action (e.g., reminder about an appointment).
Alerting ATC: These are devices which draw attention to something present in the environment.
Executive Function: Specific mental functions that enable goal directed behavior. This includes the functions of planning, engaging, and disengaging attention, postponing reward and sequencing complex behaviors.
Micro-Prompting ATC: Micro-prompting devices provide detailed step-by-step prompts, guiding the user through an immediately present task. The supported tasks are usually complex with multiple embedded stages so the devices often require feedback on task progress in order to generate the next prompt in the sequence.
Navigating ATC: These devices help the user to be aware of their location.
Storing and Displaying ATC: These devices store and present stimuli that is personally relevant. These devices are not time bound i.e. they do not present information in a time dependent fashion but instead are always used in an interpersonal context. These devices are never an impetus to action.
Assistive Technology for Cognition: Use of technology to extend human mental capacity.