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TopIntroduction
Assistive technology for cognition (ATC) is technology to extend mental capacity. The majority of people reading this article will use technology to support their everyday cognitive function; by setting appointment reminders on their phone to support prospective memory, using a SatNav to support navigational skills or an search engine as an alternative to storing information in long term memory. If technology can support the cognition of ordinary individuals, potentially it can have an even greater role in assisting the cognition of people who through illness, injury or developmental disorders live with cognitive impairment. In these cases technology can act as a cognitive prosthetic or orthotic supporting or replacing lost or impaired cognitive function (Cole, Dehdashti, Petti, & Angert, 1994).
Research on Assistive Technology
Research on assistive technology for cognition has been accelerating over the last twenty years and has already been the subject of a number of authoritative reviews (LoPresti, Mihailidis, & Kirsch, 2004). It is common for reviews to restrict their scope to a single clinical group e.g. dementia (Bharucha et al., 2009) or technology type e.g. electronic portable devices (Charters, Gillett, & Simpson, 2014) or type of cognitive impairment e.g. memory disorders (Jamieson, Cullen, McGee-Lennon, Brewster, & Evans, 2013). However there is no reason why the application of ATC devices should be limited by the etiology of the cognitive disorder. A device that supports prospective memory is just as likely to work for someone with traumatic brain injury as it is for someone with intellectual disabilities. Likewise devices such as a smart phone can perform a myriad of functions. Therefore examining the effectiveness of smart phones as an ATC lacks specificity. To counter these difficulties Gillespie, Best & O’Neill (2012) classified ATC by the function of the device and looked across all the ways technology can act as a cognitive prosthesis for the diverse etiologies of cognitive impairment. ATC devices were classified into: reminding, storing and displaying, navigating, distracting, biofeedback and micro prompting technologies (see (Best, O’Neill, & Gillespie, 2013; Gillespie, Best, & O’Neill, 2012). This review focuses on one type of assistive technology ‘microprompting technologies’.
Microprompting Technologies
Microprompting technologies are a type of assistive technology for cognition that support the planning and execution of complex behavioral sequences. Even mundane tasks such as getting dressed, hand washing or making a cup of tea require complex prioritization of action, goal monitoring, decision making and problem solving for their successful execution. Microprompting devices break down complex tasks into steps and prompt the user through each step of the sequence and continually check that the activity goal is being achieved. Microprompting devices guide the user through an immediately present task step-by-step usually using either verbal and/or visual prompts. In this chapter we aim to review existing studies of microprompting devices and discuss the limitations of these studies. We will then cover how these limitations have been addressed by the most recent work in this area and outline the most pressing research priorities. Section 1 of this chapter describes and evaluates existing research on microprompting devices; section 2 discusses how recent research addresses the limitations of previous work and section 3 outlines future research priorities.
Background
Gillespie, Best and O’Neill’s 2012 review identified 22 trials of microprompting technologies. These studies are shown in Table 1.
Key Terms in this Chapter
Alerting ATC: These are devices which draw attention to something present in the environment.
Distracting ATC: Distracting devices are those which distract users from anxiety provoking stimuli.
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).
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.
Cognition: Thinking, remembering, and knowing.
Navigating ATC: These devices help the user to be aware of their location.
Assistive Technology for Cognition: Use of technology to extend human mental capacity.
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.
Storing and Displaying ATC: These devices store and present stimuli that are 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.