Simulating naturalistic instruction: the case for a voice mediated interface for assistive technology for cognition

A variety of brain pathologies can result in difficulties performing complex behavioural sequences. Assistive technology for cognition (ATC) attempts support of complex sequences with the aim of reducing disability. Traditional ATCs are cognitively demanding to use and thus have had poor uptake. A more intuitive interface may allow ATCs to reach their potential. Insights from psychological science may be useful to technologists in this area. We propose that an auditory-verbal interface is more intuitive than a visual interface and reduces cognitive demands on users. Two experiments demonstrate a novel ATC, the General User Interface for Disorders of Execution (GUIDE). GUIDE is novel because it simulates normal conversational prompting to support task performance. GUIDE provides verbal prompts and questions and voice recognition allows the user to interact with the GUIDE. Research with non-cognitively impaired participants and a single participant experiment involving a person with vascular dementia provide support for using interactive auditory-verbal interfaces. Suggestions for the future development of auditory-verbal interfaces are discussed

Physical activity to improve cognition in older adults: can physical activity programs enriched with cognitive challenges enhance the effects? A systematic review and meta-analysis

: EPHPP quality rating scores (DOCX 38 kb

The process of decline in advanced activities of daily living: a qualitative explorative study in mild cognitive impairment

Background: The notion of "minimal impairment in instrumental activities of daily living (i-ADL)" is important in the diagnosis of mild cognitive impairment (MCI), but is presently not adequately operationalized. ADL is stratified according to difficulty, complexity, and also to vulnerability to early cognitive changes in a threefold hierarchy: basic activities of daily living (b-ADL), i-ADL, and advanced activities of daily living (a-ADL). This study aims to gain a deeper understanding of the functional decline in the process of MCI. Methods: In a qualitative design, 37 consecutive patients diagnosed with amnestic (a)-MCI and their proxies were interviewed at two geriatric day hospitals. Constant comparative analysis was used for the analysis. Results: The a-ADL-concept emerged as important in the diagnosis of MCI. All participants were engaged in a wide range of activities, which could be clustered according to the International Classification of Functioning, Disability and Health (ICF). Participants reported subtle difficulties in performance. A process of functional decline was identified in which adaptation and coping mechanisms interacted with the process of reduced skills, leading to an activity disruption and an insufficiency in functioning. Conclusion: This study asserts the inclusion of an evaluation of a-ADL in the assessment of older persons. When evaluating ADL at three levels (b-ADL, i-ADL, and a-ADL), all the activities one can perform in daily living are covered

The advanced activities of daily living: a tool allowing the evaluation of subtle functional decline in mild cognitive impairment

Objectives: Assessment of advanced activities of daily living (a-ADL) can be of interest in establishing the diagnosis of Alzheimer's disease (AD) in an earlier stage, since these activities demand high cognitive functioning and are more responsive to subtle changes. In this study we tested a new a-ADL tool, developed according to the International Classification of Functioning, Disability and Health (ICF). The a-ADL tool is based on the total number of activities performed (TNA) by a person and takes each subject as his own reference. It distinguishes a total Disability Index (a-ADL-DI), a Cognitive Disability Index (a-ADL-CDI), and a Physical Disability Index (a-ADL-PDI), with lower score representing more independency. We explored whether these indices allow distinction between cognitively healthy persons, patients with Mild Cognitive Impairment (MCI) and patients with mild AD. Methods: Participants were on average 80 years old (SD 4.6; 66-90), were community dwelling, and were diagnosed as (1) cognitively healthy subjects (n=26); (2) patients with MCI (n = 17), or (3) mild AD (n = 25), based upon extensive clinical evaluation and a set of global, cognitive, mood and functional assessments. The a-ADL-tool was not part of the clinical evaluation. Results: The a-ADL-CDI was significantly different between the three groups (p<.01). The a-ADL-DI was significantly different between MCI and AD (p<.001). The tool had good psychometrical properties (inter-rater reliability; agreement between patient and proxy; correlations with cognitive tests). Although the sample size was relatively small, ROC curves were computed for the a-ADL-DI and a-ADL-CDI with satisfactory and promising results. Conclusion: The a-ADL-CDI and a-ADL-DI might offer a useful contribution to the identification and follow up of patients with mild cognitive disorders in an older population

Neuroscience-informed Auditory Training in Schizophrenia: A Final Report of the Effects on Cognition and Serum Brain-Derived Neurotrophic Factor.

ObjectiveWe previously reported the interim effects in a per protocol analysis of a randomized controlled trial of an innovative neuroscience-informed computerized cognitive training approach in schizophrenia. Here we report the effects of training on behavioral outcome measures in our final sample using an intent-to-treat analysis. We also report the effects on serum brain-derived neurotrophic factor (BDNF).MethodEighty-seven clinically stable participants with schizophrenia were randomly assigned to either targeted auditory training (AT, N=46) or a computer games control condition (CG, N=41). Participants were assessed on neurocognition, symptoms and functional outcome at baseline and after 50 hours of intervention delivered over 10 weeks. Serum BDNF was assessed at baseline, at 2 weeks, and at 10 weeks.ResultsAfter the intervention, AT participants showed significant gains in global cognition, speed of processing, verbal learning, and verbal memory, relative to CG participants, with no changes in symptoms or functioning. At baseline, schizophrenia participants had significantly lower-than-normal serum BDNF. AT participants showed a significant increase in serum BDNF compared to CG participants, and "normalized" levels by post training.ConclusionsParticipants with chronic schizophrenia made significant cognitive gains after 50 hours of intensive computerized training delivered as a stand-alone treatment, but no improvement in symptoms or functioning. Serum BDNF levels were significantly increased, and may serve as a peripheral biomarker for the effects of training. Future research must focus on: 1) Methods of integrating cognitive training with psychosocial treatments; 2) A deeper understanding of underlying neurophysiology in order to enhance critical mechanisms of action

Teaching and learning beyond academic-reality: an experience on teaching english to cognitively impaired learners

La presente investigación reporta una experiencia sobre la enseñanza del idioma inglés a personas adultas con discapacidad cognitiva, cuya lengua materna es el español. Para dicho propósito, se llevaron a cabo diez sesiones de enseñanza del inglés a trece aprendices con discapacidad cognitiva en un instituto con énfasis en el campo de la educación especial “SEI”. El objetivo de este estudio fue describir la experiencia de enseñar inglés tanto de los aprendices como de los maestros. La recolección de datos se hizo usando diferentes instrumentos como entrevistas, observaciones, y la producción de los estudiantes. Los resultados de este estudio sugieren que los estudiantes con discapacidad cognitiva pueden aprender vocabulario de una lengua extranjera exitosamente usando estrategias, materiales, técnicas y métodos como lo son: el aprendizaje cooperativo y la respuesta física total. Del mismo modo este estudio muestra algunos casos particulares en los cuales las clases pudieron haber contribuido no solamente a que los estudiantes aprendieran vocabulario en inglés, sino que al parecer también tuvo un impacto en su desarrollo de la lengua materna, así como en su desempeño en cuanto a conducta y actitud.This research study reports an experience on teaching English to cognitively impaired (CI) adults whose mother tongue is Spanish. Ten lessons of English language were conducted to thirteen learners with cognitive disabilities from an institute specialized in the field of special education “SEI”. The study aimed at describing the experience of teaching English for both, learners and practitioners. The information was gathered through the application of diverse instruments such as: interviews, observations, researchers’ journals, and learners’ products. Some findings originated from this study suggest that CI students can succeed at learning vocabulary in a foreign language through the use of different strategies, materials, techniques and methods, such; collaborative learning, and total physical response. Moreover, this study conveys some particular cases, where English lessons not only might have contributed to CI learners to learn some English vocabulary, but it also seemed to have impacted their first language development, as well as their behavioral and attitudinal development

Cognitive Training With Healthy Older Adults: Investigating the Effectiveness of the Brain Age Software for Nintendo DS

An increasing number of empirical studies have demonstrated the effectiveness of cognitive training (CT) with healthy, cognitively intact older adults. Less is known regarding the effectiveness of commercially available “brain training” programs. The current study investigated the impact of daily CT presented via the Brain Age® software for Nintendo DS on neurocognitive abilities in a sample of healthy, community-dwelling older adults. Over the six-week study, participants in the CT group completed training activities and were compared to an active control group who played card games on the Nintendo DS. At pre-test and post-test, a wide range of empirically validated neuropsychological outcome measures was administered to examine the proximal and distal transfer effects of training. Although within normal range, the average MMSE score was significantly higher in the control group at pre-test; no other baseline differences in demographics or performance on primary neuropsychological outcome measures were observed. In the CT group, estimated “brain age” decreased and performance on daily training tasks significantly improved over the six-week study period. Importantly however, performance improved from pre-test to post-test on measures of everyday verbal memory, visual working memory, and math fluency in both the CT and active control groups. Participants in the CT group rated usage of the Brain Age software as significantly more mentally challenging and endorsed greater subjective memory improvement at post-test than participants in the control group. These findings demonstrate that both CT and cognitive stimulation protocols produced transfer effects in the current study. That is, Brain Age software use led to enhanced cognitive performance over time, but it did not do in a manner that exceeded the effects achieved by general cognitive stimulation. Enhanced working memory in the CT group and executive attention in the control group are discussed as possible explanation for improved performance on the outcome measures

Enhancing creativity and play through accessible projector-based interactive PC-control touch technology

Standard computer peripherals are often challenging to use for mobility impaired, and in particular controlling computer mouse movements efficiently and without risking strain injuries. Projected touch screen technology show promise in this respect. This paper presents a Projected Interactive PC-control pilot (PIP) solution for computer interaction. The paper focus on testing and improving the usability of the PIP solution through iterative user tests with mobility impaired children. It describes prototype improvements aimed at fulfilling the requirements of users with reduced motor skills, and discusses challenges and key findings from the extensive usability tests. Our results demonstrates that interactive touch based solutions may enable heavily impaired children to independently partake in creative activities and play, and points to the value of creating a touch based computer interaction solution tailored to the needs of this user group