Augmented Input (PDAs/Smartphones) Enhances Memory, Organization, and Social Skills ___________________________________

1. Augmented Input (PDAs/Smartphones) Enhances Memory, Organization, and Social Skills ________________________________________________ The University of Akron School of Speech-Language Pathology and Audiology Yvonne Gillette, yg@uakron.edu Roberta DePompei, rdepom1@uakron.edu

2. What are PDAs and Smartphones? --- ROBOTS! • PDAs (Personal Data Assistants) • Robots in the shape of small notebook • Enhances your memory and organization skills • Includes pages similar to daily planners • Smartphones • Cell phones with PDA-like software • Phone service • Note: Many cell phones have the same planning features

3. Key Features of PDAs/Smartphones • Appointment Calendar (alarms) • Contacts • To Do List: Daily, Weekly, Long-Term • Claculator, Expense List • Self-reminders-Voice or Written Memos • Camera

4. Benefits of PDAs/Smartphones • Benefits over Paper Planners • Can provide alarms for calendar entries • Insurance against loss-can be backed up • General Benefits of Planners • Increase independence for your client • Assist with organization and memory • Provide a platform for planning • Promotes social skills

5. PDA Intervention Plan : Assessment • Assesses a variety of functions • Appts, • Contacts, • To Do List, • Calculator/Expense List, • Self – reminders (written, voice) • Camera • Helps determine the need for PDA intervention • Provides baseline data

6. PDA Intervention Plan : Assessment Assess skills on this 1-7 independence rating scale • 7- Independent (no prompts needed) • 6- Modified independence (independent in certain situations) • 5- Low assistance (prompts needed in 2/10 attempts) • 4- Moderate assistance (prompts needed in 4/10 attempts) • 3- Moderate/high assistance (prompts needed in 6/10 attempts) • 2- High assistance (prompts needed in 8/10 attempts) • 1- Total prompting & assistance

7. Appointments: Day, Time, Event

8. Appointments • How well does your client keep track of appointments? • Could a device assist with this issue? • What is your client’s current organization method? • Would a device help for keeping track of appointments?

9. Contacts: Name, Address, Phone, Other

10. Contacts • How well does your client keep track of contacts? • Could a device assist with this issue? • What is your client’s current organization method? • Would a device help for keeping track of contacts?

11. To Do List: Daily, Weekly, Long-Term

12. To Do List • How well does your client plan or follow to do lists? • Could a device assist with this issue? • What is your client’s current organization method? • Would a device help for planning and following to do lists?

13. Calculator, Expense List

14. Calculator, Expense List • How well does your client keep track of finances or use a calculator? • Could a device assist with this issue? • What is your client’s current organization method? • Would a device help for use of a calculator or expense list?

15. Self-reminders: Voice or Written Memos

16. Self- reminders • How well does your client keep track of reminders/memos? • Could a device assist with this issue? • What is your client’s current organization method? • Would a device help for self-reminders?

17. Camera

18. Camera • How well does your client keep track of personal events? • Could a device assist with this issue? • What is your client’s current organization method? • Would a device help for a record of personal events?

19. Intervention Plan: Identify Environment, Partner, Opportunities Provides Negotiations Points for interventionist and client/significant others • Choose environments, • Choose partners • Choose opportunities for use within environs • Remindering (Meds, Appts. Assignments) • Planning the day • Planning and monitoring expenses • Interacting with healthcare system, friends, family • Providing access to portable computer functions – Office, email

20. PDA Intervention Plan: Identify Functions • Identify useful functions and one function to target for intervention • Calendar • Alarm • Contacts • To Do List • Notes/memos to self – written, oral • Calculator • Camera • Games • Computer functions • Microsoft Office

21. PDA Intervention Plan: Identify Outcomes • Identify initial outcomes, formulate a measurable outcome • Examples • Responds once each day to one alarm in a timely fashion • Present level, moderate assistance, prompts needed 4/10 opportunities • Projected level: Low assistance, prompts needed 2/10 • Completes one chore once each day • Present level, Low assistance, prompts needed 2/10 opps • Projected level: modified independence, independent at home with trash • Subtracts amount spent from total amount to determine change • Present level, Moderate/high assistance, prompts needed 6/10 opps • Projected level: Moderate assistance, prompts needed 4/10

22. PDA Intervention Plan: Identify Schedule • Schedule – ideally should be within the PDA/Smartphone • Days and Times each opportunity will occur • Person responsible for task completion should be part of the scheduling negotiation • Adjust schedule as needed • Important but often neglected step

23. PDA Intervention Planning: Monitoring Plan • Identify progress on the plan • Identify what needs to change – consider environment, partner, opportunity-function , outcome, or schedule as potentially needing change • Collect views of client • Collect views of partner • Negotiate a new plan based on data collected

24. Mean Rate of Responding Across Condition (Baseline, Planner, Dell, Palm) 100 90 80 70 60 Weeks 1-4 Mean Rate of Responding 50 Weeks 5-8 40 30 20 10 0 SA- A-TBI A-ID SA- A-TBI A-ID SA- A-TBI A-ID SA- A-TBI A-ID ID/TBI ID/TBI ID/TBI ID/TBI Baseline Planner Dell Palm Condition by Population Mean Rate of Responding Across Condition

25. Key Findings for Rate of Responding: • Palm PDA was the most effective reminder method across groups • School-age TBI/ID site had greatest mean rate of response across sites and conditions with Palm • Adult TBI site had next highest rate with Palm • Planner was the least effective • Reminder systems were most effective with school-age TBI/ID and adult TBI sites

26. Key Findings for Adults with TBI: • Participants: • Performed best with PDA • Performed better with simple list than PDA • Showed no difference between phone call and daily task • Performed better with Palm than Dell • Gender, age, and cognitive test performance levels were not predictive

27. Key Findings for Students with ID or TBI: • Participants: • Performed best with PDA • Performed better with simple list than PDA • Showed no difference between phone call and daily task • Had similar performance with Dell and Palm • Performed 15% better in least restrictive environment • Were 50% better with an A.M. reminder • Gender, age, diagnosis, and cognitive test performance levels were not predictive

28. Key findings for adults with ID: • More independence with electronic • Relieved caregiver burden • Performed best with A.M. reminder • Better performance in non-sheltered workshops due to more environmental opportunities

29. Case Studies

30. Three Studies • 35 - Alarm Study participants • 07 - Multiple Function participants • 02 - SmartPhone Studies

31. Case 1: RW • Female • Age: 19 • Sustained TBI in car crash • School Placement: Educ. Services through a county MRDD program • Device: Palm

32. RW – Video

33. RW: Alarm Response Studies Results

34. RW Alarm Study Findings

35. Used pre and post training: Calendar Responding to alarms Setting alarms Accessing data Contact List Accessing data Entering data Task List Accessing data Calculator Games Solitaire Camera Computer Functions Hot sync RW: Multiple Function Study Did not use pre or post: • MS Office • Personalization options

36. RW: Multiple Function Study New Functions: • Task List • Entering data • Notes • Text • Voice • Games • Tetris • Beaming • Computer Functions • File upload

37. RW – Task List Video

38. RW – CellContacts Video

39. RW Phase 3– Smartphone Functions • Additional functions used at end of phase 3: • Phone • Calendar • Entering data • Games • Jawbreaker • New features used: • Ring tones • Screen settings • Background

40. Subject Description: MB • Male • Age 14 • Intellectual Disability • Special education classroom/middle school • Limited literacy skills; good verbal skills • Dell Pocket PC

41. MB: Alarm Response Studies Results

42. MB Alarm Study Findings

43. Used pre and post training: Calendar Responding to alarms Games Jawbreaker MB: Multiple Function Study Did not use pre or post: • Task List • Computer Functions • MS Office • Personalization options

44. MB: Multiple Function Study New Functions: • Calendar • Setting alarms • Accessing data • Contact List • Accessing data • Notes • Text • Voice • Calculator • Games • Tetris • Beaming

45. MB- Dell Calendar Video

46. MB Teaches Another Student to Use the Dell Video

47. MB Phase 3 – Smartphone Functions • Additional functions used at end of phase 3: • Phone • Calendar • Entering data (with written prompts) • Contact List • Entering data (with written prompts) • Task List • Accessing data • Camera • New features used: • Ring tones • Background

48. MB – Cell Text Message Video

49. MB – Cell Picture Video

50. MB – Cell Contacts Video