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Heidi Cramm

Heidi Cramm . Assistive Technology and Mental Health May 12, 2009 M.A., M.Sc. (O.T.—Post-Professional), Doctoral Candidate Occupational Therapist Proprietor, Compass Occupational Therapist Solutions, Kingston, ON. Objectives.

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Heidi Cramm

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  1. Heidi Cramm Assistive Technology and Mental Health May 12, 2009 M.A., M.Sc. (O.T.—Post-Professional), Doctoral Candidate Occupational Therapist Proprietor, Compass Occupational Therapist Solutions, Kingston, ON Heidi Cramm, May 12 2009

  2. Objectives • To discuss the significance of mental health issues for students • To become familiar with executive functioning skill deficits and how they relate to mental health disorders • To describe assistive technology features and applications that may benefit students who have mental health disorders and experience executive dysfunction Heidi Cramm, May 12 2009

  3. Students and Mental Health • 1 in 5 children and adolescents in Canada are affected by mental health issues. • 80% NEVER get help • Seventy per cent of adults living with a mental health problem developed symptoms before they were 18. (http://www.thespec.com/article/559061) Heidi Cramm, May 12 2009

  4. Students and Mental Health • By the time many students enter post-secondary institutions, their mental health status has already been affected • Major life changes such as leaving home or beginning post-secondary studies can place these students at further risk Heidi Cramm, May 12 2009

  5. Executive Functions • Capacities related to successful engagement in productive, independent, and constructive behaviours • Relate to: • Planning tasks • Initiating activity • Self-monitoring of task performance • Self-correcting of behaviour • Anticipating outcomes • Levels of motivation Heidi Cramm, May 12 2009

  6. Executive Functions are distinct from Cognitive Functions Executive Functions Cognitive Functions • How do you do something? • How do you do things? • PROCESS • How much do you know? • What can you do? • KNOWLEDGE Heidi Cramm, May 12 2009

  7. EXECUTIVE FUNCTIONS …knowing what you need, how long it will take, how to start, how to keep going, how to know when you are finished, where you need to be, etc. The executive assistant to your brain Heidi Cramm, May 12 2009

  8. Executive Dysfunctions • Manifested in difficulties in • Initiation • Identifying needs and wants • Planning • Identifying the components of the task • Sequencing the steps in an organized way • Purposive action • Translating intentions into actions • Requires maintaining efforts and switching between steps • Monitoring effectiveness of performance • Being able to monitor and adjust one’s performance Heidi Cramm, May 12 2009

  9. Executive Dysfunction Simulations • Writing • Reading Heidi Cramm, May 12 2009

  10. Heidi Cramm, May 12 2009 NE WD is cove Rat the DnNIOsURsCPtOl of thEWrlb RceNtbisOVeriEshavestrnthnb Al8ERTS ruPUtatOIn as the “DnoSUarCaptolOF THE Wrolb” sCIentISTtsattheROyel Tyrell Musseum inDruMHeller, Al8RtA, ar eExAMnin9 the frist 8uCk-DillbbinsoaRSkelTOn to 8e recOVRrb in nrTHern Alberta. The SKlEtnculbRreprsNTa new species of DinoSor. The habROsaur, or bUC8illebbiNOSoaur, lvb a8out 73 miiliion YEarSa9o, whENMuch Of AlbRTA was cVoreb 8y aVaStinlanbsea. HreD of DUck/DiillEbcreturs MOVED acroosthelsushly Vee9eETGteb lo Wlanbs, foloW in tMIe8ySUch prEDtRs as the Tyrannosaursusrex.

  11. Executive Dysfunction Simulations • Attention: • http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp1a.html • Memory: • http://www.pbs.org/wgbh/misunderstoodminds/experiences/readexp2a.html Heidi Cramm, May 12 2009

  12. Relating Executive Functions to Mental Health Heidi Cramm, May 12 2009

  13. Learning Disability • Processing information can take longer, so individuals may persist at tasks and miss other information • Individuals may also avoid tasks due to the effort and energy required • The mechanics of reading, writing, spelling, and memorizing can hog cognitive resources, making it difficult to sequence and plan larger tasks Heidi Cramm, May 12 2009

  14. Attention Deficit Disorders • Inattention is a common difficulty • Impulsivity associated with difficulties with self-monitoring and self-regulation is common • Distractibility also occurs, and individuals may shift attention to novel stimuli as they are introduced Heidi Cramm, May 12 2009

  15. Comorbidity with LDs and ADHD • LD and AHDH often comorbid • May be comorbid with • Anxiety • Mood • Behavioural disorders Heidi Cramm, May 12 2009

  16. Bottom line:If you are working with students with LD and/or ADHD, be prepared to see anxiety or mood issues Heidi Cramm, May 12 2009

  17. Anxiety Disorders • Difficulties with • Maintaining concentration • Recurrent and persistent thoughts, images, and behaviours that create an experience of distress • Trying to control the worry • Keeping oneself regulated in emotion, thinking, and behaviour Heidi Cramm, May 12 2009

  18. Mood Disorders • Mood disorders can have powerful impacts on initiation of goal-directed behaviours • Sequencing tasks places a heavy demand on executive functions to prioritize, organize, and anticipate, posing a challenge for those with mood disorders Heidi Cramm, May 12 2009

  19. Asperger’s Syndrome • Shifting between tasks is difficult • Can become “stuck” cognitively in rigid thought patterns • Shifting perspectives to see big picture and how details are connected is extremely difficult • “connecting the dots” problematic • Initiation of goal-directed behaviour may be difficult as identification of needs and wants may prove challenging • Decoding single constructs into an organized sequence is very difficult Heidi Cramm, May 12 2009

  20. Psychotic Disorders • Intrusive thoughts and sensations can impair an individual’s ability to maintain concentration • Vigilance required to maintain focus and actively disregard those intrusions is very energy demanding Heidi Cramm, May 12 2009

  21. Other factors • Pain • Fatigue • Medication effects Heidi Cramm, May 12 2009

  22. How can assistive technology help? Heidi Cramm, May 12 2009

  23. How? • Mechanical burden mitigated • Expectation that student read, write, and memorize to learn realized through the use of AT • Lack of automatization accommodated for • Discrete chunks of information more accessible in clear sequence • See how the pieces of information are linked, can alternate between big picture and little picture • Inefficiencies shored up through study skill tools • Organizational supports provided • Difficulty in switching between tasks supported Heidi Cramm, May 12 2009

  24. Kurzweil 3000 • Reading features supports attention • Study skill features can allow for effective and efficient note taking • Highlight and extract • Extract to column notes • Extract column notes to outline • Writing features allow for integration of reading and writing into one task • Supports for • Commonly confused words • Revision learning strategies • Word lists Heidi Cramm, May 12 2009

  25. Dragon 10 • Significantly improved from earlier versions • Those with experience using Dragon dictation software from 3 or 4 years ago or longer will not recognize the program as it currently works • Dictation that works well can be an incredible to support to individuals who can lose their train of thought or who would benefit from the efficiencies it offers doing written work • Integrates with the other AT for synergistic results Heidi Cramm, May 12 2009

  26. Inspiration • An incredible process support • Visually allows individuals to • See the sequence • Prioritize and sort the information • Monitor their performance • Comprehension checking • Connect big picture and details without losing the thread • Hyperlink series of documents Heidi Cramm, May 12 2009

  27. Microsoft OneNote • Acts like an electronic binder • Customizable to suit need • Automatically saves • Offers a visible index of the material so it can be found quickly Heidi Cramm, May 12 2009

  28. Email contact information • Please feel free to contact me at: hcramm@cogeco.ca heidi.cramm@queensu.ca Heidi Cramm, May 12 2009

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