In my last article, I wrote about a local teen that experienced brain injury. March is Brain Injury Awareness Month and this time around I will share some strategies using mobile technologies to support those with brain injuries.
Just as every person is unique, the symptoms of brain injury may vary from one person to the next. Common cognitive challenges, however, include memory and attention issues, difficulty with step-by-step tasks, wayfinding and stress management.
Tony Gentry, PhD, OTR/L has treated clients with brain injuries for over 20 years and now directs VCU’s Assistive Technology for Cognition Laboratory, where he has conducted a series of studies on the use of mobile devices as cognitive aids.
Tony has found that reminder alerts on mobile devices can compensate for memory deficits after brain injury, helping people manage everyday tasks that they might otherwise forget. Tony says, “Nobody likes to be nagged. So when we begin, I ask a person, ‘What are the top 4 or 5 things that people nag you about the most?’ It might be something as routine as brushing your teeth or remembering to take medicine. Then we program the device to do the nagging, which reduces the need for supervision.”
Tony has learned that individuals who have trouble completing multi-step tasks can benefit from step-by-step lists or picture-sequence supports, both of which are available on mobile devices. Free apps like Muzio and Snapguide allow you to build talking slide shows or instructional videos directly on your mobile device. Other uses of mobile video include behavioral coaching and wayfinding. For an example, see this video designed for one of Tony’s classes by a VCU Occupational Therapy student team.
Many people with brain injury face daily anxiety and stress. Tony explains, “Apps that offer instruction in deep breathing or relaxation can help. Sometimes music, puzzle or game apps offer welcome distractions from worry. If a person with a brain injury is at risk of wandering, it is important to use a GPS-based person-tracking app, such as Find my iPhone or Family Tracker to help caregivers find her/him, if they get lost.”
For school, finance management and organizational work tasks, a host of apps are available. The same is true of healthy living apps that address fitness, sleep and diet. The biggest challenge, Tony feels, is keeping up with all the available tools and selecting the best suite of apps for each particular client. He cautions against using too many apps. In his research, most clients rely on only 3 or 4 apps – typically a reminder, a task-sequencing list, a task management video or two, and a relaxation app. This gets the job done without the risk of overwhelming or confusing a person with too many choices. He starts with reminders, and as a person becomes competent in their use, adds an additional support one at a time.
Tony says, “There is a growing body of research evidence showing that mobile devices help people with cognitive-behavioral challenges function more independently. Best of all, these devices are portable, relatively inexpensive, and – because they are so popular with the general public — they are not stigmatizing.” He cautions that it is important to work with a clinician who understands brain injury and the devices themselves, one who can follow a step-by-step assessment, intervention and follow-along approach to ensure success. Without that, a device that may have been life-changing can end up gathering dust in a drawer.
Tony Gentry, PhD OTR/L is an associate professor in the occupational therapy department at Virginia Commonwealth University, where he directs the Assistive Technology for Cognition Laboratory, which conducts research in the development and utilization of smart homes, mobile applications, and sensor-based telehealth strategies to support individuals with cognitive-behavioral challenges.