Quarter Project ProposalHCI 511

Spring Quarter 2012

Team TBIJoseph HowertonJessica LoPresti Carlyn Porter

Submitted on May 5th, 2012

Project TypeTeam TBI is proposing to engage in a pre-design, qualitative research study that will examine the use of assistive technologies to aid memory for people who have experienced a Traumatic Brain Injury (TBI), with associated permanent brain damage and memory loss.

Target PopulationWe will focus our research on the support needs of one person between the ages of 14 and 18 years old. Ideally, our participant will be an adolescent who has experienced a significant TBI, permanent brain damage, and is affected by short-term memory loss. To recruit our participant, we will be reaching out to Amy LaBay of Anixter Center to identify a candidate and their family.

The ProblemWith any TBI - whether mild, moderate, or severe - there is a considerable chance for permanent brain damage. One of the most common factors associated with permanent brain damage is some form of memory loss. This loss of memory can be connected to a diminished ability for the person to perform even the easiest of daily tasks without help from another person, which leads to an increased interdependency on their support system. Inherent in the spectrum of frustrations are anxiety, decreased sense of self and a lack of overall autonomy.

Project SummaryTeam TBI intends to explore and discover the impact of Traumatic Brain Injury (TBI) on human memory. We understand that there are two primary forms of memory loss - short term and long term. Our focus will be on short-term memory (STM) loss and working memory (WM) limitations. We will study the impact this has on independence by understanding the constructs of their Distributed Cognition Network, or scaffolding.

The goal of this research is to define the design of a memory aid, otherwise known as an artificial agent. In order to ascertain what is required of such a device, we plan to identify one candidate and the people that constitute their support environment, which we will call stakeholders. The stakeholders are the scaffolding, or the human agents that make up the distributed cognition network, for one member of the target population.

To better understand the user needs of the target population, we will perform a discovery phase and a process of requirements analysis. These efforts will incorporate the feedback of a diverse group of stakeholders, as well as the evaluation of existing assistive technologies also known as artificial agents.

Research Question(s)What are the impacts of a TBI, permanent brain damage and memory loss on the support system of the individual?What makes up the complete support system of the individual, both in terms of human and artificial agents, or assistive technologies?

MethodsThe approach we will take to conducting our research study will include, exploratory interviews, observations and participatory design. In the exploratory interview phase, we will conduct in-person interviews with the participant and his or her family members. If possible, we may also interview other significant individuals in his or her network such as caretakers, teachers and doctors in order to understand the impact of the injury on the participant’s memory.

Sample Interview Questions What is the impact of memory loss on study habits and overall learning? What assistive technology, if any, does the participant use to aid memory? What are the pros and cons of this particular device? What type of preferred features would the participant (and others in his or her

network) like to see in an assistive device? What are the main sources of frustration for the participant? For the family?

Annotated Bibliography

Boussemart, B. & Giroux, S. (2007). Tangible user interfaces for cognitive assistance. 21st International Conference on Advanced Information Networking and Applications Workshops. doi:10.1109/ainaw.2007.3

The authors, researchers at Laboratoire DOMUS, explored tangible user interface as assistive cognitive aids. This research proposes a new approach to computer interaction. These researchers discuss design of an interactive table to support cognitive assistance in household kitchen activities. This research suggests an alternative approach to traditional HCI when tackling assistant aids in contrast to traditional devices discussed in articles mentioned below.

Burdea, G., Rabin, B., Chaperon, A. & Hundal, J. (year). Emotive, cognitive and motor rehabilitation post severe traumatic brain injury: A new convergent approach. Virtual Rehabilitation ICVR), 2011 International Conference. dol:10.1109/ICVR.2011.5971817

The authors, researchers at the Tele-Rehabilitation Institute at Rutgers University and Center for Head Injuries at the JFK Johnson Rehabilitation Institute, studied the effects of gaming on cognitive and motor abilities and depression. The study found improvement in each of these areas, most notably in level of depression. Participants showed improvements in their day-to-day lives having less difficulty performing tasks, for example, preparing food and walking the dog.

Dawe, M. (2006). Desperately Seeking Simplicity: How Young Adults with Cognitive Disabilities and Their Families Adopt Assistive Technologies. Paper presented at the Conference on Human Factors in Computing Systems, CHI '06 Montréal, Québec, Canada.

The author, a researcher at the Center for LifeLong Learning and Design, conducted research to understand the usage of  technology and how they benefit both the individual with disabilities and also their families. This research found that use of technology increased independence, safety and social interactions.

Doherty, A. & Smeaton, A. (2008). Combining face detection and novelty to identify important events in a visual lifelog. IEEE 8th International Conference on Computer and Information Technology Workshops, 31, 348-353. doi:10.1109/cit.2008.Workshops.31

The authors, researchers at Centre for Digital Video Processing and Adaptive Information Cluster, discuss improvements in a visual lifelog through enhanced functionality of detecting and logging important events in the user’s day-to-day life. This article is offers a device that could take the place of taking physical pictures by caretakers as discussed in the article above (Dawe 2006).

Gentry, T., Wallace, J. Kvarfordt, C. & Lynch, K.B. (2008). Personal digital assistants as cognitive aids for individuals with severe traumatic brain injury: A community-based trial. Brain Injury, 22(1), 19-24.

The authors, researchers at Virginia Commonwealth University, the Assistive Technology Loan Fund Authority and the University of Windsor, examine the effectiveness of personal digital assistants (PDAs) as cognitive aids for people with severe traumatic brain injury. They discovered statistically significant improvement regarding satisfaction and self-ratings of performance in everyday tasks. In contrast, an earlier study by Stapleton, Adams and Atterton cited below did not see improvements in memory of individuals with a severe traumatic brain injury who used a mobile phone as a cognitive aid.

Hart, T., Buchhofer, R. & Vaccaro, M. (2004). Portable electronic devices as memory and organizational aids after traumatic brain injury: A consumer survey study. Journal of Head Trauma Rehabilitation, 19(5), 351-363.  

The authors, researchers at the Moss Rehabilitation Research Institute and the Department of Rehabilitation Medicine at Thomas Jefferson University, investigate attitudes and experiences regarding the use of portable electronic memory aids by individuals with a moderate to severe traumatic brain injury. Participants expressed preferences for devices that are easy to use, that provide technical support and have long-lasting battery power. These devices were mainly used to monitor spending, remembering things to do and remembering what other people say. Our research group will be able to compare these findings with what we discover in our interviews for our project.

Hutchins, E. (2000). Distributed Cognition. Retrieved May 2, 2012 from http://www.artmap-research.com/wp-content/uploads/2009/11/Hutchins_DistributedCognition.pdf

      The psychological theory of Socially Distributed Cognition was first developed by Hutchins in the 1980s. The framework draws from the disciplines of sociology, psychology, and cognitive science. At its core, it posits that cognitive processes may be distributed across the members of a social group. Applied to cognitive rehabilitation therapy, the concept provides a foundation for creating an understanding of the requirements of a support system around a person after Traumatic Brain Injury.

Jorgensen, M. & Togher, L. (2009). Narrative after traumatic brain injury: A comparison of monologic and jointly-produced discourse. Brain Injury, 23(9), 727-740.

           This article represents a culmination of research into the communications of a person after they have experienced a Traumatic Brain Injury (TBI). It explores the effects of TBI on the individual’s ability to communicate a narrative on their own which has been called Monologic in this study. Further, the researchers assessed the effectiveness of the person’s communication abilities while forming a jointly produced narrative of an event with a partner. The bases for measurement were narrative cohesion, grammar,

information units, and exchange structure. The research offers meaningful insights into the nature of scaffolding around a person with a TBI, the effectiveness of those communications, and how to form effective support structures to aid in their recovery.

Kim, H., Burke, D., Dowds, M., Boone, K. & Parks, G. (2000). Electronic memory aids for outpatient brain injury: follow-up findings. Brain Injury, 14(2), 187-196.

The authors, researchers at Harvard Medical School Spaulding Rehabilitation Hospital, Emerson College and the State University of New York Health Science Center, examine if individuals with a brain injury, who are in outpatient care, benefit from the use of palmtop computers to assist with daily memory-related activities. During a follow-up period ranging from 2 months to 4 years, the majority of the patients continued to use assistive technologies to aid memory. This research may assist in determining helpful features in the development of a new memory aid.

Stapleton, S., Adams, M. & Atterton, L. (2007). A mobile phone as a memory aid for individuals with traumatic brain injury: A preliminary investigation. Brain Injury, 21(4), 401-411.   

The authors, researchers at Julian Hospital, Colman Hospital and the University of East Anglia, investigate the use of setting reminders on a mobile phone as a memory aid for people with a traumatic brain injury. Their preliminary investigation with five participants suggests that this memory aid works best for individuals who do not have severe memory impairment or who require 24-hour care. The use of the phone assisted two participants in learning and remembering their routines, which improved target behaviors after removal of the phone. This work provides support to our research project, which examines how individuals with a TBI use assistive technologies as a memory aid. This article may also be helpful in determining the design requirements of a new memory system.

Wilson, B., Emslie, H., Quirk, K., Evans, J. & Watson, P. (2005). A randomized control trial to evaluate a paging system for people with traumatic brain injury. Brain Injury, 19(11), 891-894.  

The authors, researchers at Addenbrooke’s Hospital in Cambridge, conducted a randomized control trial to see if a paging system could reduce memory and planning issues for people with traumatic brain injury. The researchers concluded that this particular paging system is a useful memory aid due to the statistically significant increase in task achievement and level of independence for people with TBI. This is another study that can assist in determining the requirements for the development of a new memory aid for our research project.

Wisconsin’s Traumatic Brain Injury (TBI) Statewide Task Force/Network. (2007). Memory Module. Retrieved May 2, 2012 from from http://dpi.wi.gov/sped/pdf/tbi- memoryguide.pdf.

This guide is the result of an extensive study that was put together by the Wisconsin TBI Initiative through research grants that they received. The article explores the constructs of memory and memory loss as a by-product of TBI and provides a comprehensive overview on the subject(s). The target audience is essentially parents who are dealing with a child who has experienced a Traumatic Brain Injury (TBI), as well as educators. This work effectively underpins our research and helps us to form the basis of our understanding of the physical repercussions of TBI and associated permanent brain damage on learning and memory. It includes several valuable checklists that assist in creating a complete understanding of the effects of TBI and associated permanent brain damage.