Medicine
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A Computerized Functional Skills Assessment and Training Program Targeting Technology Based Everyday Functional Skills
Chapters
Summary February 13th, 2020
This training protocol uses computerized training to teach technology-related everyday functional skills. These skills include financial skills, travel and transit, as well as medication management.
Transcript
Since interactions with technology are not optional for most older people, being able to both learn new skills and feel comfortable using these skills in the real world are essential. A tutorial on how to use a computer mouse or a computer keyboard is widely needed and provides a very helpful starting point for many participants. This technique uses realistic simulations of everyday technology-based functional activities to assess a person's ability to perform these activities before training using direct structured feedback delivered by the application itself.
Cognitive challenges associated with aging-related conditions like mild cognitive impairment, brain injury, or a severe mental illness make it much harder for people with cognitive impairments to learn new skills. We believe that the combination of skills training and computerized cognitive training has the potential to fill a major gap in current research and clinical interventions. Demonstrating the procedure will be Lize Tibirica, doctoral candidate at Albizu University and clinical associate at I-Function.
After obtaining written informed consent, have the participant answer MOCA screening tasks. First, connect numbers and letters in sequence. Next, show the participant three pictures of animals and have the participant name the animals.Camel.
Then, read five verbal learning words and have the participant recall them.Face.Velvet.Church.Red.Daisy. To perform a baseline cognitive assessment using the tablet version of the Brief Assessment of Cognition, open the app and present the overall instructions for the assessment on the app. When the participant has read these instructions, present the instructions for the symbol coding task and have the participant perform practice coding with monitoring.
At the end of the practice, present the instructions for the Tower of London task and have the participant perform the practice tasks with monitoring. To assess the participant with six different functional tasks in a fixed difficulty format, launch the ticket purchase task and have the participant select purchase a new ticket. Have the participant select one way from airport and check the balance on the transit card.
Then have the participant add 60 to the transit card. Next, launch the telephone refill task and have the participant dial the number for the pharmacy. Then have the participant enter the prescription number and select the time to pick up the medication.
Launch the ATM banking task and have participant enter the pin to start the session. Then have the participant check the balance in the checking account and withdraw 180 from the checking account. Launch the medication label comprehension task and have the participant select the correct time of day to take the medication.
Launch the medication organizer subtask and have the participant pack up a day's worth of medications. Then have the participant correctly identify how many pills to take each day. Launch the internet banking task and have the participant enter the user ID and password.
Then check the balance in the checking account and have the participant make a transfer of 15 from savings to checking. Launch the internet prescription refill and online shopping task and have the participant enter the user ID and password. Have the participant select the correct city, street, and car color to verify their identity and select Prinivil and no generic equivalent.
Then have the participant select the correct date and time for pick up. For a computerized functional skills training, first explain the training task to the participant stating that all six of the tasks will be trained. Next, launch the ATM banking task and enter the PIN.
Select a transaction and visualize the process of program delivered feedback for errors. Then look at the four levels of feedback provided for errors. For a combined commercially available cognitive and computerized functional skills training, first explain the process of training on computerized cognitive training as well as the skills training before launching the brain HQ double decision task.
Have the participant perform the practice tasks. Then have the participant perform the actual test tasks with monitoring. In this representative analysis, the first subject was screened on July 14, 2018.
The screened participants included 78 females and 76 males. Sixteen cases were excluded because of possible dementia and four were excluded because of motor or vision problems. Of the 121 subjects who completed the baseline assessment, 51 cases completed the training with 44 cases still training and 15 cases waiting to train.
The dropout rate after any training was 9%Paired T tests found that the completion time for all six of the tests significantly improved from the baseline assessment to the final training assessment in completers. Further, none of the simulations improved differentially in the non-impaired older individuals or mild cognitive impaired subjects as indexed by the percentage of improvement from baseline to end of training. Both groups also demonstrated substantial improvements in performance on alternative versions of the assessment tasks.
It is very important to ensure that the people being trained are oriented to the fact that all of the instructions and feedback are presented by the application itself. The application can be easily customized or modified to create alternative versions of the existing tasks or to create new tasks. Our software is being widely used in research projects examining technology-based task performance in mild cognitive impairment, healthy agent, autism spectrum conditions, major depression, bipolar disorder and schizophrenia.
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