Technology for reading and writing and executive function

1
Technology for reading and writing and executive
function

• Kurt Johnson, Ph.D.
• University of Washington (Thanks to Mark Harniss,
  Ph.D. and Dagmar Amtmann, Ph.D.)

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Causes of reading and/or writing problems and
frontal lobe inefficiencies

• A whole range of conditions
• Specific learning disabilities
• Brain injury
• Developmental disabilities
• Attention deficits
• Alzheimers disease
• many other conditions

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Identification Models

• Aptitude Achievement Discrepancy model
• Difficulties unexpected in relation to other
  cognitive abilities (normal or higher IQ).
• Low Achievement Model
• Based on absolute low achievement.
• Intraindividual Differences Model
• Unevenness in development as evidenced by a
  battery of cognitive or neuropsychological tests.
  
• Response to Intervention (RTI)
• Failure to respond to successive tiers of
  increasingly rigorous interventions.

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Sources of variability influencing academic
outcomes in individuals with LD

• Neurobiology
• Genetic Factors
• Brain Structure Function

Academic Skills Deficits (e.g. word recognition)
Core Cognitive Processes (e.g., phonemic
awareness)
Behavioral/Psychosocial Factors (e.g.,
attention, anxiety, motivation)

• Environment
• Socioeconomic
• Schooling
• Intervention

Fletcher, Lyons, Fuchs, Barnes, 2007
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Never Start with Technology!
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Technology for cognitive changes caution

• Caution technology can make things worse!

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Common accommodations

• Being a person with dyslexia, I constantly
  advise that we dyslexics can influence genetic
  predisposition (and improve the quality of our
  book reports) by marrying someone who can spell.
• Jeff Gilger, Ph.D.
• Professor and Chair, Child Family Studies,
  California State University at LA
  Vice-President of the International Dyslexia
  Association

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Accessible IT

• If IT isnt accessible, we can defeat the best
  AT!
• IT accessibility includes
• Web
• Hardware
• OS
• Find resources athttp//www.washington.edu/acces
  sIT

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Technology as an intervention

• Two general uses of technology for individuals
  with LD.
• Remediation
• instructional, rehabilitative
• Compensation
• accommodation, modification

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Using technology for remediation

• Instructional technology
• Most often aimed at providing more practice
  opportunities and on-going assessment
• Ineffective strategies unlikely to be more
  effective when delivered via computers

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Using technology for compensation

• Assistive technology
• Provides access to reading materials beyond
  persons current skills
• Makes writing easier and faster
• Helps with spelling

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Role of technology across the lifespan

• Early grades K-3 intensive remediation
• From 3rd or 4th grade through postsecondary
  combine instruction with compensatory strategies
• Adults focus on compensatory strategies

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What is the best LD software?

• For whom?
• For what tasks?
• In what environments?
• With what supports?

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Decision-making in Selecting AT

1. Identification of Need
2. Functional Assessment
3. Identify Options
4. Decision-making
5. Acquisition and/or treatment
6. Customization training
7. Outcome measurement re-assessment

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Linking function to feature

• What features of an AT product will support an
  individual who has a specific set of functional
  deficits to complete specific tasks in a specific
  environment with a specific support system (e.g.,
  personal assistance)?

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Important Considerations

• Adoption of new technology can have a high cost
  to benefit ratio
• Efficiency
• Cognitive economy
• Reading/writing software helpful for users who
• Have good verbal skills
• Can learn to operate the software
• Can learn to use the features effectively
• Have access to training and technical support

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Separating Reading and Writing

• Important to remember that reading and writing
  are separate domains, but many software programs
  have features that address both. Need to be clear
  about what functional deficits you are trying to
  address and what features are appropriate.

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Features to consider

• Quality and choice of voices
• Easily adjustable speed
• Flexibility of appearance
• Study skills features (voice and text notes,
  highlighting)
• Ease of using different file formats (HTML, PDF,
  MS Word)
• Quality of scanning and OCR (if included)

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Software for reading

• ReadPlease!
• Kurzweil 3000
• Wynn
• ReadWrite Gold
• WordQ
• .many, many others
• Reading features are also built into word
  processing, voice recognition, and writing
  software.

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Functional writing system

• Transcription processes (low-level skills)
• Handwriting
• Spelling
• Text generation (high-level skills)
• compositional fluency
• compositional quality

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Software for supporting writing

• WordQ
• ReadWrite
• Solo
• WYNN
• Kurzweil 3000
• Dragon Naturally Speaking
• Inspiration
• .and many others

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Handwriting and spelling

• Handwriting replaced by
• Keyboarding
• Word prediction (also helps with spelling)
• Speech recognition (also helps with spelling)

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Keyboarding

• Some people with handwriting problems also have
  difficulties learning to type
• Cover the keyboard
• Supervised, frequent and short practice works
  better

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Word prediction

• Assists with text entry spelling
• Ability to recognize correct word
• Trade off speed for accuracy
• Speech feedback

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Speech recognition

• Less flexibility
• Training and practice required
• Speech feedback and playback
• Most effective when combined with teaching
  writing organization and planning

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Spelling checkers

• Identify errors
• Offer suggestions for correction
• Limitations homonyms, severe misspellings

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Speech feedback

• Find different errors than spelling checkers
• Included in talking word processors (WriteOut
  Loud), some speech recognition programs
  (Naturally Speaking)

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Word processors

• Auto Text
• AutoCorrect
• Thesaurus, dictionary
• Most effective with explicit instruction on how
  and when to use the features

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Implementing AT Solutions

• Without adequate training and ongoing support,
  individuals with LD will not benefit. They may
• Fail to use AT to best advantage (e.g., not use
  all relevant features)
• Abandon the AT completely
• Training must be
• Explicit, structured, ongoing
• Embedded in real world tasks

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Technology To Support Executive Function

• Frontal Lobe Inefficiency
• Memory
• Sustained attention
• Speed of information processing
• Planning, organizing, logical sequencing
• Estimating and scaling
• Divided attention
• And more!
• Cognitive Economy

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Technology to accommodate cognitive changes

• Sticky notes, lists, daytimers, etc.
• Prompts from friends, co-workers, etc.
• Emailing reminders (in box chaos!)

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Technology to accommodate cognitive changes

• Using off-the-shelf products such as Microsoft
  Outlook (PC, PDA, Smart Phone)
• Organizing email
• By folder
• Color coding

• Calendar
• Shared calendar (Google, Outlook Exchange)
• Alarms and prompts

• Task Lists

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Assistive Technology for Cognition

• With Henry Kautz, CS at Rochester, Gaetano
  Borriello, CS at UW, Shwetak Patel, CS at UW, and
  Mark Harniss and Pat Brown, Rehab Med, Rich
  Levinson, Ph.D., Santa Clara
• Ubiquitous Computer
• Artificial intelligent agent
• Sensors (wearable, environmental)
• Location detection

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Applications of ATC

• Project Access Aided Navigation
• ADL Monitoring and Prompting
• Improving Behavioral Self Management
• Caregiver Respite
• Supporting Executive Functioning

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Integrated Cueing Sensinghttp//www.brainaid.co
m/

• PEAT handheld-based activity cueing system for
  persons with executive function impairment
  (Attention Control Systems Inc Rich Levinson
• Problem requires frequent input from user
• Solution use sensor to detect activities
• Reduce user interaction
• Reduce learned dependency
• Enable context-dependent cues

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Adding Sensors to PEAT

• Sensors to detect users location(GPS and floor
  mats)
• Sensors to detect whichobjects user is
  touching(RFID Radio Frequency ID)
• State Estimation and Activity Recognition
  softwareinfers current state and current
  activity
• (Kautz, Levinson, Johnson, Brown, Harniss)

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Technology

• Wearable multi-sensor board (UW/Intel)
• Acceleration (movement)
• Sound
• Altitude
• Proximity to voices
• Autonomic arousal
• Wireless data transfer

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Resources

• U. W. Summer Institute on Technology and
  DisabilityJune 27 June 30http//uwctds.washing
  ton.edu/summerinstitute
• Washington Assistive Technology Act
  ProgramDevice loans, demonstrations,
  evaluations, technical assistance,
  consultationhttp//watap.org
• U. W. Center for Technology and Disability
  StudiesTraining, Research, Consultationhttp//uw
  ctds.washington.edu
• Department of Rehabilitation Medicinehttp//rehab
  .washington.edu

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Thank you!

• Kurt L. Johnson, Ph.D.kjohnson_at_u.washington.edu2
  06.543.3677