Posted by Stuart Brazington, Partner
How assistive technology can help people who have experienced mTBI
Here, Oliver Lewis – an Assistive Technology Consultant from Lewis Support – explains what assistive technology is and how suitable solutions and products are identified. He has also included examples of how assistive technology can support individuals who have experienced a mild traumatic brain injury (mTBI).
I have worked in the field of Assistive Technology for 14 years, and have completed assessments within many organisations including the University of Oxford, IBM, Microsoft, Hewlett-Packard, Lloyds TSB, and Halifax, as well as a large range of specialist schools, mainstream schools and universities.
Currently I support solicitors, insurance companies, case managers and clients by assessing, advising, setting up and training on assistive technology. But, what is assistive technology?
What is assistive technology?
Assistive technology defines any product, including software/apps, that increases, maintains, or improves the functional capabilities of persons with a disability or limiting condition.
Therefore, assistive technology does not always need to involve expensive specialist items. Indeed many ‘standard’ products, such as an iPhone, have features to support people with disabilities.
Identifying the right products
Without support, it can be difficult for clients or those supporting them to identify the appropriate assistive technology.
Many clients I work with already own products which have additional features to support them, if only they were aware of the fact. For example, a client with a visual impairment can use their iPhone to read text and app content aloud. Consequently, supportive advice and tailored training will help them greatly.
However, specialist equipment should often be considered, and therefore it’s important that professional and independent advice is sought to avoid expensive mistakes. One such mistake could be having to duplicate computerised devices used for communication that cannot open the home’s automated doors and allow the disabled client to talk at the same time. Therefore, seeking support from an independent assistive technology consultant can be more cost-effective and simplifies the process.
Examples of how assistive technology can support clients with an mTBI
mTBI affects people in a number of different ways, and therefore there are many different situations that I find myself dealing with. Here I outline a few examples to help you understand what options are available to those who are struggling following mTBI.
A university student who is struggling to concentrate in lectures after an mTBI
University students who have experienced mTBI can experience symptoms such as poor attention/concentration and memory issues. Therefore, it can be difficult for a student to listen, read the information from a slide, process and summarise information and then to convert this into notes.
Initially, I would consider approaching the university to see if they provide ‘lecture capture’ facilities. Lecture capture varies depending on the university, but services can involve the lecture being videoed, streamed live, or simply audio recorded.
However, the student may still struggle with concentration when listening back to the lecture, even after several attempts. Consequently, a range of strategies can be used including using mind-mapping software. Whilst listening back to the lecture the student can produce a visual representation of information in the form of a mind map. Examples of suitable software include Inspiration and Matchware.
I often advise students to simply write down every key point and not worry about the structure or appearance. Then, using the software, the student can organise information into topics and categories. Consequently, the information will be clearly laid out and categorised to support the student’s visual memory.
Where lecture capture is not available, I would consider alternative methods to record the audio and would request permission to record taught sessions and ask that the student is sent a copy of the lecture slides.
Lecture recording software – such as Sonocent – can run on a student’s mobile phone, tablet or computer and allows them to see the lecture slide alongside their typed notes and audio recording. The typed notes and audio recordings can be categorised by colour – for example, to identify the most important points.
As a result of this, rather than watching the entire lecture again, the student can listen back to the most relevant parts to support their concentration or memory difficulties. Some students like to summarise all parts of key lectures and listen to these on the way to the exam.
I would always consider the nature of the student’s course. For example, if a student is studying a graphical or mathematical course such as engineering, accessing the slides or recording the audio may not be enough as lecturers draw mathematical formulas on whiteboards/smart-boards. Therefore, smartpens can support the student by recording the audio of the lecture.
Whilst the student writes a formula or diagram on paper, the pen will track the lecturer’s voice. Therefore, when reviewing the notes, the student could tap the pen’s nib on the drawing and the pen will playback what the lecturer said. This strategy supports students with memory issues but also when struggling to process the complexity of drawing the image whilst listening at the same time.
Office worker with visual acuity loss due to mTBI
A loss of visual acuity can sometimes be treated with glasses. However, depending on the level of loss an office worker who spends all day looking at a computer screen can struggle.
Using a larger monitor is the simplest solution. However, more magnification may be necessary. This may simply be the magnification integrated into the computer; for example, moving the mouse wheel whilst holding the control key will magnify the program when working within Windows.
Although this helps an office worker read the small print, it does not increase the menu or icon size. The icon and menu sizes can be increased within the computer’s accessibility options.
Outside of the accessibility options magnification software is available which can magnify all or some sections of a screen. In more extreme circumstances where magnification is insufficient then graphical information and text can be turned into speech using a screen reader.
Dealing with light sensitivity
Some individuals can experience difficulties with sensitivity to light, so spending an office day looking at a computer monitor can be tricky. Alongside support such as tinted glasses, the office worker’s computer screen can be tinted using overlay software. Many individuals prefer a soft pastel colour to replace the harsh white ‘paper’ of electronic documents. However, in more extreme cases the whole computer’s colour system can be changed.
Helping with reading
Reading letters and printed reports from paper can be difficult for those who have lost visual acuity. These documents can be scanned using optical character recognition software and then converted into an accessible format on a computer whereby text size and images can be increased. CCTV systems can also be used.
In terms of magnification, the CCTV system is a desktop or portable high-resolution camera used to magnify images on paper. Many of these systems have integrated text-to-speech. Consequently, the office worker can place a document underneath the camera and press a button and the camera will read aloud the document through its speaker or via headphones.
A year-7 student starting at a new school after an mTBI
It is particularly difficult for a year-7 school student starting a new school after an mTBI if they are experiencing mood changes, fatigue, irritability, emotional disturbances, or feelings of depression. Understandably, professional support outside of assistive technology would be the most effective solution. However, assistive technology can work alongside such support.
Although I would consider the learner’s needs within lessons, in this section I am purely focusing on their mental health and energy levels. Introducing assistive technology to help a year-7 student needs careful consideration with support from the learner and parents/guardians in the school.
Learning support through apps
Many of the recommendations involve the usage of apps running on a student’s mobile phone. If the school has banned mobile phones, I recommend smartwatches. Although the mobile phone ban could be lifted for a disability-related reason, many of the students I have worked with would not want to draw attention to themselves in this way.
Supportive apps can include mood tracking apps which aid the learner to rate their mood or anxiety level by clicking on the relevant image and then selecting what activity they have been doing or thinking about. The student can then view their mood log, which identifies mood level, date or time, and activity. This displays information in the simplest way, allowing them to identify particular triggers which affect their mental health. The student’s parents/guardians or professionals supporting the learner can also view this data.
Starting a new school can be very difficult for a student after an mTBI. Many I have worked with are concerned about following their timetable, knowing which subject is next, who is teaching it, and where they need to go.
Specialist timetable apps provide a simplistic timetable which it is easier for the student to use than the calendars integrated into a smartwatch or mobile phone. Consequently, the student can look at their agenda for that day and know whether they need to take the hockey stick or the geography textbook, for example.
A salesperson struggling to concentrate when presenting after an mTBI
Memory issues, headaches, processing speed and becoming easily confused make it very difficult for a salesperson to concisely put a point across whilst presenting or talking to a client.
Similar to a university student struggling to take notes, the salesperson may wish to plan their presentation via a mind-map so they can see the overall structure and help support their memory. In addition, it can be easier to identify the key points and find information on a mind-map than looking through notes when struggling with confusion and issues with processing speed.
What’s more, while presenting it can be difficult to appear relaxed at the same time as controlling slides, remembering key points and answering questions. Specialist presentation apps – such as PresentPal and Prezi – intended to support people with these issues can help by allowing the salesperson to use a mobile phone to control the slides whilst only showing three main points at a time – perhaps even using soft colour codes. As a result, the salesperson only needs to process relevant information and has quick access to suitable memory support.
This strategy is easier to manage than printed notes and more flexible than having to be positioned in front of a laptop screen. In addition, specialist presentation apps allow presenters to be flexible in changing the order of the slides when necessary to answer questions and still have the necessary information on slides in front of them.
mTBI affects people in subtle but often life-changing ways, requiring they adjust to their new circumstances. The examples I have included here reflect a selection of possible assistive technology solutions. When carefully considered and tailored to a client’s needs, they can enable and enhance a person’s functional capabilities to ensure that they go beyond whatever limitations they are experiencing.
Oliver Lewis is an Assistive Technology Consultant at Lewis Support:
If you have any questions about accessing specialist assistance for those with a brain injury, please contact our specialist team today.
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