TECHNOLOGY FOR READING AND WRITING AND EXECUTIVE FUNCTIONKurt Johnson, Ph.D.

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

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 Alzheimer’s disease … many other conditions

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.

Sources of variability influencing academic outcomes in individuals with LD

Academic Skills

Deficits (e.g. word

recognition)

Neurobiology•Genetic Factors•Brain Structure &

Function

Core Cognitive Processes

(e.g., phonemic awareness)

Behavioral/Psychosocial Factors

(e.g., attention, anxiety, motivation)

Environment•Socioeconomic•Schooling•Intervention

Fletcher, Lyons, Fuchs, & Barnes, 2007

Never Start with Technology!

Technology for cognitive changes: caution

Caution: technology can make things worse!

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

Accessible IT

If IT isn’t accessible, we can defeat the best AT!

IT accessibility includes Web Hardware OS

Find resources at:http://www.washington.edu/accessIT

Technology as an intervention Two general uses of technology for

individuals with LD. Remediation

instructional, rehabilitative Compensation

accommodation, modification

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

Using technology for compensation Assistive technology

Provides access to reading materials beyond person’s current skills

Makes writing easier and faster Helps with spelling

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

What is the best LD software? For whom? For what tasks? In what environments? With what supports?

Decision-making in Selecting AT1. Identification of Need2. Functional Assessment3. Identify Options4. Decision-making 5. Acquisition and/or treatment6. Customization & training7. Outcome measurement & re-

assessment

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)?

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

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.

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)

Software for reading

ReadPlease! Kurzweil 3000 Wynn Read&Write Gold WordQ ….many, many others Reading features are also built into word

processing, voice recognition, and writing software.

Functional writing system

Transcription processes (low-level skills) Handwriting Spelling

Text generation (high-level skills) compositional fluency compositional quality

Software for supporting writing WordQ Read&Write Solo WYNN Kurzweil 3000 Dragon Naturally Speaking Inspiration ….and many others

Handwriting and spelling

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

spelling)

Keyboarding

Some people with handwriting problems also have difficulties learning to type

Cover the keyboard Supervised, frequent and short practice

works better

Word prediction

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

Speech recognition

Less flexibility Training and practice required Speech feedback and playback Most effective when combined with

teaching writing organization and planning

Spelling checkers

Identify errors Offer suggestions for correction Limitations: homonyms, severe

misspellings

Speech feedback

Find different errors than spelling checkers

Included in talking word processors (WriteOut Loud), some speech recognition programs (Naturally Speaking)

Word processors

Auto Text AutoCorrect Thesaurus, dictionary Most effective with explicit instruction on

how and when to use the features

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

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

Technology to accommodate cognitive changes Sticky notes, lists, daytimers, etc.

Prompts from friends, co-workers, etc. Emailing reminders (in box chaos!)

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

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

Applications of ATC

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

Integrated Cueing & Sensinghttp://www.brainaid.com/• 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

Adding Sensors to PEAT

• Sensors to detect user’s 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)

State Estimator

Cellphone

Wireless connectionsGPS, Bluetooth (BT), WiFi

State DB

Daily Activity Planning & Cueing

PEAT User Interface

PEAT

RFID reader bracelet

WiFi Relay

BT

ZigBee

WiFi

A wireless cognitive aid with sensing, planning and cueing

Pressure mats

User

Technology Wearable multi-sensor board (UW/Intel)

Acceleration (movement) Sound Altitude Proximity to voices Autonomic arousal Wireless data transfer

Resources

U. W. Summer Institute on Technology and DisabilityJune 27 – June 30http://uwctds.washington.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://uwctds.washington.edu

Department of Rehabilitation Medicinehttp://rehab.washington.edu

Thank you!

Kurt L. Johnson, Ph.D.kjohnson@u.washington.edu206.543.3677