Project Update: The Final Year

    It is hard to believe, but Think and Link is in its final year.  Thanks to our research team and especially our participants with cognitive impairments, it has been a productive and highly rewarding project. Our goals for the upcoming year focus on preparing the Think and Link email interface for commercialization. Under the new commercial name, CogLink, there will now be a supported email program usable by people with significant impairments in attention, memory and organization. 

The Original Research Questions

    Below is a list of our original research questions and a brief response about how they have been addressed. Readers are encouraged to view the list of publications for resources documenting detailed outcomes.

  1. What are the individual and environmental factors that affect email use by persons with cognitive disabilities?: Our survey and focus groups studies and the results of our longitudinal research revealed a wide variety of personal and contextual factors that affect email use. Cognitive and sensory abilities, psychosocial functioning, physical computing space, previous experience with computers all factor into the ease with which someone implements email and determine the types of ongoing support that may be required.
  2. What supports and modifications to software and hardware are needed to address these factors to permit independent use of email by persons with cognitive disabilities? We developed a “default” interface that is usable by people with severe cognitive impairments. Beyond this most basic interface, some individuals can learn to use more complex features and increase functionality after learning the basic email skills. For example, being able to “archive” or store previously received email needs to be an option for people who can manage the complexity of stored mail on an inbox.
  3. Does the ability to send email to selected friends and family reduce feelings of isolation in persons with cognitive disabilities? Yes! Our longitudinal data clearly documented improvements in self esteem and feelings of social connectedness associated long term emailing.
  4. Are there other psychosocial or cognitive effects of sustained emailing by persons with cognitive disabilities? We did not see any patterns of change on neuropsychological tests following intensive emails. We did document improvements in keyboard efficiency and complexity of writing within the emails.
  5. Does the evaluation of (a) environmental factors and (b) individual skills and behaviors identified as important to successful email use provide sufficient information to identify needed supports? Originally, we had designed an evaluation of skills related to email use including contextual supports . Our work suggested that the development of a default interface usable by everyone with the option of individualizing features for specific circumstances was the most accessible method for delivering email.
  6. How should manuals and software be designed to facilitate training of email users with cognitive disabilities by care-providers and practitioners? Over time our work revealed that training would need to be automated and not heavily dependent upon careproviders or professionals. This led us to develop an automated training disk that teaches keyboarding, mouse skills and the steps for emailing. It is based on an instructional model for people with cognitive impairments. Pilot studies showed that individuals could learn the email program using  the training disk with little input from careproviders. In terms of ongoing support, our data suggest individuals need to have a tech support person available for questions and guidance. Hence the commercialization process involves setting up a HelpDesk accessible by phone and email to problem solve technology questions.

Accomplishments from the past year.

    We continued to add more longitudinal users and implement our volunteer email buddy program. These activities added to our data pool.  Additional accomplishments are highlighted below.

     Dissemination: We have been busy publishing articles and participating in conferences in the fields of Assistive Technology, Computer Science, and Cognitive Rehabilitation. Additionally, our team has been visiting assisted living facilities and support groups throughout our state to tell them about the availability of CogLink.

     Automated training disks: Considerable effort was expended to develop training disks that potential email users could utilize to teach themselves how to use the Think and Link email interface. A series of progressive lessons were designed in three skill areas: (1)mouse movement, (2)keyboarding and (3)email steps. The program probes the user’s skills and automatically puts them at the indicated level. The training is based on sound instructional theory and includes a reliance on task analyses, chaining steps together, errorfree learning during the initial acquisition phase followed by high rates of practice. The program assumes that users may require assistance and includes some automated error analysis and feedback. The pilot users were successful learning email without input from the researchers.

     Sharing of source code: The source code was made available on the open source site SourceForge to allow other software developers to build on our experiences.

     HelpDesk Framework: Our data revealed the need for ongoing technology assistance to people who would use an assistive email program. We looked at our data and learned that voice to voice help would be necessary for many individuals and catalogued the type of help people require. For example, we learned that many perceived problems can be addressed by talking an individual through the process of shutting down and restarting their computer. Based on this information, we developed a HelpDesk button on the interface and secured a 1-800 number to continue researching the support needs and responses.

Next Steps—CogLink will be available!

    This year we will continue with dissemination efforts and refining the HelpDesk and support models. By the conclusion of the grant, the email program will be widely available as CogLink. For information on support, registration and billing see the CogLink website