Assistive Technology: Memory Aids
By Shanan Raines, PhD, Psychologist
What do the following things have in common: calculators, key hooks, day planners, address books, computers, “post it” notes and a piece of string?
They are all items that can be considered cognitive aids, assistive devices or cognitive orthoses. These terms refer to techniques or tools that help someone to function better by supporting the way a person thinks, plans, organizes and remembers.
What is the difference between a cognitive aid and cognitive remediation or rehabilitation?
Cognitive remediation refers to strategies designed to improve, increase or bolster cognitive (thinking) abilities. Cognitive aids refer to external (outside the brain) tools that do what the brain is supposed to do.
Who uses these devices?
All of us use both cognitive remediation strategies and cognitive aids. We use memory strategies to try to remember someone’s name or a grocery list. When our attempts at improving our memory skills fail or are not reliable, we fall back on aids such as writing down the information.
Cognitive aids are particularly well suited for children who have sustained a traumatic brain injury or have learning differences. Young children will especially benefit from having aids because they don’t have the knowledge and strategies yet. Simple tools and techniques (e.g., a chore list) can be used to remind a child of daily responsibilities.
What’s the difference between “Low Tech” and “High Tech” devices?
Rick Parente, Ph.D., a neuropsychologist from Towson University in Maryland, has researched cognitive prosthetics or orthoses. According to Dr. Parente, low tech devices refer to any cognitive aids that are relatively cheap ($100 or less), are easy to use, are easy to keep with you or to set up, and do not require a great deal of maintenance. “Post it” notes, a calendar or a hook to hang your keys on are all low tech devices. A list of what Dr. Parente considers low tech devices can be found at the end of this article.
High tech devices include more costly machines, computers or other tools that are generally more difficult to use, may not be portable and require training to maintain. The advantage of these devices is they often perform more complex and varied functions. Dr. Parente reports that most people prefer to use low tech devices even when aware of high tech options.
What do cognitive aids do?
Cognitive aids can be used for any functions our brains perform. The most common of these are planning our activities and remembering information. We all use schedules to plan what we will be doing and when and then to remember to do it. We also need to remember facts, experiences we have had, where things are, what we own, information about others, etc.
Children are less likely or able to use some of the common tools we all use, such as schedules or daily organizers. However, a calendar or tracker binder is a good starting point for children. Watches with date and time are easy to use and fun for kids to wear. In addition, Timex, as well as other watch manufacturers, make watches with alarms that beep in order to remind you of scheduled events. These can be used, for example, when you want your child to come inside for dinner at 6 o’clock or to work on his homework for 30 minutes.
Memory aids can also be as simple as a string around your finger, a hook to hang your keys or a box by the front door, providing a place for book bags, lunch boxes, etc., so they won’t be forgotten.
Cognitive aids can be used to help students with learning and remembering basic academic facts. Spell checkers, such as a “Franklin Speller,” will help children check and review spelling. However, students often complain because spellers don’t help if they have no idea of the first few letters of the word.
A device called “Quicktionary” Reading Pen is a small pen-shaped tool that you run over the written page. The tool then says the word out loud and provides a definition.
Tape-recording lectures is often recommended for children who have sustained a traumatic brain injury or have a learning disability. The problem with this strategy is that finding the time or remembering to listen to the tape can create overwhelming obstacles. In addition, it is often boring and therefore hard to pay attention to someone talking without being able to see them and the visual aids they are using. To avoid some of these problems, you can use tape recorders which compress speech so that an hour lecture can be listened to in twenty minutes. It takes practice to get good at listening to the compressed version; and, again, these types of devices are better suited for older children and teenagers.
On the high tech end, laptop computers and PCs offer a wide range of memory and cognitive tools. These devices tend to be less portable, are not always user-friendly, and take time and energy to utilize properly. The newer “palm top” computers make portability less of a problem.
Organizer and planner devices include those that can “talk” to your computer and automatically download your schedule from your personal computer. While these hand-held electronic organizers work well for older kids and young adults, they are hard to keep track of and to use for younger children.
Also on the high tech end are the new generation of “talking books.” These are electronic “books” that allow storage of many digital books at once. They also allow use of a “stylus” pen so that notes can be written on the “pages” of the book. The advantage for all students and particularly students with a traumatic brain injury or learning problem is the “talking book” device which includes a dictionary in order to immediately define unknown words, search capabilities to search books for certain words or subjects, and the ability to organize and store your notes about each book.
There are many new software packages that use voice recognition technology responding to voice commands (remember Star Trek?). These programs allow the user to not only tell the computer what to do or write, but they will also read information out loud, thus avoiding the need to read. Early versions of these programs were expensive, slow and cumbersome, but some of the newer versions show promise. For example, the L & H Voice Xpress claims a user can learn to use the system in five minutes and can dictate up to 160 words per minute.
What are some other uses of cognitive aids?
Organization strategies and communication aids are widespread in their usage. Organization tools can range from drawer separators to keep your socks in order to advanced software programs to organize every aspect of your work and home. Communication devices range from paper and pencil to advanced computer-based devices that allow for communication of millions of different messages, anything you might want to say.
Where can you get these aids?
Any electronics store such as Radio Shack or Circuit City has a wide range of devices. Walmart, Target and other department stores carry a variety of organizational aids and low tech solutions. Mail order catalogs such as Sharper Image have some more expensive and complex devices. Some devices are recommended by and available through neuropsychologists, occupational therapists and speech/language pathologists. If you have access to a personal computer with a modem, online services such as Amazon.com or any of the shopping networks have options, but it is harder to sort through for specific needs and to try products.
What are resources in the community to help me determine appropriate aids for my child?
The special education consultant or teacher who works with your child may be able to offer suggestions. Consult with a neuropsychologist who specializes in learning disabilities and traumatic brain injury (there are several on staff at Children’s Hospital in the Psychology Department). Occupational therapists and speech/language pathologists also have information about many cognitive aids that may be useful to your child.
Additionally, Children’s Hospital has an Assistive Technology Lab with specialists who provide evaluations and training services for specialized technology that can help people of all ages function more independently.
What’s the take home message?
While there are an overwhelming array of devices and tools available, it is best to stick with a tool your child likes and finds easy to use and that meets his or her needs. Keep the device as simple as possible and appropriate. High tech devices have important functions, but there’s no need to go to the expense if there is a low tech aid that has the same function.
Be sure to involve your child in the process of deciding upon a device, and how and when it will be used. The right match between tool and skill deficit will allow your child’s other skills to be bolstered, and his or her confidence improved, ultimately leading to increased independence and sense of responsibility.
Low Tech & High Tech Devices Used for Assistive Technology
“Low Tech” Devices
- Note cards
- Checklist (e.g., preprinted grocery list)
- Appointment calendars
- “Day organizers”
- Electronic organizers
- Beeping watches
- Personal information card
- Phone dialer (electronic device you hold to phone and dials #)
- Electronic spellers
- Voice activated telephone
- Answering machine
“High Tech” Devices
- Computers, Lap top computers, Palm top computers
- Speech recognition software programs
- Organizational software programs
- NeuroPage system (easy-to-use paging system linked to computer to remind of appointments, pill taking, etc.)
---adapted from Rick Parente, PhD
Reviewed by Donna Purcell, PsyD, Licensed Clinical Psychologist, December 2002
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