Digital Assistant Helps Survivors Overcome TBI's Invisible Scars

August 2015
Topics: Cognitive Systems Engineering, Psychology, Social and Behavioral Sciences
A MITRE team's free tablet application provides "assistive technology" that helps traumatic brain injury patients improve prospective memory, reversing a lingering symptom: Remembering to remember.
MITRE staff Lindsay Kaye and Adam Holmes review plans for the BrainKit TaskPlanner app.

Many of us share the experience of walking into a room and forgetting the reason why. We might forget an anniversary or birthday or leave the theater tickets home. We write them off as "senior moments," fatigue, or the effects of multi-tasking. People make these little mistakes all the time.

Now imagine a day full of opportunities to trip up that way, because you forgot to remember at all. What if you couldn't remember how to go to the doctor’s office, or the steps required to load the clothes washer, or to check the burgers five minutes after you put them on the grill?

"Remembering to perform an intended action—that is prospective memory," explains Lindsay Kaye, a software systems engineer for MITRE in Bedford, Mass. In many patients, impaired prospective memory is one of the potential long-term effects of a traumatic brain injury, or TBI.

To assist TBI patients in planning and completing at-home tasks, MITRE has built an iOS application, the BrainKit TaskPlanner™. Developed with funding from MITRE's research program, the BrainKit TaskPlanner is available as a free download on Apple’s App Store, with an Android version coming soon.

The app's goal is to supplement the lessons a patient learned in therapy. It acts as assistive technology for patients who need more support in remembering when and how to execute tasks.

MITRE's BrainKit TaskPlanner—available for free from the Apple iTunes store—helps people recovering from TBIs handle daily life with more confidence.
MITRE's BrainKit TaskPlanner—available for free from the Apple iTunes store—helps people recovering from TBIs handle daily life with more confidence. An Android version is coming soon.

A Digital To-do List Prompts Patients Through the Day's Tasks

Kaye, along with fellow engineers Lauren DiCristofaro, Dan Mauer, and Adam Holmes, collaborated with experts in industry and the Department of Veterans Affairs, as well as with TBI survivors in recovery and their caregivers, to make the app as easy to use as possible.

It works this way:

The user, usually the TBI patient, first works with a therapist or caregiver to identify the task to accomplish and the time required to complete it. Together, they identify the steps in the task and create a picture, text, or voice identifier for each one or all three. The patient then creates a reminder that's added to the iOS calendar. If needed, these reminders serve as prompts through the task from start to finish.

For example: Separate laundry into colors and whites; load laundry into the washer; add detergent; adjust water temperature and cycle; start the cycle; remove laundry and place in dryer, and so on.

A background logging system records user actions and displays information to a patient/clinician-shared dashboard—a screen that summarizes and tracks progress, rewarding badges for each success. Survivors and clinicians can use this information to discuss current care plans and goals. All of this takes place on an iPad, a common device that carries no stigma.

And stigma is something many TBI patients fear, especially because of the side effects that others can't see. "A lot of people appear fine," Kaye says.

Technology that Aids the Warfighter Can Benefit Other Patients

Kaye's inspiration to study TBIs and their long-term effects came at the neighborhood gym. "A lot of my friends there are great people who do special education and occupational therapy and speech pathology," she says. "It got me thinking: I'm an engineer. How can I use that for good?"

Because MITRE performs research and development for the U.S. military and has a track record of developing technologies to help the warfighter, Kaye decided to focus on the wounded who return home with invisible injuries caused by TBI.

The MITRE team began by working with clinical experts at the Department of Defense, Veterans Affairs, and the Veterans Health Administration to identify where gaps existed in mobile technology aids for TBI patients. After determining that the biggest gap existed for prospective memory aids, she and fellow researchers worked with survivors to design and test the app. The team continues to work with patients and providers to improve the app by incorporating user feedback as they receive it.

While the team developed the app with warfighters in mind, it holds benefits for patients recovering from head injuries suffered in auto accidents, falls, assaults, or even sports.

Since the app launched on the Apple App store, users have downloaded it nearly 300 times. Work continues on an Android version.

—by Molly Manchenton

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