A cognitive prosthesis and communication support for people with dementia

Norman Alm, Arlene Astell, Maggie Ellis, Richard Dye, Gary Gowans, Jim Campbell
2004 Neuropsychological Rehabilitation  
The potential of computers as augmenters of human intellect has been noted at least since Engelbart's insights (Engelbart 1963) . The term 'cognitive prosthesis' has been used to identify the application of this approach to human-computer partnership to problems caused by impairments in cognitive ability. Kirsh, Levine, Fallon-Krueger, and Jaros (1987) set out a useful description of how a cognitive prosthesis might operate in practice. A cognitive prosthesis should provide a compensatory
more » ... compensatory strategy for people with a cognitive impairment that, when added to the user's environment, increases their ability to function effectively. It has been speculated that advances in technology could eventually allow a cognitive prosthesis system to act as a 'companion' for a person with cognitive impairments, helping them by monitoring their activities and offering appropriate prompts and advice (Vanderheiden 1990) . Arnott emphasised the importance of drawing the boundaries between the person and the computer so that the person was ultimately in overall control, even if the computer was performing cognitive tasks on their behalf (Arnott 1990). Alm, Waller and Newell have argued that systems which assist non-speaking people to communicate will need to operate at the level of a cognitive prosthesis if realistic rates of communicate are to be achieved (Alm, Waller, Newell 1996) . Cole and his team have developed a range of compensatory systems for people with acquired cognitive impairments, and emphasise in their work the need for highly personalisable systems (Cole 1999). Computers do seem to have the potential to act as a kind of scaffolding to support cognitive tasks, taking over some functions which have been affected by illness, accident, or aging. Computers might also provide prompts for daily living, if they were able to track successfully the user's sequence of tasks and actions. One area which such developments would be welcome is in supplying support for elderly people with dementia and their carers. We have been working in this idea through a number of exploratory projects. The starting point for some of the thinking behind these projects was our previous work on helping non-speaking people to communicate through computer-based systems. SUPPORT FOR COMMUNICATION BY PHYSICALLY IMPAIRED NON-SPEAKING PEOPLE Some of the work done to improve communication systems for people who are unable to speak due to physical impairment has involved developing innovative ways of providing computer generated support for the communication. This support has at times acted as a cognitive prosthesis, by assisting the communication through taking over some of the cognitive processes involved when we interact through language. For severely physically impaired non-speaking people, even with current speech output technology, speaking rates of 2-10 words per minute are common, whereas unimpaired speech proceeds at 150-200 words per minute. In an attempt to improve this, a certain amount of progress has been made in the area
doi:10.1080/09602010343000147 fatcat:5e5ek6ra6vf4ddi3ruof7p6ume