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Heidi Cramm . Assistive Technology and Mental Health May 12, 2009 M.A., M.Sc. (O.T.—Post-Professional), Doctoral Candidate Occupational Therapist Proprietor, Compass Occupational Therapist Solutions, Kingston, ON. Objectives.

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Heidi cramm
Heidi Cramm

Assistive Technology and Mental Health

May 12, 2009

M.A., M.Sc. (O.T.—Post-Professional), Doctoral Candidate

Occupational Therapist

Proprietor, Compass Occupational Therapist Solutions, Kingston, ON

Heidi Cramm, May 12 2009


Objectives
Objectives

  • To discuss the significance of mental health issues for students

  • To become familiar with executive functioning skill deficits and how they relate to mental health disorders

  • To describe assistive technology features and applications that may benefit students who have mental health disorders and experience executive dysfunction

Heidi Cramm, May 12 2009


Students and mental health
Students and Mental Health

  • 1 in 5 children and adolescents in Canada are affected by mental health issues.

  • 80% NEVER get help

  • Seventy per cent of adults living with a mental health problem developed symptoms before they were 18.

    (http://www.thespec.com/article/559061)

Heidi Cramm, May 12 2009


Students and mental health1
Students and Mental Health

  • By the time many students enter post-secondary institutions, their mental health status has already been affected

    • Major life changes such as leaving home or beginning post-secondary studies can place these students at further risk

Heidi Cramm, May 12 2009


Executive functions
Executive Functions

  • Capacities related to successful engagement in productive, independent, and constructive behaviours

  • Relate to:

    • Planning tasks

    • Initiating activity

    • Self-monitoring of task performance

    • Self-correcting of behaviour

    • Anticipating outcomes

    • Levels of motivation

Heidi Cramm, May 12 2009


Executive functions are distinct from cognitive functions
Executive Functions are distinct from Cognitive Functions

Executive Functions

Cognitive Functions

  • How do you do something?

  • How do you do things?

  • PROCESS

  • How much do you know?

  • What can you do?

  • KNOWLEDGE

Heidi Cramm, May 12 2009


EXECUTIVE FUNCTIONS

…knowing what you need, how long it will take, how to start, how to keep going, how to know when you are finished, where you need to be, etc.

The executive assistant to your brain

Heidi Cramm, May 12 2009


Executive dysfunctions
Executive Dysfunctions

  • Manifested in difficulties in

    • Initiation

      • Identifying needs and wants

    • Planning

      • Identifying the components of the task

      • Sequencing the steps in an organized way

    • Purposive action

      • Translating intentions into actions

      • Requires maintaining efforts and switching between steps

    • Monitoring effectiveness of performance

      • Being able to monitor and adjust one’s performance

Heidi Cramm, May 12 2009


Executive dysfunction simulations
Executive Dysfunction Simulations

  • Writing

  • Reading

Heidi Cramm, May 12 2009


Heidi Cramm, May 12 2009

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Executive dysfunction simulations1
Executive Dysfunction Simulations

  • Attention:

    • http://www.pbs.org/wgbh/misunderstoodminds/experiences/attexp1a.html

  • Memory:

    • http://www.pbs.org/wgbh/misunderstoodminds/experiences/readexp2a.html

Heidi Cramm, May 12 2009



Learning disability
Learning Disability

  • Processing information can take longer, so individuals may persist at tasks and miss other information

    • Individuals may also avoid tasks due to the effort and energy required

  • The mechanics of reading, writing, spelling, and memorizing can hog cognitive resources, making it difficult to sequence and plan larger tasks

Heidi Cramm, May 12 2009


Attention deficit disorders
Attention Deficit Disorders

  • Inattention is a common difficulty

  • Impulsivity associated with difficulties with self-monitoring and self-regulation is common

  • Distractibility also occurs, and individuals may shift attention to novel stimuli as they are introduced

Heidi Cramm, May 12 2009


Comorbidity with lds and adhd
Comorbidity with LDs and ADHD

  • LD and AHDH often comorbid

  • May be comorbid with

    • Anxiety

    • Mood

    • Behavioural disorders

Heidi Cramm, May 12 2009


Bottom line:If you are working with students with LD and/or ADHD, be prepared to see anxiety or mood issues

Heidi Cramm, May 12 2009


Anxiety disorders
Anxiety Disorders

  • Difficulties with

    • Maintaining concentration

      • Recurrent and persistent thoughts, images, and behaviours that create an experience of distress

    • Trying to control the worry

    • Keeping oneself regulated in emotion, thinking, and behaviour

Heidi Cramm, May 12 2009


Mood disorders
Mood Disorders

  • Mood disorders can have powerful impacts on initiation of goal-directed behaviours

  • Sequencing tasks places a heavy demand on executive functions to prioritize, organize, and anticipate, posing a challenge for those with mood disorders

Heidi Cramm, May 12 2009


Asperger s syndrome
Asperger’s Syndrome

  • Shifting between tasks is difficult

  • Can become “stuck” cognitively in rigid thought patterns

  • Shifting perspectives to see big picture and how details are connected is extremely difficult

    • “connecting the dots” problematic

  • Initiation of goal-directed behaviour may be difficult as identification of needs and wants may prove challenging

  • Decoding single constructs into an organized sequence is very difficult

Heidi Cramm, May 12 2009


Psychotic disorders
Psychotic Disorders

  • Intrusive thoughts and sensations can impair an individual’s ability to maintain concentration

  • Vigilance required to maintain focus and actively disregard those intrusions is very energy demanding

Heidi Cramm, May 12 2009


Other factors
Other factors

  • Pain

  • Fatigue

  • Medication effects

Heidi Cramm, May 12 2009


How can assistive technology help
How can assistive technology help?

Heidi Cramm, May 12 2009


How?

  • Mechanical burden mitigated

    • Expectation that student read, write, and memorize to learn realized through the use of AT

  • Lack of automatization accommodated for

  • Discrete chunks of information more accessible in clear sequence

  • See how the pieces of information are linked, can alternate between big picture and little picture

  • Inefficiencies shored up through study skill tools

  • Organizational supports provided

  • Difficulty in switching between tasks supported

Heidi Cramm, May 12 2009


Kurzweil 3000
Kurzweil 3000

  • Reading features supports attention

  • Study skill features can allow for effective and efficient note taking

    • Highlight and extract

    • Extract to column notes

    • Extract column notes to outline

  • Writing features allow for integration of reading and writing into one task

  • Supports for

    • Commonly confused words

    • Revision learning strategies

    • Word lists

Heidi Cramm, May 12 2009


Dragon 10
Dragon 10

  • Significantly improved from earlier versions

  • Those with experience using Dragon dictation software from 3 or 4 years ago or longer will not recognize the program as it currently works

  • Dictation that works well can be an incredible to support to individuals who can lose their train of thought or who would benefit from the efficiencies it offers doing written work

  • Integrates with the other AT for synergistic results

Heidi Cramm, May 12 2009


Inspiration
Inspiration

  • An incredible process support

  • Visually allows individuals to

    • See the sequence

    • Prioritize and sort the information

    • Monitor their performance

      • Comprehension checking

      • Connect big picture and details without losing the thread

      • Hyperlink series of documents

Heidi Cramm, May 12 2009


Microsoft onenote
Microsoft OneNote

  • Acts like an electronic binder

  • Customizable to suit need

  • Automatically saves

  • Offers a visible index of the material so it can be found quickly

Heidi Cramm, May 12 2009


Email contact information
Email contact information

Heidi Cramm, May 12 2009


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