Disability Technology
Assistive Technology for People with Brain
Injury
by Jen Mundl and Nissa French
According to the
Centers for Disease Control and Prevention, an estimated 5.3 million
Americans currently live with a disability as a result of brain
injury, which translates to an estimated 100,000 Minnesotans. Despite
this startling statistic, brain injury is largely a silent public
health epidemic. Falls and motor vehicle crashes are the leading
causes of brain injury in Minnesota.
Clinically, brain injury is classified in two groups: traumatic
brain injury and acquired brain injury. A traumatic brain injury
occurs when an outside force impacts the head hard enough to cause
the brain to bounce against the skull and directly damage the brain.
An acquired brain injury is an injury that occurs after birth and
is not hereditary, congenital or degenerative. Common causes of acquired
brain injury include strokes, aneurysms and diseases such as encephalitis.
Brain injury may cause some of the
following changes:
Physical: movement or coordination
problems, seizures, disruption in basic bodily functions like breathing
or body temperature
Cognitive: inability to concentrate,
issues with memory, difficulty processing information, language and
communication problems
Emotional: lack of emotional control
or self-awareness, impulsivity, anxiety and depression
No Two Alike
Each brain injury is unique
and depending on where the brain is injured, the person can be
left with a range of mild to long-term physical, cognitive and/or
emotional challenges. Several factors determine the extent of the
challenges, including the damaged area of the brain, the length of
time, if in a coma, the personality and learning style before the
injury, the emotional reaction to the injury, and the social supports.
Brain injury is frequently
referred to as a silent epidemic because of the invisible nature
of the impact. Symptoms not readily apparent, such as loss of
memory or initiative, often lead others to misunderstand the
injured person’s actions and abilities.
The person with the injury may be grappling with newly acquired
difficulties, which often lead to frustration and confusion. Some
individuals develop their own compensations or strategies while
others may require assistance and accommodation.
Cognitive and Memory Accommodations
Simple tasks can suddenly become insurmountable
hurdles for many people with brain injury. Short-term memory loss,
inability to problem-solve, difficulty processing information, poor
judgment, trouble initiating activities and even reading difficulty
may vary in severity, frequency and circumstance.
The question is how to keep
track of and follow through on non-routine tasks. Carrying a
simple pocket notebook with a “to do” list
and a pencil may be sufficient as a reminder tool. A Franklin organizer
is more comprehensive, with a calendar, contact lists, note pages
and important information all together. Many technology lovers have
found Personal Digital Assistants (PDAs) and electronic organizers
to be crucial to success. The Zire is the leading PDA in ease of
operation and comprehension for brain injury users, as demonstrated
through research at the University of Colorado.
Taking medication in a timely fashion helps manage some cognitive
issues, and becomes a safety issue when seizures and other disorders
are occurring. There are medication reminders from the simple to
the complex. A watch with alarms can be set to medication times or
the CompuMed works where a medication is in a locked container then
dropped to a dispenser cup with an alarm. If the person does not
pick up the medication, it continues to alarm until either the medication
is taken or a security company calls a medical professional or family
member to respond.
Many devices have voice output options
that are beneficial to those who no longer can read. These devices,
which will speak information to the user, include talking watches,
talking calendars, books on tape, computer software, electronic reminders,
medication identifiers, talking blood pressure cuffs, and talking
scales are among the many devices.
Perceptual/Spatial Accommodations
Visual tracking and orientation may
become difficult after a brain injury. Visual training by watching
lights appear and vanish on an eye board is a therapeutic method
often prescribed by a doctor or occupational therapist to help in
regaining spatial skills. Accommodations include using a magnifier,
large print books, color coding, voice output, a writing guide, texture
for feel or alerting devices. Uncluttering the work area is also
a simple option.
Motor/Physical Accommodations
If the person with the brain injury
has balance, coordination, and/or motor skill difficulties, medical
professionals may recommend mobility aids including a quad cane,
scooter, rails, rolling walker with seat, wheelchair, or nonskid
supportive shoes.
Persons who’ve sustained
a stroke, which is a type of acquired brain injury, often use
one-handed tools for daily needs to enhance independence at home
and work. Dynamic-Living.com sells a wide variety of products
to help people with such symptoms: kitchen gadgets, telephones,
bathroom aides, rails and holders.
Closing
For people with brain injury, coping
and adjustment are lifelong processes. Assistive technology is one
avenue of rehabilitation proving beneficial to this group. Using
and adjusting to new technologies takes extra time and support initially,
but the rewards of increased independence and feeling of control
make the effort worthwhile. ![]()
Jen Mundl is the assistive technology specialist at the Courage
Center.
Nissa French is the Public Awareness Director for the Brain
Injury Association of Minnesota.
