A Verbal Cuing Device for Persons With Brain Injury: Development and Proof-of-Concept Case StudyBy Anschutz, John R.; Luther-Krug, Michelle; Seel, Ronald T.; Topics in Stroke Rehabilitation, Vol. 17, No. 5, pp. 337-344
Publication Date: September/October 2011
Study describes the development of a verbal cuing device used as an adjunct to driver training following traumatic brain injury (TBI). The Electronic Driving Coach was developed based on research showing common causes of traffic violations and accidents in drivers with TBI including difficulties with executive functioning, attention processing speed, visual episodic memory, and psychomotor functioning. Features defined as critical in the development of the verbal cuing device included (1) being programmable to meet individual driver needs; (2) being primarily an auditory device that prompts the driver to engage attention and provides procedural reminders; (3) providing positive reinforcement of targeted driving behaviors; and (4) having an interactive component in which the driver would cue the device that positive driving behaviors had been enacted. Following design by a team including a certified driver rehabilitation specialist (CDRS), an assistive technology practitioner, and a brain injury researcher, the Electronic Driving Coach prototype was evaluated in a proof-of-concept case study with a 37-year-old with TBI. Verbal cues and reminders were given by the device regarding speed regulation, checking mirrors, maintenance of space between vehicles, and habits such as keeping two hands on the wheel and using turn signals. Participant progressed to independent driving after a period of several months, travelling locally using the cuing device, and was given a driver re-evaluation after 6 months. Participant then provided motor vehicle reports to the CDRS every 6 months. Results suggested that with a combination of driver training and use of the Electronic Driving Coach, independent driving was achieved without violations or collisions through 18 months after intervention. Practical considerations for developing assistive driving devices in persons with cognitive impairments, including drivers with stroke, are discussed.
Published by: Thomas Land Publishers, Inc. (Website:http://www.thomasland.com)
National Stroke Association (Web Site: http://www.stroke.org )