Exploring assistive technology use to support cognition in college students with histories of mild traumatic brain injury

Abstract

Purpose: College students with mild traumatic brain injury (mTBI) may experience chronic cognitive deficits necessitating use of external supports for daily task completion. The purpose of this study was to explore cognitive support system selection and use by students with histories of mTBI when completing novel prospective memory tasks.

Materials and methods: We implemented a multiple case study, sequential explanatory mixed-methods design with three participants. Participants completed four experimental phases: (1) background history collection, cognitive assessment completion, pre-trial interview, and selection of two external supports for trial phase use; (2) trial Phase 1 (i.e., 10-days); (3) trial Phase 2 (i.e., 10 days); and (4) post-trial exit interview. We examined participants’ support type and characteristic preferences and evaluated task execution accuracy when implementing differing supports.

Results: Participants expressed both collective and unique cognitive aid preferences before trial completion. Trial phase results revealed that task completion accuracy did not alter substantially between trials; however, personal preferences and perceived usefulness of trialled cognitive aid systems appeared to impact support implementation and effectiveness. Themes emerged from post-trial interview relating to the (a) necessity for differing functions of individual systems and (b) importance of trialling devices prior to selection.

Conclusions: Results emphasize the necessity of person-centred approaches to treatment due to the variability of performance accuracy and system preferences. The cognitive aid selection and implementation intervention protocol piloted in this study appears beneficial for understanding unique strengths and challenges for college students following mTBI and may be useful for clinicians working with individuals with mTBI.

Implications for rehabilitation

• College-aged students with mild traumatic brain injury report unique preferences for no- and high-tech cognitive aids; however, similar patterns emerge relating to preferred system characteristics.

• Facilitating several trial periods prior to selection and implementation of external cognitive supports for individuals with mild traumatic brain injury is essential given the preference changes that occur post-trial.

• Implementing a three-phase external cognitive aid selection process appears beneficial for young adults with mild brain injuries.

Keywords:

• Cognitive supports
• mild traumatic brain injury
• task execution
• person-centred treatment

Disclosure statement

The authors report no conflicts of interest.

Additional information

Funding

This work was supported in part by the Undergraduate Research Opportunity Program at the University of Minnesota. The award was provided to the second author (i.e., Madeline Wollersheim) for her work on the project.