Development of an Assistive Technology for Cognition to Support Meal Preparation in Severe Traumatic Brain Injury: User-Centered Design Study.

BACKGROUND: Although assistive technology for cognition (ATC) has enormous potential to help individuals who have sustained a severe traumatic brain injury (TBI) prepare meals safely, no ATC has yet been developed to assist in this activity for this specific population. OBJECTIVE: This study aims to conduct a needs analysis as a first step in the design of an ATC to support safe and independent meal preparation for persons with severe TBI. This included identifying cooking-related risks to depict future users' profiles and establishing the clinical requirements of the ATC. METHODS: In a user-centered design study, the needs of 3 future users were evaluated in their real-world environments (supported-living residence) using an ecological assessment of everyday activities, a review of their medical files, a complete neuropsychological test battery, individual interviews, observational field notes, and log journals with the residents, their families, and other stakeholders from the residence (eg, staff and health professionals). The needs analysis was guided by the Disability Creation Process framework. RESULTS: The results showed that many issues had to be considered for the development of the ATC for the 3 residents and other eventual users, including cognitive issues such as distractibility and difficulty remembering information over a short period of time and important safety issues, such as potential food poisoning and risk of fire. This led to the identification of 2 main clinical requirements for the ATC: providing cognitive support based on evidence-based cognitive rehabilitation to facilitate meal preparation and ensuring safety at each step of the meal preparation task. CONCLUSIONS: This needs analysis identified the main requirements for an ATC designed to support meal preparation for persons with severe TBI. Future research will focus on implementing the ATC in the residence and evaluating its usability.

Smart Assistive Technology for Cooking for People With Cognitive Impairments Following a Traumatic Brain Injury: User Experience Study.

BACKGROUND: User experience (UX), including usability, should be formally assessed multiple times throughout the development process to optimize the acceptability and integration of a new technology before implementing it within the home environment of people living with cognitive impairments. OBJECTIVE: The aim of this study is to identify UX issues, notably usability issues, and factors to consider for the future implementation of the COOK (Cognitive Orthosis for Cooking) within the home of individuals with traumatic brain injury (TBI) to identify modifications to improve the technology. METHODS: This study comprised two rounds of UX evaluations, including extensive usability testing, which were completed in a laboratory context: 3 sessions with 5 experts and, after improvement of COOK, 2 sessions with 10 participants with TBI. Each session included the use of scenarios and questionnaires on UX and usability. RESULTS: Both rounds demonstrated good usability outcomes and hedonic qualities. Various usability issues were identified by participants, such as navigation inconsistencies, technical bugs, and the need for more feedback. Factors to consider in the future implementation of COOK were also mentioned by participants with TBI, including environmental (eg, space available and presence of pets) and personal factors (eg, level of comfort with technology, presence of visual deficits, and preferences). CONCLUSIONS: By evaluating UX, including usability, various times throughout the development process and including experts and end users, our research team was able to develop a technology that was perceived as usable, pleasant, and well-designed. This research is an example of how and when people with cognitive impairments (ie, people with TBI) can be involved in evaluating the UX of new technology.

Design and usability evaluation of COOK, an assistive technology for meal preparation for persons with severe TBI.

AIM: In Canada, 100,000 people suffer a traumatic brain injury (TBI) every year. The prevalence of moderate to severe TBI is highest for young men, who will live an average of 50 years with this chronic condition associated with physical, emotional and cognitive deficits. Meal preparation, a complex activity with high safety risks, is one of the most significant activities impacted by TBI. Technology shows great promise to support their overall functioning, but no context-aware technology is available to support meal preparation for this population. The main goal of this study was to design and test a technology to support meal preparation with and for persons with severe TBI living in a supported-living residence. METHODOLOGY: As part of a transdisciplinary technology project linking rehabilitation and informatics, COOK (Cognitive Orthosis for coOKing) was designed with and for future users and stakeholders with a user-centred design methodology. COOK was implemented in three participants' apartments, and its usability was evaluated at 1, 3 and 6 months post-implementation. RESULTS: COOK is a context-aware assistive technology consisting of two main systems: security and cognitive support system. After implementation of COOK, participants were able to resume safe preparation of meals independently. Usability testing showed good effectiveness and an acceptable level of satisfaction. CONCLUSION: COOK appears promising for rehabilitating clients with cognitive disabilities, improving safety in a home environment, and diminishing the need for human supervision. Future studies will need to explore how COOK can be adapted to a broader TBI population, other environments, and other clienteles.Implications for rehabilitationThis paper presents a promising context-aware assistive technology for cognition designed with and for clients with severe brain injury to support their independence in meal preparation;COOK, (Cognitive Orthesis for coOKing) is the first cooking assistant in which evidence-based cognitive rehabilitation interventions have been translated into smart technological assistance, to support cognition and ensure safety in a real-life context;Its context-aware characteristic ensures that users receive the assistance they need at the right time and at the right moment.The long-term perspective regarding the use of COOK in clinical practice is promising as this technology has the potential of becoming an additional means of supporting the rehabilitation of people with cognitive impairments and becoming part of a comprehensive solution to help them live at home more independently.

Special issue on technology and neuropsychological rehabilitation: Overview and reflections on ways to conduct future studies and support clinical practice.

In this editorial, we wish to highlight and reflect on research advances presented in the articles comprising this special issue on technology and neuropsychological rehabilitation, which happens to be published more than a decade after the first special issue on the subject. In 2004, the journal recognised the great potential of information technology for increasing the support provided to people with cognitive deficits, and published emerging state-of-the art practices in the field. Since that time, research and technology have made tremendous progress, and the influence of information technology on research methods has transformed the field of neurorehabilitation. The aim of this editorial is thus to shed light on methodological and conceptual issues requiring further attention from researchers and clinicians in the fields of neuropsychological rehabilitation and technology, and to stimulate debate on promising avenues in clinical research.