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

<b>Purpose:</b> 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. <b>Materials and methods:</b> 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. <b>Results:</b> 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. <b>Conclusions:</b> 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 rehabilitationCollege-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. 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.

<b>研究目的：</b> 合并轻度创伤性脑损伤（mild traumatic brain injury, mTBI）的大学生可能会出现慢性认知缺陷，需借助外部支持以完成日常任务。本研究旨在探究有轻度创伤性脑损伤病史的学生在完成新型前瞻性记忆任务（prospective memory task）时，其认知支持系统的选择与使用情况。<b>材料与方法：</b> 本研究采用多案例研究、序贯解释性混合方法设计，共纳入3名参与者。参与者需完成4个实验阶段：（1）背景病史采集、认知评估、试验前访谈，以及选择2种外部支持工具用于试验阶段；（2）试验阶段1（即10天）；（3）试验阶段2（即10天）；（4）试验后收尾访谈。本研究分析了参与者对支持工具类型与特征的偏好，并评估了使用不同支持工具时的任务执行准确率。<b>研究结果：</b> 参与者在试验完成前，既表现出共性的认知辅助工具偏好，也存在独特的个体偏好。试验阶段结果显示，不同试验间的任务完成准确率无显著变化；但个人偏好与受试认知辅助系统的感知有用性，似乎会对支持工具的使用与效果产生影响。试验后访谈提炼出两大主题：（a）不同系统需具备差异化功能；（b）在选择设备前进行试用的重要性。<b>结论：</b> 本研究结果强调了以患者为中心的治疗方法的必要性，这是因为任务表现准确率与系统偏好均存在个体差异。本研究试点的认知辅助工具选择与实施干预方案，有助于深入了解轻度创伤性脑损伤后大学生的独特优势与挑战，对服务于轻度创伤性脑损伤患者的临床工作者具有参考价值。<b>康复启示：</b> 合并轻度创伤性脑损伤的高校年龄段学生，对无科技与高科技认知辅助工具均存在独特偏好，但在偏好的系统特征方面呈现出相似模式。鉴于受试后偏好会发生变化，在为轻度创伤性脑损伤患者选择并实施外部认知支持前，先开展多次试用周期至关重要。采用三阶段外部认知辅助工具选择流程，对轻度脑损伤青年群体似乎具有积极意义。合并轻度创伤性脑损伤的高校年龄段学生，对无科技与高科技认知辅助工具均存在独特偏好，但在偏好的系统特征方面呈现出相似模式。鉴于受试后偏好会发生变化，在为轻度创伤性脑损伤患者选择并实施外部认知支持前，先开展多次试用周期至关重要。采用三阶段外部认知辅助工具选择流程，对轻度脑损伤青年群体似乎具有积极意义。