2. The 21st Century Employment Specialist
Facilitators
Bill Youngman, MSW
Assistive Technology Specialist
Division of Vocational Rehabilitation, Washington State
Ryan Farrow --
Program Manager
Washington Initiative for Supported Employment (WISE)
Kathy Moeller, BA, CBIS (Certified Brain Injury Specialist)
Creator, My Bionic Brain® Cognitive Prosthetic and Training Program
Melissa Campbell will introduce webinar:
Good afternoon. My name is Melissa Campbell. I am the (insert title) for RESNA and will be providing technical support for today’s webinar on the topic of Assistive Technology for Cognition at the Workplace.
This webinar is being sponsored by RESNA’s Cognition and Sensory Loss Special Interest Group. The facilitators are Kathy Moeller, Bill Youngman and Ryan Farrow. Several invited guests may be introduced during the webinar.
Copies of the PowerPoint will be on the RESNA website or participants can the facilitator for copies.

3. Introductions: Bill Youngman Webinar Overview: Ryan Farrow
Objective: Share real-world examples of effective technologies used in the workplace
Introductions: Bill Youngman
Webinar Overview: Ryan Farrow
Technologies
● Evernote (Ryan Farrow)
● VoCal (Bill Youngman)
● First Then Visual Scheduler (Bill Youngman)
● My Bionic Brain® (Kathy Moeller)
History of Job Coaching (Bill Youngman)
Screening and Assessment (Kathy Moeller)
High-tech and Low-tech solutions working together (Ryan Farrow)
Wrap up and Questions
Participatory format
Everyone will be muted at first. Use CHAT box to make comment, ask question or ask to be un-muted for alive comment. I’d like to now turn the meeting over to Kathy Moeller
Good afternoon and welcome. My name is Kathy Moeller and I have been using, creating and distributing assistive technology for cognition for 25 years, beginning in 1990, when I learned about assistive technology for cognition during my 5-month stay in a residential cognitive rehabilitation facility after experiencing a brain injury as the result of a car crash. Since that time, I have worked with hundreds of individuals with cognitive impairment, focusing on using assistive technology for cognition in the workplace to support workers and their job coaches
Bill Youngman is one of our co-facilitators today. He is an Assistive Technology Specialist for the Division of Vocational Rehabilitation, Washington State, since 2007 and has had previous experience as a Vocational Rehabilitation Counselor and Job Coach. He has special training in assistive technology from the University of Wisconsin and served as the chair of RESNA’s Special Interest Group for Cognition and Sensory Loss from 2013 to 2016. 
Ryan Farrow is also a co-facilitator. He serves as Program Manager for the Washington Initiative for Supported Employment (WISE). His career has included consulting, job coaching and job development services, as well as providing technical assistance to consumers and employment specialists with respect to worksite accommodations and building natural supports. Flash agenda, speak headings only
We will cover some of the topics and slides pretty quickly, and it may be the case that you will want to review the detail from the PowerPoint itself. A copy will be available on the RESNA site, and Bill, Ryan and I will have PDF versions we can share with you, as well.
Bill to speak to Landscape topic / VR Component

6.  Emotional Regulation with video cues
Ryan ???
Pictello is another example of AT supporting emotional regulation.
Benefits:
Who trains and customizes?
Technical support:
Ask “Do any participants want to comment?”
 Emotional Regulation with video cues
Bill Youngman:
Source:

7. First Then Visual Schedule
 Scheduling  Task List and Sequencing Cues Bill Youngman: Source:
Bill
Benefits
Feature
Ease of learning
Who trains and customizes?
Technical support
Ask “Do any participants want to comment?”

8. iPrompts app - $49.99 for iOs Picture cue’ed visual timers
Bill Youngman:
Source:
Bill
Benefits
Feature
Ease of learning
Who trains and customizes?
Technical support
Ask “Do any participants want to comment?”

9. Time Timer App & Watch Time Management Cueing Ryan Benefits Features
Ease of learning
Who trains and customizes?
Built in visual timer on ipad too. Also Apple Care has recently initiated a special customer service support line for anyone who needs help with the accessibility features in Apple’s tablets, iphones and watches
Technical support
Ask “Do any participants want to comment?”
Time Management Cueing
Ryan Farrow or Peter Bertram
Source:

11. Web Version  Note Taking, To Do List, Step Sequencing Peter
Easy to use Note Taking / Memory Tool
Uses: To Do Lists, Shopping Lists, Sequencing, Reminders, Notes (photo, text, audio)
Features : Take photos, Type notes, Make Lists, Share notes / lists, Search All Notes
Easy to learn
Powerful Search Tool
Ask “Do any participants want to comment?”
Web Version
 Note Taking, To Do List, Step Sequencing
Ryan Farrow or Peter Bertram
Source:

12. iPhone
Peter
The Evernote App is available on Apple, Android, and Windows devices.
The appearance may look a little different, but the function and features are almost the same.
Using Evernote on a Smartphone will give you the most benefits, but your notes can be accessed through any web browser.
Ask “Do any participants want to comment?”
Android

13. Peter
Create lists, and share them. (Supervisor to Employee, or Job Coach to Worker)
You can add reminders, pictures, an audio note, or a handwritten note or drawing.
Ask “Do any participants want to comment?”

14. Peter
Hand written notes can be captured by the Evernote App and are searchable from the App or on a computer.
Photos can be of handwritten or typed text.
Evernote will search all text (including photos of text) and will highlight the words you searched.
Ask “Do any participants want to comment?”

15. VoCal-Voice Calendar Scheduler
 Scheduling with voice commands
Bill Youngman:
Source:
Property of Alan Killoren
Bill
Benefits
Feature
Ease of learning
Who trains and customizes?
Technical support
Ask “Do any participants want to comment?”

16. My Bionic Brain® Life and Work Manager

17. My Bionic Brain® Overview
Bill
(mention as you see fit)
Most significant benefits: AT is designed specifically for workers and is a single source for multiple challenges
Features include
Voice-to-text note-taking
Schedule that syncs to multiple calendars, such as Outlook and Google Calendar
Cue Cards for breaking complex tasks into smaller steps
Special Sections that house cues for Work Instructions and Supervisor’s feedback
24/7 Technical support and embedded training supports
Who trains and customizes? The vendor, who happens to be Kathy Moeller, one of our facilitators
Technical support: Same.
Ask “Do any participants want to comment?”

18. Specialized Scheduling My Bionic Brain® ACTION PLAN
Special Design for individuals with
memory impairment
Syncs to other calendars for remote access to Action Plan

19. Electronic Cue Cards Breaking Tasks into STEPS
Multi-step Tasks Broken Down
Color-coded “check off” when done with each step

20. Managing Troubling Feelings

21. Organizing Communications
Bill
(mention as you see fit or turn over to Kathy if you wish)
KM to define aphasia
There are a number of assistive technologies supporting communication. Many of them focus on expressive aphasia, which includes word finding challenges.
This particular example, again from My Bionic Brain, illustrates one strategy that helps individuals who have difficulty organizing and remembering what they want to say. The First Then Visual Scheduler would also support this communication challenge for some individuals
Specific apps focusing on aphasia can also be found by contacting the National Aphasia Association
Bill: Note that I added this slide because, after reviewing the Test Questions we were required to submit to Melissa, I saw that one of them focused on communication, expressive aphasia in particular.
I’ll send all the questions separately in an message

22. Short History of Job Coaching
Development Disability Behavioral Model (1980’s)
Role of Task Analysis
Other Cognitive Disabilities – Similarities & Differences
Soft Skill Management
Customization improves success rate
Without sustainable Assistive Technology
end-users and VR agencies become dependent on extensive and repeated
human job coaching support
Bill Youngman to discuss.
Question for Bill:
Did the expectation (norm) evolve in such a way that it was assumed that individuals with significant cognitive impairments would need the same type of job coaching as individuals with DD needed? Especially when memory deficits are significant?
Goal is to use AT to eliminate Revolving Door Syndrome:
-- New job coaches” may be called in whenever the work environment or work tasks change
-- Consumer returns multiple times after each job failure, and a new job coach is assigned each time
Talk about soft skills – Examples:
- Getting ready to get ready
- Punching time clock, organizing materials, etc.
- Social aspects too, reading social cues, starting and stopping behaviors,
emotional regulation
Soft skills are often neglected, yet are often deal breakers even if job skills are mastered

24. “Challenges Checklist” Easy-to-use Tool to Identify Types of Functional Limitations
This worksheet is designed as an easy-to-use pre-screening tool for AT’s, VR counselors and others who may need to do needs-based pre-assessment screening to either rule out or rule in further exploration. There are others, of course, and some of the more sophisticated resources will be listed at the end of this PowerPoint.
This particular checklist emanated from VR counselors in the field who needed something simple to start with, and is reported to be useful.
This view of the checklist illustrates the breadth – or types -- of issues an individual may be dealing with

25. Identify Frequency
This is a close-up view of a portion of the checklist and is shared to illustrate how the individual can convey the depth – or frequency – of particular challenge they experience.

27. Apps Organized by Functional Need
Ryan
Ryan Farrow:
Source:

28. Organize by Functional Need (continued)
Ryan
Ryan Farrow:
Source:

29. Resources Marcia Scherer’s work Tate Tool Kit
Go to
Brian O’Neill and Alex Gillespie: Assistive Technology for Cognition
Go to:
Tony Gentry’s work -- link to RESNA Catalyst Project Webinar
An Update on Cognitive Aids for People with Brain Injury Go to
Flash on screen

30. How the World Can Feel -- End User’s Perspective
Taking Notes
Scheduling
Task Initiation
& Execution
This is how many individuals with cognitive challenges feel on the work site when faced with having to use strategies for note taking, scheduling and managing tasks with lists, particular those with multiple steps.
There are often more needs than illustrated here, but these tend to be the ones that generally need some form of, and are conducive to technology support.
As a rule, these three areas most often need to be addressed. If the individual needs support because they are foundational and the odds are not in their favor if the need is not addressed. In other words, lack of support in these areas are often “deal breakers” on the job.

31. Common Challenges
● Short-term memory gaps ● Maintaining focus ● Dividing or alternating attention ● Time management ● Time estimation ● Time tracking ● Getting lost in the details ● Managing troubling feelings ● Managing “Intruder thoughts”
● Losing information ● Not knowing whom to ask for help ● Feeling overwhelmed ● Difficulty executing multi-step tasks ● Miscommunication ● Uncomfortable social interaction ● Decision Making ● Problem Solving ● Judgment
Flash list
This is a more detailed list of common cognitive challenges

32. How Common Challenges Affect Work
Memory ● Remembering instructions, supervisor feedback, steps for completing multi-step tasks, ● Remembering to make notes ● Remembering to schedule tasks, appointments, meetings, etc. ● Remembering anticipated future events (prospective memory) ● Remembering to use compensatory strategies, including assistive technology ● Remembering how or when to use compensatory strategies or assistive technology Time Management ● Difficulty organizing, scheduling tasks and checking off completed tasks ● Difficulty scheduling enough time to do a task, including time between tasks ● Difficulty knowing (sensing) how much time has passed ● Difficulty managing troubling feelings, especially when feeling overwhelmed Communication ● Difficulty with clarifying and verifying communications ● Difficulty organizing communications ● Difficulty remembering communications ● Difficulty expressing thoughts Executive Function ● Getting stuck when confronted with making decisions or solving problems ● Making poor (inappropriate) choices, generally ● Uncomfortable social interaction
Flash list
This is a more detailed list of common cognitive challenges. Memory challenges are often the biggest “deal breaker,” and more specifically, perhaps obviously, remembering a supervisor instructions.
Because the most important focus is on an individual’s challenges, it’s important to remember that those of us who are involved with selection or recommendations of technologies DO NOT NEED TO KNOW ABOUT EVERYTHING that’s available, when it may well be more important to know what has been tested and is known to work IN THE FIELD
That said, one community project I hear a lot of support for is to develop a master list of assistive technologies for cognition that’s used in the workplace – complete with input from vocational workers in the field. Keep an eye out on our Special Interest Group’s discussion list for progress on this project.

33. Navigating the Cognitive Obstacle Course
Information Capture
Information Storage
Information Retrieval
Information Use
This is a helpful way to look at the core cognitive processes individuals experience. When we look at all the things an individual needs to be able to do on the worksite, in terms of these fundamental cognitive functions, it gets easier to identify strategies, tactics and technologies that will be helpful
All four parts of cognition need to be “present and accounted for” – or compensated for since they are always present – whether a person is getting ready to go to working in the morning, is setting up their work station to prepare for assembling widgets – or launching a space shuttle.
I find it helpful to use metaphors to keep these basic principles in mind. A helpful one is that of navigating an obstacle course. Any number of obstacles can contribute to failure, and it is often the case that a person needs to navigate them all in order to maintain employment
Use mine field metaphor if time allows and if it feels right.

34. Integrating Low-tech and High-tech
Multiple Monitors
Desk-top Focusing Cues
Apple Watch
synced with multiple calendars
(iPhone, iPad, Google and Outlook)
Electronic Sticky Notes
(StikyNot)
Kathy
Benefits:
Multiple monitors are a relatively low cost solution for office workers with memory and attention challenges because multiple projects are visually available without the need to minimize needed information (which individual may not remember)
Simple, low-tech supports like Focus Cue Cards and graduated desk-top files are often overlooked, but can be significantly beneficial as AT
Many consumers find electronic sticky notes helpful. This particular one is very powerful and color customizable
The Apple Watch works well for consumers who use iPhones and iPads and need to carry a device on their body. Can be synced with iOS calendars as well as Outlook and Google calendars. Again, users have access to Apple Care’s customer service support line for anyone who needs help with the accessibility features. The number is
Ask “Do any participants want to comment?”

35. YouMail Visual Voicemail
Kathy
Benefits:
Eliminates the time it takes to listen to and make notes for voic messages
Particularly helpful when significant memory problems are present and a lot of voic processing is involved in the job
Who trains and customizes? support with free version, in-person support with paid versions
Technical support: Same
Ask “Do any participants want to comment?”
 Note Taking and Memory
Kathy Moeller:
Source:

36. From Forbes On-line Culture is moving toward neuro-diversity
Source:
In the foreseeable future, AT for Cognition is expected to be in wide use for many (most) workers who do not fit the profile of a worker with a disability, especially as workers who age continue in the workforce

37. From Robert Szczerba’s article (emphasis added)
It’s estimated that, at any given time, 25% of the workforce may be experiencing some type of cognitive issue.  
Furthermore, most cognitive disabilities are “invisible,” which may result in behaviors being misattributed and mismanaged.  
For a large company, this can result in high turnover and lack of engagement.  The good news is that technology augmenting cognitive processing functions is rapidly entering the market.
Will apply to larger numbers than at present

38. Resources
AT Apps Resource List
Cognitiveharmonics.com

39. Community Partnership Model
Joining Forces
Client / Consumer / Student
Vocational Rehabilitation Counselor
Pre-placement Work Assessment Provider(s)
Assistive Technology Professional
Technical Support Provider(s)
Assistive Technology Trainer(s)
Job Coach
Compensatory Skills Trainer
Employment Specialist (AKA “Job Developer”)
Certified Specialist (CBIS, CAS, etc.)
Neuropsychologist
Consulting SLP or OT
Family
Employer
Natural Supports Liaison
Bill Youngman
Show slide, no detailed comments, though Bill plans to mention the “TSM” Manual with respect to what is necessary for delivering AT to a person with a disability

41. Wrap Up + Q&A

42. KathyM@CognitiveHarmonics
Creator, My Bionic Brain® Cognitive Prosthetic and Training Program
Assistive Technology Specialist
Program Manager