Intelligent Technologies : New Initiatives to Bridge the Digital Divide

(in collaboration with Dr. John Heng, School of MAE, NTU, Singapore)

Introduction and Concerns

As the pace of life increases, the need for independent living among the aged has been growing. This has been accompanied by increasing populations of aged and disabled elderly in the past two decades, which has resulted in further isolation at physical and emotional levels for the aged.

As a person ages, he finds himself trying harder to remain functional. The motor and cognitive impairment becomes the new reality. This has an immediate impact on the self-image and the patient perceives himself as a dependent and a increasing burden on family and society. This gives rise to new independence and relation needs[1,2]. On the other hand, individuals above 65 years of age may also lose interest in independent living and believe they will never improve[3].

The development of assistive technology has tried to focus primarily on helping the elderly cope with physical tasks, activities of daily living, accessing entertainment and using communication tools to exchange information. Hence the approach has so far been to enable interaction with the outside environment.

We find, however, the usage of such technologies among the aged have not shown the dramatic rise that may have been expected. The low technology objects in both rehabilitation and assistive technology have the highest usage. So it seems that this population is more comfortable with technology that has a high level of usability, even though the device may have a low level of intelligence.

Several bodies of research from medicine, neuroscience and physiology have shown that it is possible to recover or maintain many inherent faculties in the aged, which may have deteriorated from disuse or damage. These include memory, mobility, motor function, audio sensitivity, cognition and so on[4,5,6,]. The self-determination theory [7] states that humans who are naturally motivated tend to incorporate an internal regulation strategy for all important activities. It has been also proven through several studies that attention, motivation and repetitive task practice are essential factors in the reorganization of the brain [8,9,10,]which can take place well into old age.

It seems that the major factors affecting this recovery or maintenance relate to the high level of engagement of the individual with the task at hand. Studies in psychology and accelerated learning also highlight that such high levels of engagement occur when there is an “emotional connect” for the individual to the task and when all sensory pathways like visual, auditory and kinesthetic pathways are brought into play. This can happen when there is a collaborative environment[11].

A New Mission for Assistive Technology

The new mission will be to highlight initiatives being taken in various studies and experiments to develop technological platforms which involve multi-level haptic interfaces. This new approach focuses on usability, simplicity and engagement, thus making choice of device easier.

Such multi-level platforms will make it possible for the aged to re-connect with their own residual capabilities at the physical, cognitive and adaptive levels. At the same time, it will allow interaction with others through artistic expression and collaborative play. Multi-level platforms can be adjusted as the person improves or deteriorates over a period of time.

Building into the basic design a capability of HMHI (Human- Machine-Human Interaction) moves the user away from “Isolation” to a more “Relational” environment, where he or she is able to interact with a living being at various levels. From this perspective, it may be beneficial to design a technological platform that enables

1) Allow sharing of resources such as strength, mobility and motivation between two or more aged persons

2) Allow use of the system in multiple environments, so that it is usable for all levels of impairment and fatigue as well as facilitates more variety in activity

3) Gives elders a chance to integrate with the system at multiple levels with their residual functions, so that they can adjust, communicate and respond faster.

Along with principles of universal design, this new paradigm of design can then be the springboard for a new generation of simple assistive devices which can integrate seamlessly with the user. The graded sensitivity of such devices to the user’s needs, rather than merely its level of intelligence, will enable higher usability and help the aged to integrate with society and the environment.

References

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[2] R. Goldberg, Psychosocial aspects of stroke, Rehabilitation Psychology, Kruger DW and Collins LB (Eds.), Rockville: Aspen Publication, 1984.
[3] C.B. Lewis, Rehabilitation of an older person: a psychosocial focus, Physical Therapy, vol 64(4), 517-522, April, 1984.
[4] J. Williams, D. Ramaswamy, et al., 10Hz flicker improves recognition memory in older people, BMC Neuroscience, 7:21, 1471-2202/7/21, 2006.
[5] D.O.Clark, D.E. Stump, Predictors of onset of and recovery from mobility difficulty among adults aged 51-61 years, American Journal of Epidemiology, vol. 148:1, pp. 63-71., 1998
[6] C. Hofgren, A. Bjorkdahl, et al., Recovery after stroke: cognition, ADL function and return to work, Acta Neurologica Scandinavica, 115(2): 73-80, 2007.
[7] E.L. Deci, H. Eghrari, B.C. Patrick, D.R. Leone., Facilitating internalization: the self determination theory perspective, Journal of Personality, vol 62(1), 1994.
[8] Neural Basis of Decision in Perception and Control of Movement, Neurobiology in Decision Making, Springer, 83-100, 1996.
[9] P. Bach-y-Rita, Theoretical and practical considerations in the restoration of functions following stroke, Topics in Stroke Rehabilitation, vol 8(3), 1-15, 2001.
[10] I.H. Robertson, J.M.J. Murre,Rehabilitation of brain damage: Brain plasticity and principles of guided recovery”, Psychological Bulletin, vol 125(5), 544-547, 1999.
[11]R.C.V. Loureiro, M.J. Johnson, et al., Collaborative tele-rehabilitation: a strategy for increasing engagement, Proceedings of the 1st IEEE Int. Conference on Biomedical Robotics and Biomechatronics, , art. 1639198, pp 859-864, 2006.