The First Hundred Yards: Navigation Planning Systems for People with Cognitive Impairments

辅助技术领域已经在改善认知障碍人群的社区出行方面取得了初步进展，有几个大型研究中心致力于为这一用户群体开发路线辅助（系统和设备）。然而，这种关注忽视了这些人使用这些设备所必需的关键和基本技能。记忆、新学习和执行功能（即启动、计划）方面的困难使潜在的设备用户无法出门，甚至无法打开设备或工具。PI的数据表明，大多数旅行注定失败，不是因为路线上的旅行问题，而是由于缺乏旅行准备，以及未能成功地开始旅行，走出家门，到达第一个公共汽车或出租车站。在这个项目中，PI将在假设下承担“前一百码”的问题，即有可能(a)设计有效的旅行准备系统，可以在社区访问方面支持认知障碍人群，以及(b)避免这类人群的常见问题。研究方法基于以下假设：旅行系统的成功设计过程必须与捕获个人目标和技能的个人需求工程过程联系起来；设计过程必须是复合的，同时考虑到基于计算机的组件和人；而且这个问题必须结合实际情况来解决，这意味着要吸引安全网的成员和许多目的地已经到位的社区服务提供者来帮助旅行者。该项目基于PI在脑损伤人群方面15年的经验，以及5年提供基于计算机的辅助技术的经验。它的基础是对人口在社区访问方面的愿望和需求进行全面研究。一种两阶段评估方法将被用于评估本研究的结果，该方法在辅助技术和脑损伤人群的先前工作中已被证明非常成功。更广泛的影响：在美国，每年有超过100万的成年人被诊断出由于神经系统疾病或创伤而导致的认知障碍，据估计，目前有多达1600万的美国人患有慢性脑部疾病。重型创伤性脑损伤的发病率高于脊髓损伤、多发性硬化症、脑瘫和肌肉萎缩症的发病率总和。不幸的是，创伤和其他疾病造成的认知残疾是一种“无声的流行病”，因为研究和技术资源不成比例地分配给了那些很容易观察到的盲人、聋哑人或身体残疾者。该项目将试图纠正这种不平衡，为患有后天脑损伤的认知障碍患者提供使用各种交通方式访问公共社区资源的能力，包括步行、特殊需要的面包车和固定路线的公共交通。

The field of assistive technology has made initial strides towards improving community travel for people with cognitive impairments, with several large research centers devoted to developing on-route assistance (systems and devices) for this user community. This focus, however, ignores critical and fundamental skills necessary for this population to utilize such devices. Difficulties with memory, new learning and executive functions (i.e., initiation, planning) prevent potential device users from getting out the door and even turning on a device or tool. The PI's data suggests that most trips are doomed not because of on-route travel problems, but rather due to lack of trip preparation and failure to successfully start a trip by getting out the door and to the first bus or taxi stop. In this project, the PI will take on this problem of "the first hundred yards" under the hypothesis is that it is possible to (a) design effective trip preparation systems that can support the cognitively impaired population in terms of community access, and (b) avoid the common problem of device abandonment for this population. The research approach is based on the following assumptions: that a successful design process for a travel system must be linked to a personal requirements engineering process that captures the goals and skills of individuals; that the design process must be composite, taking into account both computer-based components and people; and that the problem must be solved in context, which implies drawing in both members of a safety-net and community service-providers already in place at many destinations to assist a traveler. The project builds on the PI's fifteen years of experience with the brain injury population, as well as five years of experience delivering computer-based assistive technology. It has at its foundation a comprehensive study of the desires and needs of the population in terms of community access. A two-phase evaluation approach, which has proven highly successful in prior work on assistive technology and the brain-injury population, will be used to assess the outcomes of this research.Broader Impacts: More than a million adults in the United States are diagnosed annually with cognitive impairments due to neurological disease or trauma, and it is estimated that there are currently up to 16 million Americans living with chronic brain disorders. Incidence rates for severe traumatic brain injury are higher than those for spinal cord injury, multiple sclerosis, cerebral palsy, and muscular dystrophy combined. Unfortunately, cognitive disability from trauma and other conditions represents a "silent epidemic" in that research and technological resources are disproportionately distributed to help those who are blind, deaf or physically disabled, conditions which are easily observable. This project will attempt to redress this imbalance by affording individuals living with cognitive impairment due to acquired brain injury the ability to access public community resources using various modes of transportation, including walking, special-needs vans, and fixed-route public transport.