Lorenza Tiberio

ISTC-CNR [PST]

Institute for Cognitive Science and Technology National Research Council of Italy

Planning and Scheduling Teamhttp://pst.istc.cnr.it

Workshop on Telematics and Robotics for the Quality of Life of the Elderly – ISTC-CNR – Rome 28 September 2009

Introduction & Rationale Literature Review

Cognitive decline in agingMemory Training Intervention

Assistive Technology for Cognition (ATC)

About PST Projects Experience RoboCareRoboCare

The system Design User Evaluation Outcomes of RoboCare Evaluation

CogGymCogGym Project Motivation Architecture Current Implementation and future work

Conclusions

Introduction

Elderly population increase!Elderly population increase!

Mobility and cognitive impairments lead to

functional decline, thereby reducing independence

Active lifestyle

Can physical activity and cognitive training intervention

prevent or delay the onset of age-related cognitive impairment?(Verhaeghen et. al., 1992; Floyd & Scogin, 1997; Willis et al., 2006; Craick et al., 2007, Rockwood& Middleton, 2007)

Can technology contribute to improve cognitive function in older adults? (Basak et al., 2008; Kirsch et al., 2004)

Literature Review

InfancyInfancy MiddleMiddleAdulthoodAdulthood

ChildhoodChildhood Young Young AdulthoodAdulthood

LateLateAdulthoodAdulthood

Crystallized Intelligence

FluidIntelligence

Memory Training LiteratureLiterature Review

Cognitive training may have substantial and lasting effects on the cognitive abilities of older adults (e.g. Ball et all., 2002; Wolinsky et al.2006; Park et all., 2007).

Recent researches indicate that regularly scheduled cognitive exercises can not only improve cognitive functioning, but also reduce the risk of dementia (Wilson et all., 2002).

Traditional training usually consist in simple exercises “paper and pencil” or computerized-based including different tasks (e.g reasoning, recognition, perception, speed of information processing, attention and memory)

Computer training programs may improve specific skills generically involved with games

But there is a little evidence yet that “playing computer games” improves other skills or reduce the risk of memory loss

Brain Age (Nintendo Japan)

Brain Fitness (Posit Science, CA)

Happy Neuron (Quixit, France)

Mindfit (Cognitive Fit, Israel)

Lumonosity (Stanford University)

Literature Review

Compensative or training technological devices that

support and stimulate cognitive functions, in order to

improve or maintain functional abilities in daily activities (LoPresti et al., 2004; Scherer et al., 2005).

ATC interventions can represent an

innovative support in case of :

Cognitive Impairment &

Dementia

Traumatic Brain injury

Cerebrovascular injury

Autism

Learning disabilities

Literature Review

Literature Review

“A cognitive orthotic system intended to help older adults adapt

to cognitive decline and continue the satisfactory performance

of routine activities. Autominder achieves this goal by

providing adaptive, personalized reminders of (basic,

instrumental, and extended) activities of daily living”. (Pollack et

al., 2003)

PEAT (Planning and Execution Assistant and

Trainer) is an hand-held device increasing the

independence of persons with brain injury by

compensation for executive function deficits.

(Levinson R., 1997)

COACH supports older adults with

moderate-levels of dementia and their

caregivers by audio and/or audio-video

prompts. (Mihailidis et al. 2008)

Literature Review

When dealing with technological applications the

acceptabilityacceptability by elderly users is a relevant issue.

People overestimate manipulative

and underestimate cognitive

abilities;

People prefer small robots, hardly

resembling human beings;

Robots should intrude as little as

possible in domestic life;

Robots should simply respond to

the task to be performed.

Privacy violation;

Lack of human responders or a

replacement of human assistance

by technology;

User-friendliness of the devices;

Need for training tailored to

elderly.

Demiris et al., 2008

Scopelliti et al., 2005

PST

Projects

Experience

“The objective of the project is to build a distributed multi-agent system which provides assistance services for elderly users at home.

The agents are a highly heterogeneous collection of fixed and mobile robotic, sensory and problem solving components.

The project is centered on obtaining a virtual community of human and artificial agents who cooperate in the continuous management of an enclosed environment.”

Quote from the original project proposal (2001)

Undestanding users’ attitudes and

psychological variables affecting

acceptability of cognitive support

system in domestic environment:

LikelihoodLikelihood of the proposed scenarios

UtilityUtility and acceptabilityacceptability of the system

Users’ preferencespreferences with respect to proactiveproactive and on-demandon-demand

interactioninteraction

Influence of psychological variables psychological variables on acceptability and

usefulness

PST

Projects

Experience

Participants

100 elderly (average age of 70 years) recruited through the support of an university for the elderly in Rome and a snowball sampling procedure.

Materials

Eight short movies (< 2 minutes each) showing potential interaction scenarios between an elderly person and the robotic agent in a real domestic environment.

PST

Projects

Experience

System Initiative (Emergency & Safety)The system takes the initiative for safety related situations

Environmental safetyThe robot warns the assisted person of a potentially dangerous situation(e.g., the kettle was forgotten on the stove.)

Personal safetyThe system detects a medical emergency and alarms the assisted person'sfamily.

User Initiative The user asks for the system help

Finding objectsThe person asks for the robots' help to find objects within the environment

Activity planningThe system supports the activity planning of the assisted person (e.g. planning his/her weekly appointments).

Reminding medicationThe assisted person does not remember whether or not he/she took his/her medicine after lunch, and asks the robot.

System Initiative (Suggestion)The system takes the initiative for suggestions or warnings

Reminding analysesThe robotic assistant reminds the user of a medical appointment he/she had forgotten.

SuggestionsThe system suggests to go for a walk as the user has been watching television all day (noncritical situation).

Reminding eventsThe system reminds the assisted person of the birthday of the user's acquaintance (noncritical situation).

Tools

Questionnaire divided into 3 sections, plus socio-demograpichs focused on:

a)likelihood of the situations presented, usefulness and acceptability of the system;

b)user’s attitude towards intelligent system;

c)emotional reaction to possible implementation of the system in user’s home.

Disagree completely Disagree Undecided Agree Agree

completely

0 1 2 3 4

1 The robot is nice to look at 0 1 2 3 4

2 The robot allows someone living alone to feel safer 0 1 2 3 4

3 The robot moves too slowly 0 1 2 3 4

Likert Scale

Procedure

Participants were shown the eight videos: on a notebook monitor in a face-to-face administration on a larger screen in a small-group administration

PST

Projects

Experience

PST

Projects

Experience

A signicant correlationcorrelation emerged (Pearson's r) between likelihoodbetween likelihood of

a specic scenario, usefulness and acceptability usefulness and acceptability of the system in

that scenario.

(i.e., the higher the likelihood of the scenario, the higher the users‘

perceived usefulness and the probability they would accept such a device at

home).

PST

Projects

Experience

Interactive situations: User-initiative vs. System-initiative

System- initiative and User-initiative situations involving emergency

and healthcare (safety) were evaluated as significantly more likely, more

useful and more acceptable than System-initiative situations referring

to suggestions.

PST

Projects

Experience

Influence of psychological aspects.

Perceived health Perceived health was not found to significantly influence the

attitude towards the cognitive system. Worry about future cognitive impairment have an effect on user’s

attitude.

Does age-related memory loss worry you?

PST

Projects

Experience

Influence of psychological aspects.

“Would you like the support system to keep your memory active

through games/exercises?”

People reporting a higher level of worry expressed a better

evaluation of Advantages and capabilities of the cognitive system Advantages and capabilities of the cognitive system

support support (possibility for the system to perform tasks at home, support the

users' activities and reduce age-related impairments).

PST

Projects

Experience

A well defined relationship between likelihood of situations, perceived utility of and acceptability for the cognitive system support (emergency situation vs. uncritical activities in everyday life)

The distinction between User-initiative vs. System-Initiative situations showed to be meaningful as well, because elderly people evaluations of the system are influenced by the specific typology of the activity in which assistance is given.

PST

Projects

Experience

Elderly persons showing a great apprehension for age-related cognitive impairments perceived an higher utility and acceptability of the system in terms of a cognitive resource for daily activities demanding use of memory.

PST

Projects

Experience

Aging is responsible for a Aging is responsible for a progressive decline of cognitive functions.

Empirical evidences outline that cognitive stimulation cognitive stimulation had a significant positive impact positive impact as well for maintaining a high-quality high-quality cognitive performance.cognitive performance.

The CogGym Framework CogGym Framework is intended to exploit Assistive Technology for Cognition (ATC) by providing immediate access to training services in an ecological context in order to reinforce elderly declining cognitive resources

The framework integrates a number of techniques from constraint based problem solving techniques to cognitive systems research (e.g., for the user related issues)

PST

Projects

Experience

Case-study driven development: each case is a known instance of agerelated cognitive decline

Problem solving the ability to solve new, non-routine problems, e.g., using new technology

Spatial orientationthe ability to locate places and objects, orientation in geographical space and path planning (e.g., finding shortcuts)

Prospective memorythe ability to manage tasks which are planned to occur in the future

PST

Projects

Experience

Smart blackboard maintains a list of grocery items

the blackboard is both written by the assisted person and read by the system

the system can propose a cognitive exercise pertaining the list of shopping items

the system may be aware of missing items before the user notices (e.g., through RFIDs), and stimulate the user accordingly

PST

Projects

Experience

COGGYM Training

Related to real aspects of the user needs Related to real aspects of the user needs (i.e., the need to prepare the shopping list);Difficulty and frequency are decided on the basis of Difficulty and frequency are decided on the basis of previous users performances. previous users performances.

Contextualizing and personalizing the exercises

enhances the training efficacy and increases the

probability that the

memorization strategies are employed in real-life

situations

PST

Projects

Experience

TRAINING KNOWLEDGE REPOSITORY

TRAINING KNOWLEDGE REPOSITORY

PROBLEM SOLVERPROBLEM SOLVER

INTERACTION MANAGER

INTERACTION MANAGER

USER MODELERUSER MODELER SCENARIO MODELERSCENARIO MODELER

PERFORMANCE DATA BASE

PERFORMANCE DATA BASE

ENVIRONMENTAL SENSORS

ENVIRONMENTAL SENSORS

DATA FILTERINGDATA FILTERING DATA FILTERINGDATA FILTERING

User status User status assessmentassessment

Environmental Environmental assessmentassessment

PST

Projects

Experience

Improving of prospective memory case:

We are adding different types of exercises

We are studing wheter alternative modalities would be more suitable for elderly people

Testing the software framework on additional cases

We plan to include the spatial orientation and problem solving case

We plan to adopt the experimental methodology we have developed from RoboCare

Participatory Design and development process together with users (older people, caregivers, gerontologist, computer scientists)

PST

Projects

Experience

We have presented an overview of recent and current efforts in

synthesizing cognitive technology for elderly population

integrating heterogeneous AI technologies to obtain innovative interactive systems

understanding critical features for user’s involvement and acceptance

A multi-disciplinary team of people

RoboCare and CogGym generate from an hybridization of teams that used to work in parallel

The obtained flavor is quite unique

Even if … a non trivial effort to understand each other is always required.

Conclusoins