the role of assistive technology in supporting students ... · pdf filethe role of assistive...

The Role of Assistive Technology in Supporting Students with Mental Health Difficulties in Higher Education

Niall KirraneOccupational Therapist

23rd June 2017

Technology In Our Daily Lives

How many people here have already used technology in some way to help them this morning?

Examples…

- Used an alarm clock

- Checked their phone calendar

- Set a reminder to do something

- Contacted a friend/family member

- Listened to music / radio

Aims & Objectives

To explore:

• The functional and occupational barriers to engagement in the student role that students with a mental health difficulty can experience.

• Ways to assess the role for AT with students – from initial meeting to in-depth assessment.

• The types of AT that can be used to meet these student needs.

• The importance of a team approach to ensure that AT is a successful intervention for the student.

Background & Context

• Occupational Therapist working in Trinity College Disability Service.

• Assistive Technology can be part of my role, however I am not an Assistive Technology Officer.

• Occupational Therapy takes the perspective of looking at the person / student as whole, focusing on all areas of occupational performance (eg.; productivity, self-care, leisure).

• AT has huge potential as an intervention to improve occupational performance.

Person – Environment - OccupationLaw et al. (1996)

Person

EnvironmentOccupation

Occupational Performance

Trinity College Dublin, The University of Dublin

Mental Health & University Students

• The college years represent a time in a person’s life when they are most at risk of developing a mental health difficulty.

• One in four young people aged 18 – 25 experience a mental health difficulty (Dooley and Fitzgerald, 2012).

• Transition Thresholds / Liminal Spaces:

Secondary Education Third Level Education

Emerging Adulthood

Adolescence Adulthood


Mental Health & University Students

• Mental illness is related to early termination of schooling at all levels (Breslau, et. al. (2008))

• Less than one in four students seek support (Blanco et al., 2008).

• “The scale of mental health difficulties experienced by young people in Ireland also coincides with an increase in numbers of young people making the transition to third level education” (Ahead, 2016)


Mental Health & University StudentsTrinity Disability Service Registrants 2016/2017

ADHD or ADD8%

Autistic Spectrum

6%

Blind/Visual Impairment

2%Deaf/ Hard of Hearing

3%DCD /

Dyspraxia6%

Intellectual Disability

1%

Mental Health22%Neurological

4%Physical Disability

7%

Significant Ongoing Illness

14%

Speech Language &

Communication Disorders

0%

Specific Learning Difficulty

27%


Functional Impacts of Mental Illness

• Mental health difficulties can significantly impact upon a student’s academic ability, productivity and social engagement.

• “People with psychiatric disabilities also frequently experience cognitive disabilities.” (Medalia & Ravheim, 2002, Levine et al., 1992).

• Cognitive impairment is when a person has trouble remembering, learning new things, concentrating, or making decisions that affect their everyday life.


Cognitive Dysfunction Associated with Mental Health Diagnoses:


Functional Impacts of Mental Illness

Cognitive Difficulty Student Occupation

Attention - Focusing in lectures- Studying in library- Writing assignments

Memory:(Working, Episodic, Semantic, Verbal,Visual, Procedural)

- Studying / Assignments- Exams / Spot Tests- Seminars/ Tutorials- Labs / Placements- Remembering appointments

Executive Functioning - Planning assignments- Prioritising tasks- Managing appointments

Processing Speed - Tutorial questions- Lab work- Professional Placements

Social Cognition - Student Societies- Peer interactions


Other Functional Impacts of Mental IllnessSkills Area Impact on Student Role

Organisation / Time Management: ₋ Assignment deadlines₋ Late for lectures₋ Missing appointments

Emotional Regulation: ₋ College attendance₋ Completing assignments₋ Social engagement

Motivation: ₋ College Attendance₋ Social events

Fatigue: ₋ Attendance₋ Placement


Assistive Technology and Mental Health

• Assistive Technology (AT) can be defined as "any item, piece of equipment, or product that is used to increase, maintain or improve functional capabilities” (Washington Assistive Technology Act Programme, 2017)

• AT can optimize occupational performance throughout a person's life span and in multiple contexts in ways that allow people to retain or regain meaningful life roles.

• AT can assist people with disabilities to compete with their non-disabled counterparts in occupational areas such as education, work, housing, and recreation (Gitlow et al., 2011)

http://watap.org/


Assistive Technology in Higher Education

• Despite the availability of AT for people with cognitive disabilities associated with mental illness, many people who could benefit from these technologies are likely not to be receiving them (Gitlow et al. 2011)

• Mental health workers from a variety of fields reported a lack of knowledge related to AT interventions (Gitlow et al. 2007).

• Many universities have limited resources available to support comprehensive approaches to student mental health (Farrer, 2013)

• Potential of online interventions for university students with mental health difficulties.


Assistive Technology and Mental Health

Research shows that people living with schizophrenia use digital technology generally as much as the rest of the population—and in ways that help them cope with the effects of their condition:

- 42% by blocking or managing auditory hallucinations with music or audio files

– 38% for health information on the Internet

– 37% for calendar reminders

– 32% for transportation and map needs

– 28% for medication management

– 26% for supporting others

– 26% for developing relationships with other persons with schizophrenia

– 25% for monitoring symptoms

– 24% for identifying coping strategies.

(National Alliance on Mental Illness, 2016)


Assessment ProcessA Full Team Approach

- Disability Officer

- Occupational Therapist

- AT Officer

- Needs Assessment

- OT Assessment (eg; ETSP)

- AT Assessment (eg; MST)

Functional difficulty?

Assistive Technology Solution?


e-Trinity Student Profile (eTSP)Occupational Therapy Assessment


Assistive Technology Interventions

Functional Area Examples of AT Products

Organisation & Time

Management

- Calendars

- To Do Lists

- Reminders

(Appointments,

Medication)

- Notemaking / Memory

aids

- Maps & Route Planners

- MyStudyLife

- Wunderlist

- Trello

- Google Calendar

- Google Maps




Concentration Difficulties - Audio recorder apps

- Notemaking apps

- Text to Speech

- Evernote

- Audio Notetaker

- Noteability

- Balabolka




Mood Instability - Wellness trackers

- Self-Help Apps

- CBT Online

- Daylio

- WRAP

- Insight Timer




Anxiety - Mindfulness Apps

- Guided Meditations

Apps

- Music

- CBT Online

- Headspace- Calm- Spotify- The Mindfulness App- TED Talks- Podcasts




Behavioural Change - Sleep Trackers/Planners

- Exercise apps

- Diet & Nutrition apps

- FitBits

- C25K

- Apple Sleep

- Sleep Cycle App




Sensory Difficulties - Music

- Noise cancelling

headphones

- Personalized sensory

kits

- iTunes

- Spotify

- Online White Noise

Generator


Review & Support

Why Process is Important

• Many AT options – a good, thorough process helps to identify choices.

• Up to 50% of all AT is abandoned:

- User’s preferences or environment were not considered.

- User purchased device without trying it out

- User did not receive needed services (evaluation, training, follow-up, repairs)


In Summary…

Mastery of activities of daily living – A smart phone:

“My smart phone replaces the calendar, the alarm clock, the address lists and the memo notes. It tells me who is calling, tells me what time it is, and it notifies me when I have to go to keep appointments. In short, the smart phone functions as a reminder watch, time log, radio, pocket calculator and a lot more. In addition, I can have various ringing tones in the telephone that help me to decide, whether I want to respond to a call promptly or wait until later. All this has a positive influence on my level of stress, which gives me more energy to work with other issues. Having all the necessary functions in my smart phone, I find it easier to structure my life, and I do not have to remember or search for different assistive devices before I leave home. It makes it easier for me to leave as planned. With an mp3-player in the cell phone, I also am able to listen to relaxing music. I think my quality of life has improved after I have learnt to use the functions of the cell phone.”

http://www.sjukra.is/media/notendaleidbeiningar/assistive_technology.pdf


ReferencesAHEAD Educational Press (2016). Mental Health Matters: Mapping Best practices in Higher Education.

Blanco, C., M. Okuda, C. Wright, D. Hasin, B. Grant, L. Shang-Min and M. Olfson. (2008). “Mental health of college students and their non-college peers: results from the National Epidemiologic Study on Alcohol and Related Conditions” Archives of General Psychiatry 65 (12): 1429-1437.

Breslau, et al. (2008). Mental disorders and subsequent educational attainment in a US national sample. J Psychiatr Res; 42(9): 708716. Esch, et al. (2014). The downward spiral of mental disorders and educational attainment: a systematic review on early school leaving. BMC Psychiatry, 14:237

Dooley, B. A. and Fitzgerald, A. (2012). My World Survey: National Study of Youth Mental Health in Ireland. Headstrong and UCD School of Psychology, Dublin.

Farrer L, Gulliver A, Chan JK, Batterham PJ, Reynolds J, Calear A, Tait R, Bennett K, Griffiths KM (2013). Technology-Based Interventions for Mental Health in Tertiary Students: Systematic Review. Journal of Med Internet Res 2013;15(5):e101

Gay, K., Tourus, J., Joseph, A., Pandya, A. and Duckworth, K. (2016). Digital Technology Use Among Individuals with Schizophrenia: Results of an Online Survey. JMIR Mental Health 3(2): e15.

Gitlow, L., Dinnino, D., Choate, L., Luce, R.A. and Flecky, K. (2011). The Provision of Assistive Technology by Occupational Therapists Who Practice in Mental Health. Occupational Therapy in Mental Health (27, 2), 178-19

Gitlow L., Hofmaster P., & Wade J. (2007). Investigating the Assistive Technology Skill and Need forKnowledge of CPRPs. International Journal of Psychosocial Rehabilitation. 11 (2), 61-73

Law, M., Cooper, B., Strong, S., Stewart, D., Rigby, P., & Letts, L. (1996). The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9-23

Washington Assistive Technology Act Programme http://watap.org/

http://watap.org/

Thank You

the role of assistive technology in supporting students ... · pdf filethe role of assistive...

Documents