Thursday, December 19, 2013

Latest news from Q-interactive

Pearson is sending out a new version of Q-interactive. There are two changes that may be of interest:

1. Q-interactive now supports an iPad Mini (for the examiner only) and iPad Air.
and
2. The manuals for all the tests are now available online.

Good changes.

Izabela

Thursday, December 12, 2013

A low tech gadget to increase food intake in Alzheimer's Disease

Apparently serving food on red plates make DAT patients eat 25% more. That is a lot! The simple explanation is that they can see the food better because of better contrast. For some more information, follow the link:

http://www.bu.edu/cas/magazine/spring10/golomb/

A bonus goodie: a blog on caring for somebody with Lewy Body Dementia
http://lewybodydementia.blogspot.com.au
(yes, that's where I found the red plates)

cheers,
Izabela

Wednesday, December 11, 2013

Izabela visits the Wild West

I have promised this post for a while, but to get information, I had to make my old PC work again, and that was not an easy thing. Apologies for the delay.

My first trip into the wild west of brain training was going through the Driving module from Posit Science. It is no longer available in its original form, because Posit Science's offerings are now on-line, and available for a cheap monthly subscription. It wasn't the case when I started playing with it. The training programs arrived on disks and cost well over a thousand dollars. I decided to try out the Driving module, as it was a small subset of exercises, and considerably cheaper. Also, at the time I have just experienced a nasty close call with a motorcyclist, and was feeling rather anxious on the road.

The package contained visual training tasks. The three that I have data on are:

- Sweep Seeker - this was an exercise in which one had to decide on a direction of movement of alternating gray and white bands. I have very vague memory of movement perception research using similar stimuli - maybe somebody can give us some info in the comments? You can read about the exercise here . It is supposed to increase visual processing speed.

Jewel diver - keeping track of multiple moving objects among distractors. Similar exercise available from BrainHQ is explained here. This was supposed to train divided visual attention.

Road Tour - in this exercise one needed to notice things in the visual periphery. It trained up what is called a useful field of view. Basically useful field of view is an area from which you can obtain information at one glance. Research shows that it is closely related to driving safety. I know that it is one of the aspects OTs may assess in relation to driving.

I think there were other tasks, but in the end, I did not practice them enough, so have no test-retest data.

The package was fairly rigorous - you were supposed to do it every day, and there was a reasonable amount of material to be done.

It started from a pre-test, on which I scored well (cannot remember details), apart from useful field of view task, which was picked up as a problem. Unfortunately, the program did not keep percentile rankings, I only have the initial speed (useful field of view is measured in how long you need to see a picture to pick up detail in the periphery). For those who may make up anything of it, it was 554ms, and apparently it wasn't that good.

When I dug out my data the other week, I realised that I never finished the whole package. I stopped just after half-way. However, I had re-test data on the three tasks:

Sweep Seeker: baseline 46 ms, 11% improvement, training time 1h, 30 minutes
Jewel Diver: baseline 5.6 objects, improvement to 6.2 objects, 12 % improvement
Road Tour - baseline 554 ms, improvement 69%, time of training 2h 20 minutes.

Yes, the interesting one is the Road Tour with an improvement of almost 70%.

At that point in the training, I went away for a few days, did a lot of driving and noticed a difference in what I saw. I felt as if my eyes got slit at the outside corners, with me seeing a lot more to the side. I got very happy with the result, decided myself improved, and did not bother to return to training after the holiday, especially as my driving anxiety seemed to disappear around this time.

This whole thing was a bit weird. While I expected improvement, I did not expect dramatic improvement. 69% is a lot, especially in less than 3 hours of training. And the improvement was steady, spread over sessions, rather than being due to getting acquainted with the task and appearing in the first few days.

The explanation I settled on was this:
I wear glasses and the periphery of my vision is either uncorrected or covered by frames. This means that peripheral information is significantly degraded. My brain may well have learned to happily ignore it, because there were no goodies there.  In this context, training peripheral field of view simply re-activated attention to the periphery. As things were disused rather than impaired, the reactivation resulted in quick and significant change.
So, this is my hypothesis. I'm sure you can think of others and may be right at that. And this was an n=1 experiment with a non-objective experimenter, so the results are a bit iffy. But it was an interesting process.

I would like to re-test myself to see how much of this improvement in useful field of view stayed with me. Unfortunately, while I have the program, it would force me to do some practice before it'd retest me, defeating the goal of the exercise. If somebody has access to field of view, this lab rat will be happy to have a go.

cheers,
Izabela

PS1: there are changes between the old product and BrainHQ, mainly in intensity, that may have lowered the efficiency of training.

PS2: Not all brain training is so effortless or quick, of which more in a future post about my second trip into the Wild West

Q-interactive Hacks

For those who are considering moving to Q-interactive, here are some hacks and tips:

1. While Pearson claims not to support iPad mini, the mini works exactly like the bigger models. The only difference is the size of pixels - so the same screen real estate fits on a smaller device. All the apps for the big iPad work on the small one as well.
While the iPad for presenting information to clients needs to be full-size, the clinician's iPad can be a mini. I have been using the mini for quite a while now and have had no trouble.
Why would mini be better? For me it is the weight of my handbag. This iPad goes everywhere with me, because I can access my practice calendar, room booking and a few other important goodies from it. And after a few hours carrying it with me, the weight and size difference really matter. So if you are thinking of buying two iPads for the Q-interactive, it may be worthwhile to consider a mini as an option.

2. With thanks to Debbie Anderson who mentioned this hack at the latest CCN Conference:
Those of us who routinely plug in all the scores into a WAIS-WMS scoring program may as well save $4.40 per client by not administering SS and Cd on the iPad. You just need a timer to get a raw score, which you then put into the scoring program.

3. Also with thanks to Debbie Anderson, who devised this hack:
After each subtest, the iPad provides raw and scaled scores, which is very nice. It is useful to record these on a piece of paper. This is a backup in case of iPad malfunction (although it is a solid program, with no problems to date).  Also, it provides a convenient summary of scores to be plugged into the scoring program without opening the Q-interactive and digging into its bowels. I have made myself a nice recording sheet, with space for behavioural observations and find it very convenient.

4. If you are planning to buy the subscription in the near future, I have heard that it is worthwhile to do it now and pay before the end of the year, because the inclusion of the goodies that Pearson supplies with the subscription is finishing. The goodies include a pack each of all the forms you may be using with the Q-interactive, and the value considerably exceeds the price of subscription. I've heard that if you pay this year, you may set it up in such a way that the subscription time starts a bit later. Handy if you don't want to pay for holiday time. Also, you may want to give yourself time to use that free 1 month trial to skill up on the new way of administering things.

cheers,
Izabela