New Mobile and Web Usability based upon Cognitive Accessibility Designs

Cognitive Accessibility accommodations er CognitiveAccessibility.org

Proper Cognitive Accessible Designs, Usability, and UX Designs will become the most important functionality of Tech, Web Sites, Product Information, and Store Shelve Displays in the 21st Century. Knowledge will be KING! Does your Product’s Usability meet Mass Consumption?

This blog was originally written as part of a discussion I shared on LinkedIn.com. I shared it here on my blog in Nov. 2013 – and thought to provide an update March 20, 2017. So much is happening in the field of tech, web site, and product “usability” that I cannot begin to cover here. But I will share some recent frustrating tech challenges that raise both “usability” and “cognitive accessibility.” I really think we’ve crossed a threshold today, where going forward, the two will forever be intertwined. So if you didn’t understand cognitive accessibility and special needs designs before, you’re really going to feel lost now.

Prosperity is based on sound information.

In a nutshell, about 40% of tech users and consumers have some level of cognitive challenge today, albeit thru a learning disability, neurological disorder, brain injury or concussion, drug & alcohol addiction problems, migraine disorders, or are simply aging. Baby-boomers may be the largest growing segment of the cognitive special needs population today, ranging in age from their early 50s to late 70s. This translates to increased attention and functionality on usability, UX design, and human factors understanding in everything from product design to user instructions, to site/app accessibility, to product packaging and displays on store shelves. It also transcends challenges posed by visual impairment and mobility. In this new millennia, Knowledge is King!

Design & Usability Challenges in Lottery Vending Machines

Let me share something as innocent as a poor design of a lottery machine. The images below came from one of my own adverse experiences recently with a new California Lotto vending machine. I had come to avoid trying to play my own lottery numbers on this machine after several frustrating encounters with it in my area grocery store. Then one evening, I was in a time crunch and thought I’d take another stab at it. But it whacked me upside my head again (figuratively). So I took photos of it and ran a user analysis of its design and display panel. My on-screen notes below are my conclusions. Note that this new machine also has a handicap accessible placard on it. Next, I compared it to its previous model. And below the photos, you will read what I concluded.

My Critique on Usability & Accessibility of this CA Lotto 2016 Vending Machine in my area Pavilions Grocery Store

Here’s a close up of the vending machine’s operating panel.

Critique of Usability & Accessibility of this CA Lotto 2016 Vending Machine in my area Pavilions Grocery Store

And below, is the earlier California Lottery vending machine (circa 2012-13) which I have never had a problem using, yet it does not bear the “handicap placard.”

Critique on Usability & Accessibility of earlier 2012-13 CA Lottery Vending Machine in an area Liquor Store

As to my theory on what went wrong in this newer design lottery vending machine bearing the handicap placard, I think it was designed by an individual in a “wheelchair,” because that is the only way a user would know when their ticket has printed (amidst all of its idiotic & disconnected steps). It is only through a low field of view that a user would know when their ticket printed. Anyone taller than say 4’6″ standing with three feet of the machine would never see the ticket deep in the tray – unless they could recall from a prior experience. You’d just keep trying fixes to make it print! This design renders this machine even a more horrible design for users with cognitive challenges.

What do I know about usability, cognitive accessibility, and human factors engineering?

From 1975 to 1992 I worked with (and was an expert) the most archaic poorly designed nuclear medical instruments. With my own company, Certified Nuclear Imaging, I worked in order 60 hospitals and imaging centers. Then in 1992, I suffered a head injury in an auto accident, and developed post traumatic hydrocephalus, ending up with 12 brain shunt operations today and 500-1000 shunt malfunctions over 25 years. But, if you count my sensory processing disorder (SPD) cognitive challenges from exposure to loud noise and multi-media that is everywhere around us, I’ve faced thousands of challenging cognitive situations over 25 years. One can get pretty innovative when you’re forced to live in a “virtual reality” world because of poor memory. So I came to design many different types of cognitive aides, and today am critical of the large numbers of inadequate web & app panels, user instructions, and the like.

My challenges led me in 1997 to design & patent a diagnostic monitoring app for CNS shunts used in the treatment of hydrocephalus to run on a PDA.

Original DiaCeph Test slide and software panel

And a DiaCeph Test screenshot from about 2001 taken from a Power Point presentation.

DiaCeph Test Hydrocephalus App Clinical Markers

My DiaCeph Test running on a PDA would have been one of the earliest mobile apps, for which I was labeled a “pioneer.” Unfortunately, money for start-ups like DiaCeph Inc. were hard to come by back then. But it led me into designing all kinds of assistive “cognitive” aids, solutions, researching cognition, and eventually usability – the precursor to today’s tech & user usable designs. For several years, I was in regular conduct with staff at Hewlett Packard as they had acquired Compaq and then were the top seller of PDAs, and scientists at the Coleman Institute in Colorado and others around the country. Unfortunately, they were focused on technology solutions for lower functioning individuals, and that just didn’t interest me. However, today we are able to merge this knowledge on human factors and usability.

mHealth Technology, are we there yet?
Stephen Dolle invented his DiaCeph Test following his 1996 FDA petition that was then used to direct this 1998 shunt surgery

My goal with my DiaCeph Test was to get patients with hydrocephalus to be able to operate the app by themselves – a huge challenge. So I continually played around with different design concepts. I never went back to school during all of this. But by 1999, I was being introduced as a “neuroscientist.” In 2003, when I couldn’t make a go of my DiaCeph Test, I made it available as paper forms & instructions, then got involved in music & drumming therapy, or “drum circles,” where I poured the next 10 years of my life into.

Stephen Dolle speaking on STEM3 Educational Techniques with Drums and Rhythm at Wright State University in 2011.

Sports Science vs the Brain Science of Basketball

I’ve had many many amazing experiences and discoveries with drumming, like my popular blog on the Brain Science of Basketball. I’ll save this for another day. But I’ll share that being a drum circle facilitator teaches one a great deal about cognition and human behavior.

In 2011 or so, I created a Cognitive Neuroscience page on my main web site, which features many of my efforts in the neurosciences. However, it does not contain or index the many blogs I’ve written here (as my blogs are more recent). Feel free to scroll thru some of my published web pages and articles.

Great Brain Anatomy Image

Cognitive Neuroscience page at Dolle Communications

Let me share one more example of where poor usability crossed over into cognitive accessibility, this time in the Norton Security 2017 Deluxe renewal packet that I purchased from the Norton store on Amazon.com. Their 2017 renewal product came with the instructions for a new installation, which created 2-3 hours of frustration from incorrect install steps, that required a online support and a phone call to fix.

Incorrect Installation Instructions for Norton Security 2017 Deluxe Renewal hurt its Usability and posed unnecessary Challenges with Cognitive Accessibility.

I’ve also had my cognitive and usability challenges with Amazon.com. However, here’s a nice screenshot I’d like to share on the usability of the “contact us” options at Ebay. This type panel and confusing OPTIONS is still the standard in so many large online retailers today.

The Contact Us options at Ebay Online Retailer provides way too many Contact Options, raising Usability and Cognitive Accessibility Challenges

And one of my favorite web accessibility panels we will someday see for TV programming, is Time Warner Cable‘s internet telephone panel for blocking telemarketers, that I predict someday and have added in graphic functionality the ability to block “unwanted loud TV commercials.” Hurrah!

Time Warner Cable’s Internet Telephone Web Panel for screening Telemarketing Calls may someday allow users to screen Loud TV Commercials.

And additional positive and futuristic usability is in my very popular blog on use of the eWeather HD App to manage migraines and headaches. Though I didn’t design the app, the migraine management application came out of my mHealth experiences with the DiaCeph Test for hydrocephalus. I have painstakingly done as much as I could the enable this weather app to be used as an mHealth app.

Blog on use of eWeather HD App for Management of Migraine

And finally, my blog on my DiaCeph Test as a mobile app.

DiaCeph Test hopes to be a mHealth Mobile App

Mobile App for Hydrocephalus improves care and medical outcomes worldwide

CognitiveAccessibility.org

It was in 2013 amid so much frustration with tech and multimedia, that I researched and purchased the domain CognitiveAccessibility.org. Regrettably, I am yet to publish its own. It points to a “page” of that title on my main web site. In 2017, I still do all of my own web site publishing, tech, and social media work. And because of all this, I just haven’t found the time to make its own site. I already have 3 web sites, so this would involve publishing and managing a 4th. I haven’t really updated this page since 2013. But I think you’ll get the jist of what I’m trying to do. I believe the time is now to publish its own site, as usability has now crossed the threshold into cognitive accessibility. Tomorrow is now today!

Cognitive Accessibility.org
Cognitive Accessibility.org

What does the term, “Cognitive Accessibility” actually mean? Well, it means exactly as it sounds. It is defined as “reasonable” intellectual access to public places, things, and technology for persons with “cognitive” or “intellectual” disabilities, and from any number of etiologies (brain injury, learning disabilities, PTSD, developmental, aging).

Access means that the provider must undertake a reasonable amount of consideration & design preparation so persons with cognitive affected disabilities may understand and use the products. The prevailing law in this area comes under both the Americans with Disabilities Act, and Section 508 of the Rehab Act, but more in the latter, which holds specificity in access to web sites and somewhat in product user instructions.

Cognitive Accessible Designs would then be appropriate useful designs of web sites, product labeling, and instructions on products and premises that can reasonably be understood by persons with cognitive disabilities. The reason you haven’t that much about this thru the years is that up until more recently, it was difficult to ascertain what “reasonable & appropriate” designs were as the affected persons had such a broad spectrum of disability and aptitude. So designers didn’t know who & what level they were designing for.

But, over the last 10 years, several things have changed.

First, affected persons are more able to get out and about today thru revisions in social policy, educational, and work programs. Second, we have many in the military who have returned from combat with a spectrum of post TBI & post concussion disorders, and now we have far more awareness of it – as well as new research has become available. Thirdly, we have advances in, and much more availability of, cognitive aids, PDAs, mobile smart phones, etc. today, where many more people are using them, and this high usage is rapidly redefining cognitive accessibility parameters, where cognitive accessible designs are scrambling to keep up. Fourth, we have a significant age related “digital divide,” age 50-55 today, which is raising more and more challenges to our aging population, many of which are still computer illiterate. The tech industry resultingly left these 50M Americans out of consideration in their cognitive accessible designs. And now today, there is ever increasing on these Americans to learn to use tech. And fifth, lest not leave out the rising prevalence of dementias in our aging population. They have considerable cognitive disabilities, and their needs are yet to be met.

All said, there are a lot of Americans today with cognitive disorders. Most are out and about. Instructional designs have not kept up. And now we have a cognitive accessibility crisis!

I hope to get my CognitiveAccessibility.org site online soon. In the meantime, please visit our cognitive accessibility web page on our main web site: http://www.dollecommunications.com/cognitive_accessibility.htm One key emerging challenge lies in the cognitive accessibility of popular internet web sites like Google, Facebook, iTunes, and LinkedIn. Over the last few months, each of these sites have undergone a major update & redesign of their UI, or user interface. Each time a UI is changed, there is a new learning curve for the user. And where users have any medical condition, injury, or aging issue that limits the comprehension of the changes and architecture and subsequent use of the web site, we have a problem. And the problem(s) lie both in accessibility (cognitive), which are protected by disability law, and loss of productivity, which should be of major concern to employers & persons having to use such sites as part of their school or work.

In addition to cognitive accessibility and cognitive accessible designs, most web sites today still pose accessibility challenges due to the “digital divide,” that is, the educational exposure to technology by persons over the age of about 50 today. Such persons and internet users, not having grown up with or been schooled in technology, often find the Internet, tech, and mobile apps a significant challenge. And with so many of these being baby-boomers who have never fully adopted (if at all) the internet & tech boom of the last 15 years, web site and tech providers have a growing challenge. Now, add in the growing challenges of so many items on store shelves today, and the continual rearranging of products on store shelves, and stores and their products and packaging pose additional challenges in Cognitive Accessible Designs.

Take Target, for instance, who own 1700 stores nationwide. On average they rotate, introduce, relocate, or change the products on their store shelves several times per month. And after each change, customers have to re-familiarize themselves with location, product label, and missing/changed items. It presents ever-changing cognitive and visual challenges to shoppers. And if Target and other department stores, and product manufacturers, do not give ample attention to Cognitive Accessible Designs, you end up with a lot of confusion in stores, with lots of returns due to wrong items purchased. These experiences and added time/store visits then lower both accessibility and productivity.

The poor Cognitive Accessibility of the Colgate Toothpaste section at this Target store in Fountain Valley, CA, will make anyone’s head spin.

Can you imagine how many man-hours across the U.S. in Target stores alone are at stake due to additional shopping time and lost customer & staff productivity in maintaining these shelves, and handling the many customer returns? The figure must be staggering. Yet, the trend in poor Cognitive Accessible Designs continues.

You’d think companies would want to get this right, to spend a little more time & money when they create these display designs. But these are largely new issues for most of us in the U.S. because of our mobile population, aging baby-boomers, and millions of Americans today with learning disabilities, autism, post brain injury, neurological disorders, and the like. We must address this. This is a matter of national productivity, and disability rights & accommodations!

I have written to several of the leading internet sites, but am yet to engage in any productive discussion yet. My web site suggestions thus far include:

1. When U.S. companies update their UIs and web sites, they should provide new instructions similar to that provided in “boxed” instructions, i.e. User instructions, A 1-page diagram of the site UI and architecture, and precautions & warnings for privacy & user settings.

2. Internet sites should adopt “UI standards” for display & site architecture as to how to set user privacy & notifications. Statistical data on affected internet users with brain and learning disorders requiring “Cognitive Accessible Designs” and protections under the American’s with Disabilities Act and Section 508 of the Rehab Act are considerable.

Some commonly affected disorders include:

1. Post TBI

2. Post brain tumor

3. Post stroke

4. Hydrocephalus, NPH

5. Autism

6. ADHD

7. PTSD

8. Post concussion disorder

9. Seniors w/ early onset of dementia

As web pages and web sites add more and more content and graphics, it makes the requisite design implications for cognitive accessible designs more and more critical. Recent updates and redesign of UIs including Apple, Norton, and LinkedIn, came without any notice or information that might have lessened the challenge for affected users needing to learn to use the updated UIs.

More than just issues with cognitive accessibility, Cognitive Accessible Designs also raise broad issues in Productivity and in the best use of our time. Clearly, as much as tech, web sites, smart phones, and super stores aid us in productivity, they’re resulting in our spending a huge amount of time trying to make them operational.

Cognitive Accessible Designs will become an increasing public & educational challenge for the U.S. in the years ahead. We’d be wise to commit sufficient resources to get this right.

I’ll continue this update this 2013 blog and hope to get a site up soon at CognitiveAccessibility.org.

ABOUT ME: I suffered a brain injury in 1992 w/ 12 brain shunt operations to date. Background in medical technology, the neurosciences, music & drumming therapy, and considerable insight into technology, AI use of technology, and cognitive accessibility. Work part time as a neuroscientist in music & drumming therapy, medical software/apps monitoring, and the neurosciences.

Please contact me per the information below.

Stephen Dolle

Email: contact[at]dollecommunications[dot]com
http://www.DolleCommunications.com
Newport Beach, CA

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Justice Department rejects Disability Complaint on Sound Accessibility at YMCA of Orange County, Similar Venues

Complaint to the U. S. Justice Dept for sound sensitivity accomodation for loud music and screaming at YMCA of Orange County
Complaint to the U. S. Justice Dept for sound sensitivity accomodation for loud music and screaming at YMCA of Orange County

This blog discusses my disability rights complaint to the U.S. Justice Department Civil Rights Division, and request for a sound sensory accommodation from loud music and screaming broadcast all over my YMCA of Orange County fitness center where I was a member. I had been a member from 2007 to 2011. But it was in the later part of 2010 that a new fitness director was hired, who began putting on zumba classes with loud music and screaming, which was then broadcast all over the gym. Being exposed to this in the adjacent rooms then made me ill.

I undertook numerous remedies to bring a resolution to this. I was eventually asked WHY I couldn’t tolerate it, that loudness levels were within limits set my their national organiozation, and was told to where ear plugs when in the facility – which I tried for a while. But I kept having to take them out when a nearby member spoke to me. Other members (esp seniors) I was told discontinued their membership due to the unhealthful noise. Earlier in 2007, I had abandoned my 25 year membership at 24 Hour Fitness after they began playing loud overhead music. This YMCA gym could have, and should have, made the necessary accommodation I requested. In their ruling, DOJ rejected my complaint in its entirety and instructed me to seek other (esp. civil) remedies. In my opinion, both were legally and morally in the wrong! But there’s very little advocacy for SPD and sound sensory disabilities.

YMCA’s practices effectively barred me and other members with sensory processing disorder from using their fitness facility. The loud music and screaming gave me headaches, nausea, made me dizzy, and irritable – not unlike motion sickness. This is a known medical response for affected individuals to this type of sound sensory stimuli. And it gets better. After I filed my complaint to DOJ, the fitness director created a fake incident alleging I was disturbing other members, where I was told my membership was no longer good. I left and never returned!

Prior to filing my complaint with DOJ, I verbally and requested in writing to management for a change in their music broadcast policiesYMCA declinded to make any accommodation or modification. This was also after I had done volunteer work (music therapy) for this YMCA, and after others (affected seniors) had donated money.

It took DOJ two years to respond with a “no.” My complaint was filed with the “Disability Rights” division, who has jurisdiction over public and private facilities for disability rights accommodations. My complaint asked DOJ to draft new language of protections applicable to public and private venues across the U.S. where loud music or machinery poses unhealthful consequences to persons with neurological and sensory processing disorders.

Mostly what this YMCA needed do as an accommodation – was keep the door of the Zumba classroom closed. But management decided it more important to leave the door open, despite the room already having numerous open windows to the outside that brought in fresh air, and instead chose to broadcast the loud music and screaming through the rest of the facility.

Below is my complaint to DOJ and request for accommodation to the YMCA of Orange County, both of which were denied. These parties theated sound sensitivity and sensory processing disorder as though it were a “comfort” issue, rather than health issue.

Brain centers involved in SPD or sensory processing disorder, courtesy of UCSF
Brain centers involved in SPD or sensory processing disorder, courtesy of UCSF

A large segment of the U.S. population suffers from sensory processing disorder as a result of either autism, post TBI, PTSD, ADHD, hydrocephalus, post tumor, post stroke, Parkinson’s Disease, multiple sclerosis, migraine disorder, dementia, Alzheimer’s Disease, and more. Affected individuals become very sensitive to loud/erratic sound, from music, machinery, loud raucious TV commercials, and other types of sound which carries elements which are problematic to affected individuals. The affected Americans account for 15-20 percent of the population. These unhealthful sound levels for many, are often protected by years old standards of the decibel scale & chart below. But, these acceptable limits are coming under fire as I share further below.

Standard decibel chart approved many years ago before much was known about the brain or sensory processing.
Standard decibel chart approved many years ago before much was known about the brain or sensory processing.

The above chart has been coming under fire. OSHA, the primary authority over unhealthful sound in the workplace, still agrees with the more liberable interpretation above.

The decibel chart offers some additional insight to how the readings are made. Today mobile apps also provide decibel readings.
The decibel chart offers some additional insight to how the readings are made. Today mobile apps also provide decibel readings.

This next chart illustrates the decibel levels of common machinery.

This decibel chart provides decibel readings from many common machinery.
This decibel chart provides decibel readings from many common machinery.

Now we’re getting a little more current science with this next chart, which factors in reporting by persons exposed to what were thought of as otherwise safe decibel levels. And none of this yet takes into consideration the loss of sensory processing function by persons with neurological injury and disorders, and related SPD. When affected individuals are unable to tolerate these sound/noise levels, that raises ACCESSIBILITY to public and private facilities. Such facilities would include health clubs, restaurants, night clubs, churches, schools, malls, art & music venues and events, fairs, parks, and the like.

Study of group response to decibel levels otherwise considered safe by the decibel scale.
Study of group response to decibel levels otherwise considered safe by the decibel scale.

The image below illustrates the critical brain areas in volved in sensory processing.

Drumming and the Brain.diagram

In 2016, technology has made decibel meters available as mobile phone apps. I use the Smart Tools decibel app. However, what is needed is an app and new sound standard to measure the EQ mix of sound and its likely effect on sound processing. Such data would then lower the effective healthful range of sound.

Choose the right decibel app.
Chosing the right mHealth App can be confusing.

In individuals such as myself, I will have good days and bad days, where my sound intolerance can vary and leave me in a pickle if I ignore the early warning signs. As an affected individual, you need to be aware at any given time of the status of your sensory intolerance, so you can make your optional adjustments as needed. However, there still needs to be new efforts in mitigating the hap-hazard broadcast of sound and noise as so many people are effected, with many more becoming affected who aren’t aware.

As for regulatory actions against noise, the only one that comes to mind is Congress 2012 ruling on the CALM Act – intended to prevent volume raising of TV commercials. But nothing has changed. Obnoxiously loud and ridiculous TV commercials continue on almost all channels. And on radio too. While the science in support of sensory processing disorder and affected neurological disorders exists, the U.S. government and DOJ have acted to deny the science, accommodations, and disability rights protections, while advocating for bizarre new and usual protections for special interests groups. I challenge those who deny this, to play such sounds at an official’s or company office. You will likely be thrown out! So WHY is this exposure OK for the general public? I discuss this in more detail in my 2015 blog on Tips and Information on sound related Sensory Processing Disorder below.

New sound standards and measurements must occur for there to be progress. There first needs to be a revision to current safe decibel scale, to revise it to reflect the health needs of persons with SPD disorders. Next, I am advocating a NEW decibel scale to include a “sound processing component” to account for how the human brain processes sound. Examples of difficult sounds are machinery with fast unbroken patterns, TV & radio commercials where a person is talking fast or screaming with music playing at full volume, and music with people screaming and yelling.

Cognitive Accessibility in SPDs.Hulk Destroys Tree Shredder
Cognitive Accessibility in SPDs.Hulk Destroys Tree Shredder

Since this blog was authored in 2013, I have added a new web page of information for sensory processing disorders and cognitive disabilities at CognitiveAccessibility.org, as well as several new blogs which I discuss below.

Cognitive Accessibility.org

In 2015, I authored this important blog on tips and new information on sound related sensory processing disorder, or SPD, which includes updated supporting blogs and web content on this important subject. I am hoping to find the time and energy to build a complete web site for CognitiveAccessibility.org to advocate and share science on sensory processing disorder and cognitive disabilities. In this blog below, I also share some of my efforts with drumming and drum circles that can raise one’s level of intolerance, and improve over well being.

Tips & Information on Sound related Sensory Processing Disorder (SPD)

Drumming Therapy helps Children with Autism, ADHD, and ADD with Focus and Initiation of Action.
Drumming Therapy helps Children with Autism, ADHD, and ADD with Focus and Initiation of Action.

We have supporting science. Now we simply need to connect it to protections and managing in everyday living thru accommodations, technology, and awareness.

Earlier in 2002, I undertook an important study on sensory processing disorder, which is also discussed in the above updated blog:

 2002 Study in Support of Sound related Sensory Processing Disorder 

If you would like me to speak on my efforts with sensory processing disorder, workplace drumming or therapeutic drumming, please contact me via the information below. 

Stephen Dolle
Neuroscientist & Drum Circle Facilitator
Dolle Communications
Email: contact[at]dollecommunications[dot]com

Update on Higher Incidence of Brain Diseases & CTE among Former NFL Players

A most recent study of former NFL football players reports that they are on average 3 times more likely to die from Alzheimer’s, Parkinson’s, or Lou Gehrig’s disease than the general population. But, it shouldn’t surprise you based on what we know about health and longevity: take care of yourself when you are young, and you’ll likely appreciate better health in your later years.

That means, brush your teeth 1-2 times per day, eat your fruits and vegetables, don’t smoke, watch what you eat, get some exercise, don’t drink too much, limit your high risk behavior, and don’t bust yourself up.

I would have to argue that repeated blows to the head, as is common in football, goes against everything our parents and doctors told us from our youth. Though most of the attention of brain problems in football players until now focused on the condition CTE, or chronic traumatic encephalopathy, which is traced to repeated head blows. This new study looked at the three leading cause of disabilty and death among seniors.

As a youth, I suffered at least one known concussion when I was knocked unconscious during a football game. Over the years, I probably had one or more other concussions due to all the sports I participated in, including, boxing. But, it was a 1992 auto accident at the age of 37 that turned an initially viewed mild head injury and concussion, one month later into post traumatic hydrocephalus and 10 brain shunt surgeries since.

Since my 1992 injury from an auto accident, and with a health care and scientific background, I poured a great deal of my efforts into music therapy, balance & cognitive therapies, neurological testing & patenting of an AI type monitoring system, assistive cognitive technologies, hydrocephalus advocacy, FDA regulatory affairs, and now over the last seven years, drumming for your brain and health.

I believe I can say with absolute certainty that these mindful preparations and preventions will make a significant difference in your health and longevity. I feel bad for the athletes who have sustained multiple concussions and now are having long term neurological complaints. It is never too late to take on stricter controls over activities that affect your brain and health.

Exercise and challenge your brain today thru reading, art, music, and social activities! I have found termendous brain & health benefits from drumming, or drum circles, and today am a drum circle facilitator and speaker on drumming and the brain. I have undertaken research with drumming and sensory processing disorders, common in CTE, parkinson’s, post TBI, PTSD, autism, hydrocephalus, migraine, and many other neurological disorders. Check out my web site and Facebook page at http://www.dollecommunications.com

Remember also to eat right. Drink lots of water. Get proper rest.  And watch what you put in your body, including, alcohol and/or drugs. If something seems like it might be bad for you, it probably is!

http://espn.go.com/nfl/story/_/id/8341317/study-finds-former-nfl-players-unusually-prone-dying-degenerative-brain-disease

Drumming Therapy experience in a Child with Cerebral Palsy and Autism

Hand percussion instruments helpful in music and drumming therapy, and handy when traveling
Hand percussion instruments helpful in music and drumming therapy, and handy when traveling

As many of you might expect, I almost always have percussion instruments with me, even while on vacation. When I traveled to Northern Michigan in 2012, I brought the above claves, shaker eggs, a cylinder shaker, woodpecker, gongo bell, flute, and thunder tube. I travel with these should I be asked to entertain or do a drumming therapy session. This request came from a friend of the family for an 11-yr old girl with cerebral palsy and autism from a chromosomal defect. The child was quite challenged and could not walk or talk, and suffered from restlessness and difficulty sleeping.

Stephen Dolle, Neuroscientist & Drum Circle Facilitator
Stephen Dolle, Neuroscientist & Drum Circle Facilitator

The Patient Workup

In preparing for my sessions, I perform a brief patient workup that consist of speaking to the parent in the presence of the child – to get the relevant patient history and to let each see me speaking in the presence of the other – which establishes permission. I am experienced in doing clinical workups from my prior nuclear medicine work and current hydrocephalus consults and drumming work. All together, I have 17 years of clinical workup experience as a nuclear medicine technologist (10 years with my company Certified Nuclear Imaging), 15-20 years hydrocephalus and medical device consulting, more than 10 years in drumming, and 10+ years earlier experience coaching youth soccer and baseball where some of my kids had speacial needs

Next, I introduced myself and spoke directly to Eliza, the eleven year old child in this session. I wanted to assess her present state of mind and willingness to work with me- which was positive. I assess the eyes, body movements, and listen to any verbal responses to any nervousness or physical complaints that might interfere with the session. It is important to know any issues that might limit the session – so I can ideally adjust ahead of this. I shared with her mother that I would keep the instrument play simple and not too loud, and start simple and increase stimulation and complexity as long as she was agreeable and engaging. As the therapist, I must continually observe her engagement and adjust my interactions accordingly.

Sensory Processing Disorder

Cognitive Accessibility.org currently under construction
Cognitive Accessibility.org currently under construction

Most all children with autism also suffer from sensory processing disorder (SPD), as do many with hydrocephalus, ADHD, PTSD, Parkinson’s, post TBI and the like. IN SPD, the individual will become easily over sensatized to sound, light, motion, or scents. Sound is the most common, but lights and colors are often an issue too. The list of accommodations for individuals with SPD as a medical challenge vary, but now fall under “cognitive accessibility,” which medically and legally defines the neurologic functional needs of the individual. I have become increasingly involved in cognitive accessibility over the last 5 years.

As I sat down next to Eliza, I observed her to be drooling, a bit anxious but also curious about what I was about to do. She was cooperative. My approach is to be calm and assuring. In these sessions where sensory processing disorder is present, sound, color, my voice, and movements become a critical part of the music therapy session. I maintain my attentiveness to her responses.

Color, Movement, and Music

These shakers come in all sizes and flavors and are very handy in music and drumming therapy.
These shakers come in all sizes and flavors and are very handy in music and drumming therapy.

I began by playing a simple 1-2 beat on my wooden claves, and it immediately drew her attention. I followed this up with one shaker egg, and then two, and she responded with giggles and excitement the more I played. With the colored egg shakers, it was hard to differentiate how much of her response was due to the egg color and motion versus sound from the eggs. Then I played the cylinder shaker, which can be loud if not careful, and I got more positive response from her. Next, I played the woodpecker and shaker together, and she went bananas! Yes everyone likes the wood pecker. By this time, she had been awaiting and anticipating my every movement and instrument sound. It was as much fun for me as it was for her. She became a terrific student and fan!

Then I played the Remo thunder tube. And she became so excited, she reached out and grabed it. Her mother said she couldn’t hold things in her hands. But she pinned the thunder tube between her right hand and lap, and resisted a bit as I reached to take it and play again. However, at no time did she play any of the instruments. I tried to get her to hold a shaker egg, but without success. Eventually she held the thunder tube almost entirely in her hand. My session lasted almost 40 minutes, and I was very pleased at her attentiveness, willingness to engage me, and willingness to challenge her own limitations.

Music and the Brain

This music and the brain illustration depicts the areas of the brain involved in listening and playing music
This music and the brain illustration depicts the areas of the brain involved in listening and playing music

I believe the favorable response and attentiveness during this treatment was due to the child’s attentiveness to engage me and the sounds and colors of the instruments. By the end of the session, she had remarkable focus and level of excitement, and briefly drank from a bottle. And then stood up by holding onto the porch railing, and stretched in excitement. I explained to her mother that these type of therapies might be helpful in her walking or talking someday. The family has a piano where she and the other kids will gather around and play together. I’m told she likes the bass notes on the piano. So I suspected she’d love the sound of a bass drum (I did not have on this trip). I would be curious as to what an EEG would show of her brain waves since she craved active sounds. She’d also been to a Blue Man show where the performers made her part of the show.

Music & Drumming Therapy as Healing Arts

EMDR therapy is one related sound and movement therapy that comes to mind and is used in PTSD and sensory processing disorders to desensative the individual. I reflected on new EMDR methods in 2002 when I undertook my sound sensory study with the Boss metronome (discussed further below). As EMDR is also a “healing art,” I’ve shared my blog below on CAM and alternative medicine. It is from  2012. But it’s been updated. It is the first third or so of this blog, where I discuss my past mind-body methods, that I think is relevant to music and drumming therapy today. In these regards, I believe the benefits come from more than sound and interaction, they come from the authencity and “intent” of the therapists. And this is widely true thoughout the various alternative medicine modalities. There must be a BUY IN by the patient! The trust and optimism causes a release of neurochemicals in the brain and change in cell structure throughtout the body.

Healing thru Complimentary and Alternative Medicine

Illustration of the Meridian fields used in Acupuncture and Alternative Medicine
Illustration of the Meridian fields used in Acupuncture and Alternative Medicine

Drumming for the Brain & its Effect on Brain Wave States

In EMDR Therapy, the therapists determines what to say and how to integrate sound and visual cues. It has been discovered via Parkinson’s Disease work that happy and relaxing activities please the brain and aid in the release of endorphins, particularly dopamine. Dopamine levels often run low in PD. I am uncertain as to the effect seen in cerebral palsy and autism. But I observed in my session with this child that she had a strong affinity for rapid stimulation thru musical toys, also confirmed by her mother.

The four levels of brain wave states are shown in this illustration
The four levels of brain wave states are shown in this illustration

I am unsure whether Eliza’s low functioning state kept her brain waves in a lowered state, i.e. alpha. But she craved rapid stimulation. I felt it critical that I engage her in a step-by-step method of rhythmic movements and sound so as not to overstimulate her, and maintain her focus and level of engagement. Most of what I played were slower rhythms. The most up tempo I played was a moderate samba on the bell and clave. And this was only one session. I didn’t have opportunity to stimulate her on multiple levels. And at the end of this single session, I could see she was tired.

I suspect a djembe drum or bass drum might also captivate her. I’ve observed a young girl with marked autism at the HB pier who will sit right in front of the large fast playing djembes. I’ve been concerned it may not be healthy for a child at her level, though she appears drawn to the stimulation. Children have lower brain waves until their teens. So any artificial attempt to speed them up could have adverse consequences. This is also why caffeine and sugar act differently in children.

The next day Eliza’s mother contacted me to share that she slept thru the night and seemed remarkably calmer after the drumming session. This experience is one of the reasons WHY I became involved in drumming. It has also helped me personally in managing many of my own challenges with hydrocephalus. Further below, I discuss some of the contraindications and research with sensory processing disorder, including, a blog with audio examples from YouTube of problematic machinery noise.

Group Drumming Events, Drum Circles, Drumming Therapy

Young children captivated by their play in a drum circle
Young children captivated by their play in a drum circle

I have been involved in drumming therapy since before I became involved in drumming in 2004. It was my 2002 sound sensory processing study with the Boss metronome which were my orginal efforts in sound patterning. After becoming involved in drumming in 2004, my interests were split between play and research. I authored this first web page on drumming entitled, What is a Drum Circle, which discusses some of the science plus my own views on drumming, or drum circles.

In 2005, I put on my very first drumming for the brain workshop at the High Hopes Head Injury center in Tustin, CA. From there, I began to put on a wide array of drumming for health events, though these were mostly for disorders of the brain and central nervous system. This drumming for wellness page below features some of these efforts.

Drumming for Wellness

Drumming therapy is finding success today in 1:1 and group sessions with ADHD, ADD, autism, hydrocephalus, Parkinson’s Disease, post TBI, aging, and more. What is critical in all of this is that the individual and group ENGAGE!

The information on my above drumming web pages discusss how you can obtain a drumming event, workshop, or therapy session with me.

Dolle Communications – Cognitive Neuroscience

The brain and sensory system during cognition.
The brain and sensory system during cognition.

I created the above Cognitive Neuroscience web page to encompass my neurosciences efforts from hydrocephalus to mHealth, sensory processing disorder, drumming, drumming therapy, cognitive accessibility, and related outreach. Like so many sites and pages, it is a work in progress to keep it up to date.

Generally speaking, decibel apps only help you with loudness or decibel level of surrounding sound before it might become problematic for you, your child, or parent. Unfortunately, the triggering aspect of sound, is more in its pattern and pitch than loudness, and is why I undertook this next study in 2002 on sound and sensory processing – to understand the types and effects of sound exposure on persons with hydrocephalus who also have SPD. I feel the types of SPD challenges I evaluated in hydrocephalus is similar to that of autism and other neurological and learning disorders.

Boss recorder and metronome were used in 2002 to evaluate sensory processing in individuals with hydrocephalus.
Boss recorder and metronome were used in 2002 to evaluate sensory processing in individuals with hydrocephalus.

Sound Sensory Dysfunction in Brain Injury and Neurological Disorders

Cognitive Accessibility in SPDs.Hulk Destroys Tree Shredder
Cognitive Accessibility in SPDs.Hulk Destroys Tree Shredder

As for balance, coordination, fitness, and sensory processing challenges, it doesn’t get much better than shooting baskets – which I began doing therapeutically in 2008. I eventually met up with another shooter, Al Massip, and our on court discussions turned to philosophy and brain science. One day, I posed the question, Where does the Shot come From? And this became a focal point of our shooting for several years, until 2015 when  I published this in-depth blog that now attracts 500+ monthly visitors from all over the world. This suggests a lot of people are trying to answer this question. The answer may be in part mystical too. On a therapeutic level, my basketball and drumming with basketball methods are very helpful for a number of neurological disdorders and brain health.

Sports Science vs Brain Science of Basketball: Where does the Shot come From?

Basketball allows participants to feel and move rhythmically with a touch sensitive ball
Basketball allows participants to feel and move rhythmically with a touch sensitive ball

My next blog discusses how mobile apps are helpful in managing sensory processing disorder in everyday life, no easy feat. This is a detailed blog with supporting links.

Mobile apps Helpful in Managing Sensory Processing Disorder

mHealth Apps in Neurology
mHealth Apps in Neurology

The final supporting presentation below was from my power point as part of a talk I delivered at Wayne State University on drumming and rhythm methods in STEM3 education. I discuss a range of implications from language and learning, to speaking tempo and entrainment of teacher/student, to health and sound sensory processing and classroom noise considerations.

From my 20+ years in living with hydrocephalus, research and writing about the brain, a lifetime of playing music, 17 years in nuclear medicine, and coach on 20 little league soccer and baseball teams, I truly understand how drumming helps others.

Contact me if you are interested in drumming therapy sessions, consults, or having me speak at an event. The best method of contact is via email.

Thank you.

Stephen Dolle
Neuroscientist, mHealth Inventor & Drum Circle Facilitator
Email: contact[at]dollecommunications[dot]com
DolleCommunications.com