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

Advertisements

Mobile Sound Level apps Helpful in Managing Sensory Processing Disorder

Android Apps Image
Android Apps

Decibel meter apps are helpful in managing the ill effects of sound exposure in brain injury, hydrocephalus, ADHD, PTSD, and related sensory processing disorders. Sound Meter is best app on Android. The Pro version is $.99. Though either is good. SPLnFFT is said to be best app on iPhone. Many are accurate enough for these purposes. Plus, what you really need, is comparative analysis of sound to medical sequela in the same app.

The science in support of monitoring sound level exposure comes amid findings that “sound” can trigger medical sequela, and result in a combative child or even adult out in public. The sequela typically ares headache, nausea, decreased cognition, irritability, and behavioral outbursts, and occurs in persons suffering from a variety of neurological injury & disorders. Light, motion, and scents are also triggers. The sensitivity, and type of trigger, does vary somewhat from person to person.

The medical condition for this is termed “sensory processing disorder” or SPD, and sometimes termed “sensory integration disorder,” and these tend to follow brain injury, neurological surgery (numerous ones including hydrocephalus and tumor), and many types of neurological disorders.

Brain Diagram of the Cranial Nerves
Brain Diagram of the Cranial Nerves

At any given time, the effected person is vulnerable to a range and type of sound triggers. Yet, this sensitivity and vulnerability often may not be known until AFTER the exposure. Often all it takes is 30 secs of problematic sound exposure to set off a sequel of SPD complaints. Then, you’re dealing with a medical problem.

Certainly the big ones like loud machinery, music, and room noise are predictable. But it is the not so loud and obvious exposures that’ll get you. And NOT knowing at any given time what your sensitivity or threshold is. And this comes from trial & experience.

I recommend downloading one of these apps and using it regularly for a couple of weeks to learn of your LOWEST threshold decibel levels – for when you’re not feeling well, and for various venues. Then, you can do things with more confidence in that you know your thresholds and can take the necessary interventions SOONER to avoid an ill spell or “melt down” in public. Today I learned too late, after being near a store playing loud overhead music. It was registering over 80 db on my Sound Meter app. I had not checked the sound level when I arrived. Once your system is triggered, it is often too late for other interventions or measures, and you’re likely going to have to leave that venue.

Unfortunately, current apps do not measure frequency distribution or sharp spikes in sound. Sound between 5000 Hz – 10,000 Hz is often problematic for individuals suffering with SPDs. The other causative elements includes sharp spikes in decibel level, and disordered sound presenting as “white noise.” If you, or a family member, suffers from sensory processing disorder, you know what I mean.

I undertook a sound sensory study in 2002 using a metronome to evaluate SPD complaint responses to various rhythmic patterns, and I was able to show that the component in sound most responsible for SPD complaints was “lack of rhythmic pattern.” My findings explain why white noise, or room noise, is so problematic. Read my full study below:

Study on Sound, Cognition and Sensory Processing

Boss BR-8 includes a full 50 selection Metronome
Boss BR-8 includes a full 50 selection Metronome

There are many treatments today that have found varying degrees of success in raising a person’s threshold to SPDs. They include: EMDR therapy, music therapy, group drumming (in which I have conducted research), bio feedback, mindfulness, basketball, meditation, occupational therapy. A variety of mild barbiturate medicines find use as well. I can’t say enough about the importance of proper rest & diet, managing stress, and drinking plenty of water. Vestibular exercises, meditation, mindfulness, and biofeedback therapies seem to help raise an affected persons sound intolerance.

New Dolle Communications Web Page on Cognitive Neuroscience

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

Once an exposure and SPD medical sequel has begun, your options include:
1) have the individual stay focused & “engaged” in an activity
2) insert quality ear plugs (suggest musician’s ear plugs)
3) remove the affected person from the triggering noise source
4) administer barbituate, pain or calming medication
5) force hydration preferable with water

On June 4, 2015, I published an extensive blog on basketball – which includes methods in shooting baskets, mindfulness, biofeedback & relaxation, and including drumming with basketball – which helps the brain, movement disorders, intolerance to sound, post concussion syndrome, and relieves stress.

(Dolle Blog) Sports Science vs Brain Science of Basketball

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

Understanding Sound Sensory Processing & your Intolerance Level

If you suffer from sound sensory processing difficulties, I suggest you try one of the available decibel meter apps. I use the Smart Tools Pro Sound Meter pictured below. It also has a built in Vibrometer to evaluate motion say on a boat or car. You need to become familiar with your sound threshold range and intolerance, and screen typical levels at places you visit. You’ll need to add further consideration if there is machinery or other problematic noise that the individual would normally not process very well. All it takes is 30 secs of a problematic sound exposure to set off a sequel of SPD complaints. Develop good rules of practice.

Decibel Meter by Smart Tools
Decibel Meter by Smart Tools

Call for a Sound Sensory Processing Scale & Algorithm of Measurement

The decibel sound scale is now more than 50 years old. Its time we create a Sound Processing Scale & Algorithm for Measurement
The decibel sound scale is now more than 50 years old. Its time we create a Sound Processing Scale & Algorithm for Measurement

The current challenge is that these apps only measure level of volume. What we need, is a sound distribution EQ scale to equate how the brain processes sound (along with volume), which would require a convening of neurologists to scientists study this relationship, and establish a new sound scale to include the difficulty of processing of sound distributions. Sound engineers already know a great deal about the distribution or EQ of sound. To establish a sound processing scale, we would only need to equate various EQ sound patterns with the level of difficulty of processing by the brain. There are already sound identification apps that can identify patterns in music and ID them by song name. Two very popular apps are Soundhound and Shazam. We could use these existing sensors and algorithms to ID sound as very unforavorable vs acceptable in terms of ability to be processed by the brain. Persons with brain injury, learning and neurological disorders, and SPD (sensory processing disorder) have a diminished capacity to process sound, which I believe pares the degree and location of deficits in the brain. So, I have proposed the development of a sound processing scale and algorithm.

This new sound processing scale would encompass:

1. decibel volume and rate of change between volume levels (i.e. spikes)
2. EQ frequency distribution of the sound
3. rhythmic distribution and synchronization of the sound (i.e. white noise)

I host a larger blog on sensory processing challenges with examples of problematic sounds of machinery, etc. Just follow the link below. I try and keep these blogs up to date as time permits. My biggest new discovery in SPD comes after a study I undertook almost two years ago with the MigraineX ear plugs used in the management of headache, but also in sound suppression. I found that insertion of the MigraineX ear plugs before, and even after a harmful sound exposure has occurred, can lessen the associated headache, irritability, cognitive, and SPD complaints by 50% or more. Yes, I said SPD. So I carry the MigraineX ear plugs with me all the time. They are particularly helpful amid noise from construction, machinery, malls, restaurants, theatre halls, and more. They sell for about $12 on Amazon and many drug stores.

Secondly, I have been undertaking new barometric pressure monitoring utilizing my Samsung phone’s built in barometric pressure sensor. The built in sensor can display sharp Short term changes in pressure that weather sites often do not display. Most newer high end smart phones have this sensor built in. But you need to download an app to get the display. For this, I use the uBarometer Pro.

(Blog) New Insights in Sound Sensory Processing Disorder

If any app developers are reading this, I’d love to collaborate with you on building an SPD intollerance sound EQ app for screening of problematic sound. I can advise scientifically and in the UI (user interface, I have a good tech bkg-see page below). I’d like to couple an app with a Melon or NeuroSky EEG headband to try and correlate changes on EEG waveform with reported SPD complaints. SEE my extensive work in hydrocephalus monitoring and DiaCeph Test app design.
ADA laws with respect to sound protection for persons with SPDs is termed “cognitive accessibility.” There is an interesting legal case between families of children with autism and Disney, regarding Disney’s cancellation of the handicap pass to circumvent affected visitors standing in long lines, thereby forcing affected children to stand in line amid commotion and noise, which is unhealthful and can trigger behavioral outburst and a number of medical sequela in SPDs.

Deadline.com: Disney sued by Families with Autism over Handicap Pass

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

I am advocating for a new sound processing standard to encapsulate the brain’s role in processing sound. Persons suffering neurological disorders and from SPDs have a diminshed capacity to process sensory information, sound being the most common issue.

I host a related web page on sensory processing and cognitive or intellectual disabilities at www.CognitiveAccessibility.org.

Please visit my web site and contact me accordingly. Best method of contact is email.
Stephen Dolle
Neuroscientist, mHealth Inventor & Drum Circle Facilitator
Email: contact[at]dollecommunications[dot]com
Hydrocephalus Survivor w/ 12 Shunt Revisions
DolleCommunications.com

New Insights in the Management of Sound Sensory Processing Disorder

Drumming and the Brain.diagram

This blog discusses the science and everyday managment of children and adults who live with neurological & learning disorders, PTSD, and other disorders associated with sensory processing disorder (SPD) and intolerance to sound, lights, and scents. In these affected individuals, sensory overexposure often results in medical sequela ranging from headache to dizziness, irritability, behavioral changes, descreased cognition, nausea, vomiting, and fatigue. In later stages, it can trigger “siezures.” Sound sensativity affects about 20 percent of the population. Problematic sensory processing disorder affects 5-10 percent of the population. 

Sensory processing disorder is related to dysfunction of any of the five (5) senses. It was earlier termed sensory integration disorder (SID), hyperacusis, sensory overstimulation, and sensory overload. Sensory problems and SPD commonly follow neurological disorders and brain injury spanning hydrocephalus, post TBI, post tumor resection, multiple sclerosis, migraine disorders, drug & alcohol addiction, and PTSD, ADHD, ADD, and autism spectrum learning disabilities.

I became an affected SPD sufferer after onset hydrocephalus in 1992 from a head injury. Since 1995, I’ve undertaken research and implemented my findings in neurological consults (hydrocephalus monitoring, patient consults) and in drumming therapy and drum circle workshops with a wide array of health populations. While my specialty is mhealth, medical devices, and cognition, I am also involved in general health, movement disorders, and wellness and write about my findings online. I am of the opinion that sound, light, motion, and stress act as “sensory triggers” and are responsible for the high prevalence of PTSD (post traumatic stress disorder) and mental health challenges today. Imaging studies show that PTSD produces pathological changes in the brains of children. So, no doubt PTSD and sensory overload is wreaking havak on the brains of adults, including, police officers and those living in inner cities with high rates of crime.

Police officers are now diagnosed with PTSD disorder like their counterparts in military combat.
Police officers are now diagnosed with PTSD disorder like their counterparts in military combat.

The web page linked below provides a nice overview of the five (5) senses. Typically 1 to 3 of these are compromised in sensory processing disorder (SPD).

The Mystery of the (5) Senses (Cerebromente.org)

It has only been about 15 years (about year 2000) that SPD and sensory processing dysfunction have really been recognized. So we have a long way to go. Testing and documentation, education, and protections remain years behind what they should be.

I attribute this in part to the government’s earlier efforts to refute PTSD from military combat, and in recognizing autism as a disorder in of itself. In autism, there is also much debate and criticism of a causal relationship with childhood vaccines. And this has not helped to further care and treatment of SPD disorders.

My onset of SPD was gradual and often followed my shunt malfunctions and surgical treatment of my hydrocephalus. By the late 1990s, I understood SPD as a diminished capacity to process auditory, touchvisual, olfactory, and gustatory sensory stimuli. And over time, I began to view the challenges of SPD in terms of access & accommodations to public places, and even more broadly, cognitive accommodations with web sites, store displays, and user instructions. Today, the broader terminology for these considerations is cognitive accessibility, where I have subsequently set up a web page at www.CognitiveAccessibility.org

This next study below is list breakthrough research on sensory processing disorder (SPD) where scientists were able to document the areas of the brain affected by SPD. Thie image below is taken from their study.

Breakthrough Study Reveals Biological Basis for Sensory Processing Disorders in Children

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 Little about Me

Stephen Dolle invented his DiaCeph Test following his 1996 FDA petition that was then used to direct this 1998 shunt surgery
Stephen Dolle invented his DiaCeph Test following his 1996 FDA petition that was then used to direct this 1998 shunt surgery

My name is Stephen Dolle and I began this blog in 2010. I developed hydrocephalus 4 weeks following an auto accident in 1992. In the years that followed, I had many challenges to overcome, and became involved in Food & Drug Administration advocacy that led to my designing the DiaCeph Test for mHealth monitoring of hydrocephalus.

My SPD challenges weren’t so apparent from the start due to all the challenges. It was probably year 3 that I had begun to notice how sounds and visual stimuli (lights & erratic movements) could bring on a neurological event. Young children chasing birds would really get me. For sound, it was just busy environments that bothered me. I took a few more years before I was able to identify specifically what sounds and how they could bring on a neurological event – which I term the SPD effect. This can vary a bit from person to person. But typcially you’ll see a decrease in cognition, an increase in irritability and behavior change, headache, and changes in balance and orientation.

From 1992 to 2013, I underwent twelve CNS shunt revisions. In 2015, I was also diagnosed with pachymeningitis, and it has further aggravated my SPD challenges.

It was my astute neurologist in 1999 that shared new research on sound hypersensitivity, and instructed me with tips on how to help manage it. Back then, it was often termed “overstimulation.” And it then led to my undertaking a critical SPD study.

Sound and Touch (Balance) SPD Sensory Study in Hydrocephalus

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.

In 2002, I undertook my first SPD Study, where I employed both the Aerex Balance Pad and the Boss BR-8 Recorder (w/ metronome) to evaluate touch, visual, and sound sensory challenges. I took my materials to a hydrocephalus conference at St. Joseph’s/CHOC Hospital in Orange, CA, and also to England Physical & Balance Therapy in Garden Grove, CA, where I was undergoing vestibular therapy. I published my study results on my web page below.

I employed the Boss BR-8 recorder and metronome to study the effect of sound on cognition in persons with hydrocephalus, plus interviewed about 20 individuals claiming to be affected by sound intolerance. I learned that the adverse effects of sound was more due to “rhythmic structure” of sound, or degree of syncopation or melody, versus volume or tempo.

I used the Airex balance pad to evaluate gaze dependency of balance in individuals with hydrocephalus. What I learned here, was that patients who were unable to maintain balance on the pad while focusing on a moving target (business card on a stick), termed gaze dependency, reported more problematic chronic headaches and SPD complaints. I concluded that additional deficits were likely causing the decreased sensory processing. I felt that the additional deficits might also help predict poor outcomes after the insertion of a CNS shunt for hydrocephalus.

Later in my study, I found that melodic and highly syncopated sound patterns seemed to offer a therapeutic effect to some of these complaints – as a mechanism in support of music therapy. I created an “audiotape” of melodic metronome beats and piano sequences from my Yamaha keyboard, and would play and listen to this audiotape 2-3 times per week. It seemed to help my sound sensory issues.

I published my study on my web site, and it has been hosted there since 2003.

It is common to experience difficulty with sound, light, and motion after brain injury and onset of neurological disorder. Perhaps the most problematic is offensive types of unsyncopated and white noise sound, which is everywhere today in busy urban areas.

You can simplify sound sensory processing into the “melodic” Mozart Effect on the healthy end of the spectrum, and tortuous repetitive sounds on the unhealthful end of the spectrum. Repetitive unhealthful sounds can make even normal people ill at the right decibel and sound pattern. In fact, sound is still today used to extract information from prisoners during wartime, and it plays a significant role in football & basketball.

Drumming for Football

In 2014, I published the above provocative blog on SPD and drumming for football, and detail how the ill effects of sound plays a role in college and NFL football. I discuss sensory and cognitive challenges from fan & stadium noise, and methods for using drum beats to help play call synchronization, player movements, and communications.

My Introduction to Drumming & Drum Circles

It was in 2004 that I became involved in hand drumming and drum circles from my personal and therapeutic activities with music. I had no thought or expectation that drumming would help my SPD challenges. But after about a year of regular drumming, I discovered that my SPD sound sensitivity was improved. I re-examined my research and proposed that group drumming might help affected individuals to better organize sound, like a form of physical therapy for sound processing. My company web page below discusses by durrent work with drumming for general health and neurological disorders.

 Drumming for Wellness

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

Signals traverse our brains in wave form patterns like those seen on EEG tests, and there are literally millions of signals traversing brains daily. As our brains process signals in wave patterns, so do we physically move about in wave forms or rhythmic patterns, and one area where the two overlap today is in “proprioception,” where our bodies are able to remember specific types of movement patterns, i.e. in sports, dance, and this then is integrated into whatever sport, dance, or social activity we are doing.

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

As I became involved with drum circles and drumming for the brain, I discovered how drumming can help retrain the brain’s ability to process unsyncopated sound by engaging the individual in disordered sound, and allowing them to integrate an order to the beats played – in essence, serving as physical or occupational therapy for the brain. I then began to study audible rhythm’s role in balance and movement, cognition, mental health, team-building, and stress reduction.

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

In February 2016, I updated this earlier blog on my experience with drumming therapy in cerebral palsy and autism, plus I’ve put on quite a few drumming workshops for a number of neurological disorders. I link all of my efforts together as best I can.

Drumming Therapy Experience in a Child w/ Cerebral Palsy & Autism

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

Below is the autism article in support of the autistic boy in the video at the mall. This story and short video on sensory processing disorder (SPD) in autism is featured on The Mighty web site. I’ve pasted the YouTube link below so that it might play here.

Sound Sensory Processing Dysfunction in Autism Spectrum Disorders

In this video, Alexander Marshall, 10, of West Yorkshire, England, is the star of The National Autistic Society’s new Too Much Information campaign, and he’s featured in a short video that shows what sound sensory overload can be like.

The video is shot from Alexander’s point of view during a trip to the mall. From noises to smells to bright lights, it shows all the things that might cause Alexander, who was diagnosed with autism two years ago, to have a meltdown.

SPD is often a problematic medical/disability issue in autism, and deserves to be much more a part of our public health dialog. In fact, I believe we should approach autism from the standpoint of brain health, and treat it’s related sensory processing disorder more for what it is, a sequel of medical complaints.

If 20% of the populace were found vomiting from traveling in cars and public transportation from motion sickness, that would be a big story. But when it’s an individual struggling with a health issue involving the brain (as opposed to the middle ear), the public sees it thru biased eyes. And governments do too. The link below is the National Institute on Health April 2016 publication of alternative medicine for autism.

NIH National Center for Complimentary & Integrative Health

April 2016 Newsletter on Autism

While my own SPD complaints are not normally as severe as the child in this film, at times I feel a lot of what this child is experiencing. Often I am forced to undertake a number of steps to protect me from unhealthful sound. SPD is not just about autism or hydrocephalus or PTSD. It’s about brain health, public health, and how we all approach dysfunction of the brain.

SPD, Integrative, and Alternative Medicine in Drug & Alcohol Addiction

In September 2015 I spoke on alternative medicine, SPD, cand cognitive accessibility in drug and alcohol addiction at Sovereign Health of Orange County. My presentation/blog is quite lengthy, but I share a lot of detail into SPD about 2/3 of the way through the blog.

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

Today in 2016 — the best way to manage SPD is not to put yourself in an environment that is more than your can process, leaving you overstimulated. You want to get out and do things. But your neurological stamina and your environment are changeable – and you may often not take the right intervention to head off an SPD event in time. Then you’re dealing with neurological sequela.

It’s important to know the individual medical makeup of each affected person, and the nature of their surroundings at any given time, and catch the early WARNING signs. If you’re around someone with SPD difficulties, the signs to watch for are: changes in their eyes, demeanor, irritability, cognition – which indicate overstimulation. Ultimately it’s a function of matching neurological stamina with a tolerable environment. Sound mobile apps, ear plugs, and eye cover can help too. My blog below discusses in more detail how decibel meter apps can help in managing sensory processing disorder. And I discuss my proposal for a new sound processing standard and algorithm measurement that could be used in sound measurement apps.

Decibel Meter Apps in Managing Sensory Processing Disorder

mHealth Apps in Neurology
mHealth Apps in Neurology

My Proposal for a Sound Processing Standard & SPD Algorithm for Mobile Apps

The decibel sound scale is now more than 50 years old. Its time we create a Sound Processing Scale & Algorithm for Measurement
The decibel sound scale is now more than 50 years old. Its time we create a Sound Processing Scale & Algorithm for Measurement

Cognitive Accessibility

The image of  “The Hulk” crushing a tree-schredding machine is provided as it is symbolic of the crisis facing individuals with sound sensitivities leading to neurological and behaviorial  sequela. The idea for the animated Hulk Crushing the Tree Shredder comes from my HydroPowered Super-Hero series, which is a collection of super hero stories about children living with hydrocephalus. The tree schredding machine also illustrates the challenges that public noise poses to persons with sound sensory disorders. Sound sensativity affects as much as 20 percent of the population today. Yet comes with little to no accommodations or protections. 

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

The broader issue of sensory processing disabilities and SPD spans not only adverse sensory responses on cognition, but also comprehension of information, user instructions, Internet access, access to technology, and reliability of assistive technology. In these regards then, the access to and controlled environment of, defines an accommodation that should be protected by applicable disability rights persuant to the Americans with Disability Act (ADA), and Sections 504 & 508 of the Rehab Act.

Cognitive Accessibility accommodations er CognitiveAccessibility.org
Cognitive Accessibility accommodations er CognitiveAccessibility.org

One of the common sound/SPD challenges today is with loud and eratic TV and radio advertisements. I am yet to post YouTube examples, but hope to in the near future. I have been exploring technological and regulatory solutions, including, a proposal for a new sound processing standard that would allow for a reproducible means of evaluating sound for likely unhealthful qualities.

A new sound processing standard could help identify differences in sound makeup and resulting audio & brain processing, particularly in affected individuals. This would be particularly helpful in screening offensive TV and radio commercials, machinery, and non-synchronous broadcasts in public places, and would be used in concert with the current decibel emission volume standard. Generally the more monotonous or less synchronized a sound, or the more its component audio is broadcast at the top of the EQ spectrum, the more difficult it is to process. Some types of these sounds are used to break the will of prisoners. Many of today’s audio broadcasts and public noise are now approaching unhealthful levels.

The image below is a c-panel screenshot of Time Warner Cable’s VOIP telephone options for blocking “telemarketer” and other unwanted telephone calls. I have inserted my proposal for TV quiet options (technologically possible) to screen/mute/lower unhealthful audio from TV commercials and programs. I shared this on Twitter and Facebook too recently.

Screenshot of Time Warner Cable "quiet" options to block unwanted phone calls, plus Options I added for blocking audio of unhealthful TV commercials and programs.
Screenshot of Time Warner Cable “quiet” options to block unwanted phone calls, plus Options I added for blocking audio of unhealthful TV commercials and programs.

Cognitive Accessibility at Dolle Communications

In 2013, I purchased the domain CognitiveAccessibility.org and have been organizing content for broader plans. This domain currently points to a page on my main web site. I do all of my web site work in Microsoft Frontpage, which is being phased out by web hosting companies. I am now writing more on WordPress as have found it easier to use than learning a whole new web platform.

Below I share my blog on TSA Travel Accessibility tips for when flying with a CNS shunt for hydrocephalus or any cognitive disability.

TSA Accessability Cognitive Disability Hydrocephalus Travel Tips

TSA Cares Logo
TSA Cares Logo

These last two blogs discuss healthful solutions for sensory processing disorders as they relate to the sports of basketball and football. I also discuss methods in basketball for mindfulness and therapy to help calm the brain.

Brain Science and Therapeutic uses of Basketball

image

Drum Beats help Sound Sensory Management in Football

The Challenges of Sound Sensory Processing in Football Stadiums Today
The Challenges of Sound Sensory Processing in Football Stadiums Today

And for fun stories and art in support of hydrocephalus, visit my HydroPowered.org web site or blog.

HydroPowered Blog

HydroPowered.org Share the Passion for Hydrocephalus
HydroPowered.org Share the Passion for Hydrocephalus

YouTube Videos document Harmful Audio of Sounds from Everyday Life

The audio in the videos below are known to “trigger” neurological complaints and behavioral changes in persons with neurological & learning disorders with secondary sensory processing disorder (SPD). The difficulty in the sound is often in the lack of melodic pattern as I wrote about in my above 2002 metronome study. A similar depiction is presented in the above video on autism from “The Mighty.” Sometime soon, I will update this section of videos with “offensive TV & radio commercials” airing today. Despite passage of the CALM Act baring loud commercials in 2012, it seems that little has changed. Advertisers also manipulate the sound EQ distribution of audio in commercials to get your attention, making it more problematic to persons with neurological disorders and SPD.

CAUTION: Please turn down your audio.

These sounds may trigger medical sequela.  

Video of a Problematic Noisy Construction Site

Video of a Problematic Mobile Carpet Cleaner

Video of a Mixture of Problematic Musical Sounds

Video of how I wish Construction Equipment Sounded

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