Mobile Apps and Patient Tools for Living with Hydrocephalus

This blog discusses mHealth mobile phone apps and accommodations for living with hydrocephalus.

I initially wrote this in 2015 under the title “Spread Awareness of Hydrocephalus on Rare Disease Day.” But then following several large updates of content, on April 18, 2016, I changed the title to “Mobile Apps and Accommodations for Living with Hydrocephalus,” which I feel more aply represents its content now. I discuss many of the everyday challenges faced by persons living with hydrocephalus, and discuss my experiences with specific mHealth mobile apps and accommodations-solutions needed for everyday living.
Hydrocephalus is a neurological disorder where CSF (cerebral spinal fluid) is not sufficiently cleared from within and around the surface of the brain – from a variety of etiologies. The fluid then abnormally collects in the brain’s ventricle compartment thereby exerting abnormal and often dangerous pressures on critical structures of the brain. It is normal to have CSF in the brain, as it is produced in the choroid plexus at a rate of about 20cc per hour. It’s primary purpose is in regulatiion of blood pressure (BP) and intracranial pressure (ICP). It also circulates up & down the spine and helps to circulate needed nutrients throughout the brain. Hydrocephalus then develops when the brain is not able to clear CSF fluid at the same rate it is produced, more often resulting in swelling of the ventricles – except in NPH, or normal pressure hydrocephalus, where there may be limited or no swelling, and normal amounts of pressure.
Hydrocephalus occurs in utero and shortly after birth in 1 of every 1000 births. It also occurs in children from cysts and tumors, and somewhat also in adults. It occurs post trauma through subarachnoid bleeding, and idiopathicly, or naturally, from anatomical malformations of the brain and brain-stem, and from aging. Its overall prevalence in the U.S. is estimated at about 40,000 to 50,000 new cases each year. But due to its broad spectrum of causes or etiologies, hydrocephalus has been accepted into the rare diseases database. Many scientists continue to refer to hydrocephalus as a rare disease because of its association with genetic birth defects. The illustration below identifies where CSF is produced and circulated within the brain.

Brain Diagram of Ventricles often Enlarged in Hydrocephalus

DolleCommunications is my neurosciences blog I launched in 2010 after becoming affected by hydrocephalus following a 1992 auto accident and concussion. The photo of me below was taken in 1998 after one of the shunt surgeries where I had used my newly developed DiaCeph Test mHealth method to help direct replacement of the needed medical device components on my CNS shunt system.

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

A CNS (central nervous system) shunt is the most common form of treatment for hydrocephalus. It is a two or three piece catheter with a one-way pressure valve that more often drains into the abdomen, or peritoneum, where it is termed a VP shunt. Alternately, it can drain into the heart (VA shunt), or draw fluid off the spinal canal into the abdomen (LP shunt). Over the last 20 years, a newer surgical procedure, a 3rd ventriculostomy, has been developed where a small opening is made in one of the ventricles (usually the 3rd), which if successful, allows for proper circulation and clearance around a an aqueduct blockage and can negate dependance on a CNS shunt. Only 10-15 percent of those with hydrocephalus will benefit from this procedure.

Great pic NHF members affected by hydrocephalus at a 2015 Orange County fundraiser.

It is common knowledge today that shunt technology is in need of modernization. Present day treatment outcomes (esp. with CNS shunts) often leave individuals with significant quality of life challenges with no shunt diagnostics to provide early warning shunt malfunction or accidental reprogramming, which is all to common and can result in brain damage and/or blindness. Since my onset in 1992, I’ve undergone 12 shunt revisions.
Living with hydrocephalus and especially a CNS shunt presents a number of key challenges, most notably, shunt malfunctions and corrective surgery, but also frequent headaches, cognitive and memory difficulties, challenges with balance and hand/eye coordination, and difficulty adapting to a noisy and complex world where the necessary accommodations are widely unavailable today. I discuss some of the challenges and much needed accommodaitons for hydrocephalus further below.

Shunt Illustration for Hydrocephalus

I became involved as an FDA patient advocate and inventor in hydrocephalus several years after my onset of hydrocephalus. As a patient advocate, I authored a critical 1996 citizen’s petition to the Food and Drug Administration (FDA), plus made recommendations at the 1999 STAMP Conference in Bethesda MD. I’ve also written FDA position papers and recommendations for the oversight of shunt technology, and spoke at the 1999 STAMP Conference in Bethesda, Maryland.

Stephen Dolle in Washington, D.C. for the FDA’s Hydrocephalus STAMP Conference in 1999.

After writing my FDA petition on CNS anti-siphon shunts in 1996, my research led me to design and patent a non-invasive monitoring system for hydrocephalus, I named the DiaCeph Test. It initially was to run on a PDA. But I could not raise the necessary funding to make it. The DiaCeph Test today could be made into a mobile phone data and text app. Most of the development costs today is still from burdensome FDA guidance on mHealth apps. If it were available, it would revolutionize the care of hydrocephalus.

The DiaCeph App Creative Brief details its design and unique features in monitoring of the disorder hydrocephalus

DiaCeph Test could be Mobile Phone App

In 2009, after many years of patient advocacy and answering inquiries from affected patients, I began offering patient consults for a fee. Most of my patients have been those affected by complex hydrocephalus, and with unresolved challenges. Unresolved complaints and unsatisfactory outcomes are common in hydrocephalus – as high as 70 percent of all patients with hydrocephalus.

I am also very involved with weather apps and barometric pressure monitoring. A link to my primary blog on this is listed further below.

My biggest new discovery in this space comes from a study I undertook in 2017 with the MigraineX ear plugs used in the management of headache, but also in sound suppression. I found that insertion of 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. So I carry my MigraineX ear plugs with me all the time to manage sound exposure & associated SPD complaints. They are particularly helpful amid noise from construction, machinery, malls, restaurants, theatre halls, and more. They sell for about $12 on Amazon and at many drug stores.

I have also been undertaking barometric pressure monitoring now with my Samsung phone’s built in barometric pressure sensor. The built in sensor can display sharp short term changes in pressure that weather sites & apps do not display. Most newer high end smart phones have this sensor built in. But you need an app to get the display. For this, I currently use uBarometer Pro. I have been able to correlate these short pressure changes as triggers of pain and headache.

The web link (web page) below describes how to obtain a consult for hydrocephalus, shunt monitoring, and mHealth monitoring with custom apps, and DiaCeph forms and user instructions.

Hydrocephalus & Shunt Monitoring Consults

Prosperity is based on sound information.

In 2004, I became involved in drum circles after earlier playing piano, vocal work, and some stage & film. I initially used piano as a form of therapy for my challenges, then later guitar, then in 2004 percussion. I immediately realized a call to become more involved in drumming, and I began to take classes, and eventually help put on drum circle events. Today, I am very involved in drum circles and drumming for the brain & wellness and for disorders like hydrocephalus.

Drumming Therapies for Wellness and Neurological Disorders

On Sept. 24th, 2015, I held two drumming workshops at the 2015 NHF Patient Power Conference in Anaheim, CA. My methods help with others with balance, coordination, cognition, and communications challenges. SEE info in the flyer below.

Seniors came alive in this 2010 drum circle for wellness and movement.

Drumming workshop for balance and movement challenges in living with hydrocephalus

One of the more problematic challenges with hydrocephalus, and most neurological disorders, is with cognitive accessibility and it’s related sensory processing disorder, or SPD. These challenges are often disabiling and occur in hydrocephalus and neurological and learning disorders such as autism, ADHD, PTSD, Parkinson’s, stroke, post tumor, addiction, and even migraine. I have written about both fairly extensively. And own the domain CognitiveAccessibility.org – which I am yet to host a web site. I currently have it pointing to a supporting temporary page on my main web site.

CognitiveAccessibility.org

CognitiveAccessibility.org

COGNITIVE ACCESSIBILITY describes the array of accommodations and protections needed today by affected individuals. Without these protections, cognitive dysfunction and often one’s mental health state are easily exacerbated (made worse) by exposure and stress of unhealthful cognitive triggers. In fact, today there is a large lawsuit brought by families with autism against Disney World for failing to offer cognitive disability access to park rides. The science is real. I’ve experienced thousands of first hand accounts.

Common cognitive triggers include loud TV & radio commercials, loud helter skelter music, noisy construction equipment and machinery, bright lights, and powerful odors. When these triggers are present and not managed properly in public places, they restrict access by persons susceptable to it. Today we know that mental health and physical brain changes go hand in hand, meaning, one affects the other. This next blog describes many of the key sensory challenges in sensory processing disorder (SPD) and sensory challenges in hydrocephalus, and related disorders. Below, is also a recent diagram on the brain’s mechanisms involved in sensory processing disorder.

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

New Insights in Management of (SPD) Sensory Processing Disorder

The protections cited are for public facilities where the triggers can often prevent an affected individual from safe and healthful use. It is said be a part of current disability law (i.e. autism v. Disney lawsuit). But rarely is enforced. Most people are unaware of the science and cause and effect of the triggers to behavioral melt-downs. In addittion to sensory protections, there needs to be better understanding of directions on UIs of web sites, signage, directions, product labels, etc. Today, I find you’re more likely to see a foreign language accommodation, than a cognitive disability one.

TSA Cares Logo

Airport Travel, Screening, and TSA Services for Persons with Hydrocephalus

This blog features updated information on TSA Meet and Assist services for passengers with disabilities, and safety information on airport scanners for safe use by persons with programmable shunts for hydrocephalus. I also cover use of TSA Meet and Assist services for persons with cognitive disabilities, and information on the Air Carrier Access Act.

Airport scanners had earlier worried me as I live with a programmable CNS shunt for hydrocephalus, and I have been over-exposed to radiation from CT brain scans. With my Codman Certas CNS shunt valve, I do not go thru the metal detectors at airports or anywhere (even though some state magnetic field is safe for my shunt). I recommend that if you have any type of programmable CNS shunt, that you do not go thru metal detectors.

I’ve since updated this blog with newer information on the safe use of airport scanners.

The next two blogs list helpful information on mobile apps for sensory processing disorder, as well as apps I use and recommend for living with hydrocephalus.

Blog: Mobile Sound Apps for Hydrocephalus & Sensory Processing Disorder

Barometric Pressure graph reveals steep drop and rise which can trigger micraine headache

eWeather HD App helpful in Managing Weather related Migraine Headache

This next blog is a discussion of how to best select and design medical and mHealth apps. It comes from my many years of experience in mHealth & diagnostic medicine.

mHealth Apps in Neurology

Design and Best use of mHealth Apps

Perhaps my most creative public outreach is the fun HydroPowered.org web site for hydrocephalus. I created this in 2013 as a fun platform to share art, technology, and super-hero stories among those affected by hydrocephalus.

HydroPowered.org Share the Passion for Hydrocephalus

Blog on HydroPowered.org Platform Connects Hydrocephalus Families

Let’s undertake some effort in hydrocephalus for Rare Disease Day. If needed, I am prepared to call upon “The Hulk” for a little extra help.

The Hulk comes to the aid of persons with cognitive disabilities & SPDs, crushing this noisy tree trimming machine.

Apps & Web Sites I Recommend for Persons Living with Hydrocephalus

Android Play Store Elecont HD Weather App link

Apple iTunes Store Elecont HD Weather App link

My *Blog on eWeather HD* App and How to get FREE Android Download

My Blog on Tips for Sound Sensory Processing Disorder

Smart Tools Page on the Android Play Store

Smart Tools Apps on the iTunes Apple Store

Smart Tools Instruction Manual

Tips on Airport Travel, Screening, and TSA Services for Persons with Hydrocephalus

Drumming for Wellness workshops

Drumming in the Workplace

Drumming Therapy Case Study in a Child with Cerebral Palsy and Autism

HydroPowered.org

Shunt Monitoring and Consults for NPH & Hydrocephalus

DiaCeph Monitoring Method hopes to be new Mobile App

If I’ve left out any my blogs or apps, please let me know. If I may help you with hydrocephalus mobile apps, hydrocephalus consults, or drumming therapy for hydrocephalus, or if you are interested in furthering the development of the DiaCeph Test or other mobile apps for hydrocephalus, let me know. Contact me via my info below. Feel free to CLICK and SAVE my contact JPEG card.

Stephen Dolle
Email: contact[at]dollecommunications[dot]com
Dolle Communications
HydroPowered.org
StephenDolle.com

Advertisement

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

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