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Applying Accessible Games to Brain Training

Introduction to Brain Training



In this section we will look at different types of brain training. This section will include:

What does Brain Training Do?

Cognitive Maintenance

Rehabilitation and Functional Improvement



In order to evaluate the accommodations required, the availability of accessible games and how to select the correct brain training game for your clients.

Accommodations Required

Brain Training Game Accessibility

How to Select and Use a Brain Training Game

Advantages and Disadvantages



What does Brain Training Do?


There are two different roles that computer games can play in brain training in adults:

1. Cognitive Maintenance 2. Rehabilitation and Functional Improvement

Cognitive Maintenance



Scientists have long known that the cognitive abilities of people decline starting at about age 30. It was long regarded as inevitable and unchangeable.

From the 1950’s on, studies accumulated that indicated that there was much more plasticity in the brain than previously thought. In 2003, Dr. Ryuta Kawashima, a neuroscientist in Japan, published “Train your Brain: 60 Days to a better Brain” a book that embodied the concepts that were later incorporated into the Nintendo “Brain Age” and “Brain Age2” games that helped to coin the term “Brain Training”.

There are many other Brain Training computer game systems that have been developed in the last few years. Most of these systems incorporate a number of smaller modules or games that test specific skills. All these systems work on the basic premise that individuals can improve their cognitive abilities and memories through exercising skills such as memory, attention and judgment. The focus and skills trained vary, but all exercise specific skill sets that are intended to carry over into every day life activities.

This type of brain training is intended to be used on a regular basis much as an exercise program is intended to be used. It is meant to maintain a high level of cognitive function long after the decline of function would be otherwise noticed.


Rehabilitation and Functional Improvement


While there is no cure for Alzheimer’s disease at present, there is some evidence that brain training can slow the progress of the disease in early stage Alzheimer’s patients. In one experiment computer games involving memory, concentration and problem solving skills were compared with a therapist led program conducted for a similar time and frequency. The computer brain training demonstrated improved performance on tasks similar to those trained in the computer program. The results were better than the results from the therapist led program.

In another study, using a brain training technique, volunteers were trained to reduce the amount of pain they felt by watching and mentally modifying the activity in a brain scan.

In another experiment, a computerized cognitive retraining package was used with people who had unipolar depression. Two control populations were used, one that had depression and one population that was depression free. Patients who received the cognitive retraining improved on a range of neuropsychological tests, while the controls did not.

Other computer game type rehabilitative activities have involved stroke rehabilitation, using a digital glove; improvement of attention span in people with ADD using a type of brainwave sensing helmet; and physical therapy using the Wii bowling and tennis games in an elderly population.

The rehabilitation type of brain training is intended to be used to improve functioning among people who have some type of injury, disease, or debility.


Accommodations Required


For Cognitive Maintenance, brain training games should have the following accommodations:
1. Font and graphics size adequate for the player to clearly see the playing field
2. Clear and consistent placement of controls
3. Adequate and simple directions for play
4. Appropriate feedback to the player to encourage repeated use
5. Variable speed controls, either by a control setting or in the design of the game, that enables players to start slowly as they adjust to the game and speed up as they improve

For Rehabilitative and Functional Improvement, brain training games should have the following accommodations:
1. Increased font and graphics size and compatibility with screen magnifiers and high contrast settings
2. Very simple, single key stroke controls. Chording should be avoided
3. Clear identifiable objectives
4. For players who are blind, the game needs to be self-voiced or accessible to screen readers and designed to meet the objective without dependence on visual input or mouse clicks
5. For players who are deaf or hearing impaired, no sound or audio component should be essential to the game or the game should include closed captions or sub-titles
6. For players who are motion impaired, single key strokes should be used and voice input compatibility is desirable
7. For early Alzheimer’s patients, the user interface should be as simplified as possible, speed should be adjustable and the game should start out easy enough that the user can have early success and is rewarded enough to use the game repeatedly


Brain Training Game Accessibility


There is one manufacturer of Brain Training software that seems to have a commitment to making their games accessible, Oak Systems Leisure Software in Southsea, UK at

www.oak-systems.co.uk.

The games they make are “Brain Workout 1” and “Brain Workout 2”. They state that they increased the font size. They made sure the background color of the playing area can be changed to accommodate color blind and dyslexic players. They state they have a text reader for the text games and use a text to speech program to read aloud. They currently working on “Brain Workout 3” and want their games to be enjoyed by everyone

The “Lumosity” game from

www.lumoslabs.com

is web based and any settings that affect the computer that is connected to the internet should appear as with any other internet site. They have no sound dependency in their games so a deaf player can use the program. They report all their games either target or require some visual perception so it will not work for blind players, but they have some visually impaired users.

The folks at

www.mindsrefined.com

report that handicapped accessibility was not explicitly built into their brain training game, “Art Dealer”. They do state that the sound effects are not integral to the game and that deaf players should be able to use it. People with minor visual impairment or color blindness might be able to use it.

The Nintendo games are all console based games and therefore fall outside the scope of this article.


How to Select and Use a Brain Training Game



1. Determine the objective you want to accomplish – some examples are:
· Improve peripheral vision and pattern identification
· Improve memory of object names or people names
· Boost reasoning skills
· Speed up reaction time
· Train attention and working memory
· Improve facility with numbers and quick mental calculation
· Improve mental agility by context shift or multiple simultaneous focal objects
· Improve hand-eye coordination

2. Match the skills desired to the module or game

3. Ensure the module or game has the necessary accommodation to meet the needs of the client

4. Ensure the module or game is age appropriate.

5. Ensure the module or game has entertainment as well as brain training value to encourage repeat use.

6. Practice the module or game yourself using the accommodation required by the client as much as possible. Make sure it is playable and as best you can tell will meet the desired objective.


Advantages and Disadvantages



The advantages of using a standard brain training package are the following:
1. They incorporate educational and therapeutic objectives from qualified professionals
2. They provide feedback to the user by some measure of progress
3. They have a number of different games or modules to provide variety and encourage repeated use
4. There has been some validation of the concepts involved in the game design

The disadvantages are:
1. Some of the standard brain training packages are expensive
2. Accessibility features are not present in many of the packages
3. They may or may not address the specific objective you want

A person who has minimal requirements for accommodations may be able to use one of the standard brain training packages as it comes out of the box. Others who have need for greater accommodations may require picking and choosing among a number of different games to accomplish the desired objectives.

A game which accomplishes the desired objective may not even be labeled as a brain training game and still be an effective tool to accomplish the specific objective. For example, one of the threads from the Gamers at Audyssey www.audyssey.org discussion talked about blind accessible games that might meet brain training objectives for blind gamers.

There are free brain training games at various websites across the net. Some of them might be accessible to a person who does not need much in the way of accommodation. They vary widely in terms of ease of use and what they are intended to accomplish. You can go to www.brainarena.com, www.matica.com, www.gamesforthebrain.com, or www.brainmetrix.com to try some of them.

Eleanor Robinson
Chief Operating Officer
7-128 Software

eleanor@7128.com