Digital Training Enhances Skills and Cognition
- Miller School Department of Psychiatry and Behavioral Sciences researchers have developed a digital platform that helps people improve upon technical skills like using an ATM or a smart phone.
- The platform is designed for older people with mild cognitive impairment or younger people with conditions that compromise their learning skills.
- Research shows that the FUNSAT training improves functional skills and cognition both during the training sessions and in the real world.
People need specific technical skills to navigate the world: operating an ATM, buying a transit ticket, using a smart phone, managing medication.
These tasks that many of us take for granted can be overwhelming for people with cognitive challenges or a lack of practical experience.
The Department of Psychiatry and Behavioral Sciences in the University of Miami Miller School of Medicine established the Brain Health and Fitness Program to train older people with mild cognitive impairment (MCI) or younger people with psychiatric conditions that compromise their ability to learn and perform functional skills.
“There’s a whole world of activities that older people and those with cognitive issues have trouble accessing,” said Philip Harvey, Ph.D., the Leonard M. Miller Professor of Psychiatry and Behavioral Sciences and chief and director of the Division of Psychology. “We wanted to develop evidence-based training modules that people could use at home to improve their functional skills and cognition, as well as their ability to function confidently in everyday functional tasks.”
For several years, Dr. Harvey, also vice chair for research at the Miller School, and collaborators have been developing the Functional Skills Assessment and Training (FUNSAT) platform. The system provides training for technology-related skills like online banking and shopping, as well as in-person tasks, such as using ATMs and ticket-purchasing kiosks.
Evidence-Based Skills Training
Initial FUNSAT studies showed remarkable gains. People older than 60 with MCI improved their ATM performance times by 51% while people older than 60 with no cognitive impairment improved by 43%. The studies showed similar gains in medication management, online shopping and using telephone voice menus to refill prescriptions.
A study published last year in the American Journal of Geriatric Psychiatry found FUNSAT training improved functional skills and cognition, particularly in people who trained with an inexpensive, commercially available cognitive training software in conjunction with FUNSAT.
A more recent study showed durable, improved skills performance outside of the training sessions.
“After we trained people, they went out and attempted the tasks,” Dr. Harvey said. “They trained for three months, but their ability to go out and perform those tasks continued to accelerate for three months after their training ended. There was a strong correlation between how much better participants got during training and how much better they got in the real world.”
The most recent clinical trial delivered cognitive and skills training at home, which proved easier than going to a training center for older participants. Healthy people received a significant boost in their cognitive abilities from doing skills work, even without structured cognitive training. Skills training alone improved unimpaired participants’ cognition by the equivalent of 10 IQ points.
Cognitive Training at Home with Avatars
Dr. Harvey’s team is working on adding new modules and realistic avatar assistants to help users train at home.
“The avatar reads the instructions and provides targeted instruction for people who find it challenging to train themselves at home,” he said.
The team hopes to expand cognitive skills training to people with more significant cognitive impairments, such as mild dementia.
“We’ve shown in our studies that these training programs really help people learn new skills,” Dr. Harvey said. “People sustain their gains in knowledge and even expand on it. We want to take what we’ve learned and continue to provide better tools for people with cognitive and other issues so they can better navigate the world around them.”