Completed Brain & Nervous System

Smart Interactive Reminders for Acquired Brain Injury (ABI) via repetitive cueing

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A voice assistant app called GG Care now guides people with memory loss from brain injury or dementia through daily tasks like taking medication or eating, breaking each task into simple steps with spoken prompts and questions. This matters because people with acquired brain injury (ABI) often struggle with executive function—planning, self-monitoring, and completing multi-step tasks. Existing voice assistants offer quick access to services but are rarely designed for this user group. The research builds on evidence that metacognitive strategy training, which uses structured, repetitive cueing to reduce errors and improve self-regulation, is more effective than conventional rehabilitation for post-traumatic executive dysfunction. If successful, GG Care’s Interactive Reminders could become a low-cost, widely accessible tool for carers and care recipients, reducing the burden on families and health services. The system already works on both Alexa and standard telephones, closing the digital divide for people without internet access or technical skills. This is applied technology development, not fundamental science—its value lies in immediate, practical support for daily living, not in advancing theoretical understanding.

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GG Care is a start-up innovating Voice Assistant (VA) technology to help people affected by commonly shared symptoms of dementia and Acquired Brain Injuries (ABI), such as memory loss and cognitive impairment. Carers use GG Care's app to schedule repetitive cueing with Interactive Reminders (IRs). The IRs guide the care recipient via Alexa or the phone to complete the task by simplifying it into easily digestible steps with a series of questions, prompts, and hints. The wide range of IRs includes reminders to eat, stay socially connected, take medication, and more. For example, if the carer creates an IR for medication, Alexa will: 1. trigger a reminder telling the care recipient to take their medication based on the time and frequency set by the carer 2. ask the care recipient if they know where their medication is located 3. respond to the care recipient with the location of the medication as set by the carer. 4. send a message to the app confirming that the care recipient verbally responded "Although there are several potential benefits that VAs could provide to people with ABI, such as easy access to a variety of services and quick task completion, there is very little work related to the use of Voice Assistants for this particular user group."… "However, the use of VAs for people with ABI can also be informed by applications of the technology in other user groups that share some characteristics, such as people with disabilities, people with dementia or elderly users." (Malapaschas, Aris). Furthermore, "Multiple epidemiologic studies show that experiencing a TBI in early or midlife is associated with an increased risk of dementia in late life" (Shively S) Studies report metacognitive strategy training (directed at improving self-monitoring and self-regulation) is more effective compared to conventional rehabilitation in improving posttraumatic executive dysfunction (Goverover Y, Cheng SK). Metacognitive strategy training helps to assess an individual's performance and reduces or prevents errors by structured and repetitive cueing or by encouraging repeated assessment and self-monitoring. According to Mary R. T. Kennedy's published research in Neuropsychological Rehabilitation, Complex tasks can be broken into smaller steps, directly teaching individuals using step-by-step procedures (Kennedy MR). During the Connected Places Catapult testbed, GG Care conducted Patient and Public Involvement (PPI) involving people with cognitive impairment in collaboration with Brighton and Hove City Council and the University of Brighton. Post- and pre-qualitative interventions and quantitative surveys identified the strengths and weaknesses of its IRs and participant recommendations for improvements. GG Care won grant funding from Innovate UK's Inclusive Innovation award to extend its voice capabilities and increase accessibility through an Interactive Voice Response (IVR) telephone system. The flexibility to use an Alexa or a telephone to receive IRs closed the technological gap found in the PPI for less tech-savvy, less stationary participants, and underserved communities without internet access and won GG Care a best prototype award from the Joint Artificial Intelligence Network (JAIN). This leading organisation promotes artificial intelligence and tech to support people with cognitive impairment across Europe.

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