The aim of this proposal is to build a working prototype of software which designs one-of-a-kind prosthetic software for restoration of cognitive functioning following brain injury. The project addresses a significant rehabilitation issue in an original manner, and results in an innovative therapy. The Phase I goals were exceeded, and Phase II goals are expanded from those set in the Phase I application. Phase I involved the customization of prosthetic software for 3 outpatients. Patients' level of functioning were found to have increased; the therapists' described the customized prosthetic software approach as """"""""a breakthrough in cognitive remediation."""""""" Personal productivity software is customized to the therapeutic needs of the patient. The technique provides the patient with access to residual abilities, particularly when deficits impair use of their abilities. Presently therapists are highly dependent on software application developers (programmers) for customization and other assistance. Phase II will focus on two main components. One is the design and implementation of software which a therapist can use to design and highly customize prosthetic software for their patients. The principal research issues resolve around determining therapists' requirements for a new kind of tool when the tool is considerably different from its manual analog. The tool is the design and use of computer-based cognitive prosthetic for home, community, and vocational activities. The second component is the clinical environment in which data will be collected. Data will be collected on two broad issues. First is the needs of therapists in designing and implementing computer-based cognitive prosthetic interventions for patients. Second is the use and impact of the interventions on patients. Two clinical sites and seven patients will be added for Phase II; one site will continue from Phase I, and it is anticipated that two of the Phase I subjects would still be available for the study. This will provide us with a study of ten patients at three sites with at least 4 therapists at the end of phase II.
