Brief: Using a Handheld Computer as a Cognitive-Behavioral Tool

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Apple's iPod touch and iPad, and the growing catalog of Android and Microsoft tablets are remarkably versatile and agile tools that have taken the consumer world by storm. Within the disability community, it has become clear that these devices can be readily customized and adapted to address cognitive-behavioral challenges. Because they are so portable, they can be used as behavioral supports at home, at school, at work and in the community.

Because these devices can do so much, it can be challenging to figure out what to do first. The following guidelines are based on a decade of community-based PDA research in VCU's Assistive Technology for Cognition laboratory. They are not intended as strict rules but as suggestions for ways to get the most from these products.

Remembering to Do Things

The very first Palm Pilot PDAs came with to do list apps and calendars with reminder alarms, giving them a distinct advantage over paper-based scheduling products. Setting an alarm for daily tasks can be a game-changer for people with memory or attention challenges, and current devices offer a wide range of tools for doing just that. Apple products include a calendar that allows alarms to be tagged to everyday events; the iphone and ipod touch also offer a versatile Clock app that allows the user to choose a customized reminder sound for each task (including one particularly insistent reminder (dubbed "Alarm") that only turns off when the screen is tapped). Android tablets include Google Calendar, and Microsoft tablets include a tablet version of Outlook, both of which incorporate reminder alarms. All of these products feature note-taking apps that allow for the creation of "to do" lists. There are at least 500 add-on calendaring apps available, offering variants on these onboard calendars.

Task-Sequencing & Wayfinding

People who have difficulty learning to complete multi-step tasks independently (morning routines, complex job skills, etc.) can use these devices as task coaches. Some people only need a step-by-step written task list, or a list that includes a picture prompt. Visules and HomeRoutine are inexpensive apps for creating such supportive task sequences. A user can also create a PowerPoint sequence of pictures and captions for any task, click to create a movie version and download that for playback on your handheld device. For people who need audiovisual support, a video can be created showing the task being performed successfully and be available for playback when needed. Most current PDAs and tablets come with onboard video recording capabilities. Using these video cameras, it is easy to build videos showing turn-by-turn routes through a building or across a campus. For many people with cognitive challenges, these videos are easier to follow than the abstracted images on maps.

Social Stories and Behavioral Cues

As with task-sequencing, supports may include a written set of directions, a captioned picture sequence, or a videotape modeling appropriate behavior. Of all the assistive technologies in use for people with autism, video modeling is the most thoroughly researched, and has proven effective in helping people learn to manage behavioral challenges.


The deaf community has long used cellphone texting to communicate with non-signing friends, but portable communication opportunities are growing rapidly. The free app Dragon Dictate translates spoken speech into text (wi-fi required), Proloquo2go is a fully-featured tap-to-talk speech generation app that costs thousands of dollars less than standalone augmentative communication products, and there are a number of less complex free or inexpensive speech generation apps that work well for many people with speaking difficulties (examples include Voice4u ($29), iSpeak (2.99) and Tap-to-Talk (free).

Stress Management

Relaxation apps, art and music apps and many puzzle and game apps can help people relax in stressful situations. SimplyBeing, for instance, plays new age music and shows relaxing natural scenes, while Tactical Breathing Trainer and Breathe2Relax use simple video graphics to teach deep breathing relaxation methods. Bloom and Seline HD are entrancing music apps, WURM and Meritum Paint are relaxing finger painting apps, and there are thousands of puzzle and game apps that may appeal.

Academics, Healthy Living and Beyond

A portable computer may also be used as a homework tracker. iHomework and iStudiez Pro provide comprehensive support for classwork, planning and reminders. Dictionaries, algebra helpers, astronomy maps and frog dissection simulations are just a few of the thousands of academic apps now available. You may also use your handheld device as a health coach. All Fitness, for instance, provides video-guided workouts, Sleep Cycle purports to track your sleep habits, and Lose it! is one of many calorie counting weight loss apps on the market.

Clearly, it is possible to build a personalized suite of supportive apps on a smartphone, ipod touch, ipad or tablet. Good luck and VCU-ACE would like to hear about your experiences.


See the VCU-ACE website for more information and examples discussed in this Autism Technology Brief.

Information for this "Autism Tech Tips" is from Virginia Commonwealth University's Autism Center for Excellence (VCU-ACE), which is funded by the Virginia State Department of Education (Grant # 881-61172-H027A100107). The Contributor for this issue is Tony Gentry, PhD OTR/L Virginia Commonwealth University's Department of Occupational Therapy. Please contact Dr. Gentry at

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