The essential steps cognitive orthotic.
A multifunction cognitive orthotic system is designed to assist people with cognitive disorders in the performance of ecologically relevant activities. This personal computer-based compensatory approach applies neuroscience and technology to the rehabilitation needs and challenges of people with chronic brain damage. The primary goal of this approach is the independent accomplishment of practical, applied tasks integral to daily living, at home, at work, at school and in the community. This paper will describe the "Essential Steps" cognitive orthotic system, and describe its potential to facilitate skill acquisition and enhance self-sufficient life management. The software was designed to guide and protect the user as he or she progresses through each "essential step" in the progression required for completion of a targeted task. The discussion will explicate the underlying principles promoting skill acquisition with this application of a cognitive orthotic. Data have shown that this compensatory aid can promote rapid skill acquisition and support reliable performance, even long past the time when rapid recovery and progress are customarily expected. Discussion will focus on issues of design for people with brain damage, the significance of this system's prototypical structure, and research findings and clinical observations made with people using "Essential Steps".