ATU672 – Cognixion with Andreas Forsland

Andreas Forsland:
Hi, my name is Andreas Forsland. I’m the founder and CEO of Cognixion, and this is your Assistive technology update.

Josh Anderson:
Hello and welcome to your Assistive technology update, a weekly dose of information that keeps you up to date on the latest developments in the field of technology designed to assist individuals with disabilities and special needs. I’m your host, Josh Anderson with the INDATA Project at Easter Seals Crossroads in beautiful Indianapolis Indiana. Welcome to episode 672 of Assistive Technology Update, it is scheduled to be released on April 12th, 2024. Today’s show, we’re super excited to welcome Andreas Forsland. He is from Cognixion, and he is here to tell us all about just some of the really cool things that they have available that can help individuals with disabilities with some different needs. As always folks, we thank you so much for listening. Don’t forget, you can email us at tech@eastersealscrossroads.org or call our listener line at (317) 721-7124. But right now, folks, let’s go ahead and get on with the show.

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Listeners today, we are very lucky to welcome Andreas Forsland, founder and CEO of Cognixion to the show to tell us all about Cognixion and the really great and amazing technology that they have and are working on. Welcome to the show.

Andreas Forsland:
Hi, Josh. Thanks for having me.

Josh Anderson:
Yeah, I am really excited to get into talking about the tech and really learning more about it. But before we do that, could you tell our listeners a little bit about yourself?

Andreas Forsland:
Sure, yeah. Well, I am a 40 plus year old white male with a grizzly beard, and my background is design, product and user experience design. Previous to Cognixion, I worked at Citrix in their software as a service division, and then prior to that I worked at Phillips Electronics in the design organization working across worldwide operations for healthcare, lighting, consumer electronics and semiconductors. And before that, I was a design strategist working with brands including Apple, IBM and so on. But what got me into Cognixion was a personal situation.

My mom had pneumonia, which is very common except it was very aggressive and it accelerated into septic shock. So she was admitted into the intensive care unit right away, and once she was admitted, she was put on life support and intubated, which enabled her to be sustained, and she was able to be discharged. But during the period that she was in the hospital, she was unable to speak for herself and she was unable to really move her body. She had no fine motor skills in her hands, and they were also restrained because she had all of her life support on.

So for all intents and purposes, she was locked in, but cognitively fully intact. And so that was my first dry run of being a caregiver and a simulation of working with someone who is clinically locked in even if it’s temporary.

Josh Anderson:
Yeah, you led me right straight into my next question. So what is Cognixion as the whole company?

Andreas Forsland:
Cognixion started out in 2014 focused entirely on looking at augmentative communication, alternative ways for communication access. And so our mission from the very beginning was to assist hundreds of millions of people worldwide that have different conditions that impact speech and motor. So we’ve been on mission for over 10 years now on trying to unlock communication, but as we’ve developed deeper relationships in all of these different communities ranging from stroke to traumatic brain injuries, ALS, autism, cerebral Palsy, MSMD, PSP, SMA, you name it, we’ve really learned a tremendous amount of working with people in all of their different situations and lifestyles.

And as a result of that, Cognixion has evolved into really a platform, a platform for independence and human agency, so that we anticipate that we’re going to be able to deploy our technology to hundreds of millions of people and enable them to do more than just communication, enable them to be able to use our technology for smart home controls, mobility controls, and also other really fascinating healthcare applications that will be a catalyst for healthcare professionals to unlock new kinds of diagnostics and therapeutics. So Cognixion has really evolved over the last decade into really becoming a catalyst for the future of healthcare.

Josh Anderson:
Wow. No, it really has. And I think we’re going to dig into that a little bit deeper as we get kind of towards the end, but I want to talk a little bit about the technology. So I know you’ve got some different offerings, could we start by talking about the Cognixion ONE?

Andreas Forsland:
Sure. The Cognixion ONE, really broke the mold with it because some of the things that we learned early on regarding communication was most of the tools that people have to assist them require some kind of physical movement, like controlling a switch or moving a joystick or touching a screen, or if they’re using what’s called indirect selection, it requires them to use eye tracking. And so for all the good uses of all these different assistive technologies, they have their limits. And so we thought, “Well, wouldn’t it be amazing if you could just actually eliminate the need to control eye tracking or to do motor inputs at all and we could just go straight to the brain?” And we said, “Well, who wants to get brain surgery?” Most people don’t want to do brain surgery. I mean, some people will elect to do it because they need to, but most people don’t.

And so early on, we started investigating brain computer interface, so BCI, and what we found is that actually early on in 2016 and 2015, we discovered that we could actually do a lot regarding controlling computers with non-invasive wearable brain sensing technology. And so as a result of that, we started working on brain computer interface technology, but we thought that just doing a brain computer interface strap would be the way to go, some kind of headband that you could use to control computers. But then as we got into that, we realized that the computer was also the problem. Most computers were big and heavy and bulky, or they had to be mounted to a wheelchair. And then you had all kinds of other issues, portability issues, light issues, interference with ambient light, positioning issues where the eye trackers didn’t always behave correctly or needed calibration.

So we were like, “Well, that’s going to be problematic, so can we just eliminate the need for a computer altogether and bring that computer into a heads-up display like a visor or smart glasses?” And so as we iterated year over year, what we realized is we had to bring this all together into one system. So what we’ve created with Cognixion ONE, is the first ever wearable computing platform that brings augmented reality glasses together with brain sensors all in one package. And that can allow someone to use head tracking, eye tracking, and brain sensing, any one of those or combined to control their computer, but not a regular computer, but actually apps that can run in the visor, in the headset. So think about it as a wearable computer that you can control with your brain. And that’s really what Cognixion ONE was set out to do.

We sent that through initially through the FDA, and we’re happy to say that that device received FDA breakthrough device designation. So the goal there with Cognixion ONE is that Cognixion ONE will eventually be cleared through the FDA and will eventually have reimbursement coding associated with it so that Medicare and Medicaid and private insurance could cover it as a wearable computer, as a wearable prosthetic for people. But in the meantime, we have also developed a derivative version of Cognixion ONE where we take the same great technology, but we’re now making it available to researchers with a slightly different configuration and targeted for researchers. And that product is called Axon-R. So we actually have two versions of this. One is Cognixion ONE, that’s aimed to be a reimbursable device, and product number two is Axon-R, which is aimed at researchers who are doing science and clinical research.

Josh Anderson:
Very cool. And I want to dig into both of those just a little bit, but I guess since you mentioned the Axon-R, what are maybe some of the clinical uses where it might be useful for research and other things? Where do you see it going with that? Or perhaps where have you been approached for folks to try it?

Andreas Forsland:
Yeah. Yeah, it’s amazing. Well, the area of assistive technology is the most obvious. So we have a lot of universities and AT labs that are going to be using it for extending some AAC use cases, power wheelchair control. So we have a university in Canada currently that’s directly integrating the brain interface and the heads-up display for controls, think about it as a dashboard for driving your wheelchair and you can wear it, and that’s controlling the wheelchair. So that’s going on right now. Amazon Alexa, invested in our last round of investment, and so we fully integrated Amazon Alexa. So all of the things you can do with an AI assistant, including smart home controls and reminders and all these other things you can do, so occupational therapists and others who are interested in retrofitting people’s homes with smart homes and being able to control it.

So that’s an area of research like smart home interfacing. And then on the other side, on the clinical side, we have rehabilitation. So OTs and PTs are looking at it for being able to assess progress of things like cervical motion, cervical movement, brain function, attention function, cognitive processing, cognitive load, mental focus attention, within ophthalmology and optometry. Ophthalmologists are interested in understanding what’s happening in the brain as it relates to measuring early diagnostics of any kind of lesions on the optic nerve or in brain health. They’re also looking at it for some individuals who have their eyes are mid-aligned, they looking at ways of measuring changes in ophthalmology to do vision correction.

So it’s really fascinating, all these different use cases. We even have one organization that works with individual patients that have already have brain implants for deep brain stimulation or these implants you’re seeing like Neuralink and Synchron and some of these others that are coming soon as far as implants. The data that can come from those implants can also be merged with our system. So this notion of having this sensor fusion or integration between non-invasive EEG data plus implanted data together is extremely interesting for scientists and clinicians.

Josh Anderson:
Nice. And I’m sure the sky is the limit on that, and it’ll probably take it in all other kinds of directions. So that’s super cool, and I love that it’s made available so that folks can do that research and build on it and build on the system. Now, back to the Cognixion ONE, I know that I can use it for communication and stuff like that. What else can I do with the device?

Andreas Forsland:
Well, the Cognixion ONE, it’s in development in the sense that Cognixion ONE is not yet for sale. Axon-R is for sale today. And so Axon-R, if you can quickly set up experiments, we have tools and software that can allow you to create your own applications and integrate brain data into your applications to learn more. That stuff is available right now, people can go online and put deposits down to reserve a system today. Cognixion ONE is still coming soon, but as far as what it does today, it has… So the way it works with an augmented reality is, you’re not closed in virtual reality. Augmented reality is sunglasses with holograms projected onto the lenses so you can see everything around you. And so it’s fully wireless, you’re not tethered to any computer, and it’s like wearing large oversized sunglasses.

And so the applications that currently are on Cognixion ONE include various keyboards. So we have different kinds of keyboards ranging from Linotype to QWERTY keyboards, we even have a custom one we patented called the Iris. And so it kind of resembles your Iris as a radial menu that allows you to look kind of through the middle of the screen, so you’d never lose eye contact with whoever you’re communicating with, but you have equidistance access to every key in your keyboard around the perimeter of your peripheral vision. And in each of these keyboards has a sophisticated AI model that is behind it, that is a supercharged version of your predictive keyboards that you might expect. And so this AI model is really a reflection of the user, so it can be deeply personalized to the user so that all the words and phrases that get predicted and suggested really feel like they’re coming from the voice of the individual.

So if somebody has kind of a local flavor for how they talk, someone who’s in Boston might talk very differently than somebody in Alabama versus Missouri or Florida. So being able to personalize your vernacular is something that’s in there. We also have Alexa integration directly in it, so the system can allow you to do all your Alexa stuff inside the system. So that includes playing music, listening to podcasts, listening to eBooks, controlling your home smart objects, also shopping and all that other stuff. So it’s really a very immersive communications interface, and all you have to do is sort of toggle between speaking and doing.

Josh Anderson:
Yeah, and I just love the way it has all the different inputs, especially being able to use the brain without the invasiveness and most people, like you said, just aren’t ready to quite put something in their head yet unless it’s just absolutely medically necessary. So I do like that they have that option. And then you also have something else called Speakprose 3. Can you tell us about that?

Andreas Forsland:
Yeah, yeah, that preceded some of the hardware stuff that we’ve been doing, but it’s an AAC application that’s available in iOS, so iPhones, iPods, iPads. And we have two versions Speakprose 3 and Speakprose Unlimited. They’re basically the same application, it just depends on whether you want a perpetual license or you want to do a month to month deal. But it provides a lot of what I just talked about in Cognixion ONE, but in a two-dimensional iOS design. So it has the Alexa integrations, it has multiple keyboards. It supports multiple input methods like switch access, gesture recognition, taps. It can also do face tracking. So we did some really slick eye tracking technology using the iPad and the iPhone using their depth cameras. So you don’t need some extra eye tracker to be able to use it, you could actually just use it straight out of the box. And those are really meant to be affordable alternatives to the big expensive eye tracking systems that you might get.

So for those folks who maybe want to try out face tracking or eye tracking, but they don’t yet have funding available for an expensive system, you could simply get one of the latest iPads or iPhones and download Speakprose, and you’d be up and running with AAC and Smart Home Controls straight away.

Josh Anderson:
Nice. Nice. And yeah, I love that you’re using the technology that’s already kind of built in there in a new way to be able to help folks. And like you said, it makes a big difference and effort to try to get an add on or a whole nother kind of piece. I’m sure you probably have quite a few of these, but can you tell me a story about someone’s experience maybe using either Speakprose or maybe even during the testing and trying with Cognixion ONE, or really anything that’s maybe amazed you or just somebody who’s really enjoyed it, maybe it’s made a difference in their life?

Andreas Forsland:
Yeah, I’d say Speakprose is interesting. We have over a hundred thousand people that are using it around the world. Most of them are in the United States, but of the types of folks who are using Speakprose, it ranges from folks with cerebral palsy to mostly a lot of autism. A lot of autistic users are using it. There’s a growing emerging group of typers, people who are really proficient or non-speaking autistic individuals, kids and teens and young adults who are using Speakprose and using it daily to interact and communicate. So we’re very excited about how that’s affordable and accessible for teens and adults to want to break through and go to college or get into high school and things like this and transform the perception of what the world thinks, I think that’s really cool for Speakprose. Some of the things that are pretty amazing with regards to Cognixion ONE, as we’ve been testing it, we have over 200 individuals with disabilities and lived experience that work with us in the design of Cognixion ONE.

So we’re still a small company. We have roughly a six or seven to one ratio of, we call them brainiacs. Our brainiac to employee ratio is like six to one. So we very much over index on empathy and trying to embed designing with the community. And some of these brainiacs include individuals with stroke and multiple sclerosis and CP. One of the things, one of our tests… Well, there’s two stories. I’ve got a lot of stories, we have pictures of all of our Brainiacs in our office. I could talk about all of them, but one of them, he’s a DJ. He’s based here, we’re in Santa Barbara, California, and he lives here in Santa Barbara, he’s been with us for a long time. But we had an opportunity to go to New York for an event that Verizon was hosting that was very much celebrating accessible technologies, and we wanted him to go, his dream was to always go to New York, but it was such a pain to get all the transportation set up for him to fly.

So his father offered to do a cross country road trip and drive. And so what he ended up doing is he ended up taking Cognixion ONE on the road. And so as his father was driving, he was in the passenger seat, buckled in with his wheelchair, this gentleman has CP. And he was using our headset every single day at all the stops in the car driving. He was communicating with his father using the headset. He’d get out to the Rock and roll hall of Fame. Everybody be asking him, “What is that headset?” And he would just have conversations with them very quickly and easily. He even took it out on an Everglade, he took a roundabout down to Florida, and he was on an airboat in the Bayou or whatever, and he was literally driving.

So it’s amazing when I think about assistive technology and how people want to live or how they live, and most folks tend to stay home or stay out of the public. And really, I’m so inspired by our brainiacs that are using Cognixion ONE and our other technology because I really see a future where everybody’s out on Main Street, hanging out together, doing things, having conversations, living their best life. And when I think about this individual who just took it on the road was just mind-blowing,

Josh Anderson:
No, that’s great. And yeah, I always love just hearing stories, especially when people just kind of amaze you because the goal of any assistive technology is to give folks choices. They can go and do the things they want to do and not have those barriers in place. So I love, love, love hearing about that. If folks want to find out more, what’s a good way for them to find out more about Cognixion?

Andreas Forsland:
Well, the easiest thing would be to go visit our website at Cognixion.com. We spell it with a X instead of a T. so that C-O-G-N-I-X-I-O-N.com, Cognixion. And yeah, we have information about our products and if somebody’s interested in reserving an Axon-R headset, they could do that on our website. If you’d like to actually set up a demo or a conversation with us, we have the ability to just jump right into our calendars and schedule meetings with us if you want to get a demo or talk to someone for customer support. Yeah, we’re very accessible as a company and people, and we want a lot of folks to get access to our technology. And if there’s folks out there that are listening to this that are interested in doing any kind of translational research, clinical research, or any kind of interesting things that Axon-R could help unlock or help support you, do reach out and let us know. We’d love to see what you’d like to do with it.

Josh Anderson:
Awesome. We’ll put a link down in the show notes so folks can easily find it and reach out. Andreas, thank you again so much for coming on, telling us about the motivation that kind of started everything and just all the really cool things that you’re all doing there to Cognixion. Thanks again.

Andreas Forsland:
Thanks, Josh. I appreciate it. Have a great day.

Josh Anderson:
Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on an assistive technology update? If so, call our listener line at (317) 721-7124. Send us an email at tech@eastersealscrossroads.org, or shoot us a note on Twitter at INDATA Project. Our captions and transcripts for the show are sponsored by the Indiana Telephone Relay Access Corporation or InTRAC. You can find out more about InTRAC at relayindiana.com. A special thanks to Nicole Prieto for scheduling our amazing guests and making a mess of my schedule. Today’s show was produced, edited, hosted, and fraught over by yours truly. The opinions expressed by our guests are their own and may or may not reflect those of the INDATA Project, Easter Seals Crossroads are supporting partners or this host. This was your assistive technology update. And I’m Josh Anderson with the INDATA Project at Easter Seals Crossroads in beautiful Indianapolis, Indiana. We look forward to seeing you next time. Bye-Bye.