ATU607 – TREAT App with Steve Sutter from CreateAbility

Hi, this is Steve Sutter and this is your Assistive Technology Update.

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 607 of Assisted Technology Update. It is scheduled to be released on January 13th, 2023. On today’s show we’re excited to welcome Steve Sutter, president of CreateAbility back to the show. Now, Steve is not new to this show, he’s been on here quite a few times to talk about some of the amazing things that CreateAbility has made, and today he’s going to tell us all about the new TREAT app and how it can assist individuals with traumatic brain injury.

We have a story about Project Leonardo, which is a new adaptive controller that’ll be coming out for the PlayStation. As always, listeners, we want to hear from you. You can call our listener line at (317) 721-7124. Drop us a line on Twitter at INDATA Project or send us an email tech@eastersealscrossroads.org. We always love hearing from you. We can’t wait to hear from you again, but for now, let’s go ahead and get on with the show.

Maybe you’re looking for some new podcast to listen to, well make sure to check out our sister podcast, Accessibility Minute and ATFAQ or Assistive Technology Frequently Asked Questions. If you’re super busy and don’t have time to listen to a full podcast, be sure to check out Accessibility Minute, our one-minute-long podcast that gives you just a little taste of something assistive technology based so that you’re able to get your assistive technology fix without taking up the whole day. Hosted by Tracy Castillo, this show comes out weekly. Our other show is Assistive Technology, Frequently Asked Questions, or ATFAQ. On Assistive Technology, Frequently Asked Questions, Brian Norton leads our panel of experts, including myself, Belva Smith, and our own Tracy Castillo, as we try to answer your assistive technology questions. This show does rely on you, so we’re always looking for new questions, comments, or even your answers on assistive technology questions. So remember, if you’re looking for more Assistive Technology podcasts to check out, you can check out our sister shows, Accessibility Minute and ATFAQ wherever you get your podcast, now including Spotify and Amazon Music.

Listener’s, probably the biggest tech conference, CES, just wrapped up out in Las Vegas. And as always, lots of great new adaptive technology was introduced during the show. Over the course of the next few weeks, we’ll do our best to kind of talk about some of those different things and maybe even mention a few on this show, but probably none caused as big of a stir as Sony’s Project Leonardo. Project Leonardo is a fully customizable accessible console game controller. It says it was actually built with the help of individuals in the disabled community. Now, if I look at this controller, it looks a lot like, well, I’m not real sure exactly what I could say it looks like. It is circular and you can actually change the button placements on the device, much like the Microsoft’s Xbox adaptive controller, it also has places where you can plug in switches, so it looks like it’s highly customizable depending on the individual using its needs.

If you want to check it out for yourself, I will put a link to a story over in WIRED talking all about the device. Now, the Xbox accessible controller has been out for quite a while, but Sony didn’t really have anything that kind of matched up, and even though some games do have a lot more accessibility features built in than they used to, well, if you couldn’t access it with the controller, it’s not really that big of a help, I guess. So the read down on the story, it says the Project Leonardo is a first party Sony game controller that affords physically disabled players the opportunity to customize the shapes and sizes of stick caps and buttons, and even the overall positioning of each stick on the controller.

So kind of as I said, you can actually change where all the different controls are, what they look like, how you interact with them and everything else to really give you just more access to the games that you need. And I can see how this could be really helpful, especially because I’m sure that some buttons are used a lot more in some games while in others there may be kind of passive. You don’t really have to use them much. And I’m sure that there’s probably some different things built in here for assistance when you have to press more than one button. So hold down this button while pressing this one to access some different aspect of the game. I am sure there’s probably a way to fix that as well. It says in here that they’ve been working on this for years and they were really trying to make something unique that could really help out a lot of different individuals with different physical needs.

And that’s why it’s kind of customizable by each individual. So that’s why you can take the buttons off, move them around, change how they’re controlled, plug in a switch, do all kinds of different stuff with it to really make it accessible to individuals with lots of different physical challenges, not just one. It says that organizations including SpecialEffect, Stack Up and AbleGamers, along with many different play testers and consultants helped in making Project Leonardo. Another kind of cool aspect, it says that Project Leonardo can be used as a standalone controller or paired with additional Project Leonardo or dual sense wireless controllers. Actually up to two Project Leonardo controllers and one dual sense wireless controller can be used together as a single virtual controller. So if you really think, that gives you a lot of different kind of ways to access. So if maybe that dual sense, your normal kind of standard PlayStation controller, perhaps I couldn’t access every aspect of it, but there were some that I could, I just need some other buttons in a different kind of way.

Well then I could put one of these Project Leonardo controllers or two of them even on there so that these buttons are in the places that I need them to be. Does say that it can be paired with most external third party buttons and switches. As we kind of go down here, it does say, this is kind of the first iteration. They’re just introducing this and they may even end up changing the name. That may not be the name once it actually is available to the public. The other thing it does not say in this story is when exactly that release date will be. But many folks have been wondering, especially since that Xbox adaptive controller came out, when would Sony kind of join this party? When would Sony realize that a lot of individuals with disabilities play video games just like everybody else does? So making your games more accessible as many game manufacturers have really started to do.

You have to make your hardware accessible as well so that individuals can get on and use it, but it looks like they have been working on it for quite some time and are really trying to make their systems a little more accessible to all. Again, I’ll put a link to the WIRED story over in our show notes so that you can check it out for yourself and we will be sure to give you any updates as these come and hopefully in the next few weeks be able to talk about some other cool things coming out of CES 2023.

Listeners, our guest today has been a friend of the show and our program for many years, and he’s back today to tell us about a new solution they have. Please join me in welcoming Steve Sutter from CreateAbility back to Assistive Technology Update. Steve, welcome to the show.

Hey, it’s always great to be here.

And it is always great for one, you’re one of the few people I get have in the studio, so it’s nice to not be talking to a Zoom screen for once. For our listeners who haven’t heard you on the show before, could you tell us a little bit about yourself and about CreateAbility?

Sure. Well, I always dreamed of helping people with special needs using technology. And 20 years ago, actually more than 20 years ago now, I got this divine intervention that really helped me say, stop this and start something new. And so I was working with Hewlett Packard for about 18 years at the time and stopped, quit and started CreateAbility.

Excellent, excellent. Now, the reason we actually have you here today is to tell us about the TREAT app. Now, what is it?

Well, TREAT app really helps a large population. There’s over 5 million people with a blow to the head called the traumatic brain injury, but there’s also many million of people with strokes, drug overdose, anyone who’s had lack of oxygen to the brain for a certain duration of time, and this can cause a brain injury. And so what we try to help with is in that emotional awareness category. So a lot of people after their brain injury, their traumatic brain injury, they’ve lost the ability to recognize emotions or express their emotions to others. And frequently these problems are linked to negative outcomes. This affects a much broader population, but a lot of times it’s called Alexithymia, just that inability to be aware of emotions. But we get to work with a lot of different subject-matter experts. And one of those is Dr. Don Newman and her colleagues at IU Health, and they’ve developed a treatment program over many years that aims to improve that emotional awareness and understanding. And that’s so important to help them learn how to control their emotions or express them.

Oh, sure. As well as probably recognizing them and everything else. So tell me, how does the TREAT app work?

Okay, well first off, the name TREAT is an acronym for training to reconnect with Emotional Awareness training. The purpose of the TREAT app is to extend or operationalize Dr. Newman’s work and really provide that evidence-based research background that this is effective, it can be used by people and get help in the therapy for people with brain injuries. So it consists of an app for the individual with a brain injury and a dashboard and reporting capability for the clinical team. A little bit about how it works and what does it do, the TREAT app helps them by exposing them to a variety of little video snippets that are designed to increase some emotional response. So imagine this dentist having lunch with a person, a friend that’s rather rude, late, and then you have a waiter that is not very helpful or careless. Then there’s situations where they are in a doctor’s visit and then return to work.

And these little video snippets, I think there’s 17 or 18 of them in all, really expose and are designed to create an emotional response. And a lot of people, well, I’m a guy, so I might use the word feel for something that isn’t really a feeling. Like, I’m feeling stressed. Well, stress is not an emotion, but I may think it is because I use the word feel along with that and that gets promoted with brain injury. I think my wife might say that I’m in that population sometimes.

But basically we try to help them realize that there are cues into their emotional response. The way you’re thinking, the way your urges or actions might be when you are stimulated by this video. What physiological response are you sensing right now? Sweaty palms, increased heart rate, increased breathing, like I’m experiencing right now in this podcast, and that might help me tap into the emotional response. And so then we have them try to relate to what is the emotion they may be feeling right now after being exposed to these various things. And that’s the crux of the matter. That’s what we’re trying to get to.

Gotcha, gotcha. So I kind of figure out where those triggers are, what my response is, and then from there kind of how to regulate those kind of things?

Yeah, and how to express them.

Yeah. Excellent, excellent. Well, and I know that you kind of brought that up, how that is a challenge for individuals who can have traumatic brain injuries and like you said, from a stroke or all those, but I know impulse control, controlling emotions, all those things can be major, major factors. And sometimes they’re a little harder to accommodate than some other things, memory and other stuff like that. There may be some things out there that can really help, but yeah, that’s kind of a part that just wasn’t really assisted with it seemed like too much, at least on the one-on-one whenever you’re out on your own.

Yeah, you’re so right.

Very, very cool. Well, Steve, what else can it do?

Well, each of these different sessions are designed to build on each other. So we might start out with, in that dentist role, you’re late, you wake up late. So, oh my gosh, I had my appointment at 9:30 and it’s now 9:00. I overslept, what do I do? And so that would induce an emotional response. The next session might be, oh great, there’s a traffic jam and now I’m really going to be late. You finally get there and you’ve missed your appointment time slot. Oh, there’s a $50 late fee. All these things are just compounding on it. And each of these points at each time we have them go through and to try to sense and express what were their thoughts, what were their actions they might have as actions, what their physiological response is. And again, that’s the core is, what emotion might they be feeling right now?

And then we score those and then we can feed that back to the individual as well as the clinical team with their permissions so that the clinical team has more information the next time they visit with them. Because a lot of times, what’s missing is, and again, this person has a brain injury, we’re asking them to remember what things were like. My doctor, when they see me, one of the first questions is, so how you been doing lately? Well fine, is my typical response. Well, maybe it wasn’t fine, but I forgot. So this records all that for you, automatically seamlessly in the background, again, with their consent, so that the clinical team gets to see, oh, here’s my walk through these different episodes, these different experiences. And I can see, oh, Steve’s scores are increasing over time. That’s good. Or we seem to hit a problem area here. Now I know how to direct and inform therapy. So that’s the concept of it, not just timestamps of what they did and how they did it, but information about how that might inform the next treatment.

For sure. And like you said, it can really show progression and regression over time on those different things so that you can really focus what the individual really needs as opposed to, for lack of better term, beating the same dead horse and trying to find the same one. And I’m glad you brought up the doctor because yeah, I’m the same way. I can tell you what happened this week, doc, maybe today. If I had something that bothered me two months ago, odds are I’ve already forgotten that. So with the brain injury, that becomes even more challenging to try to remember everything that triggered a response or other things. Plus I’m sure that also helps the doctor because if I’m trying to explain my emotional response for things, I’m explaining that through my lens, through my eyes. Whereas with this, it’s a little bit, oh, probably just gives you better data.

It does. It really does. And being able to inform that treatment is really helpful because there’s so many individuals that are experiencing staffing shortages that all throughout the different economy. And that also happens here in the area of clinicians in brain injury. So anything that we can do to help them to be more efficient, collect more data when they’re not face-to-face with the individual over a Telehealth or Zoom call, really can help them inform that, it’s a strategy out there called ecological momentary assessments. It is this idea, this strategy of in their own environment, not in a clinical team environment, but their own home, their own couch, their own favorite chair, brief assessments that can just be very natural and easy to do to perform by the individual. All that data gives a whole different perspective of what’s going on in between office visits.

Oh gosh. For sure. Because I mean, we all have the learned behavior of how we’re supposed to act when we’re at the doctor, the therapist or those kind of things. So yeah, being able to actually kind of like you said, kind of moment in time, see when you’re in your natural habitat, how you behave. So I’m sure that’s very beneficial to the individual, the therapist and everybody involved.

So Right.

So Steve, the app itself, does this work on all platforms or how does that work for the individual?

Yeah, it’s on the app store. For the Apple or the Android stores, it’s $4.95.

Oh, nice.

Very economical. And then the clinical team can buy into that clinical perspective that they get the dashboard tools and so on that can help them.

Excellent. Excellent. Very, very cool. And is it already available or is there something coming out soon?

Yep, it’s already accepted on the app store for Apple. We’ve got one more hoop to jump through for the Android and we should have it available within the next week and a half.

Oh, awesome. Awesome. Well that will be great. Steve, some of my favorite things to talk to you about are the success stories that you guys have. Because I know we’ve worked with you on other projects on other things, and I’d just love to hear them. So do you have any stories about the TREAT app and how it’s been able to assist some individuals?

Yeah, we do. In testing at IU Health, and we always try to make sure that we have evidence-based research guiding this. And by the way, this research was funded by the App Factory within the Shepherd Center that is a NIDILRR grantee. And they then have application competitions. Dr. Newman and I applied for that and were funded for this TREAT app at development. So little plug there for their NIDILRR Project at Shepherd Center. But during that evidence-based research, which is required in this process to get approved, we had two different groups. We had the patients and we had clinicians that helped them. Both groups, really loved working with the app. Both groups were able to see its utility, they were able to navigate it correctly, but both of them had suggestions on how to make them better. We took that data, worked on it, redesigned several things before we ever published it or tested it one more time and put it on the app stores.

But what was exciting, what was amazing to me was that three of the individuals with brain injury that were tested had been dealing with emotional awareness issue for seven years.

Oh my gosh.

And two of the individuals had been working on that issue for 14 years. So it’s really exciting that we’re able to participate in research and development and development of technology that can be released economically to people that really helps them mature and regrow that emotional awareness through very simple exercises. But boy, I tell you, Dr. Newman and their research team, they worked for months developing the different scenarios, hiring actors, writing scripts, filming, editing. It was amazing all they did. So it’s really great to see it all come together this way.

Awesome, awesome. And yeah, I’ve worked with, well, not worked with, but talked to Dr. Newman before and she’s a pretty amazing individual all the way around. But I love the way that you actually got feedback, were able to change it. But yeah, that is just amazing how long individuals have been dealing with that need and there hasn’t been, something that can, I don’t know, work with on their own out there. Just a therapy appointment here and there that might help for a few weeks, but it seems to wear off after a while. So having something I can work with at home, and not only that, just at least for me, if I feel like I’m a part of my treatment a little more, I’m more apt to do it than if it’s just somebody on a couch telling me to do things.

You’re right.

It seems to make it a little bit easier and a little bit more effective, especially for those in between times when I can’t be kind of meeting with folks. Well, Steve, what else is new for CreateAbility and I guess on a smaller scale for Steve Sutter?

Well, let’s see.

So this TREAT app is just one of five different solutions we have in the brain injury population. So other things we’ve talked about in the past are the Flourish person-centered planning tool, the employment tool that really helps them review different snippets of new jobs they might do if they’re ready to return to the workforce and maybe in a different job, different capacity. So it gives them the ability to explore different jobs with little videos. Once in the job, if they’re dealing with executive function issues like memory sequencing, MeMinder, we’ve talked about in the past, that is there to prompt them and guide them. And a really cool new thing that we’re working together with Easterseals Crossroads on in a new project, and that’s called MyBrain. So MyBrain is a tool that’s to be used in conjunction with resource facilitation, which is now being funded by Department of Vocational Rehabilitation here in Indiana for Easterseals to serve this new brain injury population.

And one of the tools they’ll be using is MyBrain. MyBrain is not so much an awareness tool, but let’s see how you’re doing kind of a checkup from the neck up. How are you feeling? Any depression, any anxiety, any cognitive function issues? Fatigue is a huge issue after brain injury. Let’s get an assessment of that. Executive function, impulsivity, all these different categories. Matter of fact, there’s 48 different assessments built into this. No one would survive that kind of battery, matter of fact, you might cause a brain injury.

But the clinical team determines what measures, what assessments are to be provided to the individual, at what frequency and how often and so on. So they’re able to weigh in on how they’re feeling and even things like headaches, vision issues, dizziness, all those different components and a new area about their circle of support. If they lose that caregiver function of family members, loved ones and so on, we are also assessing how they’re feeling, how does their role as a parent, loved one, spouse, son or daughter change because this individual has had a brain injury, and how are they dealing with that stress? So we can really keep ahead of the whole equation and really help that informed treatment.

Oh, that’s awesome. No one ever thinks about the caregiver. That’s a part almost seems like no one’s ever thinks about. So I’m glad that part’s being in there and we’ll probably try to have someone on the show from Resource Facilitation just to talk about that program here sometime soon as well, as that all gears up. But yeah, we’re very excited to all be kind of working together and I promise that wasn’t a plug just to lead you into that. Well, Steve, kind of as we wrap up here, if our listeners want to find out more about CreateAbility, about all the great things you guys have, what’s the best way for them to do that?

They can go to the app store and search for the emotional awareness tool, TREAT Emotional awareness tool. They could look at our website at info@createabilityinc.com, or they can go and call us at (317) 798-4101.

All right. We will make sure to put all that information down in the show notes. Well, Steve, it is always a pleasure to have you on the show actually here in studio. Good to see you for real and just have you on and just all the amazing things that you do there with CreateAbility. It seems like you always have a new kind of solution and something I would’ve never thought of coming out just to help the individuals that we all work with. So thank you again for coming on the show, and thank you for all the great things you do.

Oh, thank you so much.

Do you have a question about assistive technology? Do you have a suggestion for someone we should interview on Assistive Technology Update? If so, call our listener line at (317) 721-7124. Send us an email @techeastersealscrossroads.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 @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, produced, edited, hosted, and fraught over by yours truly. The opinions expressed by our guest are their own and may or may not reflect those of the INDATA Project, Easterseals Crossroads, our supporting partners or this host. This was your Assistive Technology Update, and I’m Josh Anderson with the INDATA Project at Easterseals Crossroads in beautiful Indianapolis, Indiana. We look forward to seeing you next time. Bye bye.