Svoboda and Richards and Savage and Svoboda demonstrated the successful introduction of a commercial smartphone to aid both prospective and retrospective memory difficulties in a woman (RR) with moderate to severe memory impairment. Not only did RR acquire the skills to use the smartphone calendar for targeted PM tasks, but she generalised the skill to prompt everyday activities and learned to use other applications, e.g., video games and to do lists. They supplemented their original ABAB design with an 18-month follow-up study and found that RR continued to use the smartphone with similar success rates to immediately after the initial intervention and at 4-month follow-up. However, completion of memory tasks reduced when an alternative smartphone (with no training) was used. They note that training in the use of the smartphone may generalise within brands but not across different brands. In a second single case ABAB design, Svoboda et al. demonstrated the benefits of a smartphone, in particular the calendar feature, for an 18-year-old woman with severe memory difficulties who had sustained her injury at the age of 13 years. They found that the rate of completing tasks (e.g., making phone calls at the correct time or attending social events) was significantly increased using the smartphone when compared to baseline. Furthermore, use of the smartphone reduced carer strain and improved her quality of life. Svoboda et al. went on to demonstrate the success of their training protocol in 10 individuals with memory problems of varying aetiology who were taught to use either PDAs or smartphones to cue a series of phone calls or everyday memory tasks. Significant improvement was found in day-to-day memory functioning for all 10 participants and, again, some individuals generalised the training to other software applications on the devices.
Thus, studies so far suggest that mobile and smartphones, in particular the use of text message alerts, are effective in people with memory problems. There are a variety of memory applications (apps) and software packages that can be used with smartphones, such as Google Calendar (used in the present study), Microsoft office calendar and Zoho Calendar. McDonald, Haslam, Yates, Gurr, Leeder, and Sayers also explored the use of Google Calendar in 12 people with ABI (TBI, stroke, anoxia, viral infection or heart attack). This was a randomised controlled crossover study comparing the effectiveness of Google Calendar with a standard paper diary. They found that both aids improved recall of prospective memory tasks, however, Google Calendar was found to be significantly more effective than the paper-based diary. Participants highlighted that the timed text message alerts were the most beneficial feature of the calendar system, as they provided a written visual prompt as well as the auditory alert. In the latter study participants had all used memory aids prior to the study. In the present study we explore whether Google Calendar is an effective memory aid for a man (JA) with severe verbal and visual memory difficulties and impaired executive functioning who did not use any memory aids prior to his injury and was initially very unwilling to use any aid subsequent to his injury. Google Calendar was eventually chosen over other forms of memory aid after a detailed assessment that included factors influencing acceptability to JA.