Technology and AI (Smashing it after stroke)

This podcast was created and is hosted by Paul Burns, a young survivor of stroke. This podcast series is part of Stroke Foundation’s Young Stroke Project.

Special episode - Smashing it after stroke

Season 2 Episode 5, 1 March 2024 (Duration: 0:44:40)

Host: Paul Burns

Paul is back for a second season, this time talking to health professionals and industry leaders. Paul and his guests dive into current thinking on stroke recovery within their respective fields, what’s out there for those with invisible injuries and as usual, he picks up some tips and tricks along the way.

In this episode, Paul explores stroke recovery from a different angle. How can technology and AI (artificial intelligence) be used to assist people living with disabilities? Paul is joined by Marius Mathisen from Norway and Matt Giovanello from the US.

Marius and Matt are both CEOs of startups that are exploring innovative assistive technology. They share their own personal stories that inspired their ideas and talk about the current landscape and future of AI and assistive technology.

Transcript

Announcer: The information provided in this podcast is general in nature and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your doctor or other qualified medical professional.

Paul: Hi there, my name is Paul Burns and I'm a young stroke survivor. On this season of Smashing it after stroke, I'm chatting with health professionals and industry leaders.

We dive into current thinking on stroke recovery within their respective fields. What's out there for those with invisible injuries and as usual, pick up some tips and tricks along the way. 

Today, I'm speaking with two I.T. industry leaders whose families have been affected by stroke and disability.

Marius Mathisen, the CEO of Pletly from Norway, and Matt Giovanello, the CEO of Frenalytics from the United States.

We chat about their personal stories that sparked their ventures, how A.I. and personalised care are transforming the lives of individuals and families, and the future of assistive technology, and why we need to move now to bridge the care gap.

So please enjoy this chat I had with Matt and Marius.

Thank you very much for joining me today, gentlemen. We've had some real challenges when it comes to time zone management, speaking to us from Australia to Norway and to the US.

So I really do appreciate your time.

Marius: My pleasure. Thank you for having us.

Paul: So I guess the first question I'd like to ask, you know, each of you individually, just to get a little bit of background, you've got extensive backgrounds in technology, but not everyone that works in technology finds themselves working in the disability technology field.

Marius, how did you get started in this field?

Marius: I was pretty oblivious to how this space was when I first met my wife 12 years ago. But she has a daughter with IDD who is non-verbal, right now she's 19, but on the cognitive level she's 4 or 5 years old. And I was pretty shocked of how outdated the assistive technology in the space was back then.

She used to have like a LCD screen with some touch overlay, which was unresponsive, and it didn't work at all. So it's mainly just standing there and dashing down. But this was back then, back when Steve Jobs introduced the first iPad and being on the road and the early adopter, I bought that. I didn't stand in line or wait for it, but I bought it soon as possible.

And as soon as we introduced that to our daughter, we instantly saw that that kind of touch surface was much better for her.

Paul: Wow.

Marius: But still, when I did investigate different kind of applications that would suit her back then, it was still outdated in terms of efficient U.I. and the technology wasn't there. Things like cloud synchronisation, which is like almost like an ancient technology now, wasn't available at all.

So I was pretty irritated. I was provoked because neuro-normal people have all these kinds of applications available for them that are super slick, super innovative, working as it should, no problems. And this group that are having limited cognitive abilities, assisted by family caregivers who are on the brink of burnout all the time, and they are getting the short end of the stick in terms of tech innovation.

So back then I developed application, a game for our daughter and we published it online. It got downloaded over 10,000 times and ended up being used in school, something in the gardens, etc..

Paul: Wow.

Marius: We also raised money because of the media attention we got and donated iPads and gift cards to the local special occasion school and helped kickstart the use of innovation, innovative technology there.

And then after many years in the industry, in the tech world, I got the urge to do something again in the space.

Paul: I think it's interesting that you make mention that the disability support space or the business people technology space has to fight for things that neuro typical people have just taken for granted for years.

Marius: Yeah.

Paul: Matt, has that been your experience as well with your background story? How did you get started in the space? Is it a similar sort of take?

Matt: It is. And when I met Marius for the first time, I was slightly stunned by our level of overlap and the familial stories that causes each of our companies, Paul.

I have a slightly different take on this, and mine started almost in the shoes of Marius’ daughter, where I had a grandma who underwent open heart surgery and things went south.

She was in the greatest of care that New York has to offer, but she suffered a massive stroke while a undergoing surgery and she was left paralysed on the right side of her body with such irreversible brain damage on her left side that after she came out of the ICU, she was tube trach and vented. She wasn't able to speak a word.

The only thing that she could do to us was head nod, yes or no in a wheelchair. And that was not the woman we sent in for open heart surgery 24 hours before. I am half Irish, half Italian, and her Italian side somehow came flying through off the streets there and she was really stubborn with the necessary cognitive and physical rehabilitation that she so desperately needed.

She was getting the physical because I think she really shouldn't have a choice. But the way that I got started was I realised she was using flashcards and I was 12 years old when all of this happened. I could relate to those flashcards more than she could, and I didn't like them and I could see that she didn't like them as well.

She would push out with her good hand, the PT, OT and speech therapist who were trying to work with her to relearn these cognitive concepts, activities of daily living, essential life skills and the like. And so she just wasn't progressing because she didn't feel like it. She thought that it wasn't for her. She was stubborn and she wanted nothing to do with it.

And we deemed her as cognitively stagnant as if that's an answer like PT, OT and speech cannot settle for that. We have a patient who went through a significant brain injury and they need everything they desperately can get in order to get better. And flashcards aren't the solution by any means, but that's all they had back then.

So what I realised was there was a potential to personalise this process by digitising it and making it all about her, not only bringing this online into a medium that was 21st century in the world that we were living in and still living in at the time, but also like, let's make this interesting.

Let's make it about things that are most relevant to her life. And instead of doing clip art images and stick figures, let's go through real familiar relationships. Let's go through real conversational skills. And that was a complete 180 from the type of response she was getting to the flashcards. She was so much more interested and we were seeing a lot more progress as a result of it.

That's how we got started.

Paul: Isn't it funny that it's a thread that is starting to come through on a lot of people that I'm talking to because I’ve chatted to you know, physios and Ots and other allied health professionals. And there seems to be an ongoing change now from, you know, ten years ago to now it's becoming person centric care.

It's about, you know, that person as a whole with their entire life situation. Yeah, we treat them as a person that's happened to have a stroke, for example, versus you're a stroke survivor. So we go through these ABCD and if you don't fit our boxes, sorry, that's all we can do. It kind of sounds like that was your experience then, Matt, is that fair to say?

Matt: It absolutely was. And you know, it's funny, as I look back in time from when that happened in 2008, to present day, I've had many a family member who went through similar episodes. I have an uncle on my dad's side who's severely autistic. I now have my surviving grandmother. She has the advancing and worsening dementia and it's just eye opening to see what's available and also what's not available for all of these people who really need services and whose potential could be truly maximized if it was given to them in the manner that they need it.

So I feel like a lot of things are falling short. There has been progress made in the cognitive rehabilitation space, at least as we have experienced it here in the States. But there's a lot to go, and I'm glad that we have companies such as ours that are really trying to like push the calibre higher because it really needs to be.

Paul: I'm curious to know a little bit with regards to engaging people with cognitive disabilities, because I know aphasia in stroke circles is a big thing where people are in there, but they just can't communicate.

I'm assuming you would be very heavily engaging with caregivers and family members, and I guess that's how your story started, right? As a family member, you took the bull by the horns, as we say down here and and represented. Is that a fair statement?

Matt: It is a fair statement. And I think it's incredibly important to have the voice of caregivers, whether they're family members, whether they're clinicians, whether they're teachers, whoever, whomever it might be, tell them directly involved. And so we did a lot of interviews with caregivers, specifically family members. And one other piece is having the voices of people with various cognitive disabilities as well.

To the extent that they can participate and provide their voice, I think very often they're excluded and kind of receiving this information second or even third hand. And for those who are able to speak up and have something to directly contribute because we are trying to develop solutions that directly affect their care, they should be involved. And we found that towards the beginning we thought that it might not be possible to give them such a voice or give them as big of a voice as we were hoping, and we tried anyway.

And it's amazing to see that even non-verbal folks, those with a significant aphasia, those with dementia, they still have a ton of feedback that they hope gets considered. And it's amazing to be able to collect all of that, especially when you're designing something that is meant to be used directly by them in addition to their family members.

Paul: And I can only imagine, and I'm speaking for myself on this, that must be incredibly empowering too, because one of those things and fortunately I've never been touched by aphasia comprehensively, but when you have these injuries, it really does strip your identity away and you you feel disempowered.

Having someone come to you and directly ask you the question is massive. Do you guys get that feedback from the people that you talk to as well?

Matt: It's funny. It's empowering, I think, not just for the patient and student populations that we work with, but I feel that it's personally empowering to in a slightly selfish way. It's amazing to get that feedback firsthand from a person as opposed to getting it potentially translated first, not literally translating, but getting translated first by someone who works directly with them and then getting their version of that passed over to us.

Which don't get me wrong, that is not any sort of negative feedback whatsoever, but it's even better when it comes directly from the person for situations where that's available. And I love to say that we're able to do that.

Paul: Okay, now we're going to get into the tech weeds. Now we're going to get seriously nerdy. A question for both of you guys.

How do you guys see the role of artificial intelligence and machine learning in developing technologies for people, particularly with cognitive disabilities?

And I know Marius in particular, this is very near and dear to your heart.

Marius: Yeah, for sure. I'm going to maybe sound a little fluffy when I say this, but the way A.I. in itself, looking at taking into consideration assistive technology and anything in itself is going to be an evolutionary for humankind, basically.

And if you see the progress it's going right now, there are things on the horizon that are going to really, really make big steps and turn that into assistive technology and helping the underserved in the society, IDD, autism, stroke survivors, whatever it might be. There are so many opportunities. And I think it's so important for us to not drop the ball because because of how big of a leap things are going to be for the A.I. evolution if we leave somebody behind.

The difference between the neurotypical audience out there and people with disabilities are going to be even bigger.

Paul: I was going to say, we're already playing catch up. Right?

Marius: Exactly, exactly. And I think this is our opportunity to actually even the playing field a little. And I think it's a responsibility of us tech innovators to actually focus on. But we also need the support of the community.

We need support of governments. We need the support of investors just to push this forward. But a famous quote of mine now is people are spending more time and resources on innovation for people that are taking pictures of them, not just before they eat it, but rather than the underserved in society. And it's like, I really hope we're not ending up there with A.I. as well, because this is a really big opportunity and we in particular, we are looking into a lot of exciting things, just onboarded A.I. into our team in Pletly earlier this week and we are going full steam ahead.

And I think it's also important for the narrative of A.I.. Some people look at it like the new Skynet and before you know it, Terminator is going to come back. I'm not so sure. Be sceptical. That's just healthy. But at the end of the day, if you look back, if history has told us something, it's that innovation and technology are always ending up being to the benefit of humankind.

I think we as a collective are making sure of that as humans and we need to be able to showcase that you can use A.I. for good, not only for new filters and new whatever it might be on TikTok.

Matt: I completely agree with Marius and from my side, and I'm curious how you both see this from each of your respective countries. I'm encouraged, actually.

I think over the past couple of years there's been an increased emphasis and larger corporate responsibility for improving accessibility, largely the software that we use, but also physical spaces that people with disabilities enter. And I am heartened to see that. I don't think it's merely me more paying attention, although I probably think to a certain extent it is.

I think that people's eyes are finally widening and they're realising just how stark the difference is. The potential that people who are neurotypical have compared to our neurodiverse and our people with physical cognitive disabilities, where they stand, which is already several layers behind.

And as you were saying, Paul, we're already playing catch up. We can't continue to increase this level of difference between the populations with the use of A.I. benefiting one population and not the other.

I think a few specific examples come to mind. Most recently, I was at a conference a couple of months ago where a non-speaking autistic woman presented, and it was fascinating to see how on behalf of Apple, she was able to make use of a variety of different assistive technology devices to carry a full audience through her 45 minute presentation and then speak to us for Q&A afterwards where when she was growing up, that literally was not possible because that technology did not exist.

And now as of recent years, not only can folks like her benefit from that, but we can at scale, with all of the built in tech that's in our iPhones, the tech that’s in our laptops, the tech that's available in all of the devices, all of the software, all of the companies that we interact with every day. And because they're paving the way for us to all do better, I think it also empowers us startups and other companies looking to enter the scene to do better as well and to do better faster.

Paul: Yeah, and I can certainly relate from, again, a user and lived experience perspective. I mean, I've got a few little volunteer projects on the go at the moment that I try to keep myself busy with, and some of those things tax me cognitively. I mean, the things that I used to do out of reflex are things that I used to do 4 million times a day.

Now take me vast amounts of mental energy. And it's a difference between crafting a rambling email to Marius, or.. which I've done on occasion, or crafting a succinct email to yourself, Matt and Bard and Chat GPT have not only saved me mental energy, but saved you crucial time in just sitting down and reading and thinking, “What is this guy going on about?”

It is, you know I make light of it, but to be honest with you, it has enabled me to do more with less. And I think that's the same with anybody. And I think the people that feel that the most other people in the disability situations, I mean it's great to 10 X your productivity if you know, you're a, you know, a software coder or something on those sorts of lines and I'm not saying that stuff isn't important, but it's the difference between, yeah, we can be a bit more productive, log a few more billable hours for folks out there that are on the tools or for someone like me to live a life that's not quite so frustrating.

I guess from a selfish perspective, that means more to me.

Marius: Yeah. And if you think about, as I spoke about earlier, about that heavy workload that our caregivers, direct support workers, etc. are under today, and if we're just able to save them an hour or two a day with more efficient ways to take care of people with IDD, autism, stroke, whatever.

Yeah, it's huge. It's huge. Huge. For them. It frees time for them to actually focus on the taking care part, not all the other things, but also financially for many institutions and governments we're all talking about like when I was in high school, people were warning about the elderly wave because they know that the elderly wave was coming. And they were like, “Yeah, we need to do something about it…. later.”

And now we're here and everybody is like, “Oh my God, What happened?”

It’s like, “Well, the wave arrived” and they have never taken appropriate steps to make processes more efficient, technology more implemented. And you would be shocked, Paul, if you knew how many big, big companies we are talking hundreds of million dollar companies per year in budget that are still on paper and of course, double impact, efficiency, quality of care, everything inside the organisation.

I was kind of joking when I said 1983 but kind of not, not because that would be something you would expect in 1983. In the nineties, yeah, you would expect the migration over to more digital to happen. In 2000s, you would see that it be more matured and now it should be like super efficient and everything. But no.

Paul: So what do you guys think are some of maybe some of the ethical considerations because people are talking about this stuff, people are thinking about this stuff, you know, A.I. is the thing.

And you're right, there is the big bad out there. And people are saying, you know, there's going to be a man coming to my door asking me if Sarah Connor is here, you know, there's genuine fear out there.

So how do we make sure that these new technologies, and particularly for those that are most vulnerable and, you know, cognitive disabilities and others, you know, what are the ethical considerations that need to be taken into account when developing these new technologies?

Marius: Well to be able to make efficient A.I. you need data. And I think the most important thing is to be aware and conscious of the data you’re collecting from such a vulnerable group that we are serving and being transparent about it. That is super important. And making sure we are using that data to create A.I. models that is actually benefiting them and giving them a positive thing.

You could quickly go south if you don't make sure you are always aware of the A.I. discriminating, because if their model is trained on being efficient, then that will end up giving us unethical advice, for instance.

Because sometimes the most efficient thing to do in life is unethical. And so it's kind of be aware of those kind of things is super important. One of the first tasks I gave my A.I. team was actually to do an ethical evaluation of using an A.I. machine in this space and to make sure they are understanding the importance of having an ethical approach when developing A.I.

Matt: I think there are a few important pieces, Marius, that you touched on there. The first is the ethical use of the collection of data of people with disabilities and the way that it gets folded into these A.I. models, ensuring that they're being processed for good and not turned into marketing and sales stunts and making sure that the data that's being collected, especially the more sensitive P.H.I, as we refer to it here in the States for HIPA, is quoted in accordance with really robust privacy policies.

And it's not just out for the world to see. I think that's the first piece. And I think the second is also making sure that relevant, accurate information is being disseminated to very vulnerable populations, whether it's these folks themselves who have disabilities or it's their family members, or if those who are caring for them in a professional capacity, things like no, dementia is not a disease.

Unfortunately, at least at this moment in time that you can reverse. And no, autism is not a disability that you can cure for better or for worse. These are the types of diagnoses that folks are being given and make sure that you're rightly equipped with the correct knowledge so that you can take the best plan of action. But if we're starting in in a sense of where people are misinformed because of the way that they're being fed information through A.I. or otherwise, then could be a recipe for disaster.

I want to think optimistically about this, and I hope that doesn't ever reach that point. But I think there's a lot of work on a research front that can be done to make sure that the right information in these models gets processed so that they reach the right audiences and correct actions being taken as a result.

Paul: Yeah, I was just going to say, is it something along the lines of we need to regulate in ways that are smart, the kind of questions we ask A.I. Because you ask it stuff and it'll tell you based on the data that's captured.

And then I guess that opens a whole can of worms of who does the regulating, because there's lots of talk in the media, depending on which side of politics that you fall on. And I'm not going to have a political discussion, but there is a real distrust out there of in some sections of society, of government and regulatory bodies and things like that.

And wow, how do we climb that hill?

Marius: Well, how fast are regulation in general being made? It takes months, years. My concern is waiting for some government instances to actually start regulating this. That's totally wrong. We as a tech community need to have like an unspoken truth. It's like we need to at least do ethical evaluation, be conscious about things.

And of course we need government regulations down the line, but we can't wait for that.

Paul: No

Marius: And when they are done regulating, coming up with some suggestion for regulation, the tech innovation space and our space will be long gone, that it would be a completely different and they have to change everything. So you can't just say, yeah, we're going to regulate this.

We're talking about a train without a conductor in full speed and you can't just expect to like stop it with regulation. You need people on board to jump on and take the wheel, so to speak, and stare it in the right direction. I think that's their approach we need to have.

Paul: I think that's a great analogy, actually. We don't need someone in the break department. We need someone that we trust at the steering wheel.

Marius: Yeah

Paul: Because the train's already left.

Marius: Yeah.

Mark: I think it's also important to point out here in the States, our country is trying to lead the way with A.I. regulation, and yet at the same time, I think we have already fallen behind. It's interesting to see what governments of the US senate are putting out through the research of those that they are trying to bring into their court and have on their side, so to speak, and how that's informing government policy, because our lawmakers here alone do not know enough about A.I.

The majority of Americans and the majority of the world do not does not know enough about A.I. in order to make the proper decision. So I think it's a communal effort, including the experts, including the researchers, including the engineers, who are putting these models together to, to a certain extent inform regulation. But at the same time, by the time that all comes to fruition, we're going to be several steps behind and GPT 5 and 6 will be out and all of the open source LLMs will be out and the cat’s out of the bag.

So I think the responsibility and the onus falls on a lot of us not just waiting for regulation.

Paul: So to come back down to accessibility for these sorts of technologies, because you guys both run companies, there's big money that needs to be spent in these spaces because these tools just don't write themselves and don't invent themselves.

How do we make these solutions more available and more affordable to people that need them? How do we approach that?

Marius: I think as a company we are social impact companies. So we also try to focus on making sure we don't leave anybody behind. And that's why we're giving away the fam application, as is now the core functionality for care, coordination and communication, for free.

It's not easy to be a social impact company. That doesn't mean that we don't care about profit or we want to think big in terms of finance and revenue and everything, we do. We have big ambitions on that, but we also have focus on the social impact we're doing and in the impact space today in the startup world, it's I think the social impact part of it has been overshadowed by the green impact.

And I think there's too many companies trying to be like the new innovative green tech that is going to save us all from global warming and people are just throwing money at it and then they’re calling themselves impact ambassadors because they are, here in Norway, they got like so many reimbursements from the government, etc.

And I think also in the US, you know, Musk built Tesla on credits during the program that the US government had. But if we could have something similar for social impact, that would be nice to actually build and create products that is helping the social issues and the society and having government give us some credits instead of giving them to Elon all the time.

That would be one way to solve it. So yeah, and I'm also going to see some of the products in the software products like the AAC’s that are communication applications that are available. I'm not going to name drop anybody, but when I see that they're costing two, three, four hundred dollars, and to be honest, some of them, I'm sure Mark and I can put together over two weeks time at most, and that is just insulting.

It doesn't take into account the problems of it, the economical problems that care givers have. Often at least in the space of IDD and autism, there is one full time caregiver in a home with some minimal government assistance in terms of finances, and the other is going to work full time, even more to make ends meet.

And they are then they're reliant on insurance companies or have no way of the government approving, for instance, one specific application or in the process that takes like six months to a year to get through. And this is so inefficient and so unnecessary.

And I think having a model of more in line with the software as a service, accommodable prices, we have committed that when and if we create a premium product for families, ok we're never going to cost more than the subscription that they pay for for Spotify. And if you can pay for music, you can also pay for care, and that is our approach. But I think is the social impact aspect and also be have a little respect for the group that are trying to serve, but not to charge two trillion dollars for something that is… yeah.

Paul: And outside of just not being rubbish to people in really vulnerable situations, just doing the right thing as a human outside of that, which should be an absolute given. You know, one of the smartest people, you know, that was on the face of the planet had a fairly major disability with the late Stephen Hawking. How many Stephen Hawking's is society missing out on because there's not these solutions out there to allow these incredible people that have disability to contribute to our society?

I mean, that just blows my mind.

Marius: Especially in the autism space.

Paul: Yeah, I mean, particularly in the autism space. But how many missed opportunities are we are we having I mean, it's a question we don't have the answer to, but it's something that somebody somewhere should really start considering.

Marius: Yeah. People see a lot of these groups in society as a cost instead of looking up to them as a resource.

Paul: Absolutely

Marius: Untapped. And that goes for stroke survivors, that goes for people with autism. And IDD, and I'm really proud of one company here in Norway called “Helt Med”, which means completely included or completely with. Which are really focusing on creating job opportunities for for people with disabilities. I'm not talking about like, like job opportunities creating out of sympathy, more of like actual jobs like you and me would have.

And I think that is also a really important work to do. And the resources that can be for society at that level. But also, as I said, how many Stephen Hawkins are we missing? Because of maybe some selected mute autistic person with so much to give if they were just given the proper tools and opportunities and maybe the proper care in the early stages of their life?

Early intervention is super important, we are for sure missing a lot of geniuses on the super resources and the society.

Mark: I think part of the way that can be better addressed and mitigated also is giving society a better understanding for the definition of what disability is. I mean, folks in my family who literally have a disability do their diagnosis, by definition, don't even realise they have one.

And so I think if the people who are impacted don't even realise they fall within the population, then how are the people who don't fall in that population get to understand what that population even entails? I think some of those, well-known people, Elon Musk, like him or not, Marius.

Marius: I like him.

Mark: He shared a few years ago he was diagnosed with, formerly known as Aspergers, now on the autism spectrum, ASD.

Steve Jobs, we spoke about him at the beginning of this interview. He was dyslexic and I think that there's a whole band and spectrum of disabilities, of course, some more severe than others. But for people to realise they fall within the disability community and can be empowered by it and empower others that are in the same population as them is a huge step in the right direction.

And so I'm really glad to keep seeing progress made on that. I think we're making slow but steady progress and I hope that our communal society keeps going in that direction.

Marius: Yeah and me, myself. I have ADHD and or IDD or however you want to define it. And then so many opportunities I feel have been robbed from me because of how this was perceived.

When I was young, I didn't know I had that I had ADHD when I was young. But I couldn't function of writing with a pen because I was like super gripping it and I couldn't have the attention span to write more than a half a page. And I was told like, you have to learn to write with a hand. You're never going to function in society without learning to write manually with your hand, or you're never going to have access to Internet wherever you go, Marius. You're never going to have access to a calculator, Marius.

Paul: That old Chestnut

Marius: Yeah, Yeah. And look where we are now. As soon as things changed and I was able to actually use a computer and a laptop to give my reports and have the exams test, etc. I went from like consider it like a D student to like a B-A student pretty immediately.

Paul: Well played.

Marius: Yeah, well, thank you. But back in the days I think the generation before me, again then how many really smart, competent people did not have the opportunity to then get that laptop and get the environment they needed to actually function in the way that they needed?

And one other thing is like the creativity, the way people with IDD see things or the lack of risk aversion is, I wouldn't start Pletly I think, if I was neurotypical that’s for sure.

And if you see, to Matt’s point, Elon Musk, Steve Jobs, Richard Branson, they are not the typical Ivy League educated person. They have this disability that they have been able to focus into a superpower and just go with it. And I think we need to enable more of the superpower and less of the disability aspects of ADD, autism, whatever it might be.

Paul: So how do we encourage those people with disabilities, cognitive or otherwise, to pursue those careers in technology? How do we give them the push to help them realise their potential?

Matt: I think the push driven largely by the Covid pandemic to allow hybrid and remote work environments, is a huge win for the narrative of our population and those with disability.

It literally allows them to work in an area that's most comfortable for them and it allows them to get various accommodations and various schedule needs in place to avoid the typical 9 to 5 workday requiring a commute and sitting in an office all day. And for folks on my team, I know that's a huge win for them. They expect or require a remote environment because that's the way they work best, especially given their disability or diagnosis.

And it's amazing to think that something that has become the norm thanks to a pandemic, is now something that benefits them so much as I think it benefits the entire population of those who enjoy or are better off or working remotely or in a hybrid environment. If you asked this question three or four years ago, I think my answer would probably be different.

But it's amazing how such a large global shift that got necessitated by a completely unrelated reason allowed a whole population of people to be so benefited by it. And I'm glad for that. And I think that it requires us to think really big like we had to in a pandemic where it's like, okay, we're not going to not work for three years.

We need to figure something else out. Push came to shove, everyone learned how to work remotely, and for a portion of the population that found themselves in a better situation than they did prior. Amazing! And for those who are entering the workforce for the first time that are going into software engineering, going into product design, going into, whatever it might be, where they can take a disability, turn it into a superpower, to use Marius’ word, through the remote environment that they've been afforded is a huge win.

And so I think that's one way of finding an environment that works best for you and align into a company that can empower you to be in that kind of spot. Not every company, unfortunately, will take that on, but I think more have than they did a few years ago. And people are better off for it.

Marius: Yeah, I think that's spot on. A great example. I think there's accommodation at least the thing is like you can't just have a workplace work environment set up for neurotypical. And to be honest, open office is not for neurotypical people either.

Paul: No

Marius: It’s the dumbest idea ever but especially if you are prone to more anxiety, social anxiety and those kind of things and putting yourself inside a middle of a lot of people walking around talking, coming up to you and trying to speak with you.

If you're insecure about human interactions and then try to perform, is like having a marathon runner dragging a log of wood after themselves, it’s like there's never going to be a good performance. But in their own environment, with a good follow up and support network, my experience is that they are able to outperform so many of the quote unquote neurotypical people.

Paul: And I'd just like to say as an ex-project manager, and now that I understand a lot more about people that aren't neurotypical, I apologise to every developer I’ve ever nagged over the course of my career, I am so sorry. And I don't say that with irony. I legitimately am.

Do you guys have any inspiring stories that you've come across for people with cognitive disabilities or disabilities using technology to overcome the challenges and achieve their goals?

Matt: Two examples of the same person come to mind. One is involving technology and one isn’t. My uncle, who’s on my dad's side, he is severely autistic. He wasn't properly diagnosed when he was young and got kind of put to the side all throughout elementary and middle school. I'm not even sure if he made it to the point where he can succeed through a high school setting just based on how we grew up 40 years ago.

Going through school, he lived with my grandpa all of his life, and my grandpa sadly passed a little over a year ago. But the silver lining in that is he then got put into a group assisted living centre with people who think and act and work just like him. And we thought that this would be a real change of pace for someone who needed the same schedule, the same routine over and over again.

And it would be a really hard change after 55 years of the same monotony and comfort levels that he had of his routine. And he's thriving. He absolutely loves it. He's with people who understand him. He's empowered to go to work. He's excited for it. He helps with meals. He hangs out with friends that are his now, and he's just having the greatest old time.

If only we knew sooner, we would have done something like this to really put him in the position to just succeed way more than he was in years past.

A related story is when we first bringing our software that offers different personalised lessons and data collection for adults and students with various disabilities. I brought it to my grandpa’s house to try it out with him one day, and I wasn't sure of his level of reading comprehension or short-term recall.

And so I was like, “this is going to be a little bit of an experiment. Let's see where this goes.”

And so I opened up the laptop to him. He started reading a story, and then immediately after the story disappeared and the reading comprehension questions popped up. And I was not necessarily convinced that he could understand what was being read to him or read the words on the screen of the question.

And next thing you know, he's answering all of these questions with almost perfect accuracy. And it was stunning because I think we never put him in that kind of situation before, where we're asking him questions about new information through a story he’d just read and he was getting it right within seconds and granted that maybe felt a little bit like school for him.

But it was so cool to see how that piece of technology put in front of him showed me and showed others who were in the room what he's capable of. And I think people are capable of a whole lot more than what they're written off as being able to do or not do. And that was one little silver lining, also of understanding exactly what he was capable of if given the chance.

Paul: Fantastic. What about yourself, Marius. Do you have any?

Marius: Well, in terms of user technology, I think our daughter is perfect example. She was told or we were told by a really unprepared and not the best speech therapist, that she was never going to be able to speak, so there was no reason to waste our time on that.

And it was better to just only focus on sign language, which infuriated myself and my wife, of course, and using technology both as a tool but also as an incentive for her, made it possible for her to go from like five words to 25 maybe. And of course, she is not able to speak in the same manner that you and I are.

But if the baseline is five and you go up to 25, that's the same as me starting to learn four other languages in terms of how much you're able to progress. And my wife had never actually heard her daughter say, “Mum”, when I’d met them.

Paul: Wow.

Marius: But at the age of eight, we were able to string together slowly but surely the use of the tools that we had on the iPad.

An incentive to string together the “ma” word with another “ma” word. And just the first had the M and A, and then the M and A again and put it together and I remember vividly the day we were in Sweden at the time, my wife and our daughter, and we actually got it on video the first time she ever said “Mum”.

That was of course, a big, big thing. But also in general, I was speaking with so many families that tells me the same kind of story, which like the expert, told us that he was never going to function, he was never going to really learn to read and write. And now my son is finishing college and he's actually a founder of a small local company.

Paul: Wow.

Marius: Those kind of stories, I hear so many of them.

Matt: That’s amazing. I can't recall if I've shared this with either of you prior, but I'm reminded through your story Marius, of a story of my own, that my parents faced when I was younger. I didn't speak until I was three years old. Like, not a word came out of me.

So we tease now that I'm making up for lost time. Like non-stop talking. But I had very delayed speech and I had speech through elementary school. And I think it's just another great example, very relevant to our conversation here. Don't give up on people. And it's amazing that if you hold them to that higher standard and you coach them and give them the services that they need along the way, what people are capable of.

You're seeing it with your daughter. My parents saw it in me in a non-selfish way. Just reflecting on I think, you know, you relied on just the experts. The experts lead you down a dismal path to dismal outcome. But when everyone raises the bar, it's very cool to see what the outcomes are. And I think that's just a sentiment that I'm glad all three of us are following.

And I really hope others begin to as well, if they are not already.

Paul: Absolutely.

Marius: It goes back to perceived potential. I think there's a lack of perceived potential in this space, both for stroke survivors and ADHD and autism space. I think. I think you shouldn't just consider stroke survivors as being done and done for just because you had the stroke.

There's so much more living in them and I think you Paul are a living example of that doing this podcast, for instance, and all the activity you do.

Paul: Thank you. I appreciate it, thank you.

Marius: So we have an inspirational story here as well.

Matt: Exactly.

Paul: Oh wow, that's.. I was actually going to finish on that question, but that seems somehow a little bit self-serving after what Marius said.

But do you guys have any like small nuggets of wisdom that you'd like to leave a listener with, you know, any helpful hacks, any any just, you know, those little hints that you've come across in the course of your journeys as CEOs of startups in this space, or even just as caregivers for for those with disabilities. Do you guys have any little nuggets of wisdom you like to leave?

Matt: I think I would say the piece of wisdom that immediately comes to mind, it's twofold, and one is related to the other. But on a business and running a startup topic, the advice that I got years ago when I was beginning is just go for it. Like perfect is the enemy of good, perfect is the enemy of getting things done.

And so instead of waiting for this perfect moment in time that you will never, ever reach, make sure that you get things started as soon as you feel the conviction to be able to, as soon as you feel confident, comfortable, they have the resources behind you. And don't let that be a hindrance to your ability to kick start a company.

I think if I knew what I knew now, I would not have started this company. I feel very similar to Marius. It varies, but these are perceived disabilities granted to me. I think that naivete is kind of nice and then going on that conviction instead of waiting for like this perfect moment in time to come has been really helpful. That's my advice of getting started.

Marius: And I agree with you Matt. I think not knowing how it is to actually start a company, it's a strength sometimes. But I think of one other aspects, early on I was really frustrated about like, why don't people get this? What do I have to like, explain this to you guys in if was investors or whatever it might be.

And I actually think back to the quote of Nietzsche, like those of us seen dancing was called insane by those who are unable to hear the music. And I just think it's just important to just keep dancing and ignore the people who think you're crazy and just keep dancing as much as you can. And hopefully people will join in the dance.

I think I'm dancing. I think Matt dancing, and I think my wisdom would be keep dancing.

Paul: I think that's a great place to end. Thank you so much for your time today, guys. It's very late for you, Marius, so I do appreciate your time on the call. It's been a brilliant chat and I think people are going to be very excited to hear it when it’s published.

So, thank you so much.

Marius: Thank you.

Matt: Thank you Paul.