A long and windy journey to finding the best way to provided cognitive performance feedback.

Ux • Visual Design

This isn’t a case study where we found the perfect solution or redefine the way people use our product. Instead it’s a refection of a trial and error process in which we took a lot of wrong terms, learned from our mistakes and came up with a solution that was center intuitive.


BrainHQ is a computer based cognitive remediation therapy that has been shown to significantly improve issues stemming from neurological conditions. 120+ published peer reviewed studies show efficacy in areas such as dementia, schizophrenia, ADHD, driving risk, chemo brain, and hemineglect to name a few. In addition to a consumer facing product we currently have partners that range from pro football teams to auto and health insures.


Cognitive training is hard, requires time and the tasks don’t have much face validity resulting in poor conversion and retention. The obvious solution is to provide feedback on improvement, but being a new category there isn’t a language to discuss the areas of improvement and no benchmarks to measure success against.


The units of improvement aren’t easy to understand. Things like emphasis level, speech processing level or milliseconds take effort to explain. To make things worse a small change of 100 ms or a fraction of an item in a span task can have a profound impact on cognition but to someone spending hours training it dons’t seem very significant.


We initially looked towards the game industry for ideas to solve these problems. Traditional approaches like leaderboards, comparisons to age normed data, or challenging friends to beat a score all seemed like fertile grounds for exploration. In the end this didn’t work out for some obvious reasons. Most people, especially older people have been told their whole lives their condition is irreversible. One person I interviewed summed I up like this.

You make a list of all the things you love to do and every year you have to cross one or two items off the list. After a while you realize there’s nothing on the list.

You make a list of all the things you love to do and every year you have to cross one or two items off the list. After a while you realize there’s nothing on the list.

Coming form this mind set it’s easy to see why people feel vulnerable sharing their scores with friends or even feel nervous seeing how they compare to others.


We tried conceptualizing improvement in a real world context. For example if you improved your visual processing by 100 ms and you’re driving a car on the freeway you’ve essentially improved your breaking distance by 8.8 feet. This approach not only made it easy for people to see how small changes impact their life but it also gave people a language to tell their friends about the program. While this approach worked well from a customer standpoint, it made the researches nervous because there’s a big difference between recognizing a situation and acting on it.


At this point it also became obvious that the question most people wanted answered was

Am I all right? Should I see a doctor about my memory? Should I stop driving my car? Can I go back to work?

For many people the feedback we were providing was a proxy for the real real world questions they wanted answered too. They didn’t want higher scores on a test, they wanted their life back.


Ultimately the goal of providing performance feedback was to connect the value proposition of the product to the daily experience. Each step forward in a performance measures was one step closer to realizing the promise of the product. Around this time we started looking at the results of a large net promotor survey and we realized the people who recommended our product most highly where people who felt a direct benefit from it. We also started to realize that many people felt a benefit 5 - 10 hours into the program.

Given this new mindset we started focusing on what it would take to get a person though 5 hours of training. We worked on making the experience feel rewarding by obscuring the performance information an emphasizing the persons effort. We reassured them they were doing the right thing and based on their progress we suggested areas in their life where they should start seeing change. We also focused on setting up tools to help them comply with the training with weekly emails with their progress, weekly goals, streaks and reminders.