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A Biopsychosocial Survey: A Biopsychosocial Survey: Older Adults and Computer Technology Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

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Page 1: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

A Biopsychosocial Survey: A Biopsychosocial Survey: Older Adults and Computer TechnologyOlder Adults and Computer Technology

James Brown

EdPsyc 747

Human Development- Adult

Dr. Deborah Renard

Summer, 2006

Learn More!

Page 2: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Technology…

• “Broadly defined as the application of scientific knowledge (including tools, techniques, products, processes, and methods) to practical tasks …”(U.S. National Library of Medicine, 2004, as cited by Czaja et al., 2005)

• “Ubiquitous in most societal contexts with the United States and most other industrialized countries” (Czaja et al., 2005)

Page 3: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

• Coined by Dr. Simon Moors during a BBC television broadcast to describe the socioeconomic gap between developing and developed countries… (Wikipedia, 2006)

• In the U.S. it represents the gap between those who use computers and those who don’t (Morrell, Mayhorn, & Bennett, 2002)

The “Digital Divide”

Page 4: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Oldest Adults Most Under-Represented

• 25% of older Americans over 65 years old are using the Internet vs. 36% of those age 50-64, and 56% of persons age 30-49 years old.(Pew Internet and American Life Project, 2005)

• Seniors also use e-mail less, perform fewer Internet searches using search engines, and report lower self-confidence in their ability to use computers than younger adults. (AARP, 2002)

Page 5: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Adults Over Age 85 Growing Rapidly

• Along with the well-publicized rise of the Baby Boomers (71 million set to retire soon), older adult segments are growing too

• Those age 85 and older are now the fastest growing segment of the U.S. Population and will number 27 million by 2050; as many as 1 million of these will be over 100 years old (Beisgen & Kraitchman, 2003)

Page 6: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

The Over 85 Year-old Cohort

• These elders are experiencing health-related problems, are immersed in the aging process, and are fiercely self-reliant

• They have survived world wars and economic deprivation

• They prize doing things on their own and maintaining autonomy

• (Chaffin & Harlow, 2005)

Page 7: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Why Learn New Technology?

• “Not being able to use technology such as computers puts older adults at a disadvantage in terms of their ability to live and function independently and successfully perform everyday tasks.”(Czaja, Charness, Hertzog, Nair, Rogers, & Sharit, 2006)

• “Personhood and its potential are continuously unfolding and technology can become a major source of its realization.” (Chaffin & Harlow, 2005)

Page 8: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Seniors Want to Learn Computer Skills

• Substantial evidence exists that seniors want to learn computer technology, that they seek computer training to do so, and that they can be very successful at it, if the program adjusts to accommodate the biopychosocial aspects of the aging process (e.g., see articles in AARP, SeniorNet, ThirdAge; among many studies are Jones & Bayen, 1998; Morrell, 2002 ;Mayhorn et al., 2004)

Page 9: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Ageism—The Old View

• Ageism is defined as “a systematic stereotyping and pervasive view of older persons” (Palmore, 2001)

• Remains a predominant view of American Society (Purdie & Boulton-Lewis, 2003)

• But this view is beginning to change …

Page 10: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Growing Old—The New View

• Aging is now seen in Western cultures as “an essential and natural part of the cycle of life—a period in which people continue to learn and pass on knowledge to others” (Tomporowski, 2003)

• Aging means a “continual process of problem solving and discovery of knowledge derived from living” (Chaffin

& Harlow, 2005) • Aging involves an active lifestyle and contributions to

family and society throughout life (Purdie & Boulton-Lewis, 2003)

Page 11: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

An Active and Healthy Older Adult Now the Norm?

• World Health Organization (WHO) defines old age health as “a complete mental, physical, and social well-being, not merely the absence of disease or infirmity” (Chaffin & Harlow, 2005)

• However, this does not mean that older adults are not vulnerable; rather, there is not the inevitability of infirmity or dysfunction at any particular pre-set and socially-determined age

Page 12: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Benefits of Learning New Technology (Computer)

• Increases autonomy, self-efficacy, and control over the environment (McConatha,2002)

• Addresses social isolation that comes with retirement, loss of spouse, relatives and children living far away, loss of friends, and being homebound (a few examples) (McConatha,2002; Chaffin & Harlow, 2005)

Page 13: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Barriers to Learning Computer Technology for Elderly

• Technology gap– their careers ended before the advent of computers (Morris, 1988)

• Attitudes and Ageism—they fear the technology, do not understand computers, and don’t want to advertise their lack of knowledge (Bowe, 1998)

• Older adults’ needs and wants not recognized or utilized in the design of software, hardware, or training programs

Page 14: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Relevance/What’s the Need?

Self- Concept/ Possible Self

Fear /Not In Comfort Zone

Psychosocial Categories

Stanley (2003)

Page 15: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

“Too OldTo Learn”

Avoidcomputers

“I’llBreakThe

Computer”

ComputersAren’t

Relevant

Avoid Technology

centers

NegativeRemarks

AboutComputers

ExtremeCautionLearning

Computer skills

Psychosocial Reasons for

Avoiding Computer Technology

Namlu (2003) lists typical computer anxiety behaviors …

Page 16: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

EnvironmentalEnvironmentalBiologicalBiological

PsychosocialPsychosocial

The Right Culture for Teaching and Learning with the Elderly

Adapted from Whitbourne (2005), p. 2

Page 17: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

CultureCultureLocationLocation

RelevanceRelevance

A strategy for “social inclusion.” Warschauer (2002)

Norris & Conceição (2004);Stanley (2003)

Use the communication technology centers (CTCs)

Be sensitive topsychosocialdimensions ofcultural needs.

Make the learningand technologyrelevant.

Page 18: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

How Do Older Adults Learn?

• Chaffin and Harlow (2005) Model of Cognitive Learning

Page 19: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Chaffin-Harlow Model of Cognitive Learning

Art, Culture &

Technology

Create New Ideas

Test

Find Faults

Relate to World

Determine Type of

Education

Identify Barriers

to Learning

Teach

Learn

Enlarge Sense of

Self

Meet the Challenge

Initiate Cognitive Learning

(Chaffin & Harlow, 2005)

Page 20: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Art Culture Technology

Integrating New Perspectives With Old

Art is a bridge across the

generations; sharing one’s

songs, stories, and

music is a way to connect.

No longer bound by four

walls, older adults can

move from a culture of social isolation to one

of communi-cation.

The digital divide: Knowing how to use computers makes a difference in older adult lives.

Wright, 2000; Morrell et al., 2002 Chaffin & Harlow, 2005;

Page 21: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

SurvivalSurvival AdjustmentAdjustment DiscoveryDiscovery

Three Levels of Learning

Tasks make no sense and are beyond grasp. Much emotional and instructional support needed.

Learner gains in confidence and can follow most directions. Still looking for the one right way to do the task.

Skill and comfortlevel approachmastery. Learners now own the process and explore to meet their own needs.

Page 22: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Type ILimited type of

responsesRequired; “Yes,”Press Enter key;

Hence, easyTo use for training

But is a passiveActivity for

Learner

Two types of educational Applications for

computers

Maddux, Johnson, & Willis, 1997

Type IIRequires

Considerable skillAnd active userInvolvement to

Achieve creativeTasks; drawings,Letters, cards,

Emails, Internet.

Page 23: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Seating

Cognitive changes

Socialisolation

Health

Lighting Operating Computer

Finding “Faults”

Rowe, 1995; Chaffin & Harlow, 2005

Page 24: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Low-glaremonitors

Make materialsEasy to read Set up

Environment

IdentifyProblems

Roller ballIn place of

Mouse

Use metaphors to explain

Fixing “Faults”

Rowe, 1995; Chaffin & Harlow, 2005

Page 25: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Relate Ideas to Real World

• Many older adults are motivated to learn computer skills

• They want to remain independent as long as possible

• Connect the computer to everyday life• Find out what they want to do

Beisgen & Kraitchman, 2003

Page 26: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Plan forsuccess

Relate new to old experiences

Stepwise

Text with

Pictures

Provide smallAmounts ofinformationPractice drills

At slowerpace

ProvidePersonalattention

Use Appropriate Type of Educational Methods

Rowe, 1995; Chaffin & Harlow, 2005

Page 27: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

• Definition: “A biopsychological potential to process specific forms of information”

• Using this inclusive definition of intelligence, the computer can become a medium of expression

• Intelligence, then, is a collection of potentials, values, and opportunities made by individuals

Gardner’s (2004) Eight Types of Intelligence

Page 28: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

InterpersonalInterpersonal

NaturalisticNaturalistic

VerbalVerbal

IntrapersonalIntrapersonal

SpatialSpatial

TitleTitle

ViewingIntelligence

InDiverseWays

Bodily-kinesthetic

Bodily-kinesthetic Logical-

mathematical

Logical-mathematical

MusicalMusical

Gardner’s (2004) Eight Types of Intelligence

Page 29: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Motivation

BiologicalArchitectur

e

Skills

Environment

Overcoming Barriers to Learning

Ford’s (cited by Emmons, 1999) four

factors

Page 30: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

A Supportive Environment

Skills

Biological Architecture

Conclusion

11

22

33

44 Motivation

Factors for Success

Page 31: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Supportive Environment

• Myth: Older people cannot learn as well as younger learners– they do, but need more time

• Programs can also be developed in the homes and residences of frail older adults who otherwise might not be able to attend a class; for example, Senior Cyber Net (SCN)

Chaffin & Harlow, 2005 [many references]

Page 32: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

SlowerSpeed;Memory

Cognitive Problems

ImpairedVision

DepressionHomebound

Isolated

AttitudesBad or

Confused

WheelchairsWalkersOxygen

StrokeDiabetes

HeartProblems

Learn to Deal With The Real Barriers

Teachers working with older adults encounter many barriers to learning…

Purdie & Boulton-Lewis, 2003

Page 33: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

FrequentBreaks

Use Computer’s

Toolbox

Lots ofPraise

IdentifyFavoriteTopics

FormFocus

Groups

Large PrintMonitors

SeatsKeyboards

UseParallelsTo EaseLearning

Make Teaching Accommodations

Careful planning and listening can lead to accommodations that overcome barriers …

Jones & Bayen (1998)

Page 34: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

A Supportive Environment

Skills

Biological Architecture

Conclusion

11

22

33

44 Motivation

Factors for Success

Page 35: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Practice Makes Perfect

• “Skills are often the result of perseverance, a common characteristic of older adults.”

• Use games and simple, sequential steps• For example,

– Mouserobics!– Solitaire

Chaffin & Harlow, 2005

Page 36: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

A Supportive Environment

Skills

Biological Architecture

Conclusion

11

22

33

44 Motivation

Factors for Success

Page 37: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Common Physiological Problems

• Vision– Cataracts cloud the lens of the eye– Macular degeneration blocks center vision– Reading is difficult

• Common accommodations– Anti-glare screens– Large fonts– Microsoft’s Accessibility Panel (Magnifier)– IBM Software for blind

Page 38: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

A Supportive Environment

Skills

Biological Architecture

Conclusion

11

22

33

44 Motivation

Factors for Success

Page 39: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Adult Learning Theories Relevant to Computer Training

• Bandura (1979,1994), Social Learning. Concept of self-efficacy and self-esteem. Model and encourage behavior to build confidence

• Knowles (1968), Andragogy. Realization that adults learn differently than children. Recognize that adults bring resources and experiences, want self-direction, are problem-centered, and are often motivated internally to learn.

Page 40: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Adult Development Theory Relevant to Computer Training

• Kegan (1982), Constructive-Development Theory. A six-stage (but not fixed-age) theory of ego (or self) development, starting with Piaget-like stages and progressing beyond the role of ego as defined by Erikson.

• In Kegan’s theory, one is subjectively immersed in one’s world, but gradually become able to objectively view it as different from self, and so grow into the next immersive level.

• The growth is cumulative; each new stage subsumes the previous one, as one proceeds from childhood to adulthood.

Page 41: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Stages of Kegan’s (1982) Constructive-Development Theory

Page 42: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Constructive-Development Theory

Page 43: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Constructive-Development Theory

Page 44: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Transitional Phases- “Holding on; Letting go”

Page 45: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Helsing et al. (2001) Constructive-Developmental Theory

• Adults construct knowledge along four progressive levels of sophistication

• At any time, adults representing any or all of these developmental levels may be present in the classroom

• This is especially true of a general adult basic education classroom

Page 46: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Level 1 Level 2 Level 3 Level 4

Learner is concrete; sees knowledge in one dimension. Wants to be “spoon fed.”

Learner admits ambiguity of knowledge; sees it as barrier to “real” answer.

Learner is open to multiple interpretations of knowledge; can synthesize and work in groups.

Learner thinks critically and independently; can add original thoughts to knowledge others.

Four Developmental Levels of Critical Thinking

Helsing, Drago-Severson,and Kegan (2001)

Page 47: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Because of the range of developmental levels of adults, learners “will have fundamentally diverse understandings and expectations of the teachers, themselves, their peers, and the subject matter.”

Helsing et al. (2001)

Page 48: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Model for Adoption of Technology

• The authors studied why older adults have difficulty adopting technologies or they choose not to adopt them

• Broad fields of study covered– general technology– computers– use of the World Wide Web (Internet)

Page 49: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Model for Adoption of Technology

• Broad range of variables: – sociodemograhic (age, education)– attitudinal (self-efficacy, computer anxiety)– component abilities (crystallized & fluid intelligence)

• Large, diverse sample with wide age span– N= 1, 204 (750 women, 454 men)– younger adults (18-39)– middle-aged adults (40-59 years)– older adults (60-91 years)

Page 50: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Model for Adoption of Technology

Page 51: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Model for Adoption of Technology

Page 52: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Conclusions of Study

• Perhaps strongest finding was that computer self-efficacy are an important predictor of general use of technology.

• Older adults, and older women in particular, had higher levels of computer anxiety.

• Therefore, computer programs should focus on training techniques that reduce anxiety about computers as well as provider computer skills training.

Page 53: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Conclusions of Study

• There is a direct path between crystallized intelligence and breadth of computer and Web experience.

• Oldest adults have the highest level of crystallized intelligence (from the study).

• These people may be more adept at knowledge acquisition. (Beier & Ackerman, 2005)

• Age differences in the adoption of technology may be related to historical change rather than age-related declines in cognitive abilities.

Page 54: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

Czaja et al. (2006) Conclusions of Study

• Found lower adoption of technologies by older adults (Y > M >> O)

• Believe that it is socially important and cost effective to support the independence of older adults; technology can foster it.

• Limited evidence that this potential is being realized (National Research Council, 2004)

Page 55: A Biopsychosocial Survey: Older Adults and Computer Technology James Brown EdPsyc 747 Human Development- Adult Dr. Deborah Renard Summer, 2006 Learn More!

References• Chaffin, A.J. & Harlow, S.D. (2005) Cognitive learning applied to

older adult learners and technology. Educational Gerontology, 31, 301-329.

• Czaja, S.J., Charness, N., Fisk, A. & Hertzog, C., Nair, S.N., Rogers, W. & Sharit, J. (2006). Factors predicting the use of technology: Findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE). Psychology and Aging, 21, 333-352.

• Echt, K.V., Morrell, R.W., & Park, D.C. (1998) Effects of age and training formats on basic computer skill acquisition in older adults. Educational Gerontology, 24, 3-25.

• Kegan, R. (1982) The evolving self. Cambridge, Mass: Harvard University Press.

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