Delivery of multi-layer digital therapy to user to address dysfunction

Abstract

Delivery of multi-layer digital therapy to a user to address dysfunction is provided herein. Systems and methods for presenting interactive sessions to address dysfunction of a user associated with a disease or condition are provided. A computing device may provide a first session for a cognitive training layer associated with a skill. The computing system may provide a second session for the virtual function training layer for the user to apply skills in the virtual settings. The computing system may provide a third session for the functional training layer for the user to perform activities that apply skills. The efficacy of a drug being taken by a user to treat a disease or condition can be improved.

Description

[0001] CROSS-REFERENCE TO RELATED APPLICATIONS

[0002] This application claims U.S. non-provisional application No. 18 / 799,387, filed on August 9, 2024, entitled “Delivery of Multi-Layer Digital Therapy to Users for Addressing Functional Impairment,” and U.S. Provisional Application No. 63 / 632,292, filed on April 10, 2024, entitled “Delivery of Multi-Layer Digital Therapyto Users for Addressing Functional Impairment,” and U.S. Provisional Application No. 63 / 562,589, filed on March 7, 2024, entitled “Delivery of Multi-Layer Digital Therapy to Users forAddressing Functional Impairment,” and U.S. Provisional Application No. 63 / 562,589, filed on December 12, 2023, entitled “Delivery of Multi-Layer Digital Therapy to Users forAddressing Functional Impairment.” Impairment” and priority to U.S. Provisional Application No. 63 / 609,268, filed on August 30, 2023, entitled “Delivery of Multi-Layer Digital Therapy to Users for Addressing Functional Impairment,” each of which is incorporated herein by reference in its entirety. Technical Field

[0003] The present disclosure relates to the field of digital therapeutics, and more particularly to a system and method for delivering multi-layered digital therapeutics to a user to address functional impairments. Background Art

[0004] Certain illnesses may cause patients to lack functional impairment or suffer from functional impairment, such as social processing disorder, non-social processing disorder or both. Patients with illnesses that affect their ability to understand or cope with social environments may encounter functional difficulties in environments such as work, family, commercial organizations or other areas where patients interact with other people. The social processing disorder experienced by these patients can lead to concerns about surrounding social settings, thereby further preventing patients from participating in social environments. The illness can cause patients to have difficulty distinguishing social cues, such as social cues displayed by body language or tone of voice. Lack of social skills can cause patients to have extreme difficulty in coping with social settings due to not understanding or appreciating the social cues displayed by people around the patient.

[0005] In addition, patients may suffer from non-social processing disorders, such as memory (e.g., verbal memory for storing and recalling verbally communicated information), executive function (e.g., such as problem solving and planning) and other cognitive functions. These cognitive impairments can lead to decreased ability to perceive, understand or respond to the patient's surroundings and the people around the patient. With regard to verbal memory, the defects of this cognitive function may bring major challenges to all aspects of individual daily life, such as difficulty remembering conversations with others, expression disorders, and memory recall problems to names, dates and other information. Verbal memory disorders can lead to frustration and helplessness. This can also affect personal relationships with family and friends, such as forgetting important events, conversations or details that lead to misunderstandings.

[0006] Treating a functional impairment in a patient with a condition that affects their ability to cope in a social setting or to respond appropriately to their surroundings can be difficult due to the inherent nature of the condition. For example, while a patient may learn skills in an environment set up by a clinician with which the patient may be familiar, the patient may be afraid or unable to apply those skills in a real-life setting. For many patients with functional impairments, the gap between a clinical setting and a real-life setting (e.g., a bustling coffee shop or time-sensitive social interactions such as boarding the correct city bus) may be too great. As another example, a patient who has difficulty processing information may be unable to follow the instructions or guidance of a clinician, particularly after a treatment session.

[0007] Correction by traditional face-to-face clinical measures in which clinicians provide certain psychosocial therapies and other intervention techniques may not provide sufficient methods to improve functional impairment. Due to difficulties in social interaction and other ability deficiencies, it may be difficult for patients to continue to adhere to treatment. In addition, such face-to-face clinical measures may be limited by schedules and physical constraints. For example, there may be no specialized or well-trained clinicians near the patient (e.g., particularly patients located in rural or non-metropolitan areas). In addition, even for professional or well-trained clinicians, such clinicians may not be able to meet with patients frequently or immediately in a short period of time. This problem may be exacerbated by the fact that patients may have time-sensitive conditions to be treated or resolved. Summary of the invention

[0008] To address these and other technical challenges, digital therapy in the form of a three-tier intervention system (also known as Enhanced Life Skills through Cognitive Intervention (ELSCI)) can fill the gaps and limitations of current standard of care treatments by moving users from a low-stimulation psychoeducational layer to an intermediate practice and response layer to a high-stimulation real-world application layer. Using this multimodal, multi-tiered system, users can be trained to become familiar with applying skills related to functional impairment in an intermediate virtual environment before applying the skills and knowledge to a real-world environment. By building a bridge between training and real-world application, users can successfully transform knowledge into skills learned and applied in real-world function. The transfer of knowledge and the application of skills can enhance self-confidence, help users in their daily lives at school or work, and strengthen users' relationships with friends and family. In addition, compared to traditional therapies that are limited to infrequent face-to-face clinical settings, digital delivery allows patients to experience a higher frequency of interaction, particularly in the form of frequent (e.g., multiple times a day) real-time feedback and proactive reminders to help users perform training tasks.

[0009] Each layer can improve the ability of users with functional impairments through a series of exercises, and can build on the previous session, using increasingly complex and realistic virtual scenes to simulate and contextualize real-life situations. The session can progress from digital cognitive correction tasks that train users to recognize clues (or other markers) through images displayed by the device to ecological generalization of cognitive correction, where users can interact in real-world settings. The ecological generalization of cognitive correction can correspond to applying the therapy of other sessions to virtual or real-life environments. For example, in order to solve social processing disorders that lead to functional impairments, the session can present images and prompts to the user via the end-user device to train the user to recognize certain social cues and respond with certain interactions in social settings. In order to solve non-social processing disorders that lead to functional impairments, the session can present images and prompts via the end-user device to help the user build cognitive skills such as memory, communication, attention, and problem solving. Through the combination of cognitive correction of sessions associated with different layers and the ecological generalization of such corrections, users can be able to improve functional impairments.

[0010] Training can include three layers, moving from low stimulation and difficulty in a practice setting to high stimulation and difficulty and real-world functionality. To address social processing disorders, the first layer can include a set of cognitive exercises designed to improve the subject's cognitive abilities through repetition. For example, an application on a user's device can present a set of images, videos, or audio recordings of social cues (e.g., in the form of body language) with prompts asking the user to select the correct social cues depicted in the image. To address non-social processing disorders (e.g., verbal memory), in the first layer, the application can present a set of images, videos, or audio recordings, followed by a prompt asking the user to select the correct object or character depicted in the image.

[0011] The second layer may include a set of virtual scenes whose purpose is to improve the subject's ability to apply skills in a virtual social setting. In the second layer for addressing social processing disorders that lead to functional impairment, the application may present another set of social setting images with prompts that guide the user to select responses (e.g., dialogue or actions) to the characters depicted in the setting to further consolidate social skills. To address non-social processing disorders that lead to functional impairment, in the second layer, the application may present a set of images, videos, or audio of virtual settings with characters or objects, followed by prompts that guide the user to select responses (e.g., actions) to help the user build cognitive skills (such as verbal memory or problem solving). In both cases, feedback can be provided to the user in response to the user's selection.

[0012] Continuing, the third layer may include a set of prompts whose goal is to have the user perform skills (e.g., social and non-social) in real-world settings. For example, the application may prompt the user to perform activities in the user's environment, such as interacting with other people to improve social processing. Through this multi-layered approach, users can be trained to develop social skills and apply social skills to real-world functions. As a result, users can be adapted to develop social skills to overcome functional impairments associated with the user's condition (e.g., schizophrenia or affective disorders such as depression and bipolar disorder).

[0013] Treatment components can combine cognitive remediation with additional layers in the functional remediation model, helping patients learn, practice, and apply skills in more complex application settings to translate cognitive improvements into functional needs. Content can be contextualized and personalized, with functional areas for remediation to drive engagement. Users can be presented with rationales that explicitly link cognitive remediation exercises to the two layers of ecological generalization. For example, when completing exercises in the first layer, the exercises can allow users to practice cognitive exercises associated with social or non-social skills. In the second layer, the intervention may incorporate relevant, realistic aspects of daily life into the in-app exercises. In the third layer, users may be asked to practice activities in the real world, such as observing social cues during interactions with trusted people. After each practice session, activity progress can be reviewed, with notifications issued to celebrate successes and improvements in skill implementation in the user's daily life. In these components, learning theory approaches can be used to improve self-efficacy and engagement. The additional ecological generalization component can optimize the likelihood that users will transfer cognitive remediation to have a meaningful impact on their ability to function in the real world.

[0014] To provide these digital therapy sessions, the service can select and provide stimulation and associated prompts for the user to be presented via an end-user device. For the first layer, the service can select a set of media with characters having specific social cues and prompts that provide a set of candidate options for social cues, including images, videos, audio, or a combination thereof. After a successful response rate for each presented media for the first session, the service can provide a second session. For the second layer, the service can identify a set of media with a virtual social setting of one or more characters, with prompts that define a set of candidate responses (e.g., dialogues or actions) for the user to select when interacting with the character. The service can provide feedback based on user selections. When the correct response rate meets a threshold, the service can determine to provide a third-layer session to the user. Through this multi-session, multi-layer corrective therapy method for social processing disorders that cause functional impairments, subjects can improve their ability to recognize social cues and interact socially in a real-world environment.

[0015] In addition, the service may schedule the delivery or presentation of the layer to the user to avoid the user having to actively access the digital therapeutic application on their device when experiencing their condition. The service may schedule the delivery or presentation of the layer to the user after the completion of a previous action related to the session. In addition, as the service obtains additional data about the user, the service may be able to select images, prompts, or text that are more targeted to the specific user and their condition, and may store this data in the user's profile. The service may calculate execution metrics for the user in the session. The service may select subsequent sessions based on at least previous selections or responses, execution metrics, completion of previous actions, or the user's profile, etc.

[0016] By using a multi-layered approach to improve functional impairment, users of digital therapeutic applications can learn, practice, and make ecologically valid real-world attempts at practicing social and non-social skills. This approach can include moving from low-difficulty sessions to high-difficulty or real-world functional sessions. The synergistic combination of multiple psychosocial therapies can provide multiple benefits, particularly (i) extending the benefits of cognitive remediation to functional improvements; (ii) providing more ecological validity and real-time interactions than face-to-face clinical settings; and (iii) developing easily accessible digital therapeutics.

[0017] In this way, the user can easily receive a session related to the condition to help alleviate the functional impairment associated with the condition as recorded herein. This can reduce or eliminate the user's physical access to their device when combating the condition. By selecting a session sent to the user to address the subject's functional difficulties, the quality of the human-computer interaction (HCI) between the user and the device can be improved. In addition, because the session is more relevant to the user's condition, unnecessary consumption of computing resources (e.g., processing and memory) and network bandwidth of the service and user device can be reduced relative to sending invalid messages.

[0018] Furthermore, in the context of a digital therapeutic application, selection of such a session can result in the delivery of a user-specific intervention to improve the subject's compliance with treatment. Furthermore, the multi-layered approach provided by the digital therapeutic application can provide potential improvements in the subject's functional impairment due to the condition that the user has (e.g., schizophrenia or an affective disorder) as will be recorded herein.

[0019] Aspects of the present disclosure relate to systems and methods for presenting an interactive session to address a user's functional impairment. The system may include a computing system having one or more processors coupled to a memory. The computing system may identify a set of sessions to address an impairment associated with a condition of the user. Each session in the set of sessions may include a corresponding layer in a set of layers for the user. The computing system may provide a first session for a cognitive training layer by displaying one or more first images, the user employing the first image to identify one or more of a set of social cues associated with a social skill. The computer system may provide a second session for a virtual functional training layer for the user to apply the social skill in a virtual social setting. The second session may include the computer system displaying a second image of the social setting, with a set of interactive elements that (a) identifies a first prompt for a query associated with one of the characters of the set displaying the social cues and (b) identifies a corresponding set of responses to the characters. The second session may include the computer system receiving a first response to the set of responses selected by the user via at least one of the set of interactive elements. The second session may include the computer system providing feedback to the user based on the query and the response to the social setting. The computer system may provide a third session for the functional training layer for the user to apply the social skill. The third session may include the computer system displaying a second prompt to guide the user to perform an activity. The third session may include the computer system receiving a second response associated with the performance of the activity.The above also applies to non-social skills.

[0020] In some embodiments, the computing system may generate an execution metric for the user based on a first response received from the user at the first time instance during the second session. The computing system may modify at least one parameter in a set of parameters defining presentation of at least one of an image, a prompt, and an interactive element for the virtual functional training layer based on the execution metric. The computing system may provide a second session for the virtual functional training layer at the second time instance.

[0021] In some embodiments, the computing system may provide a second conversation by displaying a third image of a second social setting, the third image of the second social setting having (i) a third prompt identifying a second query of a second character in the second social setting; and (ii) a second set of interactive elements identifying a corresponding set of responses to the second character based on the set of parameters. In some embodiments, the set of parameters may include at least one of: (i) content modality type, (ii) context of the social setting in the image, (iii) number of characters in the social setting, (iv) prompt type, (v) difficulty level of the response, (vi) response type, or (vii) number of responses. The foregoing also applies to non-social skills.

[0022] In some embodiments, the computing system may generate an execution metric for the user based on a correct selection rate in one or more sessions for the cognitive training layer. The computing system may determine to transition the user from the cognitive training layer to the virtual functional training layer in response to the execution metric satisfying a threshold. The computing system may determine to adjust the difficulty of the exercises within the cognitive training layer in response to the execution metric satisfying a threshold. In some embodiments, the computing system may generate an execution metric for the user based on a correct response rate in one or more sessions for the virtual functional training layer. The computing system may determine to adjust the difficulty of the exercises within the virtual functional training layer in response to the execution metric satisfying a threshold. The computing system may determine to transition the user from the virtual functional training layer to the functional training layer in response to the execution metric satisfying a threshold.

[0023] In some embodiments, a computing system may provide a first session by (i) displaying a first image of social cues, with a set of interactive elements identifying a corresponding set of types of social cues associated with the first image; and (ii) receiving a selection by a user of one of the set of social cues via at least one of the set of interactive elements. The set of social cues for the first image in the first session for the cognitive training layer may include at least one of: (a) head movement, (b) body language, (c) gestures, or (d) eye contact. The foregoing also applies to non-social skills.

[0024] In some embodiments, a second session for the virtual functional training layer may include displaying a set of images with a social setting of a character according to a defined sequence. In some embodiments, a third session for the functional training layer may include displaying a third prompt for the user to select a time to provide a message prompting the user to perform an activity. In some embodiments, the computing system may identify a time to provide one of the group of sessions to the user based on a session schedule. In some embodiments, the user's condition may include schizophrenia, where the user is being treated at least partially concurrently with at least one of the first session, the second session, or the third session. The treatment may include at least one of a psychosocial intervention or a medication for treating schizophrenia. The session may improve the efficacy of a medication that the user is taking to treat the condition. The above also applies to non-social skills.

[0025] Other aspects of the present disclosure relate to methods for improving functional impairment of a schizophrenia user in need. A computing system may obtain a first metric associated with a user before a plurality of sessions. The computing system may repeatedly provide one or more of the plurality of sessions to the user. The plurality of sessions may include a first session for a cognitive training layer by displaying one or more first images, the user employing the first image to identify one or more of a plurality of social cues associated with a social skill. The plurality of sessions may include a second session for a virtual functional training layer for the user to apply social skills in a virtual social setting, including (i) displaying a second image of a social setting, having (a) a first prompt identifying a query associated with a character displaying one of the plurality of social cues, and (b) a second set of interactive elements identifying a plurality of responses corresponding to the character, (ii) receiving a response from a plurality of responses selected by the user via at least one of the second set of interactive elements, and (iii) providing feedback to the user based on the query and the response for the setting. The plurality of sessions may include a third session for a functional training layer, including (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a response associated with the performance of the activity. The computing system may obtain a second metric associated with the user after at least one of the plurality of sessions. When the second metric is (i) reduced by a first predetermined margin from the first metric or (ii) increased by a second predetermined margin from the first metric, improvement in functional impairment associated with schizophrenia may occur in the user.The above also applies to non-social skills.

[0026] In some embodiments, the user's schizophrenia may include at least one of the following: (i) schizophrenia with positive symptoms, including hallucinations or delusions; or (ii) schizophrenia with negative symptoms, including decreased motivation or emotional expression. In some embodiments, the functional impairment associated with the user may include at least one of the following: (i) reduced education, (ii) reduced quality of life, (iii) difficulty living independently, (iv) decreased social functioning, or (v) occupational dysfunction. In some embodiments, the user may be an adult who is at least 18 years of age or older and has been diagnosed with schizophrenia and experiences functional impairment.

[0027] In some embodiments, when the second metric decreases by a first predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur. The first metric and the second metric may be Multnomah Community Ability Scale (MCAS) values. In some embodiments, when the second metric increases by a second predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia occurs. The first metric and the second metric may be Lawton Instrumental Activities of Daily Living (Lawton IADL) scale values.

[0028] In some embodiments, when the second metric increases a second predetermined margin from the first metric, an improvement in the functional impairment associated with schizophrenia occurs. In some embodiments, the first metric and the second metric may be a Personal and Social Performance (PSP) scale value. In some embodiments, when the second metric decreases a first predetermined margin from the first metric, an improvement in the functional impairment associated with schizophrenia may occur. The first metric and the second metric may be a World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS2.0) scale value. In some embodiments, when the second metric decreases a first predetermined margin from the first metric, an improvement in the functional impairment associated with schizophrenia occurs, and wherein the first metric and the second metric are Columbia Suicide Severity Rating Scale (C-SSRS) values.

[0029] In some embodiments, the plurality of sessions may further include a second session for training a virtual function at a first time instance, including displaying a third image of a second setting, having (i) a third prompt for a second query of a second character in the second setting; and (ii) a third set of interactive elements for identifying a corresponding plurality of responses to the second character according to a plurality of parameters. In some embodiments, at least one of the plurality of parameters may be modified based on a performance metric for the user using a response received from the user during the second session at a second time instance prior to the first time instance. The foregoing also applies to non-social skills.

[0030] In some embodiments, the plurality of parameters includes at least one of: (i) a content modality type, (ii) a context of a setting in an image, (iii) a number of characters in a setting, (iv) a prompt type, (v) a difficulty level of a response, (vi) a response type, or (vii) a number of responses. In some embodiments, the computing system may determine, for at least one of the plurality of sessions, to transition from one tier to another tier based on a performance metric of the user across one or more of the plurality of sessions.

[0031] In some embodiments, the computing system may provide a first session to include (i) a first image displaying social cues, a set of interactive elements identifying corresponding multiple types of cues associated with the first image, and (ii) receiving a selection of one of the multiple types of social cues by a user via at least one interactive element in a second set of interactive elements. In some embodiments, the multiple social cues of the first image in the first session for the cognitive training layer further include at least one of the following: (a) head movement, (b) body language, (c) gestures, or (d) eye contact. The above also applies to non-social skills.

[0032] In some embodiments, a second session for the virtual functional training layer may include displaying multiple images with settings of characters according to a defined sequence. In some embodiments, a third session for the functional training layer may include displaying a third prompt for the user to select a time to provide a message prompting the user to perform an activity. In some embodiments, multiple sessions may be provided over a time period between 2 weeks and 30 weeks. In some embodiments, the user may receive treatment at least partially concurrently with at least one of the multiple sessions. In some embodiments, the treatment may include at least one of a psychosocial intervention or a medication for treating schizophrenia. The session may improve the efficacy of a medication that the user is taking to treat the condition. The above also applies to non-social skills.

[0033] Other aspects of the present disclosure relate to systems and methods for presenting interactive sessions to address a user's verbal learning and memory and cognitive-related disorders. A computing system may identify multiple sessions to address a disorder associated with a user's condition, each of the multiple sessions including a corresponding layer in a plurality of layers for the user. The computing system may provide a first session for a cognitive training layer associated with verbal memory skills by presenting one or more first audio recordings used by the user to recall one or more words in a plurality of words. The computing system may provide a second session for a virtual functional training layer for the user to apply verbal memory skills in a virtual setting. The second session may include (i) presenting a second audio recording of a voice sample, having (a) a first prompt identifying a query associated with the voice sample and (b) a set of interactive elements identifying a corresponding plurality of responses, (ii) receiving a first response from a plurality of responses selected by the user via at least one interactive element in a set of interactive elements, and (iii) providing feedback to the user based on the query and response for the voice sample. The computing system may provide a third session for a functional training layer for the user to apply verbal memory skills, including (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a second response associated with the performance of the activity. The foregoing content may use prompts, videos or images instead of audio recordings.

[0034] In some embodiments, the computing system may generate an execution metric for the user based on a first response received from the user at a first time instance during a second session. The computing system may modify at least one of a plurality of parameters defining the presentation of at least one of an audio recording, a prompt, and an interactive element for the virtual functional training layer based on the execution metric. The computing system may provide a second session for the virtual functional training layer at a second time instance, including presenting a third audio recording of a speech sample between characters in a social setting, with (i) a third prompt identifying a second query associated with the characters and the speech sample in the social setting and (ii) a second set of interactive elements identifying a corresponding plurality of responses according to the plurality of parameters.

[0035] In some embodiments, the plurality of parameters may include at least one of: (i) content modality type, (ii) context of a social setting in an audio recording, (iii) number of characters in a social setting, (iv) prompt type, (v) response difficulty level, (vi) response type, or (vii) number of responses. In some embodiments, the computing system may present the second audio recording based on the plurality of parameters. The plurality of parameters may include at least one of: (a) inclusion of distractions, (b) ability to repeat the second audio recording, (c) modification of speed, (d) time between each word, (e) number of words in each sentence, (f) length of the audio recording, or (g) ability to control distractions.

[0036] In some embodiments, the computing system may generate an execution metric for the user based on a correct selection rate in one or more sessions for the cognitive training layer. The computing system may determine to transition the user from the cognitive training layer to the virtual functional training layer in response to the execution metric satisfying a threshold. In some embodiments, the computing system may generate an execution metric for the user based on a correct response rate in one or more sessions for the virtual functional training layer. The computing system may determine to transition the user from the virtual functional training layer to the functional training layer in response to the execution metric satisfying a threshold.

[0037] In some embodiments, a computing system may provide a first session by identifying a set of records to be presented to a user from a plurality of records, each record in the plurality of records corresponding to one or more words; presenting the set of records to the user according to a format defining a context in which one or more words for each record in the set of records are presented; displaying an interface to prompt the user to select at least one word from the plurality of words as presented in the set of records; and receiving, via the interface, a selection by the user of at least one word or image.

[0038] In some embodiments, the third session for the functional training layer may include displaying a third prompt for the user to select a time to provide a message prompting the user to perform an activity. In some embodiments, the computing system may identify a time to provide one of the multiple sessions to the user based on the session schedule. In some embodiments, the user's condition may include schizophrenia. The user may receive treatment at least partially concurrently with at least one of the first session, the second session, or the third session. The treatment may include at least one of a psychosocial intervention or a medication to treat schizophrenia.

[0039] Other aspects of the present disclosure relate to a method for improving a functional impairment associated with verbal memory in a schizophrenia user in need. A computing system may obtain a first metric associated with a user before a plurality of sessions. The computing system may repeatedly provide one or more of the plurality of sessions to the user. The plurality of sessions may include a first session for a cognitive training layer associated with verbal memory skills by presenting one or more first audio recordings, and the user employs the first audio recording to recall one or more of a plurality of words. The plurality of sessions may include a second session for a virtual functional training layer for the user to apply verbal memory skills in a virtual setting, including (i) presenting a second audio recording, having (a) a first prompt for identifying a query associated with a voice sample and (b) a set of interactive elements for identifying a corresponding plurality of responses, (ii) receiving a first response of a plurality of responses selected by the user via at least one of a set of interactive elements, and (iii) providing feedback to the user based on the query and response for the voice sample. The plurality of sessions may include a third session for a functional training layer for the user to apply verbal memory skills, including (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a second response associated with the execution of the activity. The computing system may obtain a second metric associated with the user after at least one of the plurality of sessions. When the second metric is (i) reduced by a first predetermined margin from the first metric or (ii) increased by a second predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur in the user.

[0040] In some embodiments, schizophrenia further includes schizophrenia with negative symptoms, including a decrease in motivation or emotional expression. In some embodiments, the functional impairment associated with the user may also include at least one of: (i) reduced education, (ii) reduced quality of life, (iii) difficulty living independently, (iv) decreased social functioning, or (v) occupational dysfunction. In some embodiments, the user may be an adult who is at least 18 years of age or older and has been diagnosed with schizophrenia experiencing functional impairment. In some embodiments, multiple sessions may be provided over a period of between 2 weeks and 30 weeks.

[0041] In some embodiments, when the second metric decreases by a first predetermined margin from the first metric, improvement in functional impairment associated with schizophrenia may occur, and wherein the first metric and the second metric are Multnomah Community Capacity Scale (MCAS) values. In some embodiments, when the second metric increases by a second predetermined margin from the first metric, improvement in functional impairment associated with schizophrenia may occur, and wherein the first metric and the second metric are Clinical Rating Scale (CRS) values.

[0042] In some embodiments, when the second metric is reduced by a first predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur, and wherein the first metric and the second metric are Patient Global Impression of Improvement (PGI-I) scale values. In some embodiments, when the second metric is reduced by a first predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur, and wherein the first metric and the second metric are Clinical Global Impression of Improvement (CGI-I) scale values. In some embodiments, when the second metric is reduced by a first predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur, and wherein the first metric and the second metric are Clinical Global Impression of Improvement (CGI-I) scale values. In some embodiments, when the second metric is reduced by a first predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur, and wherein the difference between the first metric and the second metric is a PGI-I or CGI-I scale value. In some embodiments, when the second metric is increased by a second predetermined margin from the first metric, an improvement in functional impairment associated with schizophrenia may occur, and wherein the first metric and the second metric are Medication Adherence Rating Scale (MARS-a) values. In some embodiments, improvement in functional impairment associated with schizophrenia may occur when the second metric decreases from the first metric by a first predetermined margin, and wherein the first metric and the second metric are Columbia-Suicidality Severity Rating Scale (C-SSRS) values.

[0043] In some embodiments, the computing system may determine, for at least one of the plurality of sessions, a transition from one tier to another tier based on a performance metric of the user across one or more of the plurality of sessions. In some embodiments, the second session may include presenting the second audio recording according to a plurality of parameters. The plurality of parameters may include at least one of: (a) inclusion of distractions, (b) ability to repeat the second audio recording, (c) modification of speed, (d) time between each word, (e) number of words in each sentence, (f) length of the audio recording, or (g) ability to control distractions.

[0044] In some embodiments, the first session may include identifying a set of records from a plurality of records to present to the user, each record in the plurality of records corresponding to one or more words; presenting the set of records to the user according to a format defining a context in which one or more words for each record in the set of records are presented; displaying an interface to prompt the user to select at least one word from the plurality of words as presented in the set of records; and receiving a user selection of at least one word or image via the interface. In some embodiments, the user may receive treatment at least partially concurrently with at least one of the plurality of sessions. The treatment may include at least one of a psychosocial intervention or a medication to treat schizophrenia. BRIEF DESCRIPTION OF THE DRAWINGS

[0045] The above and other objects, aspects, features and advantages of the present disclosure will become more apparent and better understood by referring to the following description in conjunction with the accompanying drawings, in which:

[0046] Figure 1 depicts a block diagram of a system for presenting an interactive session to address a user's dysfunction in accordance with an illustrative embodiment;

[0047] Figure 2 A block diagram depicting a process of identifying a set of sessions to address a user's functional impairment and providing a first session of a cognitive training layer for the set of sessions in accordance with an illustrative embodiment;

[0048] Figures 3A-3H A collection of screenshots depicting an example user interface for providing a first session in accordance with an illustrative embodiment;

[0049] Figure 4 A block diagram depicting a process for providing a second session for a virtual functional training layer for a user to apply social skills in a virtual social setting in accordance with an illustrative embodiment;

[0050] Figure 5A-5G A collection of screenshots depicting an example user interface for providing a second session in accordance with an illustrative embodiment;

[0051] Figure 6 A block diagram depicting a process for providing a third session for a functional training layer for a user to apply social skills in accordance with an illustrative embodiment;

[0052] Figures 7A-7E Screen shots depicting a set of example user interfaces for providing a third session in accordance with an illustrative embodiment;

[0053] Figures 8A-8C A flowchart depicting a method for presenting an interactive session to resolve a user's dysfunction according to an illustrative embodiment;

[0054] Fig. 9 a flow chart depicting a method of improving functional impairment in a user suffering from schizophrenia according to an illustrative embodiment; and

[0055] Fig.10 Shown is a decrease in WHO-DAS2.0 disability assessment after 4 weeks of interaction with the CT-156 mobile app. WHO-DAS2.0 assesses disability based on 36 individual items with a score ranging from 1 (none) to 5 (extreme). Changes in WHO-DAS screening from the beginning to the end of the study showed a significant decrease in disability assessment, indicating that participants' abilities improved in multiple areas of functioning.

[0056] Fig.11 is a block diagram of a server system and a client computer system in accordance with an illustrative embodiment. DETAILED DESCRIPTION

[0057] In order to read the description of the various embodiments below, the following listing of the sections of the specification and their corresponding contents may be helpful:

[0058] Section A describes systems and methods for presenting an interactive session to address user dysfunction;

[0059] Section B describes a method for ameliorating functional impairment in a user suffering from schizophrenia; and

[0060] Section C describes a network and computing environment that may be useful for practicing the embodiments described herein.

[0061] A. Systems and methods for presenting an interactive session to address a user's dysfunction

[0062] Reference now Figure 1 , depicts a block diagram of a system 100 for presenting an interactive session to address a user's dysfunction (e.g., social processing or non-social processing). In summary, the system 100 may include at least one session management service 105 and a set of user devices 110A-N (hereinafter collectively referred to as user devices 110) that are communicatively coupled to each other via at least one network 115. At least one user device 110 (e.g., the first user device 110A as shown) may include at least one application 125. The application 125 may include or provide at least one user interface 130 having one or more user interface (UI) elements 135A-N (hereinafter collectively referred to as UI elements 135). The session management service 105 may include at least one session manager 140, an interaction handler 145, an execution evaluator 150, or at least one feedback provider 155, etc. The session management service 105 may include or have access to at least one database 160. The database 160 may store, maintain, or otherwise include one or more user profiles 165A-N (hereinafter collectively referred to as user profiles 165), one or more layer configurations 170A-N (hereinafter collectively referred to as layer configurations 170 or layers 170), one or more images 180A-N (hereinafter collectively referred to as images 180), or one or more audio recordings 185A-N (hereinafter collectively referred to as audio recordings 185), etc. The functionality of the application 125 may be partially performed on the session management service 105. Conversely, the functionality of the application 125 may also incorporate operations performed on the session management service 105. The user device 110 and the session management service 105 may collectively be part of a computing system that provides the application 125.

[0063] In more detail, the session management service 105 may (sometimes collectively referred to herein as a service) be any computing device including one or more processors coupled to memory and software and capable of performing the various processes and tasks described herein. The session management service 105 may communicate with one or more user devices 110 and a database 160 via a network 115. The session management service 105 may be located, positioned at, or otherwise associated with at least one server group. The server group may correspond to a data center, a branch office, or a site where one or more servers corresponding to the session management service 105 are located. The session management service 105 may be located, positioned at, or otherwise associated with one or more client devices 110. Some components of the session management service 105 may be located within the server group, and some components may be located within the client device. For example, the session manager 140 may operate or be located on the user device 110, and the interaction handler 145 may operate or be located on the server group.

[0064] In the session management service 105, the session manager 140 can identify a set of sessions from the layer configuration 170 to be presented to the user by the application 125 on the corresponding user device 110. The session manager 140 can manage a set of sessions to address the user's functional impairment and can present one or more stimuli (e.g., images 180) according to the sessions in the set of sessions. The interaction handler 145 can monitor the user's response on the user interface 130 in the sessions provided via the user device 110. The execution evaluator 150 can determine the execution metric of the user in each session. The feedback provider 155 can provide feedback based on the execution to be presented to the user via the application 125 operating on the user device 110.

[0065] The user device 110 (sometimes referred to as an end-user computing device or client device) can be any computing device that includes one or more processors coupled to memory and software and capable of performing the various processes and tasks described herein. The user device 110 can communicate with the session management service 105 and the database 160 via the network 115. The user device 110 can be a smart phone, other mobile phone, tablet computer, wearable computing device (e.g., smart watch, glasses), or laptop computer. The user device 110 can be used to access the application 125. In some embodiments, the application 125 can be downloaded and installed on the user device 110 (e.g., via a digital distribution platform). In some embodiments, the application 125 can be a web application with resources accessible via the network 115.

[0066] The application 125 executed on the user device 110 can be a digital therapy application and can provide sessions (sometimes referred to as therapy sessions) to address functional impairment associated with the condition. The user of the application 125 may have the condition, be diagnosed with the condition, or be at risk for the condition. The condition can include any number of diseases that cause the user to have functional impairment. The functional impairment can include social processing or non-social processing disorders across any number of domains. Social processing disorders can correspond to limitations or constraints on the user when performing daily activities (such as social interactions with others). For example, functional impairment can include decreased education, decreased quality of life, difficulty living independently, decreased social functioning, or occupational dysfunction, etc.

[0067] In addition, non-social processing disorders may correspond to difficulties or limitations in cognitive processes, such as mental operations related to attention, memory, language processing, executive function or sensory processing. The illness may include, for example, neurological disorders (e.g., schizophrenia or multiple sclerosis with positive or negative symptoms) or affective disorders (e.g., major depression, anxiety, bipolar disorder, or post-traumatic stress disorder (PTSD)), etc. The illness may hinder or impede social skills, such as acting or expressing emotions or needs in a socially appropriate manner. In some embodiments, processing disorders may include defects in verbal memory in the user. Verbal memory may correspond to the ability of the user to encode, store and retrieve information related to language and verbal communication. Verbal memory may include memory recall and cognitive association, etc. Memory recall may refer to the ability of the user to retrieve information after providing information (e.g., within 5-10 minutes). Cognitive association may refer to the ability of the user to connect or link between verbally received information and another piece of information (e.g., in the form of a prompt).

[0068] Application 125 can be used to present a session that prompts the user to perform an action to reduce the functional impairment associated with the user's condition. The action can be presented to the user as a result of sending a request to start a session, a detected measurement of the user received from the client device, or a predetermined time or period, etc. Acting in an appropriate social manner can include performing ordinary daily interactions without causing excessive stress or embarrassment. In some cases, social interactions that can be understood by people without the condition can be very difficult, stressful or confusing to perform for people with conditions such as schizophrenia. For example, buying coffee in a socially appropriate manner may cause stress or discomfort to a subject with schizophrenia. Initially, the user may not know the appropriate tone, word pattern or physical characteristics associated with the action of interacting with the barista in order to buy coffee. This may cause the subject to have difficulty functioning in public or social situations and may hinder the subject's lifestyle. Other behaviors may cause the user's condition or be related to the user's condition. By providing a digital therapy session to the user via application 125, limitations in social and non-social skills caused by functional impairment caused by the condition can be addressed.

[0069] The user may receive treatment to address the condition at least in part concurrently with the session through the application 125. The user may receive treatment at least in part concurrently with the first session, the second session, the third session, or any combination thereof. Treatment may include taking medication. The medication may be administered at least orally, intravenously, or topically. For example, for schizophrenia, the user may include a typical antipsychotic (e.g., haloperidol, chlorpromazine, fluphenazine, perphenazine, loracetam, thioridazine, or trifluoperazine) or an atypical antipsychotic (e.g., aripiprazole, risperidone, clozapine, quetiapine, olanzapine, ziprasidone, lurasidone, paliperidone, or iclepertin), etc. For affective disorders (e.g., PTSD or depression), the user may take a serotonin reuptake inhibitor (SRI) or a mood stabilizing drug (e.g., lithium, valproic acid, divalproex sodium, carbamazepine, or lamotrigine), etc. The application 125 may increase the efficacy of the medication the user is taking to treat the condition. Treatment may include psychosocial interventions such as psychoeducation, group therapy, cognitive behavioral therapy (CBT), early intervention for first-episode psychosis (FEP), cognitive rehabilitation, or educational programs.

[0070] Application 125 may include, present, or otherwise provide a user interface 130 including one or more UI elements 135 to a user of user device 110 according to a configuration on application 125. UI elements 135 may correspond to visual components of user interface 130, such as command buttons, text boxes, check boxes, radio buttons, menu items, sliders, etc. In some embodiments, application 125 may be a digital therapy application and may provide one or more sessions (sometimes referred to as therapy sessions) via user interface 130 to address a user's dysfunction.

[0071] The application 125 may receive instructions for presenting a session to the user. The session may include or be defined by a corresponding layer configuration 170 provided from the database 160. The layer configuration 170 may correspond to or include a layer, a treatment technique, an image, a prompt, or other display for presenting to the user via the application 125 during the session. The session may include an interactive interface through the user interface 130 to allow the user to participate in one or more treatments designed to improve the cognitive function of the user associated with the condition. For example, the user may play a game presented by the application 125 on the user device 110, which combines one or more therapies to address the dysfunction. Each session may correspond to a layer. In some embodiments, each session corresponds to a layer. The layer may refer to the difficulty and type of content displayed during the session. For example, a first session may include a first layer. The first layer may be configured to display a set of first images corresponding to a first treatment technique. The layer may include instructions for the presentation of an image 180, an audio recording 185, a prompt, a UI element 135, or other visual displays associated with the session.

[0072] In some embodiments, application 125 can present three sessions, each corresponding to a corresponding layer, to solve the obstacle associated with the user's illness. Each layer associated with its corresponding session will increase the difficulty of actions such as prompts or queries. The first layer can include prompts and images 180 or audio recordings 185 for presenting to the subject through the subject's mobile device (such as user device 110). In order to solve social processing obstacles, for example, image 180 can be a role, and the prompt can guide the subject to select the social clues of the role depicted in image 180 (or audio recording 185) to train the subject to identify social clues. In order to solve non-social processing obstacles, for example, image 180 (or audio recording 185) can be an object, and the prompt can guide the subject to choose which object to depict to solve the subject's attention and memory. The first layer can be a cognitive training layer, providing cognitive exercises to teach the subject social skills through repetition. The first image 180A in the image 180 depicting a social setting, a role or a social clue can be presented to the subject. In some embodiments, the first layer may be a cognitive training layer associated with non-social skills such as verbal memory to present one or more audio recordings 185 where the user is to recall one or more words from a plurality of words presented in the audio recordings 185 .

[0073] The first session associated with the first layer may provide prompts and UI elements 135 about social clues depicted in the first image 180A (or audio recording 185A or both the first image 180A and the audio recording 185A). The subject may select one or more UI elements 135 based on the depicted social settings or clues. One or more of the UI elements 135 may be associated with the correct selection, and one or more of the UI elements 135 may be associated with incorrect selections. In some cases, each selection may include different degrees of correctness. For example, the first session may include two images. The first image 180A may depict a person actively cooking, while the second image 180B may depict a person just sitting on a sofa. The subject may be prompted to select an image depicting a busy person. In this illustrative example, the correct choice would be the first image 180A depicting a person cooking. A series of images 180 (or audio recordings 185) and prompts such as the above examples may be provided in the first layer to reinforce the knowledge of social and non-social skills through repetition.

[0074] The second layer of the three layers can correspond to a second session. The second session can provide a second image 180B (or an audio recording 185B or both the second image 180B and the audio recording 185B) and a second prompt via the user's mobile device. The second session may include a set of interactive elements, such as UI elements 135. The second image 180B can present a social setting as a virtual environment. For example, the second image 180B can present a virtual social setting through an application 125. In this way, the second layer can provide virtual training that combines relevant realistic aspects of daily life with the goal of solving functional disorders. The second session may include prompts that indicate problems associated with the characters depicted in the social setting and display social cues.

[0075] For the social processing example, the second layer may include a text presentation depicting a social setting, where a character stands at a door, unknowingly and unconsciously preventing the subject from leaving the room. The second prompt may include a question, such as "How can you leave the room?" In this example, the interactive element may include text such as "1. Politely ask the other person to go away," "2. Push that person away," or "3. Don't talk, wait for that person to act." The subject's correct response may include a selection via the interactive element, indicating an appropriate social interaction based on the depicted social situation. In this example, the correct selection may be selection 1.

[0076] To address non-social processing, for example, image 180B may be multiple characters in a setting, and prompts may guide the subject to select responses, with the goal of training the user to practice executive functions (e.g., planning and problem solving) in a virtual environment. In another example, for the purpose of training the user to practice verbal memory, an audio recording 185 of a conversation may be presented to the user, and the user may be prompted to provide a response regarding the information conveyed in the conversation.

[0077] The third layer may correspond to a third session, in which a third image 180C (or an audio recording 185C, or both an image 180C and an audio recording 185C) is presented to the user. The third session may not include the third image 180C and may only include prompts. The third image 180C may include a third prompt for an activity (e.g., an action) completed by the user in the real world. For example, in order to solve a social processing disorder that causes a functional disorder, the third prompt may instruct the user to smile at a stranger, or ask a librarian where to find a book. The third session may prompt the subject to make a response associated with the execution of the activity. For example, the third session may prompt the subject to indicate the completion of a task, such as an assessment of how the activity went or whether the subject completed the activity. In order to solve a non-social processing disorder that causes a functional disorder, the prompt may guide the subject to perform an activity and plan to perform the activity at a specified time, with the purpose of training the user to practice executive functions (e.g., plans) in a real environment. As an example, in order to practice verbal memory in a real environment, the prompt may require the user to follow the instructions in the operation guide video, such as making a sandwich, or the user may be required to have a conversation and then recall the person's name.

[0078] Image 180 may be or include a display to be presented to a user as an image, video, or other visual presentation. Image 180 may be subdivided into groups, such as a first group of images 180A or a second group of images 180B. In some embodiments, a group of images 180N may still include images, videos, text, or a combination thereof. One or more images 180 may be repeated across groups. Image 180 may include live, pre-recorded, or generated video or animation, such as a video recording, an animated short, or an animated image, etc. Image 180 may include an audio or tactile presentation. For example, image 180 may include a sound, phrase, word, or other auditory noise presented to the user. Image 180 may be any size or orientation executable by user interface 130. Image 180 may include text, such as a word or sentence to be presented to the user via user interface 130. Image 180 may include instructions for a user to perform an action as part of an ecologically effective cognitive correction. For example, image 180 may include text, graphics, or auditory instructions depicting an action related to a session that a user is to take or perform. Image 180 may depict a social setting, a person, an animal, an object, or the like, or a combination thereof. Image 180 may be coupled with or correspond to one or more prompts.

[0079] Audio recording 185 can be or include one or more files corresponding to the audio content to be presented to the user. Audio recording 185 can include live, pre-recorded or generated audio, such as a sound recording of the voice of an individual or a conversation between two or more human individuals. For example, each audio recording 185 can be a record of one or more words, one or more sentences spoken by a single speaker, or a group of sentences in a conversational form by two or more individuals. In some embodiments, audio recording 185 can include audio generated using a speech synthesizer or generated audio. In some embodiments, at least one audio recording 185 can be associated with image 180. In some embodiments, at least one audio recording 185 can be associated or corresponding to one or more prompts. Files for audio recording 185 can include, for example, waveform audio file format (WAV), MPEG file format (MP3), audio interchange file format (AIFF) or OggVorbis (OGG), etc.

[0080] The prompt may include instructions or instructions for the user to perform an action or make a selection to solve a functional disorder associated with the disease. The prompt may be associated with an image 180 (or an audio recording 185, or both an image 180 and an audio recording 185). The prompt may be displayed within the image 180, overlapped with the image 180, or adjacent to the image 180, etc. The prompt may include a query related to one or more images 180 displayed by an application 125 operating on the user device 110A. The prompt may include text indicating that the user interacts with one or more UI elements 135. For example, the prompt may be based on an image 180 displayed by the application 125 on the user interface 130, and may indicate that the user makes a selection to the UI element 135 based on the image 180 and the query. The prompt may include instructions for the user to perform an action or task according to the session.

[0081] Actions associated with a session may be included in the layer configuration 170. The action may include interacting or not interacting with the user device 110. For example, the action may include tilting the user interface 130 or selecting a UI element 135 presented by the user device 110. The action may include a physical task to be performed by the user. For example, the action may include the user leaving home, talking to a cashier, or buying milk. The action may include instructions for the user to resolve the condition. Actions may be included in a session to resolve a functional impairment associated with the user's condition. For example, a prompt may instruct the user to perform an action outside of the virtual environment, such as going to a coffee shop in person and purchasing coffee. One or more actions may be associated with the layer configuration 170 stored in the database 160.

[0082] The database 160 may store and maintain various resources and data associated with the session management service 105 and the application 125. The database 160 may include a database management system (DBMS) to arrange and organize the data maintained thereon. The database 160 may communicate with the session management service 105 and one or more user devices 110 via the network 115. When executing various operations, the session management service 105 and the application 125 may access the database 160 to retrieve data identified thereby. The session management service 105 and the application 125 may also write data to the database 160 by executing such operations.

[0083] Such operations may include maintenance of a user profile 165 (sometimes referred to as a subject profile). The user profile 165 may include information related to the user's condition, as described herein. For example, the user profile 165 may include information related to the severity of the condition, the occurrence of the condition (such as the occurrence of symptoms associated with a condition that affects the user's cognitive function), medications or treatments taken by the user for the condition, and / or the duration of the condition, etc. The user profile 165 may be updated in response to a schedule, periodically (e.g., daily, weekly), in response to changes in user information (e.g., input by the user via the user interface 130 or learned from the user device 110), or in response to a clinician (e.g., a doctor or nurse) addressing the user's condition, etc.

[0084] The user profile 165 may store and maintain information related to the user of the application 125 via the user device 110. Each user profile 165 may be associated or correspond to a respective subject or user of the application 125. The user profile 165 may contain or store information for each session performed by the user. The information for the session may include various parameters, actions, images 180, prompts, layer configurations 170, or selections or actions of a previous session performed by the user, and may initially be empty. The user profile 165 may enable simplified communication with the user by presenting the user with a session that is most likely to help the user reduce a functional impairment or improve cognitive function based at least on the user profile 165. This targeted approach may reduce the need to communicate with the user multiple times, thereby reducing bandwidth and increasing the benefits of user-computer interaction.

[0085] In some embodiments, the user profile 165 may identify or include information about treatment regimens taken by the user, such as treatment type (e.g., therapy, medication, or psychotherapy), duration (e.g., day, week, or year), and frequency (e.g., daily, weekly, quarterly, annually), etc. The user profile 165 may be stored and maintained in the database 160 using one or more files (e.g., Extensible Markup Language (XML), Comma Separated Values ​​(CSV) delimited text files, or Structured Query Language (SQL) files). The user profile 165 may be iteratively updated as the user provides responses, makes selections, and performs actions related to sessions, layer configurations 170, or images 180, etc.

[0086] The layer configuration 170 may identify or include a set of instructions that define each layer to be provided as a session for the application 125 on the user device 110 through the user interface 130. The layer configuration 170 may correspond to or include a layer, a therapeutic technique, an image, a prompt, or other display to be presented to the user via the application 125 during the session. In some embodiments, the layer configuration 170 may be used for social skills training. For example, for a first layer, the layer configuration 170 may identify a file corresponding to a character image 180 and define prompts for candidate selections of social cues detected in the image 180. For a second layer, the layer configuration 170 may identify a file corresponding to an image 180 of a social setting with one or more characters and define prompts for candidate selections of responses to the settings depicted in the image 180. For a third layer, the layer configuration 170 may identify prompts for guiding a user of the application 125 to perform an activity in the user's surrounding environment (e.g., an interaction with another person).

[0087] In some embodiments, the layer configuration 170 can be used for non-social skill training, such as verbal memory training, to address verbal learning and memory and cognitive association barriers. For example, for the first layer, the layer configuration 170 can identify files corresponding to the image 180 and the audio recording 185, and define prompts for candidate selections of one or more words presented in the audio recording 185. For the second layer, the layer configuration 170 can identify files corresponding to the image 180 or the audio recording 185 of the conversation between individuals in the virtual setting, and define prompts for candidate selections of responses associated with the information presented in the conversation. For the third layer, the layer configuration 170 can identify prompts for guiding the user of the application 125 to perform activities in the user's surrounding environment (e.g., interaction with another person). The layer configuration 170 can be maintained in the database 160 using one or more files (e.g., extensible markup language (XML), comma separated value (CSV) delimited text files, or structured query language (SQL) files, etc.).

[0088] The images 180, audio recordings 185, layer configurations 170, identification of actions or prompts may be stored and maintained on the database 160. For example, the database 160 may use one or more data structures or files to maintain the images 180 and audio recordings 185. Each of the images 180 may prompt a user to perform an action via the application 125 or to make a selection via the application 125. For example, the application 125 may receive instructions to present a layer including one or more images 180. The layers and sessions may be used to provide therapy to improve cognitive function, such as social or non-social skills, symptoms of a condition, or other cognitive or behavioral effects of a condition, etc. The session may be presented as a game, activity, or action performed by a user via the user interface 130. For example, one or more sessions may be presented as a sequence of images 180 with a prompt including a user query to select an interactive element (e.g., UI element 135) associated with the query and the image 180.

[0089] Reference now Figure 2 , depicts a block diagram of a process 200 for identifying a set of sessions to address a user's dysfunction and providing a first session of a cognitive training layer for the set of sessions. The process 200 may include or correspond to operations performed in the system 100 to present an interactive session to address a user's dysfunction. Under the process 200, the session manager 140 executed on the session management service 105 may access the database 160 to retrieve, obtain, or otherwise identify a user profile 165 of a user 210 (sometimes referred to herein as a subject, patient, or individual) of an application 125 on a user device 110. The user profile 165 may identify or define information associated with the user 210, an instance of the application 125 on the user device 110, and the user device 110, etc. For example, the user profile 165 may identify that the user 210 has a dysfunction, symptoms associated with a condition, or other cognitive or behavioral results from the condition. The user profile 165 may identify medications taken by the user 210 to address the user's 210 condition or symptoms associated with the condition, etc.

[0090] The session manager 140 may determine or identify a set of sessions for the user 210 for addressing a functional impairment associated with a condition. Each session may correspond to a corresponding layer to address an impairment associated with the condition of the user 210. Each layer may correspond to one or more cognitive remediation exercises to help the user 210 overcome or improve the functional impairment. For example, each layer may include a different therapy designed to teach the user 210 social skills or recognize social cues. The session manager 140 may identify sessions for a functional impairment associated with the condition of the user 210 associated with the user profile 165.

[0091] The user profile 165 may include information about the image 180, the layer configuration 170, previous sessions (such as previous selections identified for the user 210), performance associated with sessions that have been identified for the user 210, or medications taken by the user 210 to address the user's condition, etc. The user profile 165 may also identify or include information about recorded dysfunctional performance, such as the number of occurrences of failed social interactions, symptoms associated with the condition, the number of occurrences of participating in social settings, the duration of previous occurrences, and taking medications, etc. The user profile 165 may initially lack information about previous sessions and may build information as the user 210 participates in a session via the application 125. The user profile 165 may be used to select one or more sessions to be provided to the user 210 in the session via the application 125.

[0092] The session manager 140 may initiate a session in response to receiving a request from the user 210 via the application 125. The user 210 may provide a request to initiate a session via the user interface 130 for execution through the application 125. The request may include information related to the functional disorder. The request may include attributes associated with the condition, such as an identification of the user 210 or the user profile 165, symptoms associated with the condition of the user 210, the time of the request, or the severity of the condition, etc. The application 125 operating on the user device 110 may generate a request to initiate a session to send to the session management service 105 in response to the user 210 interacting with the application 125 (such as selecting one or more selections 205 by the user 210 through the UI element 135). In some embodiments, the session manager 140 may initiate or identify a session in response to a scheduled session time, in response to the completion of a previous session, or based on the user 210 taking a prescribed medication to address the condition, etc.

[0093] In some embodiments, the session manager 140 may identify a session based on a predefined session schedule. For example, the session manager 140 may identify a first session including a cognitive training skill layer associated with a disease according to a predefined task schedule. In this illustrative example, the session manager 140 may identify a second session based on a subsequent session of a predefined schedule. For example, a predefined session schedule may include a first, second, and third session corresponding to different psychosocial therapies. The session manager 140 may define a schedule or time to identify or provide a session or mark a session for presentation. In some embodiments, the session manager 140 may identify a session based on a set of rules. The rules may be configured to provide a session to target the root cause of the disease or train the user 210 to improve the social and non-social skills of the user 210 in a systematic, objective, and therapeutically effective manner. The rules may be based on the completion time of the action or selection 205 associated with the session, user profile 165, prompt, or other attributes of the system 100.

[0094] Once identified, session manager 140 may provide, send, or otherwise communicate one or more sessions to user device 110. In some embodiments, session manager 140 may send instructions for presenting the session and its corresponding image and prompt via user interface 130 of application 125 on user device 110. The instructions may include, for example, specifications regarding which UI elements 135 are to be used and may identify content to be displayed on UI elements 135 of user interface 130. The instructions may further identify or include image 180. The instructions may be code, data package, or control for presenting the session to user 210 via application 125 running on user device 110.

[0095] The session manager 140 may create, write, or otherwise generate instructions for the session 220 based on the layer configuration 170 of the identified session 220. The session 220 may be a first session and may include a cognitive training layer such as stored in the layer configuration 170A. For the session 220, the session manager 140 may select or identify a set of images 180A-N (hereinafter generally referred to as images 180), a set of audio recordings 185A-N (hereinafter generally referred to as audio recordings 185), and prompts 230A-N (hereinafter generally referred to as prompts 230) to be displayed during the session 220. The session manager 140 may select the images 180 and prompts 230 based on the layer configuration 170A, the user profile 165, or previous sessions, etc. For example, the session manager 140 may select images and prompts 230 to address verbal memory, social skills, or other areas in which the user may suffer from impairment. The session manager 140 may identify or select images 180 and prompts 230 as part of the session to provide a cognitive training layer for the user 210 who is experiencing functional impairment associated with a condition.

[0096] In some embodiments, the session manager 140 may select or identify a set of audio recordings 185 for the session 220. The selection may be based on the layer configuration 170A, the user profile 165, or a previous session, etc. Each recording 185 may correspond to or be associated with one or more words. For example, the set of selected recordings 185 may correspond to a list of words to be presented to the user 210. The session manager 140 may also identify or specify a format in which the set of audio recordings 185 are to be presented. The format may identify or define the context in which the words in each audio recording 185 are to be presented. For example, the format may include a list of words or a sentence, etc.

[0097] The session manager 140 may provide instructions for the session 220 to display the image 180, the audio recording 185, and the prompt 230 on the application 125. The session manager 140 may transmit the session 220 to the user device 110 for execution through the application 125. The session manager 140 may provide the image 180 or the audio recording 185 (or both) as part of the session 220. The session manager 140 may provide the prompts 230A-N as part of the session 220 at least partially simultaneously with the presentation of the image 180 or the audio recording 185. The instructions may also include prompts instructing the user 210 to make a selection 205 or perform an activity related to their session. For example, the prompt 230 may display a message instructing the user 210 to make a selection 205 of the UI element 135. The image 180 may include text, images, audio, or video presented by the user device 110 via the application 125. For example, the image 180 may include the presentation of an image indicating that the user 210 interacts with the application 125 via the user interface 130.

[0098] Conversation manager 140 may provide prompt 230 as part of conversation 220 at least partially concurrently with the presentation of images 180 or audio recording 185. Instructions may also include prompt 230 instructing user 210 to make selection 205 to indicate which word or words were presented during the presentation of audio recording 185. For example, prompt 230 may display a message instructing user 210 to make selection 205 for UI element 135. At least some of images 180 may correspond to words presented in audio recording 185, and at least some of images 180 may not correspond to any words presented through audio recording 185. For example, when at least one of audio recordings 185 presents the word "banana," images 180 may depict different fruits.

[0099] Applications 125 on user device 110 may render, display, or otherwise present one or more sessions 220. Session 220 may be presented via one or more UI elements 135 of user interface 130 of application 125 on user device 110. Presentation of UI elements 135 may present session 220 to user 210 via application 125 according to instructions provided by session manager 140. In some embodiments, application 125 may render, display, or otherwise present various aspects of session 220, such as images 180, audio recordings 185, or prompts, independently of session management service 105.

[0100] Application 125 can render, display or otherwise present image 180 and audio recording 185 for conversation 220. Image 180 can include one or more clues 235 to teach or train user 210 to identify such clues 235 for social skills. Clues 235 can relate to or include social clues. As described herein, social clues can be an indication of social behavior exhibited by a character or person. In some embodiments, a neurologically normal person (e.g., a person who does not experience a disorder associated with user 210) can easily identify social clues and can make social decisions or interactions based on observed social clues. For example, a user 210 who experiences the disorder may have difficulty understanding social clues.

[0101] The clues 235 may include at least one of head movement (e.g., nodding, shaking, tilting, or other head gestures), body language (e.g., facial expressions, overall body posture, and proximity to another character), gestures (e.g., using a finger to point or express emotions through hands or fingers), or eye contact (e.g., the orientation of eyes with respect to another person to show engagement or emotion), etc. For example, an image 180 displayed on the user interface 130 via the application 125 may depict social clues 235, such as a character nodding, a character smiling, a character making eye contact, a character avoiding eye contact, a character crossing arms, a character waving, a character frowning, a character talking with his hands, a character shaking his head, etc. In some embodiments, the social clues 235 may be described in text in the image. For example, the image 180 may include text describing the character's body language. In some embodiments, the presented image 180 may lack clues 235. For example, when the application 125 plays back a set of recordings 185, the image 180 displayed by the application 125 may lack any social clues 235.

[0102] In conjunction, application 125 may present prompts 230A-N associated with session 220. Prompt 230 may include text or an image associated with image 180. Prompt 230 may indicate selection 205 for user 210 to select. In some embodiments, prompt 230 may include or be coupled with UI elements 135A-N. UI elements 135A-N may identify one or more types of social cues 235 depicted in image 180. The types of social cues 235 may include the physicality of cues 235 (e.g., head movement, body language, gestures, or eye contact, etc.) or the context of cues 235 (e.g., cues 235 indicating that a character is busy, annoyed, hurried, not paying attention, etc.). Application 125 may share or have the same functionality as session manager 140, interaction handler 145, execution evaluator 150, or other components of session management service 105 as described above. For example, application 125 may maintain a timer to record the time that has passed since a previous session was presented.

[0103] In some embodiments, the application 125 may display, render, or otherwise present the image 180 or prompt at different time periods. The application 125 may present the first image 180A at a first time period and the second image 180B at a second time period. For example, the application 125 may present the first image 180A during the first time period and then present the second image 180B during the second time period. In some cases, the application 125 may delay the presentation of the second image 180B during the session after displaying the first image 180A. The application 125 may present the images 180A and 180B or prompts simultaneously. Presenting the images 180 or prompts simultaneously may refer to displaying the images 180 or prompts during the same time period or at the same display position on the user interface 130. In combination, the application 125 may display prompts 230A-N to guide the user 210 to interact with the display. The images 180 or UI elements 135A-N may include prompts for the user 210 to perform actions or selections 205 associated with the session 220. Selection 205 may include actions such as physical manipulation of user device 110 , actuation of UI element 135 , or viewing of a video or image of image 180 .

[0104] In some embodiments, session manager 140 may provide user 210 with a series of images 180 (or audio recordings 185) and prompts 230 to provide selections 205 based on clues 235 depicted in images 180. User 210 may make a selection indicating clues 235 via UI element 135. For example, image 180 may include a picture of a person shaking his head. Prompts 230 may be coupled with UI element 135 or separate, and may instruct user 210 to select one or more of UI elements 135 based on clues 235 (e.g., shaking head, audio) presented in image 180. For example, first prompt 230A may be coupled with first UI element 135A and may include text stating "If she says 'yes', then select me", and second prompt 230B may be coupled with second UI element 135B including text stating "If she says 'no', then select me". In this manner of prompt selection based on cues 235 associated with presented images 180 , user 210 may iteratively perform training exercises to teach user 210 to recognize social cues 235 .

[0105] In some embodiments, the application 125 can play back or present the group of audio recordings 185 to the user 210 (e.g., via a speaker or headphones). The presentation of the audio recordings 185 can be in accordance with a specified format that defines the context in which the words are to be presented. For example, when the format specifies that the words corresponding to the audio recordings 185 are a list of words, the application 125 can play the group of audio recordings 185 sequentially. The application 125 can also play a single audio recording 185 when the format specifies that the words form a sentence to be presented to the user 210. In conjunction with the presentation of the audio recordings 185 or after the presentation of the audio recordings 185, the application 125 can present or display a prompt 230 for the user 210 on the user interface 130. The prompt 230 can allow the user 210 to provide a selection 205 to identify at least one word in a group of words as presented in the group of recordings 185. The words can be presented in the form of text or an image 180 representing an object. Prompt 230 may include any number of inquiries, such as whether a word was presented; which word was presented; which word was not presented; which of the words was presented; one word from a list, one word not from a list; n words from a list, one word from a list; and one word from a list, one word not from a list, etc. Prompt 230 may be presented in conjunction with or after presentation of audio recording 185. In some embodiments, application 125 may present at least one UI element 135 to allow user 210 to replay audio recording 185.

[0106] In some embodiments, the audio recording 185 may be accompanied by one or more images 180 to teach the user 210 to understand, know, and remember auditory information, such as words, sentences, and stories. As an illustrative example, the third prompt 230C may be coupled to multiple UI elements such as UI element 135. The third prompt 230C may instruct the user to select a UI element 135 that corresponds to an audio clue played for the user via a speaker coupled to the client device. For example, the audio clue may play the word "cat", and the third prompt 230C may require the user 210 to select the UI element 135 corresponding to the audio clue. UI elements 135C-E may include corresponding text, such as "horse", "dog", or "cat", and the user may select a UI element 135 that is considered to correspond to the third prompt 230C that includes the word "cat". In this manner based on the prompt selection of the clue 235 associated with the presented image 180, the user 210 may iteratively perform training exercises to help the user.

[0107] The application 125 may monitor at least one selection 205 of the UI elements 135A-N. The application 125 may monitor during the session in response to the presentation of the image 180, the presentation of the prompt 230, or in response to receiving the selection 205. The application 125 may monitor the receipt of the selection 205. The application 125 may monitor the selection 205 through the user interface 130 or through a sensor associated with the user device 110, etc. The application 125 may receive multiple selections 205 during the session. For example, the application 125 may monitor a series of selections 205 provided by the user 210 during the session. The application 125 may monitor and record information related to the received selections 205. For example, the application 125 may monitor and record the time of the selection 205, the duration of the selection 205, the sequence of the selections 205, the prompt 230 or image 180 associated with the selection 205, and / or the delay time between the presentation of the prompt 230 or image 180 and the selection 205, etc.

[0108] When user 210 provides selection 205, application 125 may generate at least one response 225. Response 225 may identify selection 205. Response 225 may include information about selection 205, such as the duration of selection 205, the time of selection 205, an image 180 or prompt 230 associated with selection 205, and / or a delay time between presentation of image 180 or prompt 230 and selection 205, etc. Application 125 may generate response 225 for transmission to session management service 105. Response 225 may be in a format readable by session management service 105, such as an electronic file readable by session management service 105 or a data packet readable by session management service 105, etc.

[0109] The interaction handler 145 may receive, identify, or otherwise detect a response 225 identifying a selection 205. The interaction handler 145 may receive the response 225 from the application 125. The interaction handler 145 may receive the response 225 at predetermined time intervals or when a selection 205 occurs during the session 220. The interaction handler 145 may query or ping the application 125 to obtain the response 225. The interaction handler 145 may receive multiple responses 225 during a time period. For example, the interaction handler 145 may receive a first response 225 indicating a first selection 205 and a second response 225 indicating a second selection 205.

[0110] The interaction handler 145 may store and maintain responses 225 including the selections 205 in the database 160. The interaction handler 145 may store information related to the responses 225, including the time of the response 225, the action associated with the selection 205, the user profile 165 associated with the response 225, and the image 180 or prompt 230 associated with the response 225, etc. The response 225 may include or identify the selection 205 by the user 210 using the UI element 135. The response 225 may identify the type of social clue 235 depicted in the image 180. In some embodiments, the response 225 may identify one or more words presented through the audio recording 185. The response 225 may include the time when the task was completed. For example, the response 225 may include that the user took 4 minutes to perform an action associated with the presentation of the session 220.

[0111] The response 225 may include the total time to complete the session 220 and may also include the time the session 220 was initiated and the time the session 220 was completed. The response 225 may include UI elements 135 that were interacted with during the presentation of the session 220. For example, the response 225 may include a list of buttons, toggles, or other UI elements 135 selected by the user 210 at a specified time during the presentation of the session 220. The response 225 may include other information, such as the location of the user 210 when the session was performed, such as a geographic location, IP address, GPS location, or triangulation of cellular towers. The response 225 may include measurements, such as measurements of time, location, or user data.

[0112] In some embodiments, the performance evaluator 150 may generate performance metrics 215 based at least on the selections 205, the responses 225, the user profile 165, or previous sessions, etc. The performance metrics 215 may be qualitative (e.g., "poor," "average," "good") or quantitative (e.g., numerical) scores to indicate the performance of the user 210 during the session 220 or a series of sessions. The performance evaluator 150 may generate the performance metrics 215 based on the correct selection 205 rate of the cognitive training layer. For example, a series of images 180 (or audio recordings 185) and prompts 230 may be provided to the user 210 as part of the session 220. The user 210 may provide one or more selections 205 during the session 220. In some cases, the selections 205 made by the user 210 may correctly identify the social cues 235 depicted in the images 180, and in some cases, the selections 205 made by the user 210 may not correctly identify the social cues 235. In some embodiments, the selections 205 made by the user 210 may identify (e.g., correctly or incorrectly) words presented via the audio recording 185. The execution evaluator 150 can determine the execution metric 215 based on the ratio of correct selections 205 to incorrect selections 205, the ratio of correct selections 205 to total selections 205, the ratio of incorrect selections 205 to total selections 205, the ratio of correct or incorrect selections 205 during a time period, the ratio of correct or incorrect selections 205 during the duration of a session 220, etc.

[0113] The execution evaluator 150 may determine whether the execution of the user 210 is equal to or above a threshold execution. The execution evaluator 150 may compare the determined execution metric 215 to the threshold execution. When the execution evaluator 150 determines that the execution metric 215 is below the threshold execution, the execution evaluator 150 may instruct the session manager 140 to maintain the current session 220. Conversely, when the execution evaluator 150 determines that the execution metric 215 is at or above the threshold execution, the session 220 may be considered completed or passed. When the session 220 is completed or passed, the session manager 140 may determine to present a second session to the user 210 via the application 125. For example, when the execution metric 215 satisfies the threshold, the session manager 140 may determine to transition the user 210 from the cognitive training layer associated with the session 220 to a different layer, such as a virtual functional training layer.

[0114] In addition, the feedback provider 155 can generate, output or otherwise generate feedback that the user 210 receives via the application 125 operating on the user interface 130. The feedback provider 155 can generate feedback based on at least the execution metrics 215, the response 225, the prompt 230 including the query, the user profile 165 or the historical session, the image 180, the audio recording 185, or the prompt presentation. The feedback may include text, video, or audio presented to the user 210 via the application 125 displayed by the user interface 130. The feedback may include the presentation of the execution metrics. The feedback may display messages such as motivational messages, suggestions for improving execution, congratulatory messages, or comforting messages. In some embodiments, the feedback provider 155 may generate feedback during a session that the user 210 is executing. In some embodiments, the feedback may include an indication of the correct response to the query in the prompt 230.

[0115] The interaction handler 145 may provide, send or otherwise transmit feedback to the application 125 for display on the user interface 130. The interaction handler 145 may provide instructions for rendering or displaying feedback. The interaction handler 145 may transmit a data packet, a signal or other instructions to indicate the presentation of feedback to the application 125. After receiving the feedback, the application 125 may present the feedback to the user 210 via the user interface 130. The presentation of the feedback may include a UI element 135. For example, the user 210 may make a selection related to the feedback, such as increasing the difficulty of the session or resuming the session 220. In some embodiments, the application 125 may also present the feedback to indicate the correct response. For example, if the user's selection is incorrect, the application 125 may set the color of the UI element 135 corresponding to the user's selection to indicate that the user's selection is incorrect (e.g., set to red). The application 125 may also set the color of the UI element 135 corresponding to the correct response to a different color (e.g., set to green). Otherwise, if the user's selection is correct, the application 125 may set the color of the UI element 135 corresponding to the user's selection to indicate that the user's selection is correct (eg, to green).

[0116] Reference now Figures 3A-3H , depicting an example set 300A-H of user interfaces for providing a first session. The set 300 may be presented via the application 125. The application 125 may be presented on a user interface or display such as the user interface 130 of the user device 110 associated with the first layer. The first session depicted by the set 300 may be associated with a cognitive training layer, such as reference Figure 2Depicted. In set 300A-B, a user (e.g., user 210) can interact with user interfaces 305A-310B. User interfaces 305A-310B can include one or more user elements, such as UI element 135, to accept input from user 210 using at least one hand 525. Interfaces 305A and 305B can be prompts to inform the user how to perform subsequent tasks. Interfaces 310A and 310B can include a pair of images 315A and 315B or a single image 303 with a character, and a prompt for the user to select a character with a specific social clue (e.g., busy, conversation flow status, and attention).

[0117] In set 300C, user interface 305C may include a play button 306 to start playing a set of audio recordings 185 corresponding to a list of words. When the button is pressed, application 125 may present user interface 309 in conjunction with playback of the set of audio recordings 185. When playback of the audio recordings is complete, application 125 may present user interface 310C to prompt user 210 whether a certain word (e.g., "milk") is presented. Set 300D may be a continuation of set 300C. Through the user interface, application 125 may continue to prompt user 210 to select whether to play a certain word. Application 125 may also present a user interface to prompt user 210 whether a certain word is not played. In addition, application 125 may present a user interface to prompt whether to play a certain word using images depicting various words (e.g., yogurt and banana as shown). The user interfaces shown in sets 300E-H may allow users to go through similar exercises. For example, in set 300E, the user may be prompted to indicate whether a word is presented, and in set 300F, the user may be prompted to indicate whether a word is presented at a particular position within a played list of words.

[0118] Reference now Figure 4 , depicts a block diagram of a process 400 for providing a second session for a virtual functional training layer for a user to apply social skills in a virtual social setting. The process 400 may include or correspond to operations performed in the system 100 or the process 200. Under the process 400, the session manager 140 may provide a session 420 corresponding to the virtual functional training layer. The interaction handler 145 may receive a response 425 indicating a set of selections 205' from the user 210. The execution evaluator 150 may generate or determine an execution metric 415 for the session 420. The feedback provider 155 may generate feedback 450 based on its execution during the session 420 to provide to the user 210. The interaction handler 145 may transmit the feedback 450 to the application 125 for presentation to the user 210.

[0119] The session manager 140 may provide the session 420 for presentation to the user 210 via the application 125. The session manager 140 may be used in conjunction with Figure 2 Session 420 may be provided by similar operations in process 200 described in connection with session 220 in connection with the present invention. Session 420 may include images 180'AN (hereinafter collectively referred to as images 180'), audio recordings 185'AN (hereinafter collectively referred to as audio recordings 185'), and prompts 430A-N (hereinafter collectively referred to as prompts 430). Images 180' and prompts 430 may be similar or analogous to images 180 and prompts 230.

[0120] The session 420 may be a second session corresponding to the virtual functional training layer. The virtual functional training layer may provide a virtual setting 435 including one or more characters 440 for presentation to the user 210 within the image 180'. The virtual functional training layer may be used to provide a virtual, artificial, or otherwise generated environment for display through the user interface 130 to train the user 210 to recognize and react to the virtual setting 435. In some embodiments, the second session may be a virtual functional training layer in which the user 210 applies social skills (e.g., social perception) or non-social skills (e.g., verbal memory). In this way, by providing a second session with a virtual setting 435, the session management service 105 may build on the teachings of the previous session 220.

[0121] Virtual setting 435 may correspond to or refer to a virtual social setting. A social setting may include an environment in which one or more people or characters 440 interact socially with each other. For example, a social setting may include a party, a store, a school, an office, a workplace, a park, or other settings in which interaction with other characters 440 is common or expected. Interaction with other characters 440 may include conversations, written communications, body movements (e.g., handshakes or hugs), or other forms of verbal or non-verbal communication. In some embodiments, image 180' may depict a virtual setting 435 including one or more characters 440, such as an office, a store, a party, etc., as part of a conversation 420 via user interface 130. In some embodiments, virtual setting 435 may be presented via a set of audio recordings 185' of a conversation between two or more individuals. Virtual setting 435 may lack image 180' and may lack a depiction of the characters 440 within image 180'.

[0122] One or more characters 440 may include the people shown in image 180'. Characters 440 may include a librarian, a cashier, a passerby, a coworker, a child, a police officer, a clerk, a waiter, a mail carrier, and others that may be encountered in a social setting. Image 180' may depict character 440 interacting with virtual setting 435. For example, image 180' may depict character 440 buying coffee, talking to a police officer, or passing another character in a store. Image 180' may depict character 440 performing or displaying social cues, such as regarding Figure 2 235 clues depicted.

[0123] The session manager 140 may provide a session 420 including a prompt 430. The prompt 430 may correspond to an image 180' or an aspect thereof, such as a virtual setting 435 or a character 440. In some embodiments, the prompt 430 may include a query or question. The query or question may be displayed as a text or symbol image or presented as audio via the user device 110. The query may correspond to the image 180'. The query may be associated with the character 440 depicted in the virtual setting 435. In some embodiments, the query identified by the prompt 430 may be related to a clue depicted by the character 440 in the image 180'. For example, the prompt 430 may include a query such as "What should the character say to order coffee?" or "Is the barista busy?" The prompt may include any query related to the character 440 depicted in the virtual setting 435 to enable the user 210 to determine an appropriate or correct response based on the image 180'.

[0124] In some embodiments, the session manager 140 may provide images 180' (or audio recordings 185') for presentation via the user interface 130 of the application 125 in a defined sequence. The session manager 140 may present one or more images 180' during the session 420. The images 180' of the defined sequence may include the same character 440, the same virtual setting 435, different characters 440, different virtual settings 435, or a combination thereof. In some embodiments, the sequence of images 180' may depict a sequence or causal group of social cues or interactions. For example, a first image 180A' may depict a character ordering coffee, and a second image 180B' may depict a character subsequently receiving their coffee. As another example, a first image 180A' may depict a character blocking another character, and a second image 180B' may depict a character giving way to another character. In some embodiments, the sequence of images 180' may be determined by the session manager 140 based on a defined set of images 180', or the session manager 140 may determine the sequence of images 180' based on the user profile 165, a response 425 from the user 210, or an execution metric 415 associated with the user 210 during the session 420.

[0125] In some embodiments, the session manager 140 may provide instructions for the session 420 to present the image 180', the audio recording 185', and the prompt 430 on the application 125. The session manager 140 may provide the image 180' or the audio recording 185' (or both) as part of the session 420. The session manager 140 may provide the prompt 430 as part of the session 420 at least partially simultaneously with the presentation of the image 180' or the audio recording 185'. In some embodiments, the session manager 140 may provide one or more audio recordings 185' of speech samples from at least one speaker associated with the virtual setting 435. The speech samples may correspond to one or more sentences of the speaker, such as statements, questions, explanations, requests, commands, or suggestions, etc. In some embodiments, the recording may be a conversation between two or more speakers. The conversation may be speech between characters in the virtual setting 435. In some embodiments, the session manager 140 may provide instructions to include one or more images 180' associated with a set of audio recordings 185'. For example, the image 180' may include a depiction of the virtual setting 435 and avatars corresponding to speakers in a conversation presented via the audio recording 185'. In some embodiments, the image 180' may include a depiction of the virtual setting 435 without any characters. For example, the audio recording 185' may be a conversation about refueling a car, and the image 180' accompanying the presentation of the audio recording 185' may be a gas station.

[0126] In some embodiments, the instructions may also include a prompt 430 instructing the user 210 to make a selection 205' to indicate what information is presented during the presentation of the audio recording 185. The information may be inferred or associated with the words presented during the conversation 420. For example, the prompt may display a message instructing the user 210 to make a selection 205' for the UI element 135. At least some of the images 180 may correspond to the information presented in the audio recording 185, and at least some of the images 180 may not correspond to any information presented through the audio recording 185. In some embodiments, the prompt 430 may identify or include a query associated with the conversation presented in the audio recording 185'. The query of the prompt 430 may be to recall the information conveyed in the voice sample in the audio recording 185 in the virtual setting 435.

[0127] When presenting one or more images 180' including a virtual setting 435 and a character 440, the user 210 can make a selection based on the prompt 430. The user 210 can make a selection 205' through the UI element 135 to answer the prompt including a query related to the image 180'. In some embodiments, the UI element 135 may include other prompts 430. The user 210 selects the UI element 135 in response to the presentation of the prompt 430, which includes the query, the image 180', the character 440, the virtual setting 435, or a combination thereof.

[0128] The application 125 may monitor one or more selections 205' via the UI element 135. The application 125 may monitor one or more selections 205' via the UI element 135. Figure 2 4. The application 125 may monitor one or more selections 205' in a similar manner as described for selection 205 in . Upon detecting a selection 205', the application 125 may generate at least one response 425. The response 425 may identify the selection 205'. The response 425 may include information related to the selection 205', such as the duration of the selection 205', the time of the selection 205', the image 180' or prompt 430 associated with the selection 205', and / or the delay time between the presentation of the image 180' or prompt 430 and the selection 205'. The application 125 may generate the response 425 for transmission to the session management service 105. The response 425 may be in a format readable by the session management service 105, such as an electronic file readable by the session management service 105, or a data packet readable by the session management service 105.

[0129] In some embodiments, the application 125 may play back or present the set of audio recordings 185' to the user 210 as part of a conversation 420 (e.g., via a speaker or headset). The set of audio recordings 185' may include a recording of a voice sample from at least one speaker associated with a social setting. In some embodiments, the recording may be a conversation between two or more speakers. The voice sample may include one or more pieces of information that the user 210 will be queried for after or in conjunction with the presentation of the audio recording 185'. In some embodiments, the application 125 may display one or more images 180' in conjunction with the presentation of the audio recording 185'. The images 180' may depict a social setting in which the characters are conversing.

[0130] In conjunction with or after the presentation of the audio recording 185', the application 125 may present or display a prompt 430 to the user 210 on the user interface 130. The prompt 430 may allow the user 210 to provide a selection 205 to identify information presented in a conversation from a set of audio recordings 185'. The information may correspond to semantic content that may be inferred or otherwise associated with one or more words presented in a set of audio recordings 185'. The prompt 430 may ask the user 210, for example, to indicate whether a particular statement about the content presented in the audio recording 185' is true. The prompt 430 may be presented in conjunction with or after the presentation of the audio recording 185'. In some embodiments, the application 125 may present at least one UI element 135 to allow the user 210 to replay the audio recording 185'.

[0131] The interaction handler 145 may receive, identify, or otherwise detect a response 425 identifying a selection 205'. The interaction handler 145 may receive the response 425 from the application 125. The interaction handler 145 may receive the response 425 at predetermined time intervals or when a selection 205' occurs during the session 420. The interaction handler 145 may query or ping the application 125 for the response 425. The interaction handler 145 may receive multiple responses 425 during a time period. For example, the interaction handler 145 may receive a first response 425 indicating a first selection 205' and a second response 425 indicating a second selection 205'.

[0132] The interaction handler 145 may store the response 425 including the selection 205' in the database 160. The interaction handler 145 may store information related to the response 425, including the time of the response 425, the action associated with the selection 205', the user profile 165 associated with the response 425, and the image 180', audio recording 185', or prompt 430 associated with the response 425, etc. The response 425 may include or identify the selection 205' that the user 210 adopted the UI element 135. In some embodiments, the response 425 may identify the type of social clues depicted in the image 180, the appropriate social interaction given the virtual setting 435, or the social clues associated with the character 440. In some embodiments, the response 425 may indicate the information presented in a set of audio recordings 185'. The response 425 may include the time when the task was completed. For example, the response 425 may include that the user 210 took four minutes to perform the action associated with the presentation of the session 420.

[0133] In some embodiments, response 425 may include the total time to complete session 420 and may also include the time session 420 was initiated and the time session 420 was completed. Response 425 may include UI elements 135 that were interacted with during the duration of the presentation of session 420. For example, response 425 may include a list of buttons, toggles, or other UI elements 135 selected by user 210 at a specified time during the presentation of session 420. Response 425 may include other information, such as the location of user 210 when the session was performed, such as a geographic location, IP address, GPS location, or triangulation of cellular towers. Response 425 may include measurements, such as measurements of time, location, or user data.

[0134] Execution evaluator 150 may calculate, generate, or otherwise determine execution metrics 415 associated with session 420 based on response 425. Execution metrics 415 may be or include Figure 2 4. In some embodiments, execution evaluator 150 may determine execution metric 415 based on previous execution metric 415. In some embodiments, execution evaluator 150 may maintain separate execution metrics for each session or may generate a combined execution metric. In some embodiments, a high execution metric 415 may correspond to a user performing well in session 420 (e.g., selecting the correct choice 205').

[0135] Correct selection 205' may refer to a selection representing a correct response to a query about virtual setting 435 and character 440 posed by prompt 430. Correct response 425 may be associated with a social interaction that is socially acceptable or polite, well-behaved, moral, or emotionally stable in the presented virtual setting 435. For example, a correct response to the query "How do you order coffee?" in virtual setting 435 may be indicated by UI element 135A depicting the words "say 'I'd like to order a medium black coffee'". In some embodiments, correct response 425 may correspond to a selection of information inferred from a conversation in a set of audio recordings 185' presented to user 210. For example, in a conversation where two interlocutors are discussing which item to purchase at a grocery store, correct response 425 may be associated with an action related to purchasing the item discussed in the conversation.

[0136] In contrast, an incorrect response may be indicated by a UI element 135B depicting the words "say 'give me coffee'" or a UI element 135C depicting "take someone else's coffee." In this manner, an incorrect response may be associated with a socially inappropriate action, an immoral action, an abnormal behavior, or an emotionally unstable action. Examples of incorrect responses include shouting, stealing, physical fighting, lying, or being rude. In some embodiments, incorrect response 425 may correspond to a selection of information that cannot be inferred from a conversation in a set of audio recordings 185' presented to user 210. For example, in a conversation where two individuals are discussing vacation plans, incorrect response 425 may be associated with an incorrect amount for the vacation budget.

[0137] Based on whether the response 425 is correct or incorrect, the execution evaluator 150 can calculate, generate or otherwise evaluate the execution metric 415 of the user 210 based on the selection 205' associated with the response 425. For example, the execution evaluator 150 can set the execution metric 415 of the given response 425 or session 420 to "1" when correct, and to "-1" when incorrect. In some embodiments, the execution evaluator 150 can identify the reaction time or correctness of the user 210 when selecting the selection 205'. For example, the execution evaluator 150 can determine from the response 225 that the user 210 did not perform one or more actions indicated by the prompt 430 or the image 180', or that the user 210 did not perform the action within a threshold time. The threshold time can correspond to or define the amount of time that the user 210 is expected to make the selection 205' with one of the UI elements 135 and can be in the range of from 5 seconds to 10 minutes. Through this determination, the execution evaluator 150 can modify or adjust the execution metric 415 using the response time compared to the threshold time.

[0138] In some embodiments, performance evaluator 150 may calculate, generate, or otherwise determine performance metrics 415 associated with an increase in cognitive function or a decrease in dysfunction (e.g., social processing or non-social processing) of user 210. Performance evaluator 150 may determine performance metrics 415 based on a delay time between the presentation of image 180' and the receipt of response 425. For example, the delay time between a subsequent presentation of image 180' (or audio recording 185') and the receipt of selection 205' may decrease. A decrease in delay time may indicate an increase in cognitive function or a decrease in dysfunction of user 210.

[0139] The session manager 140 may modify the session 420 (e.g., including the presentation of the image 180', the audio recording 185', and the prompt 430) based on the execution metrics 415. In some embodiments, the execution evaluator 150 may generate the execution metrics 415 during the first time period based on the responses 425. The session manager 140 may modify the layer parameters 445A-N associated with the layer of the session 420. The layer parameters 445A-N (hereinafter collectively referred to as layer parameters 445 or parameters 445) may define the presentation of the session 420. The parameters 445 may correspond to the presentation of the image 180', the audio recording 185', the prompt 430, or the UI element 135, etc.

[0140] Parameter 445 may include a modality type of content. The modality type of content may include a manner of presenting session 420, such as auditory, visual, tactile, or text. For example, session manager 140 may modify image 180' to include an auditory reading of the text depicted therein. Parameter 445 may include a context of a social setting in the image. The context of the social setting in the image may relate to information about virtual setting 435 provided during the session, such as the location of virtual setting 435 or social interactions shown in image 180'. Parameter 445 may include the number of characters 440 in virtual setting 435. For example, session manager 140 may add characters 440 to virtual setting 435 or remove characters 440 from virtual setting 435. Parameter 445 may include a prompt type. Prompt types may include queries, actions, or instructions, etc.

[0141] In some embodiments, the session manager 140 may modify the prompt 430 to display an alternative text or image, or to be associated with an alternative UI element 135. The session manager 140 may change the type of prompt from a query to an action, or may reword the query type. Parameter 445 may include a difficulty level for the response. The difficulty level may be related to the frequency with which a group of users select the correct choice for a given prompt. For example, a first prompt that elicits more incorrect responses than a second prompt may be more difficult than the second prompt. Parameter 445 may include a response type. The response type may refer to the UI element 135 selected by the user 210 or may refer to a classification of the response. For example, based on the selection of the UI element 135, the first response may be classified as an "aggressive" response, and the second response may be classified as a "calm" response. Parameter 445 may include the number of responses. For example, the session manager 140 may modify the presentation of the prompt 430 to include more prompts based on the number of responses received by the session manager 140 so far.

[0142] In some embodiments, the session manager 140 may modify the presentation of the audio recording 185' according to a set of parameters 445. The set of parameters 445 may include a set of controls or constraints to be applied to the presentation of the audio recording 185'. In some embodiments, the session manager 140 may use the constraints defined by the set of parameters 445 when selecting a new audio recording 185' for a subsequent session. The parameters 445 may include the inclusion of interference. For example, interference may include adding noise (e.g., Gaussian noise) or including interrupted speech within a speech sample in the audio recording 185'. The parameters 445 may include the ability to repeat the presentation of the audio recording 185'. For example, the constraint may limit the number of times the user 210 can repeatedly press (e.g., one of the UI elements 135) to listen to the audio recording 185'. The parameters 445 may include a modification of the speed. For example, the constraint may specify the playback speed of the audio in the audio recording 185'. The parameters 445 may include the volume (or intensity) of the speech in the audio recording 185'.

[0143] In addition, parameter 445 may also identify the time between each word (or sentence) in audio recording 185'. For example, parameter 445 may define the amount of time between presenting one phrase and a subsequent phrase when presenting audio recording 185'. Parameter 445 may include the number of words in each sentence. For example, a constraint may specify a minimum or maximum number of words presented in each sentence of audio recording 185'. Parameter 445 may include the length of audio recording 185'. The length may specify a minimum or maximum duration of audio recording 185'. Parameter 445 may include the ability to control distractions. For example, user interface 130 may include UI element 135 to include or exclude distractions in the presentation of audio recording 185'.

[0144] The session manager 140 may provide a modified session for presentation at a second time instance. The session manager 140 may provide a modified session including a modified image 180', an audio recording 185', a modified prompt 430, a modified UI element 135, or any combination thereof. In some embodiments, providing the session 420 at the second time instance may include displaying a third image 180C'. The third image 180C' may include a second virtual setting 435, a second prompt 430B, or a second group of UI elements 135B. The second prompt 430B may identify a second query for a second character depicted in the second virtual setting 435. For example, the session manager 140 may modify the prompt by modifying the layer parameters 445 to display a second or different query for a second or different character 440 during the session 420. The group of UI elements 135 may identify a corresponding set of responses associated with the second character. In some embodiments, the session manager 140 may provide the prompt 430 to the modified session to configure, set, or otherwise modify the parameters 445 applied to the presentation of the audio recording 185'. For example, conversation manager 140 may specify that prompt 430 include options for reducing distractions, speaking more slowly, or increasing volume, etc.

[0145] Based on the parameters 445, the application 125 may display a UI element 135 corresponding to a set of selections 205' associated with a second character in a second virtual setting. The application 125 may present the audio recording 185' with one or more constraints applied as defined by the parameters 445. For example, the application 125 may remove the UI element 135 corresponding to the replay button and increase the replay speed of the audio recording 185'. By modifying the parameters 445 of the session 420, the session manager 140 may provide a curated session for the user 210 based on the user's performance as indicated by the performance metrics 415. This cognitive remediation method may reduce computing resources allocated to unrelated sessions and may further improve compliance with the digital therapy regimen. In some embodiments, the application 125 may present a prompt 430 via the UI element 135 to allow the user 130 to modify the parameters 445 applied to the presentation of the audio recording 185'. For example, the user interface 130 of the prompt 430 may include a UI element 135 to reduce distractions, increase volume, reduce speed, and repeat at least a portion of the conversation, etc.

[0146] In addition, the feedback provider 155 may generate, output, or otherwise generate feedback 450 for the user 210 to receive via the application 125 operating on the user interface 130. The feedback provider 155 may generate the feedback 450 based on at least the performance metrics 415, the response 425, the prompt 430 including the query, the user profile 165, or the historical session, the image 180', the audio recording 185', or the prompt presentation. The feedback 450 may include text, video, or audio presented to the user 210 via the application 125 displayed by the user interface 130. The feedback 450 may include the presentation of the performance metrics 415. The feedback 450 may display a message, such as a motivational message, a suggestion to improve performance, a congratulatory message, or a comforting message. In some embodiments, the feedback provider 155 may generate the feedback 450 during the session that the user 210 is performing. In some embodiments, the feedback provider 155 may generate the feedback 450 to provide an explanation text including the correct response. The interpretation text may be maintained and stored on database 160 (eg, using one or more files), and retrieved from database 160 for feedback 450 .

[0147] The interaction handler 145 may provide, send, or otherwise transmit feedback 450 to the application 125 for display on the user interface 130. The interaction handler 145 may provide instructions for rendering or displaying the feedback 450. The interaction handler 145 may transmit a data packet, signal, or other instruction to indicate the presentation of the feedback 450 to the application 125. Upon receiving the feedback 450, the application 125 may present the feedback 450 to the user 210 via the user interface 130. The presentation of the feedback 450 may include a UI element 135. For example, the user 210 may make a selection related to the feedback 450, such as increasing the difficulty of the session or resuming the session 420. In some embodiments, the application 125 may present the feedback 450 to display explanatory text regarding the correct response.

[0148] By determining the execution metric 415 by the execution evaluator 150, the session manager 140 may determine to transition to a third session. The session manager 140 may determine to transition the user 210 from the virtual functional training layer associated with the session 420 to the functional training layer associated with another session. In response to the execution evaluator 150 determining that the execution metric 415 is at or above the threshold, the session manager 140 may provide the third session. The execution evaluator 150 may determine that the execution metric 415 is at or above the execution threshold for the session 420. Conversely, upon determining that the execution metric 415 is at or above the execution threshold for the session, the session manager 140 may provide another session. The execution evaluator 150 may determine that the execution metric 415 is below the execution threshold for the session 420. Upon determining that the execution metric 415 is below the execution threshold, the session manager 140 may maintain the session 420.

[0149] Reference now Figure 5A-5G , depicting a set 500A-G of example user interfaces for providing a second session. Set 500A may include user interfaces 505-520. In some embodiments, set 500 may be part of or included in a second session providing a virtual functional training layer. User interfaces 505-520 may depict example virtual settings, such as reference Figure 4 Depicted virtual setting 435. User interface 520 can include feedback 525 for a user's selection in a previous interface. Feedback 525 can be presented by the service in response to a user's response received at interface 515.

[0150] By providing interface set 500A in a second session (e.g., session 420), a user can be trained in social skills or non-social skills. Social skills can include social interactions in social situations, such as ordering coffee in a store, asking a stranger for directions, or trying to reach an object when another individual is in the way. Non-social skills can include time management and memory skills, such as verbal memory skills, such as remembering spoken words or associating images with spoken phrases. A social setting can include observed interactions between one or more individuals, or interactions with one or more other individuals in which the subject is participating. For example, a subject can read or observe a social setting in which a customer argues with a cashier, or a subject can participate in interactions, such as transactions, conversations, object exchanges, dining, or other social interactions with a variety of individuals (such as cashiers, tellers, neighbors, friends, colleagues, or other individuals).

[0151] Social settings may include settings such as parties, offices, public spaces, public transportation, or other environments where subjects may observe or participate in social interactions. Social interactions and social settings do not require speech, and may include written communication, nonverbal communication, or sign language, etc. Social interactions and social settings may include social cues, such as individual body language, tone, volume, eye contact, or facial expressions, etc. In some cases, subjects may determine appropriate social interactions for social settings by social cues presented by people in social settings. The conversations provided by the service may facilitate training subjects to determine or select their social interactions based on social cues of social situations. For example, as depicted in user interfaces 505-520, after successfully completing a conversational scenario, if the cashier's body language, eye contact, and facial expressions indicate to the subject that the cashier is not busy, the subject may decide to politely obtain the cashier's attention.

[0152] In set 500B, application 125 may display user interface 525A with a play button to start playing a set of audio recordings 185' corresponding to a conversation associated with a social setting. The conversation may be about obtaining items at a supermarket. When the button is pressed, application 125 may play back audio recordings 185'. After playback, application 125 may display user interface 530A with an image 180' of a supermarket to prompt user 210 about the information conveyed in the conversation. In the depicted example, application 125 may include questions about which aisle user 210 should go to to obtain the items involved in the conversation.

[0153] In set 500C, application 125 may display user interface 525B with a play button to start playing a set of audio recordings 185' corresponding to a conversation associated with a social setting. The conversation may include instructions for making a salad and obtaining ingredients to make the salad. When the button is pressed, application 125 may play back audio recordings 185'. After playback, application 125 may display user interface 530B to prompt user 210 about information conveyed in the conversation. In the depicted example, application 125 may include a question about which step appears first in the instructions for making a salad.

[0154] In set 500D, the application 125 may display a user interface 535A with a play button to start playing a set of audio recordings 185' corresponding to a conversation associated with a social setting. After the user presses the button "Tap to Continue", the application 125 may present a user interface 540A to prompt the user 210 to listen to the conversation. Thereafter, the application 125 may present a user interface 545A prompting the user to recall information about the conversation presented by the audio recording 185'. When the user presses Continue, the application 125 may display a user interface 550A to provide instructions to the user 210 to try to get as many correct answers as possible. The application 125 may continue to play back the set of audio recordings 185'.

[0155] Set 500E can be similar to the user interface presented in set 500D, with the addition of parameters 445 applied to the presentation of audio recordings 185'. In set 500E, application 125 can display user interface 535B with a play button to start playing a set of audio recordings 185' corresponding to a conversation associated with a social setting. After the user presses the button "Tap to Continue", application 125 can present user interface 540B to prompt user 210 to listen to the conversation and notify user 210 of potential interference including noise and other speech. Thereafter, application 125 can present user interface 545B to notify the user about the ability to reduce interference in the conversation. When the user presses Continue, application 125 can display user interface 550A to provide instructions to user 210 to try to get as many correct answers as possible. Application 125 can continue to play back the set of audio recordings 185', as well as additional interference.

[0156] In set 500F, the application 125 can display a user interface 555A with a play button to start playing a set of audio recordings 185' corresponding to the conversation. After the user presses the button, the application 125 can play back the audio recordings 185' with one or more parameters 445, such as noise, low volume, or fast speech. After presenting the audio recordings 185', the application 125 can present a user interface 560A to prompt the user 210 to modify the presentation of the conversation in the set of audio recordings 185' regarding the parameters 445. By selecting one of the options, the application 125 can present a user interface 565A to provide feedback 450 on the user 210's selection.

[0157] In set 500G, application 125 can display user interface 555B with a play button to start playing a set of audio recordings 185' corresponding to the conversation. After the user presses the button, application 125 can play back audio recordings 185'. After presenting audio recordings 185', application 125 can present user interface 560A to prompt user 210 about information conveyed in the conversation and provide a list of options regarding the information. By selecting one of the options, application 125 can present user interface 565B to provide feedback 450 about user 210's selection.

[0158] Figure 6A block diagram of a process 600 for providing a third session for a functional training layer for a user to apply a social skill is depicted. The process 600 may include or correspond to operations performed in the system 100, the process 200, or the process 400. Under the process 600, the session manager 140 may provide a session 620 corresponding to the functional training layer. The interaction handler 145 may receive a response 625 indicating the execution of an action of the functional training layer. The execution evaluator 150 may determine an execution metric 615 based on the response 625. The feedback provider 155 may provide feedback to the user 210 based on the execution metric 615.

[0159] The session manager 140 may provide the session 620 to the application 125. The session 620 may be a third session 620 and may correspond to a third layer. The third layer may be a functional training layer. The functional training layer may be a therapeutic layer in which one or more prompts 630 are displayed to the user via the user interface 130 to guide the user to perform an activity. The activity may include Figure 4 The activity may include user 210 participating in a social setting such as a library, a store, or a park. For example, the activity may include user 210 personally purchasing coffee at a coffee shop, personally asking a librarian for help locating a book in a library, or having a face-to-face conversation on a bus. By participating in activities in a real-world environment, user 210 can practice real-world social skills in conjunction with the teachings of previous sessions to reduce functional impairments. The functional training layer may also further develop non-social skills, such as verbal memory in previous layers, such as following recipe instructions in a tutorial video about how to bake a cake or having a conversation and recalling a person's contact information.

[0160] The user interface 130 may display one or more prompts 630A-N that guide the user 210 to perform one or more activities. When the session 620 is presented, the user 210 may choose to perform the activity later or may choose to delay the activity until later. In some embodiments, when the prompts 630A-N are presented, the user 210 may use the UI element 135 to select a time to perform the activity. For example, the user 210 may use the UI element 135 to make a selection 605 to indicate a time to perform the activity. A response 625 may be transmitted at a first time T1. The response 625 may indicate a second time T2 at which the user selects to perform the activity. In some embodiments, the second time T2 may indicate a time at which the user 210 will perform the activity. In some embodiments, the second time T2 may indicate a time at which the session management service 105 may transmit a reminder message 635 to guide the user 210 to perform the activity.

[0161] The interaction processing program 145 may transmit a reminder message 635 at the time T2 indicated by the user 210 in the response 625. The interaction processing program 145 may automatically transmit the reminder message 635 when the time T2 is reached. The time T2 may be a countdown (e.g., delayed by one hour, one day) or the time T2 may be a specific time or date (e.g., Friday at 6 p.m.). The interaction processing program 145 may transmit a reminder message 635 including a reminder 630 of the activity to be performed. The reminder message 635 may be displayed on the user interface 130. The user 210 may pause (e.g., delay to a later time) the reminder message 635. In some cases, the reminder message 635 may be paused a threshold number of times. Once the threshold number of pauses is exceeded, the user 210 may no longer be able to pause the reminder message 635.

[0162] The user 210 may perform the activity indicated in the prompt 630 or reminder message 635. When the user 210 performs the activity, the user may select one or more selections 605 to indicate the performance of the activity. In some cases, the session management service 105 or application 125 may prompt for an indication of the performance of the activity regardless of the user 210 indicating the completion of the activity. The session management service 105 or application 125 may prompt for an indication of the performance of the activity in response to the passage of a period of time, in response to a selection 605 made by the user 210, or in response to a prompt schedule. Prompting for an indication of the performance of the activity may include providing a UI element 135 on the user interface 130. In some embodiments, the user 210 may be provided with a plurality of possible selections of the UI element 135 corresponding to the user 210 performing the activity. For example, the user interface 130 may display a first UI element 135A indicating that the activity went well, a second UI element 135B indicating that the activity went poorly, or a third UI element 135C indicating that the user 210 did not perform the activity. In some embodiments, the UI element 135 may include a text box in which the user 210 may dictate or type a response indicating the performance of the activity.

[0163] The execution of the activity may identify the state (e.g., emotional state, response, or task difficulty) of the user 210 during the execution of the activity. For example, the execution of the activity may include whether the user performed the activity, the length of time to perform the activity, the challenges encountered during the activity, the general feelings or reflections on the activity, or a numerical rating of how the user 210 felt about performing the activity, etc. The user 210 may indicate their performance in the activity through a selection 605 of the UI element 135. The application 125 may detect the selection 605 and transmit a response 625 indicating the execution of the activity to the interaction handler 145.

[0164] The execution evaluator 150 can determine the execution metric 615 of the session 620 based on the response 625. The execution evaluator 150 can determine the execution metric 615 of the session 620 based on the response 625. Figure 2 Execution Metrics 215 or Figure 4 Execution evaluator 150 may determine execution metric 615 in the same or similar manner as described for execution metric 415 of FIG. 10 . Execution evaluator 150 may determine execution metric 615 based on response 625 including an indication of execution of the activity. Execution evaluator 150 may determine execution metric 615 based on the indication of execution. In some embodiments, user 210 may indicate that the activity went well. When user 210 indicates that the activity went well, execution evaluator 150 may determine a high execution metric 615. Conversely, when user 210 indicates that the activity did not go well or user 210 did not perform the activity, execution evaluator 150 may determine a low execution metric 615.

[0165] The session management service 105 may repeat the above functions (e.g., processes 200, 400, and 600) over multiple sessions. The number of sessions may last for a certain number of days, weeks, or even years, or may have no clear end point. By iteratively providing different sessions corresponding to different layers based on at least the execution metrics 215, 415, and 615, the user profile 165, or the responses 225, 425, and 625, the user 210 is able to receive training to improve the functional impairments associated with its condition (e.g., social processing or non-social processing). This can alleviate the symptoms faced by the user 210, even when having a condition that would otherwise prevent the user from seeking treatment or even physically accessing the user device 110. In addition, by participating in a session when presented via the user interface 130 of the application 125, the quality of the human-computer interaction (HCI) between the user 210 and the user device 110 can be improved.

[0166] Because the sessions build upon each other to provide a comprehensive, accessible solution, the user 210 may be more likely to engage in the session when it is presented via the user device 110. This may reduce unnecessary consumption of computing resources (e.g., processing and memory) of the service and the user device 110, and reduce usage of network bandwidth, relative to sending ineffective or irrelevant sessions. Furthermore, in the context of digital therapeutic applications, personalized selection of sessions including images and prompts may result in the delivery of user-specific interventions to improve the subject's compliance with treatment. This may not only improve compliance with the therapeutic intervention, but may also potentially improve the user's condition or cognitive or functional impairment.

[0167] Figures 7A-7EScreenshots of a set 700A-E of example user interfaces for providing a third session are depicted. In set 700A, application 125 may present user interfaces 705-730. Set 700 may be part of or included in a third session providing a functional training layer. User interfaces 705-730 depict activities to be performed by a user, such as those described herein. Interface 705 may be a prompt to guide a user to perform a particular activity (e.g., observing and practicing a posture). Second interface 710 may include information for a user to identify social cues in a real-world setting. Third interface 715 may include a prompt to select a time to send a reminder.

[0168] In set 700B, application 125 may present user interfaces 720-730. User interface 720 may allow user 210 to send a reminder message when. User interface 725 may prompt user 210 to indicate feedback about a specific activity performed in the user's 210 surroundings. User interface 730 may provide user 210 with feedback about a response in user interface 725. In set 700C, application 125 may present user interface 735 to indicate to user 210 the start of a new activity to apply a verbal memory-based skill in the user's surroundings. When an interaction with a start button is detected, application 125 may present user interface 740 to prompt user 210 about the activity. Continuing, application 125 may present user interface 745 to provide instructions about a listening skill activity. Application 125 may present user interface 750 to provide specific goals for the listening skill activity.

[0169] In set 700D, the application 125 may present a user interface 755 to guide the user 210 to perform a task in a surrounding area (e.g., the user's house). When the user presses Continue, the application 125 may present a user interface 760 to provide additional instructions about the task to be performed. The application 125 may also display a user interface 765 to allow the user 210 to select a time to perform the activity. Once continued, the application 125 may present a user interface 770 to provide a prompt about the performance of the activity. The application 125 may display a user interface 775 to notify the user to return to the application 125 to perform the task and record it via the application 125. In set 700E, after the activity is completed, the application 125 may present user interfaces 780 and 785 to notify the user 210 about the successful completion of the task.

[0170] Figures 8A-8CA flow chart depicting a method 800 for presenting an interactive session to address a user's dysfunction. The method 800 may be implemented or performed using any of the components detailed herein, such as the session management service 105 and the user device 110, or any combination thereof. Under the method 800, a service (e.g., the session management service 105) may identify a group of sessions (805). Each session may correspond to a respective layer and may include one or more images and prompts. The service may provide a first session in the group of sessions to a user device (e.g., the user device 110) (810). Providing the first session may include providing an image and a prompt associated with the first session. The user device may present the first image and a first prompt using a display device of the user device (815). While presenting the first image and the first prompt, an application operating on the user device may detect and send a first selection associated with a clue indicated in the first session (825). The clue may be or include Figure 2 235 shown in . The service may receive a first selection of the clue (820). Upon receiving the first selection of the clue, the service may determine whether a selection rate is above a threshold (830). The selection rate may refer to a rate of correct selections received by the service from the user device. If the selection rate is below the threshold, the service may return to providing the first session (810). If the selection rate is at or above the threshold, the service may provide a second session (835). The second session may include a virtual functional training layer. The user device may present a second image, a second prompt, and an interactive element associated with the second session (840).

[0171] continue Figure 8B In method 800, in response to presenting the second image, the second prompt, and the interactive element (840), an application operating on the user device can detect a selection of a response via the interactive element (850). In some embodiments, the user 210 can use the interactive element to select a first response corresponding to the second image or the second prompt. In some embodiments, the application can detect the selection of the interactive element and can generate a response based on the selection transmitted to the service. The service can receive the first response (845). The service can receive the first response indicating the selection associated with the second session. The service can generate an execution metric (855). The service can generate the execution metric based on at least the first response. The service can provide feedback (860). The service can provide feedback to the user device via the application. The feedback can be generated by the service based on at least one of the first response, the execution metric, the selection, the second image, or the second prompt. The user device can present the feedback (865). The user device can present the feedback through an application operating on the user device.

[0172] After providing feedback, the service may determine whether the execution metric is above a threshold (870). If the execution metric is not above the threshold, the service may modify the presentation of the session (875). If the execution metric is at or above the threshold, the service may provide a third session (880). The third session may include or correspond to a functional training layer and may include one or more third prompts. The user device may present the third prompt (885).

[0173] continue Figure 8C In method 800 of the present invention, the user device may present a third prompt (885). Presenting the third prompt may include presenting a prompt to guide the user to perform the activity. The user device may send a response (895). The response may include an indication of the activity to be performed, or the response may include a time to remind the user to perform the activity. The service may receive a second response (890). Upon receiving the second response, the service may transmit a reminder message at a time indicated in the second response, store the response, or generate an execution metric for the user based on the response.

[0174] B. Methods of improving functional impairment in users with schizophrenia

[0175] Reference now Fig. 9 , depicting a flow chart of a method 900 for improving a functional impairment of a schizophrenia user in need. The method 900 may be performed by any component or participant described herein, such as a session management service 105, a user device 110, or a user 210, etc. The method 900 may be used in conjunction with any function or action described in the examples in Sections A and B herein. The method 900 may include a method for improving a functional impairment of a schizophrenia user in need. The functional impairment may include social processing (e.g., social perception and emotional processing) or non-social processing (e.g., verbal memory, mentalization, theory of mind, and problem solving), etc. In brief overview, the method 900 may include obtaining a baseline metric (905). The method 900 may include identifying a layer of a session (910). The method 900 may include providing a session of the layer (915). The method 900 may include determining whether to transition to the next layer (920). The method 900 may include identifying the next layer when it is determined to transition (925). Otherwise, the method 900 may include maintaining the current layer when it is determined not to transition (930). The method 900 may include obtaining a session metric (935). The method 900 may include determining whether to continue (940). The method 900 may include determining whether the session metric is an improvement relative to the baseline metric (945). The method 900 may include determining that improvement is shown when the session metric is determined to be an improvement relative to the baseline metric (950). The method 900 may include determining that improvement is not shown when the session metric is determined to be not an improvement relative to the baseline metric (955).

[0176] In more detail, method 900 may include retrieving, identifying, or otherwise obtaining a baseline metric (905). The baseline metric may be associated with a user (e.g., user 210) who suffers from schizophrenia or is diagnosed with schizophrenia. The user's schizophrenia may further include positive symptoms, including hallucinations or delusions, or negative symptoms, including a decrease in motivation or emotional expression. The user's schizophrenia may lead to functional impairment (e.g., social processing or non-social processing). For example, the functional impairment associated with the user may include one or more of reduced education, reduced quality of life, difficulty living independently, reduced social functioning or occupational dysfunction, etc.

[0177] Before any session is provided to the user via a digital therapy application (e.g., application 125 or a study application described herein (StudyApp)), a baseline metric may be obtained (e.g., by a computing system such as session management service 105 or user device 110 or both). The baseline metric may indicate the severity of the user's functional impairment due to schizophrenia. The baseline measurement may include, for example, a Multnomah Community Ability Scale (MCAS) value, a Lawton Daily Living Instrumental Activities (Lawton IADL) value, a Personal and Social Performance (PSP) scale value, a Time Use Survey value, a Patient Global Improvement Impression (PGI-I) scale value, a Clinical Global Improvement Impression (CGI-I) scale value, or a World Health Organization Disability Assessment Scale 2.0 (WHO-DAS2.0) value, etc. Other metrics may be used to show other related effects (e.g., showing medication compliance or as an exclusion criterion), such as a Clinician Rating Scale (CRS) value, a Medication Adherence Rating Scale (MARS) value, or a Columbia Suicide Severity Rating Scale (C-SSRS) value, etc. The scales used to measure the severity of functional impairment may differ based on whether social processing or non-social processing is addressed. For social processing (e.g., social perception), the measure may include MCAS, Lawton IADL, PSP, or WHO-DAS2.0 scale values, etc. For non-social processing (e.g., verbal memory), the measure may include MCAS, CRS, CGI-I, or MARS-a, etc. Further explanation of the scales is provided below.

[0178] Multnomah Community Capacity Scale (MCAS): The Multnomah Community Capacity Scale is used to assess the functioning of adults with mental disabilities living in the community. Both instruments (clinician version and self-report version) are based on standard methods for rating scale development. For the purposes of this study, the clinician-rated version of the Multnomah Community Capacity Scale will be used and will continue to be referenced. An extended version will be used, which includes behavioral anchors and additional interview surveys that have been standardized in patients with schizophrenia and other serious mental illnesses. Trained non-clinicians can also serve as raters and have been shown to have high reliability. The Multnomah Community Capacity Scale measures the degree of functional ability over the past month through seventeen indicators. These indicators are scored on a 5-point scale, ranging from 5 (no impairment) to 1 (extreme impairment). The highest score indicating a high level of functioning is 85. It takes an average of 20 minutes to complete the trainer-rated Multnomah Community Capacity Scale.

[0179] Lawton Instrumental Activities of Daily Living: The Lawton Instrumental Activities of Daily Living (Lawton IADL) scale assesses a person's independent living skills in eight categories: using the telephone, shopping, cooking, housekeeping, laundry, using transportation, taking medications as prescribed, and financial management. Each category has a list of tasks, and the person is rated 0 (low functioning, dependent) or 1 (high functioning, independent). The total score ranges from 0 (low functioning, dependent) to 8 (high functioning, independent) for women and 0 (low functioning, dependent) to 5 (high functioning, independent) for men.

[0180] Personal and Social Performance Scale (PSP): The PSP is a validated clinician-rated scale that measures personal and social functioning in four areas: socially useful activities (e.g., work and school), personal and social relationships, self-care, and disruptive and aggressive behavior. Scores for each area range from 0-100 with anchor points at 10-point intervals. The total score is obtained on a 10-point scale.

[0181] World Health Organization Disability Assessment Scale (WHO-DAS2.0): WHO DAS2.0 is a 36-item self-assessment scale that measures participants' functioning and disability in six life domains: cognition (understanding and communicating), mobility (moving and getting around), self-care (hygiene, dressing, eating, being alone), getting along (interacting with others), life activities (family responsibilities, leisure, work, and learning), and participation (community and society).

[0182] Clinician Rating Scale (CRS): The CRS is a single-item scale in which clinicians assess the patient's observed level of medication or treatment adherence. The item is rated on a scale of 1-7, with 1 indicating a complete refusal to adhere to the medication or treatment and 7 indicating active participation in their treatment.

[0183] Medication Adherence Rating Scale (MARS): MARS is a 10-item scale in which patients are asked about their adherence to psychiatric medications. For each item, patients are asked questions related to their behavior or attitude toward medications over the past week. Patients are asked to answer "yes" or "no" to each item. The sum of these items yields a final score ranked from 0 (poor adherence to psychiatric medications) to 10 (good adherence to psychiatric medications).

[0184] Time Use Survey: The time use survey is a semistructured interview to assess how patients have spent their time in the past month. Patients are asked about work, education, volunteer work, leisure, sports, hobbies, socializing, rest, housework / chores, childcare, and sleep. The time spent on each activity is calculated based on the number of hours per week allocated to that activity in the past month. The interview takes approximately 30 to 45 minutes to complete.

[0185] Columbia-Suicide Severity Rating Scale (C-SSRS): The Columbia-Suicide Severity Rating Scale (C-SSRS) is an assessment tool that evaluates suicidal ideation and behavior. The scale has been successfully implemented in many settings, including schools, college campuses, the military, fire departments, the justice system, primary care, and scientific research. The scale is intended to be used by individuals who have been trained to administer it. The questions included in the Columbia-Suicide Severity Rating Scale are suggested investigations to determine suicide risk. Ultimately, the presence or absence of suicidal ideation or behavior depends on the judgment of the individual administering the scale.

[0186] Patient Global Impression of Improvement (PGI-I): The PGI-I is a single-item patient-reported outcome that measures participatory subjective improvement in the severity of experienced negative symptoms on a 7-point scale. Higher scores on the PGI-I indicate subjective reports of disease worsening during treatment. Response options include: 1 = very good, 2 = much better, 3 = a little better, 4 = no change, 5 = a little worse, 6 = a lot worse, and 7 = very worse.

[0187] Clinical Global Impression of Improvement (CGI-I): The CGI-I is a single-item standardized clinician-rated measure that assesses the degree to which the patient's condition has improved or worsened over the past 7 days since study entry or treatment. The measure uses a 7-point Likert scale, with higher scores indicating worsening of the condition. Response options include: 1 = very much improved, 2 = much improved, 3 = very little improved, 4 = no change, 5 = slightly worse, 6 = much worse, and 7 = very worse.

[0188] Clinical Global Impression of Severity (CGI-S): The CGI-S is a single-item standardized clinician-rated global rating scale that measures the severity of negative symptoms experienced over the past 7 days using a 7-point Likert scale. Higher scores on the CGI-S indicate greater illness severity. Response options include: 0 = not assessed; 1 = normal, not ill; 2 = borderline mental illness; 3 = mildly ill; 4 = moderately ill; 5 = markedly ill; 6 = severely ill; and 7 = the sickest participant.

[0189] Medication Adherence Rating Scale (MARS-a): MARS-a is a 10-item scale in which patients are asked about their adherence to psychiatric medications. For each item, patients are asked a question related to their behavior or attitude toward medications over the past week. Patients are asked to answer "yes" or "no" to each item. The sum of these items yields a final score ranked from 0 (poor adherence to psychiatric medications) to 10 (good adherence to psychiatric medications).

[0190] Benefit Assessment: Trial participants may derive immediate benefits from an interactive, software-based intervention featuring cognitive training and messaging. CT-156 is an adaptation of ecologically generalized cognitive remediation training supplemented with cognitive training, which has been well validated as a treatment option for the treatment of functional impairment in people diagnosed with schizophrenia. It integrates multiple psychosocial treatment techniques that together treat functional impairment associated with schizophrenia as described in the symptomology psychological model.

[0191] The user may have any demographic or characteristic, such as age (e.g., adult (over 18 years old) or late teen (between 18-24 years old)) or gender (e.g., male, female, or non-binary gender), etc. The user may be receiving treatment for schizophrenia at least during part of one or more sessions. The treatment may include psychosocial interventions or medications to treat schizophrenia. The psychosocial interventions may include, for example, psychoeducation, group therapy, cognitive behavioral therapy (CBT), or early intervention for first-episode psychosis (FEP), etc. The medications may include, for example, typical antipsychotics (e.g., haloperidol, chlorpromazine, fluphenazine, perphenazine, loracetam, thioridazine, or trifluoperazine) or atypical antipsychotics (e.g., aripiprazole, risperidone, clozapine, quetiapine, olanzapine, ziprasidone, lurasidone, paliperidone, or exepertin), etc.

[0192] Method 900 may include selecting, determining, or otherwise identifying at least one layer (910) of a set of layers of one or more sessions (e.g., sessions 220, 420, or 620) of a user. A computing system (e.g., session management service 105 or user device 110 or both) may execute a digital therapy application (e.g., application 125) to provide enhanced life skills through cognitive intervention (ELSCI). The computing system may identify the layers of the session based on a schedule or user profile (e.g., user profile 165). The layers may include a first layer for cognitive training, a second layer for virtual functional training, and a third layer for ecological functional training, etc. The schedule or profile may identify which layer of tasks the user is currently working on. The user may first start with the first layer, and then enter the second and third layers after completing the previous layers. Based on the schedule or profile, the computing system may identify the user's layers.

[0193] Method 900 may include providing or presenting a session of the identified layer (915). The computing system may provide instructions for the session according to the identified layer. Each session may correspond to an identified layer in which the user will be trained with specific social or non-social skills intended to address functional impairments due to schizophrenia. The instructions may define images (e.g., images 180) and prompts according to a configuration of the layer (e.g., layer configuration 170). Upon receipt, the application may present the images and prompts via one or more elements of a user interface (e.g., user interface 130).

[0194] For the first level of conversation, the computing system may display one or more images (e.g., image 180) that the user uses to identify one or more of a plurality of social cues associated with social skills. In some embodiments, the computing system may display an image of a social cue (e.g., clue 235) with a prompt (e.g., prompt 230) of a set of interactive elements that include a corresponding plurality of types of cues for the identification image. The computing system may receive a selection of one of a plurality of types of social cues by the user via at least one interactive element in the group of interactive elements. Social cues may include head movements (e.g., nodding, shaking, tilting, or other head gestures), body language (e.g., facial expressions, overall body posture, and proximity to another character), gestures (e.g., using a finger to point or express emotion through a hand or finger), or eye contact (e.g., the orientation of the eyes relative to another person to show engagement or emotion), and the like.

[0195] In some embodiments, for a first-tier session associated with a non-social skill such as verbal memory, a computing system may present one or more first audio recordings (e.g., audio recording 185) that a user uses to recall one or more of a plurality of words. The computing system may identify a set of audio recordings to present to the user. Each recording may correspond to one or more words. By identifying the set of audio recordings, the computing system may present the set of audio recordings according to a format. The format may define the context in which the words of the audio recordings are presented. The computing system may display a user interface to prompt the user to select at least one of the words presented in the audio recording. The computing system may receive a selection of a word from the user.

[0196] For the second layer of the session, the computing system may display an image (e.g., image 180') of a social setting (e.g., virtual setting 435). The image may be presented with a prompt (e.g., prompt 430) identifying a query associated with a character (e.g., character 440) displaying one of the plurality of social cues and a set of interactive elements identifying a corresponding plurality of responses to the character. In some embodiments, the computing system may display a set of images of the setting with the character according to a defined sequence. The computing system may receive a response (e.g., response 425) from the plurality of responses selected by the user via at least one interactive element in the second set of interactive elements. The computing system may provide feedback to the user (e.g., feedback 450) based on the query and response to the setting.

[0197] In some embodiments, the computing system may present the second layer according to a set of parameters (e.g., parameters 445). The parameters may include, for example, the type of content modality, the context of the setting in the image, the number of characters in the setting, the type of prompt, the difficulty level of the response, the type of response or the number of responses, etc. In some embodiments, the computing system may use the response of the user in the session of the second layer in the previous instance to modify the provision of the session of the second layer at one instance. For example, the computing system may display an image of a social setting, a prompt with a query identifying the characters in the setting, and a set of interactive elements that identify the corresponding multiple responses to the second character according to multiple parameters.

[0198] In some embodiments, for a second-tier session to apply verbal memory skills in a virtual social setting, the computing system may present an audio recording of a voice sample (e.g., audio recording 185'). The voice sample may be from at least one speaker and may correspond to one or more sentences of the speaker, such as statements, questions, exclamations, requests, commands, or suggestions, etc. In some embodiments, the computing system may modify the presentation or selection of the audio recording in the second tier according to a set of parameters. The set of parameters may include the inclusion of distractions; the ability to repeat presentations; changes in speed; the volume of voice in the audio recording; the time between each word or sentence; the number of words in each sentence; the length of the audio recording; and the ability to control the inclusion or exclusion of distractions, etc. In addition, the computing system may present a prompt identifying a query associated with the voice sample and a set of interactive elements identifying a set of responses. The query may require the user to recall information about at least a portion of the voice sample. The computing system may receive a response selected by the user from the set of responses via at least one of the user interface elements. The computing system may generate feedback based on the query and the response and provide feedback to the user.

[0199] For the third level of the session, the computing system may display a prompt to guide the user to perform an activity in the user's surroundings or environment. The computing system may then receive a response associated with the performance of the activity (e.g., response 625). In addition, the computing system may present a prompt for the user to select a time to provide a message (e.g., reminder message 635) prompting the user to perform the activity.

[0200] The method 900 may include determining whether to transition to the next layer (920). The computing system may generate, calculate, or otherwise determine an execution metric (e.g., execution metric 215 or 415) for the user in the current session. Based on the determination, the computing system may compare the execution metric to a threshold. The threshold may depict or identify a value of the execution metric that transitions the user to the next layer (e.g., from the first layer to the second layer or from the second layer to the third layer). The method 900 may include identifying the next layer when it is determined to transition (925). When the execution metric meets (e.g., is greater than or equal to) the threshold, the computing system may determine to transition the user to the next layer. Otherwise, the method 900 may include maintaining the current layer when it is determined not to transition (930). When the execution metric does not meet (e.g., is less than) the threshold, the computing system may determine not to transition the user to the next layer and maintain the user at the current layer.

[0201] Method 900 may include retrieving, identifying, or otherwise obtaining a session metric (935). The session metric may be obtained after providing at least one session to the user via a digital therapy application (e.g., by a computing system). After providing at least one session in one or more layers, the session metric may indicate the severity of functional impairment due to the user's schizophrenia. The session metric may include, for example, a Multnomah Community Ability Scale (MCAS) value, a Lawton Instrumental Activities of Daily Living (Lawton IADL) value, a Personal and Social Performance (PSP) scale value, a Time Use Survey value, a Patient Global Impression of Improvement (PGI-I) scale value, a Clinical Global Impression of Improvement (CGI-I) scale value, or a World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS2.0) value, etc. Other metrics may be used (e.g., to show medication adherence or as an exclusion criterion), such as a Clinician Rating Scale (CRS) value, a Medication Adherence Rating Scale (MARS) value, or a Columbia Suicide Severity Rating Scale (C-SSRS) value, etc. The session metric may be a metric or scale of the same type as the baseline metric.

[0202] Method 900 may include identifying or determining whether to continue (940). The determination may be based on a set length of the trial (e.g., days, weeks, or years), a set number of time instances during which one or more sessions are performed, or a set number of sessions to be provided to the user. For example, the set number of time instances may be between 2 and 30 weeks relative to the beginning of obtaining the baseline metric or the user's initial session. When the amount of time since obtaining the baseline metric exceeds the set length, it may be determined to stop providing additional tasks. Conversely, when the amount of time does not exceed the set length, the determination may be to continue providing additional tasks and repeat from (910).

[0203] Method 900 may include identifying or determining whether a session metric is an improvement relative to a baseline metric (945). The improvement may correspond to an improvement in the severity of a functional impairment due to schizophrenia of the user. The functional impairment may include social processing (e.g., social perception) or non-social processing (e.g., verbal memory). The improvement may be shown when the session metric increases by a first predetermined margin compared to the baseline metric or when the session metric decreases by a second predetermined margin compared to the baseline metric. The margin may identify or define a difference in value between the baseline and session metric at which the user is determined to show an improvement in the severity of the functional impairment due to schizophrenia. Whether the improvement is shown by an increase or a decrease may depend on the type of metric used to measure the user's severity of the functional impairment due to schizophrenia. The margin may also depend on the type of metric used, and may generally correspond to a difference in value that shows a clinician or user a significant difference in the severity of the functional impairment due to schizophrenia, or shows a statistically significant result caused by a difference in value between the baseline and session metric.

[0204] Method 900 may include determining that improvement is shown (950) when the session metric is determined to be an improvement relative to the baseline metric. In some embodiments, improvement may be determined to have occurred (e.g., by a computing system or a clinician examining a user) when the session MCAS metric decreases by a first predetermined margin from the baseline MCAS metric. In some embodiments, improvement may be determined to have occurred when the session Lawton IADL metric increases by a second predetermined margin from the baseline Lawton IADL metric. In some embodiments, improvement may be determined to have occurred when the session PSP metric increases by a second predetermined margin from the baseline PSP metric.

[0205] Continuing, in some embodiments, when the session WHO-DAS2.0 metric decreases by a first predetermined margin from the baseline WHO-DAS2.0 metric, an improvement may be determined to have occurred. In some embodiments, when the session CRS metric increases by a second predetermined margin from the baseline CRS metric, an improvement in medication adherence may be determined to have occurred. In some embodiments, when the session MARS metric increases by a second predetermined margin from the baseline MARS metric, an improvement in medication adherence may be determined to have occurred.

[0206] In some embodiments, when the session MCAS metric decreases by a first predetermined margin from the baseline MCAS metric, it may be determined that an improvement in a functional impairment associated with a user with schizophrenia has occurred. In some embodiments, when the session CRS metric increases by a second predetermined margin from the baseline CRS metric, it may be determined that an improvement in a functional impairment associated with a user with schizophrenia has occurred. In some embodiments, when the session PGI-I metric decreases by a first predetermined margin from the baseline PGI-I metric, it may be determined that an improvement in a functional impairment associated with a user with schizophrenia has occurred. In some embodiments, when the session MARS-a metric increases by a second predetermined margin from the baseline MARS-a metric, it may be determined that an improvement in a functional impairment associated with a user with schizophrenia has occurred.

[0207] Method 900 may include determining that improvement is not shown (955) when the session metric is determined to be not improved relative to the baseline metric. In some embodiments, improvement may be determined not to have occurred (e.g., by a computing system or a clinician examining a user) when the session MCAS metric has not decreased by a first predetermined margin from the baseline MCAS metric. In some embodiments, improvement may be determined not to have occurred when the session Lawton IADL metric has increased by a second predetermined margin from the baseline Lawton IADL metric. In some embodiments, improvement may be determined not to have occurred when the session PSP metric has not increased by a second predetermined margin from the baseline PSP metric.

[0208] Continuing, in some embodiments, when the session WHO-DAS2.0 metric does not decrease by a first predetermined margin from the baseline WHO-DAS2.0 metric, it can be determined that improvement does not occur. In some embodiments, when the session CRS metric does not increase by a second predetermined margin from the baseline CRS metric, it can be determined that improvement does not occur. In some embodiments, when the session MARS metric does not increase by a second predetermined margin from the baseline MARS metric, it can be determined that improvement does not occur. In some embodiments, when the session time usage survey metric does not increase by a second predetermined margin from the baseline time usage survey metric, it can be determined that improvement does not occur. In some embodiments, when the session C-SSRS metric does not decrease by a first predetermined margin from the baseline C-SSRS metric, it can be determined that improvement does not occur.

[0209] In some embodiments, when the session MCAS metric does not decrease by a first predetermined margin from the baseline MCAS metric, improvement in functional impairment associated with a user with schizophrenia may be determined to have not occurred. In some embodiments, when the session CRS metric does not increase by a second predetermined margin from the baseline CRS metric, improvement in functional impairment associated with a user with schizophrenia may be determined to have not occurred. In some embodiments, when the session PGI-I metric does not decrease by a first predetermined margin from the baseline PGI-I metric, improvement in functional impairment associated with a user with schizophrenia may be determined to have not occurred. In some embodiments, when the session MARS-a metric does not increase by a second predetermined margin from the baseline MARS-a metric, improvement in functional impairment associated with a user with schizophrenia may be determined to have not occurred.

[0210] Example 1: Use of ELSCI in digital therapeutics targeting social perception

[0211] In one example, the CT-156 mobile application (e.g., application 125) will be given to an individual who has schizophrenia according to the International Classification of Diseases, 11th edition (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5), is experiencing mild to moderate functional impairment as demonstrated by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0212] This study is a multicenter, exploratory, two-arm study to evaluate the overall efficacy of a simplified version of CT-156 as a treatment for mild to moderate functional impairment in participants aged 18 years and older diagnosed with schizophrenia. Eligible participants must have been diagnosed with schizophrenia according to the International Classification of Diseases, 11th Revision (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) and have experienced mild to moderate functional impairment based on the WHO-DAS2.0.

[0213] Participants who met the eligibility criteria were enrolled in the study and were offered the option to join one of the study arms (CT-156 or CT-156+UXR) at the screening visit. Participants in either arm of the study used the same study application. The study arms differed in the qualitative interviews and surveys.

[0214] Screening Period: All participants entered a 7-day screening period to determine eligibility to follow the informed consent process. Participants who met all applicable inclusion criteria and no exclusion criteria at the screening visit were introduced to the digital mobile application by downloading and installing the application onto their personal iPhone or Android smartphone device. Approximately 50 eligible participants were recruited from approximately 12 research centers in the United States during the first day of on-site clinic visits. A subset of participants (up to 15 participants) had the opportunity to opt-in to the UXR group, which included the same treatment and additional user research interviews and surveys. Approximately 35 participants were recruited in the CT-156 group.

[0215] Baseline Visit: Participant eligibility was confirmed during the baseline visit on Day 1. Participants were considered eligible to activate the study application if they continued to meet all inclusion criteria and none of the exclusion criteria.

[0216] Intervention period: Assessments and activities during this period were performed during an in-person clinic visit or remotely via telephone.

[0217] Follow-up Period: Participants entered a follow-up period of up to 1 week during which they attended visits to complete follow-up assessments. Participants did not perform any activities within the app.

[0218] Inclusion Criteria: Participants were eligible for entry into the study if they met all of the following criteria:

[0219] 1. Willing and able to provide written informed consent to participate in the study, attend study visits, and comply with study-related requirements and assessments.

[0220] 2. Be at least 18 years old at the time of informed consent.

[0221] 3. Fluent in English reading and writing, able to read and understand the informed consent form.

[0222] 4. Live in the United States.

[0223] 5. Meet the diagnostic criteria for a primary diagnosis of schizophrenia as defined in the International Classification of Diseases, 11th edition (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5) at least 6 months prior to screening.

[0224] 6. The applicants were receiving outpatient treatment at the time of screening and had no psychiatric hospitalization within 13 weeks (3 months) before screening.

[0225] 7. Currently prescribed at least one typical and / or atypical antipsychotic and has been using the same antipsychotic for at least 13 weeks (3 months) prior to enrollment (Day 1). Dose adjustments are permitted during the study as detailed in the corresponding package insert.

[0226] 8. Have an average domain score of 2'2 in at least 2 domains of WHO-DAS2.0: Understanding and Communication, Getting Along with People, and Life Activities - Family or Social Participation.

[0227] 9. The Participant is the sole user of an iPhone running iOS 15 and above or a smartphone running Android OS 12 and above and agrees to download and use the digital mobile application as required by the Agreement.

[0228] 10. Willing and able to receive Short Message Service (SMS) text messages and push messages on their smartphones.

[0229] 11. Be the owner of the email address or regularly access the email address.

[0230] 12. Regular access to the Internet via a cellular data plan and / or Wi-Fi.

[0231] 13. Have stable housing and have lived in the same residence for at least 13 weeks (3 months) before screening and will not have any housing changes during the study period.

[0232] 14. Be aware of the use of study apps during the screening period and baseline visit, based on the investigator's judgment.

[0233] Exclusion criteria: Subjects who meet any of the following criteria are not eligible to enter the study:

[0234] 1. Positive symptoms of schizophrenia that, in the opinion of the investigator, would preclude effective participation in treatment to improve functional impairment.

[0235] 2. Currently receiving or having received concomitant treatment, defined as individual or group-based structured treatment (e.g., cognitive behavioral therapy, social skills training, positive interviewing, or occupational / vocational therapy) within 3 months (13 weeks) prior to screening based on investigator assessment.

[0236] 3. Currently receiving treatment with more than two antipsychotic drugs (including more than two dosage forms).

[0237] 4. Meet ICD-11 or DSM-5 diagnostic criteria but not investigated that would affect protocol compliance, including schizophrenia, schizoaffective disorder, or psychosis nonspecific disorders (post-traumatic stress disorder [PTSD], bipolar disorder, major depressive disorder, developmental disorder).

[0238] 5. Meet ICD-11 or DSM-5 criteria for current depressive, manic, or hypomanic episode.

[0239] 6. Meet ICD-11 or DSM-5 criteria for current substance or alcohol use disorder (excluding caffeine and nicotine) that, at the investigator's discretion, interferes with adherence to the protocol. Diagnostic classification as sustained remission is permitted.

[0240] 7. The investigator believes that it is currently necessary or may be necessary to prohibit concomitant medications and / or treatments during the study.

[0241] 8. Have a moderate to high risk of suicide, defined as any of the following:

[0242] a. A “yes” response to item 4 or 5 of the Columbia-Suicidality Severity Rating Scale (C-SSRS) regarding suicidal ideation during the last 13 weeks (3 months) prior to screening or at baseline (Day 1)

[0243] b. Response of “yes” to the C-SSRS suicidal behavior item in the last 26 weeks (6 months) prior to screening or at baseline (Day 1)

[0244] c. In the opinion of the investigator, presents a serious risk of suicide

[0245] 9. Participated in another clinical study (interventional or observational) within the past 13 weeks (3 months).

[0246] 10. Participated in the following studies: CT-155-C-001, CT-155-C-002, CT-155-C-003, CT-155-P-00x, CT-155-A-001, CT-155-R-001, CT-156-D-001, CT-156-C-001, CT-156-P-00x.

[0247] Primary endpoint: The primary endpoint was participant engagement with the study application using a predefined engagement measure.

[0248] Number of days the study app was opened out of total treatment days

[0249] Number of times the study app was opened during treatment

[0250] Number of medication checks completed during treatment as a percentage of the total number of assigned

[0251] The number of assigned tasks completed during treatment

[0252] Average duration of each application usage session

[0253] Exploratory endpoints:

[0254] Change from Baseline to Week 8 in MCAS-Expanded

[0255] Changes in WHO-DAS2.0 from screening to week 8

[0256] Change in CRS from Baseline to Week 8

[0257] Change in MARS-a from baseline to week 8

[0258] Week 8 PGI-I

[0259] Week 8 CGI-I

[0260] Change in CGI-S from Baseline to Week 8

[0261] Change in strength of digital working alliance from baseline to week 8 as assessed by mARM

[0262] Participant ratings of study application quality and satisfaction as measured by MARS-b at the Week 8 / ET visit

[0263] Participant feedback captured in user research qualitative interviews

[0264] Timetable of activities and assessments:

[0265]

[0266]

[0267] like Fig.10 As shown in the study, adults (18 years and older) diagnosed with schizophrenia and taking antipsychotic medication with functional impairment were studied using the CT-156 mobile application. The results showed that self-reported disability (WHO DAS2.0) was significantly improved, and the primary efficacy endpoint (MCAS) was moving in the right direction.

[0268] Example 2: Use of ELSCI in digital therapeutics targeting problem solving

[0269] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0270] Example 3: Use of ELSCI in digital therapy targeting verbal memory

[0271] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0272] Example 4: Use of ELSCI in digital therapeutics targeting mentalization / theory of mind

[0273] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0274] Example 5: Use of ELSCI in digital therapeutics targeting emotion processing

[0275] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0276] Example 6: Use of ELSCI in digital therapeutics targeting social perception and verbal memory

[0277] In one example, the CT-156 mobile application (e.g., application 125) will be given to an individual who has schizophrenia according to the International Classification of Disease, 11th Revision (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is experiencing mild to moderate functional impairment as demonstrated by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0278] Example 7: Use of ELSCI in digital therapeutics targeting social perception, verbal memory, problem solving, and emotional processing

[0279] In one example, the CT-156 mobile application (e.g., application 125) would be administered to an individual who has schizophrenia as defined by the International Classification of Diseases, 11th Revision (ICD-11) or the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), is experiencing mild to moderate functional impairment as evidenced by the WHO-DAS 2.0, and is taking antipsychotic medication.

[0280] In some aspects, the individual is first surveyed prior to entering treatment. The individual may receive a cognitive assessment as well as a values ​​and goals assessment to determine what the patient's values ​​and goals are. Thereafter, these values ​​and goals will be used through the application to maintain motivation and engagement. A decision will be made to determine the combination and sequence of interventions, including social perception, verbal memory, problem solving, and emotional processing. The individual will be informed of the recommendations for the first intervention, and the individual will have the option of accepting the recommended first intervention or selecting a different option.

[0281] Treatment will last for 2-30 weeks. Subjects will perform each of the four interventions described above. It is expected that during the use of the CT-156 mobile application, users will show improvements in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0282] Example 8: Use of ELSCI in digital therapeutics targeting social perception, verbal memory, emotional processing, and problem solving

[0283] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0284] Using the CT-156 mobile app, patients with schizophrenia will perform Fig. 9 The method provided in the CT-156 mobile application sequentially utilizes interventions in social perception, verbal memory, emotional processing, and problem solving. The CT-156 mobile application can be used in conjunction with any of the features or actions described herein in Section A and the examples in Section B. The individual will first obtain a baseline measure of social perception, after which a layer of conversation will be identified and a conversation will be provided for that layer. Next, when it is determined that the current layer should be shifted or maintained, the individual using the CT-156 application will determine the next layer. Finally, a socially perceived conversation measure will be obtained, which may or may not be an improvement over the baseline measure.

[0285] After improvement relative to the baseline measure, the individual will move on to the next intervention, which is Verbal Memory. For Verbal Memory, the above process will be repeated. Then, the individual will move on to the Emotional Processing intervention, and the above process will be repeated for Emotional Processing. Finally, the individual will move on to the Problem Solving intervention, and the above process will be repeated for Problem Solving.

[0286] After completing the four interventions sequentially, users will experience improvements in schizophrenia functional impairment as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or Time Use Survey values, while using the CT-156 mobile application.

[0287] Example 9: Use of ELSCI in digital therapeutics targeting verbal memory, social perception, problem solving, and emotional processing

[0288] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0289] Using the CT-156 mobile app, patients with schizophrenia will perform Fig. 9 The method provided in the CT-156 mobile application sequentially utilizes interventions for verbal memory, social perception, problem solving, and emotional processing. The CT-156 mobile application can be used in conjunction with any of the features or actions described herein in Section A and the examples in Section B. The individual will first obtain a baseline measure of verbal memory, after which a tier of conversations will be identified and a conversation will be provided for that tier. Next, when it is determined that the current tier is to be transitioned or maintained, the individual using the CT-156 application will determine the next tier. Finally, a conversation measure of verbal memory will be obtained, which may or may not be an improvement over the baseline measure.

[0290] After improvement relative to the baseline measure, the individual will move on to the next intervention, which is social perception. For social perception, the above process will be repeated. Then, the individual will move on to the problem solving intervention, and the above process will be repeated for problem solving. Finally, the individual will move on to the emotion processing intervention, and the above process will be repeated for emotion processing.

[0291] After completing the four interventions sequentially, users will experience improvements in schizophrenia functional impairment as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or Time Use Survey values, while using the CT-156 mobile application.

[0292] Example 10: Use of ELSCI in digital therapeutics targeting emotional processing, verbal memory, social perception, and problem solving

[0293] In one example, the CT-156 mobile application (e.g., application 125) will be administered to an individual who, according to ICD-11 or DSM-5, suffers from schizophrenia, is experiencing mild to moderate functional impairment as evidenced by WHO-DAS2.0, and is taking antipsychotic medication. Treatment will last for 2-30 weeks. It is expected that during the use of the CT-156 mobile application, the user will show improvement in functional impairment, as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or time use survey values, etc.

[0294] Using the CT-156 mobile app, patients with schizophrenia will perform Fig. 9 The method provided in the CT-156 mobile application sequentially utilizes interventions for emotional processing, verbal memory, social perception, and problem solving. The CT-156 mobile application can be used in conjunction with any of the features or actions described herein in Section A and the examples in Section B. The individual will first obtain a baseline measure of emotional processing, after which a tier of conversation will be identified and a conversation will be provided for that tier. Next, when it is determined that the current tier is to be shifted or maintained, the individual using the CT-156 application will determine the next tier. Finally, a conversation measure of emotional processing will be obtained, which may or may not be an improvement over the baseline measure.

[0295] After improvement relative to the baseline measure, the individual will move on to the next intervention, Verbal Memory. For Verbal Memory, the above process will be repeated. Then, the individual will move on to the Social Perception intervention, and the above process will be repeated for Social Perception. Finally, the individual will move on to the Problem Solving intervention, and the above process will be repeated for Problem Solving.

[0296] After completing the four interventions sequentially, users will experience improvements in schizophrenia functional impairment as measured by MCAS values, Lawton IADL values, PSP scale values, WHO-DAS2.0 values, C-SSRS values, or Time Use Survey values, while using the CT-156 mobile application.

[0297] C. Network and computing environment

[0298] Various operations described herein can be implemented on a computer system. Fig.11A simplified block diagram of a representative server system 1000, a client computer system 1014, and a network 1026 that can be used to implement certain embodiments of the present disclosure is shown. In various embodiments, the server system 1000 or a similar system can implement the services or servers described herein or portions thereof. The client computer system 1014 or a similar system can implement the clients described herein. The system 100 described herein can be similar to the server system 1000. The server system 1000 can have a modular design that incorporates multiple modules 1002 (e.g., blades in a blade server embodiment); although two modules 1002 are shown, any number of modules can be provided. Each module 1002 can include a processing unit 1004 and a local storage device 1006.

[0299] Processing unit 1004 may include a single processor, which may have one or more cores, or multiple processors. In some embodiments, processing unit 1004 may include a general-purpose main processor and one or more special-purpose coprocessors, such as a graphics processor, a digital signal processor, etc. In some embodiments, some or all of processing units 1004 may be implemented using custom circuits, such as application-specific integrated circuits (ASICs) or field programmable gate arrays (FPGAs). In some embodiments, such integrated circuits execute instructions stored on the circuit itself. In other embodiments, processing unit 1004 may execute instructions stored in local storage device 1006. Any type of processor may be included in processing unit 1004 in any combination.

[0300] The local storage device 1006 may include volatile storage media (e.g., DRAM, SRAM, SDRAM, etc.) and / or non-volatile storage media (e.g., magnetic disks or optical disks, flash memory, etc.). The storage media incorporated in the local storage device 1006 may be fixed, removable, or upgradeable as needed. The local storage device 1006 may be physically or logically divided into various subunits, such as system memory, read-only memory (ROM), and permanent storage devices. The system memory may be a read-write memory device or a volatile read-write memory, such as a dynamic random access memory. The system memory may store some or all of the instructions and data required by the processing unit 1004 at runtime. The ROM may store static data and instructions required by the processing unit 1004. The permanent storage device may be a non-volatile read-write memory device that can store instructions and data even when the module 1002 is powered off. The term "storage medium" as used herein includes any medium that can store data indefinitely (susceptible to coverage, electrical interference, power failure, etc.), but does not include carriers and transient electronic signals propagated through wireless or wired connections.

[0301] In some embodiments, local storage device 1006 may store one or more software programs executed by processing unit 1004, such as an operating system and / or programs that implement various server functions (such as the functions of system 100 or any other system described herein, or any other server associated with system 100 or any other system described herein).

[0302] "Software" generally refers to sequences of instructions that, when executed by processing unit 1004, cause server system 1000 (or portions thereof) to perform various operations, thereby defining one or more specific machine embodiments that execute and implement the operations of the software program. Instructions may be stored as firmware residing in read-only memory and / or as program code stored in non-volatile storage media that may be read into volatile working memory for execution by processing unit 1004. Software may be implemented as a single program or as a collection of separate programs or program modules that interact as desired. From local storage device 1006 (or non-local storage device described below), processing unit 1004 may retrieve program instructions to be executed and data to be processed in order to perform the various operations described above.

[0303] In some server systems 1000, multiple modules 1002 may be interconnected via a bus or other interconnect 1008, thereby forming a local area network that supports communication between the modules 1002 and other components of the server system 1000. The interconnect 1008 may be implemented using a variety of technologies, including server racks, hubs, routers, etc.

[0304] Wide area network (WAN) interface 1010 can provide data communication capabilities between a local area network (e.g., via interconnect 1008) and a network 1026 (e.g., the Internet). Other technologies can be used to communicatively couple the server system to the network 1026, including wired (e.g., Ethernet, IEEE 802.3 standards) and / or wireless technologies (e.g., Wi-Fi, IEEE 802.11 standards).

[0305] In some embodiments, the local storage device 1006 is intended to provide working memory for the processing unit 1004, providing fast access to programs and / or data to be processed while reducing traffic on the interconnect 1008. Storage of large amounts of data can be provided on a local area network through one or more mass storage subsystems 1012 that can be connected to the interconnect 1008. The mass storage subsystem 1012 can be based on magnetic, optical, semiconductor or other data storage media. Direct attached storage, storage area networks, network attached storage, etc. can be used. Any data storage or other data collection generated, used or maintained by a service or server described herein can be stored in the mass storage subsystem 1012. In some embodiments, additional data storage resources can be accessed (possibly with increased latency) through the WAN interface 1010.

[0306] The server system 1000 can operate in response to requests received via the WAN interface 1010. For example, one of the modules 1002 can implement monitoring functions and assign discrete tasks to other modules 1002 in response to received requests. Work distribution techniques can be used. When processing a request, the result can be returned to the requester via the WAN interface 1010. Such operations can generally be automated. In addition, in some embodiments, the WAN interface 1010 can connect multiple server systems 1000 to each other, thereby providing an extensible system capable of managing a large number of activities. Other techniques for managing server systems and server farms (collaborative collections of server systems) can be used, including dynamic resource allocation and reallocation.

[0307] The server system 1000 may interact with various user-owned or user-operated devices via a wide area network, such as the Internet. Fig.11 1014. The client computing system 1014 may be implemented as, for example, a consumer device such as a smartphone, other mobile phones, a tablet computer, a wearable computing device (e.g., a smart watch, glasses), a desktop computer, a laptop computer, etc.

[0308] For example, client computing system 1014 may communicate via WAN interface 1010. Client computing system 1014 may include computer components such as processing unit 1016, storage device 1018, network interface 1020, user input device 1022, and user output device 1024. Client computing system 1014 may be a computing device implemented in a variety of form factors, such as a desktop computer, laptop computer, tablet computer, smartphone, other mobile computing device, wearable computing device, etc.

[0309] The processing unit 1016 and the storage device 1018 may be similar to the processing unit 1004 and the local storage device 1006 described above. Appropriate devices may be selected based on the requirements to be arranged on the client computing system 1014. For example, the client computing system 1014 may be implemented as a "thin" client or a high-performance computing device with limited processing capabilities. The client computing system 1014 may be equipped with program code executable by the processing unit 1016 to implement various interactions with the server system 1000.

[0310] The network interface 1020 may provide a connection to a network 1026, such as a wide area network (e.g., the Internet), to which the WAN interface 1010 of the server system 1000 is also connected. In various embodiments, the network interface 1020 may include a wired interface (e.g., Ethernet) and / or a wireless interface implementing various RF data communication standards, such as Wi-Fi, Bluetooth, or a cellular data network standard (e.g., 3G, 4G, LTE, etc.).

[0311] The user input device 1022 may include any device (or devices) via which a user may provide signals to the client computing system 1014, which the client computing system 1014 may interpret as indicating a particular user request or information. In various embodiments, the user input device 1022 may include any or all of a keyboard, a touch pad, a touch screen, a mouse or other pointing device, a scroll wheel, a click wheel, a dial, a button, a switch, a keypad, a microphone, and the like.

[0312] User output devices 1024 may include any device via which client computing system 1014 can provide information to a user. For example, user output devices 1024 may include display-to-display images generated by or transmitted to client computing system 1014. Displays may incorporate various image generation technologies, such as liquid crystal displays (LCDs), light emitting diode (LED) displays (including organic light emitting diodes (OLEDs)), projection systems, cathode ray tubes (CRTs), etc.), as well as supporting electronics (e.g., digital-to-analog converters or analog-to-digital converters, signal processors, etc.). Some embodiments may include devices (such as touch screens) that function as both input and output devices. In some embodiments, other user output devices 1024 may be provided in addition to or in lieu of a display. Examples include indicator lights, speakers, tactile "display" devices, printers, etc.

[0313] Some embodiments include electronic components, such as microprocessors, storage devices, and memories, which store computer program instructions in computer-readable storage media. Many of the features described in this specification can be implemented as processes, which are specified as a set of program instructions encoded on a computer-readable storage medium. When these program instructions are executed by one or more processing units, they cause the processing units to perform various operations indicated in the program instructions. Examples of program instructions or computer codes include machine codes, such as machine codes generated by a compiler, and files including higher-level codes executed by a computer, electronic component, or microprocessor using an interpreter. Through appropriate programming, processing units 1004 and 1016 can provide various functions for server system 1000 and client computing system 1014, including any functions or other functions performed by a server or client as described herein.

[0314] It should be understood that server system 1000 and client computing system 1014 are illustrative, and there may be variations and modifications. The computer system used in conjunction with the embodiments of the present disclosure may have other functions not specifically described herein. In addition, although server system 1000 and client computing system 1014 are described with reference to specific blocks, it should be understood that these blocks are defined for the convenience of description and are not intended to imply a specific physical arrangement of component parts. For example, different blocks may but need not be located in the same facility, the same server rack, or the same motherboard. In addition, blocks do not have to correspond to physically different components. Blocks can be configured to perform various operations, such as by programming a processor or providing appropriate control circuits, and various blocks may or may not be reconfigured, depending on how the initial configuration is obtained. The embodiments of the present disclosure can be implemented in various devices, including electronic devices implemented using any combination of circuits and software.

[0315] Although the present disclosure has been described with respect to specific embodiments, it will be appreciated by those skilled in the art that various modifications may be made. Embodiments of the present disclosure may be implemented using various computer systems and communication technologies, including but not limited to the specific examples described herein. Embodiments of the present disclosure may be implemented using any combination of dedicated components and / or programmable processors and / or other programmable devices. The various processes described herein may be implemented on the same processor or different processors in any combination. When a component is described as being configured to perform certain operations, such configurations may be implemented by, for example, designing an electronic circuit to perform the operation, by programming a programmable electronic circuit (e.g., a microprocessor) to perform the operation, or any combination thereof. In addition, although the above-described embodiments may refer to specific hardware and software components, it will be appreciated by those skilled in the art that different combinations of hardware and / or software components may also be used, and specific operations described as being implemented in hardware may also be implemented in software, and vice versa.

[0316] Computer programs incorporating various features of the present disclosure may be encoded and stored on a variety of computer-readable storage media; suitable media include disks or tapes, optical storage media (e.g., compact disks (CDs) or digital versatile disks (DVDs), flash memory, and other non-transitory media). Computer-readable media encoded with program code may be packaged with compatible electronic devices, or the program code may be provided separately from the electronic device (e.g., via Internet download or as a separately packaged computer-readable storage medium).

[0317] Therefore, although the disclosure has been described with respect to particular embodiments, it should be understood that the disclosure is intended to cover all modifications and equivalents within the scope of the following claims.

Claims

1. A method of presenting an interactive session to resolve a user's functional impairment, comprising: identifying, by a computing system, a plurality of sessions to address an impairment associated with a condition of a user, each session of the plurality of sessions including a corresponding tier of a plurality of tiers for the user; providing, by the computing system, a first session for a cognitive training layer by displaying one or more first images, the one or more first images being employed by the user to identify one or more of a plurality of social cues associated with a social skill; Providing, by the computing system, a second session for a virtual functional training layer for the user to apply the social skill in a virtual social setting, comprising: (i) displaying a second image of a social setting having (a) a first prompt identifying a query associated with a character displaying one of the plurality of social cues, and (b) a set of interactive elements identifying a corresponding plurality of responses to the character, (ii) receiving a first response from the plurality of responses selected by the user via at least one interactive element in the set of interactive elements, and (iii) providing feedback to the user based on the query and the response to the social setting; as well as The computing system provides a third session for the functional training layer for the user to apply the social skill, including (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a second response associated with the performance of the activity.

2. The method according to claim 1, further comprising: generating, by the computing system, an execution metric for the user based on the first response received from the user at a first time instance during the second session; modifying, by the computing system based on the execution metric, at least one parameter of a plurality of parameters defining presentation of at least one of an image, a prompt, and an interactive element for the virtual functional training layer; as well as providing, by the computing system at a second time instance, the second session for the virtual functional training layer, including displaying a third image of a second social setting having (i) a third prompt identifying a second query for a second role in the second social setting; and (ii) identifying a second set of interactive elements corresponding to a plurality of responses to the second character based on the plurality of parameters.

3. The method according to claim 2, wherein: The plurality of parameters include at least one of: (i) a type of content modality, (ii) a context of a social setting in an image, (iii) a number of characters in a social setting, (iv) a prompt type, (v) a response difficulty level, (vi) a response type, or (vii) a number of responses.

4. The method according to any one of the preceding claims, further comprising: generating, by the computing system, an execution metric for the user based on a correct selection rate in one or more sessions for the cognitive training layer; as well as A determination is made by the computing system to transition the user from the cognitive training layer to the virtual functional training layer in response to the execution metric satisfying a threshold.

5. The method according to any one of the preceding claims, further comprising: generating, by the computing system, an execution metric for the user based on a correct response rate in one or more sessions for the virtual function training layer; as well as A determination is made by the computing system to transition the user from the virtual functional training layer to the functional training layer in response to the execution metric satisfying a threshold.

6. A method according to any one of the preceding claims, wherein: Providing the first session further includes (i) displaying a first image of social cues with a set of interactive elements identifying corresponding multiple types of social cues associated with the first image; and (ii) receiving a selection of one of the multiple social cues by the user via at least one interactive element in the set of interactive elements, Wherein, the plurality of social cues of the first image in the first session for the cognitive training layer further include at least one of: (a) head movement, (b) body language, (c) gesture, or (d) eye contact.

7. A method according to any one of the preceding claims, wherein: The second session for the virtual functional training layer further includes displaying a plurality of images having the social setting of the character according to a defined sequence.

8. A method according to any one of the preceding claims, wherein: The third session for the functional training layer further includes displaying a third prompt for the user to select a time to provide a message prompting the user to perform the activity.

9. The method of any of the preceding claims, further comprising identifying, by the computing system, a time to provide one of the plurality of sessions to the user based on a session schedule.

10. A method according to any one of the preceding claims, wherein: the condition of the user comprises schizophrenia, wherein the user is receiving treatment at least partially concurrently with at least one of the first session, the second session, or the third session, wherein the treatment comprises at least one of a psychosocial intervention or a medication for treating schizophrenia, Wherein, the drug comprises at least one of the following: haloperidol, chlorpromazine, fluphenazine, perphenazine, loracetam, thioridazine, trifluoperazine, aripiprazole, risperidone, clozapine, quetiapine, olanzapine, ziprasidone, lurasidone, paliperidone or imeperidine.

11. A system for presenting an interactive session to resolve a user dysfunction, comprising: A computing system having one or more processors coupled to a memory, configured to: identifying a plurality of sessions to address an impairment associated with a condition of a user, each session of the plurality of sessions including a corresponding layer of a plurality of layers for the user; providing a first session for a cognitive training layer by displaying one or more first images, the one or more first images being employed by the user to identify one or more of a plurality of social cues associated with a social skill; Providing a second session for the virtual functional training layer for the user to apply the social skills in a virtual social setting, including: (i) displaying a second image of a social setting having (a) a first prompt identifying a query associated with a character displaying one of the plurality of social cues, and (b) a set of interactive elements identifying a corresponding plurality of responses to the character, (ii) receiving a first response from the plurality of responses selected by the user via at least one interactive element in the set of interactive elements, and (iii) providing feedback to the user based on the query and the response to the setting; as well as Providing a third session for the functional training layer for the user to apply the social skill includes (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a second response associated with the performance of the activity.

12. The system according to claim 11, wherein: The computing system is further configured to: generating an execution metric for the user based on the first response received from the user at a first time instance during the second session; modifying at least one parameter of a plurality of parameters defining presentation of at least one of images, prompts, and interactive elements for the virtual functional training layer based on the execution metric; as well as Providing the second session for the virtual functional training layer at a second time instance includes displaying a third image of a second social setting having a third prompt of (i) a second query identifying a second character in the second social setting, and (ii) a second set of interactive elements identifying a corresponding plurality of responses to the second character based on the plurality of parameters.

13. The system according to claim 12, wherein: The plurality of parameters include at least one of: (i) a type of content modality, (ii) a context of a social setting in an image, (iii) a number of characters in a social setting, (iv) a prompt type, (v) a response difficulty level, (vi) a response type, or (vii) a number of responses.

14. A system according to any one of claims 11 to 13, wherein: The computing system is further configured to: generating an execution metric for the user based on a correct selection rate in one or more sessions for the cognitive training layer; and In response to the execution metric satisfying a threshold, a determination is made to transition the user from the cognitive training layer to the virtual functional training layer.

15. A system according to any one of claims 11 to 14, wherein: The computing system is further configured to: generating an execution metric for the user based on a correct response rate in one or more sessions for the virtual function training layer; and In response to the execution metric satisfying a threshold, a determination is made to transition the user from the virtual functional training layer to the functional training layer.

16. A system according to any one of claims 11 to 15, wherein: providing the first session further comprising (i) displaying a first image of social cues having a set of interactive elements identifying a corresponding plurality of social cues associated with the first image, and (ii) receiving a selection of one of the plurality of social cues by the user via at least one interactive element of the second set of interactive elements, Wherein, the plurality of social cues of the first image in the first session for the cognitive training layer further include at least one of: (a) head movement, (b) body language, (c) gesture, or (d) eye contact.

17. A system according to any one of claims 11 to 16, wherein: The second session for the virtual functional training layer further includes displaying a plurality of images having the social setting of the character according to a defined sequence.

18. A system according to any one of claims 11 to 17, wherein: The third session for the functional training layer further includes displaying a third prompt for the user to select a time to provide a message prompting the user to perform the activity.

19. A system according to any one of claims 11 to 18, wherein: The computing system is further configured to identify a time to provide one of the plurality of sessions to the user based on a session schedule.

20. The system according to any one of claims 11 to 19, wherein: The condition of the user includes schizophrenia, wherein the user is receiving treatment at least partially concurrently with at least one of the first session, the second session, or the third session, wherein the treatment includes at least one of a psychosocial intervention or a medication to treat schizophrenia.

21. A method of improving functional impairment in a user suffering from schizophrenia in need thereof, comprising: obtaining, by a computing system, a first metric associated with the user a plurality of sessions ago; Repeatingly providing, by the computing system, one or more of the plurality of sessions to the user, the plurality of sessions comprising: a first session for a cognitive training layer by displaying one or more first images, the user employing the one or more first images to identify one or more of a plurality of social cues associated with a social skill; and a second session for the virtual functional training layer for the user to apply the social skill in a virtual social setting, comprising (i) displaying a second image of a social setting having a first prompt that (a) identifies a query associated with a character displaying one of the plurality of social cues and (b) a second set of interactive elements that identifies a corresponding plurality of responses to the character, (ii) receiving a response from the plurality of responses selected by the user via at least one of the second set of interactive elements, and (iii) providing feedback to the user based on the query and the response to the setting; a third session for the functional training layer, comprising (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a response associated with performance of the activity; and obtaining, by the computing system, a second metric associated with the user after at least one session of the plurality of sessions, Wherein, improvement in the functional impairment associated with schizophrenia occurs in the user when the second metric is (i) reduced by a first predetermined margin from the first metric or (ii) increased by a second predetermined margin from the first metric.

22. The method according to claim 21, wherein: The user's schizophrenia further includes at least one of: (i) schizophrenia with positive symptoms, including hallucinations or delusions; (ii) schizophrenia with negative symptoms, including decreased motivation or emotional expression.

23. The method of claim 21 or claim 22, wherein: The functional impairment associated with the user further includes at least one of: (i) reduced educational attainment, (ii) reduced quality of life, (iii) difficulty living independently, (iv) decreased social functioning, or (v) occupational functional impairment.

24. The method according to any one of claims 21 to 23, wherein: The user is an adult who is at least 18 years old or older and has been diagnosed with schizophrenia having the disorder.

25. The method according to any one of claims 21 to 24, wherein: The improvement in the functional impairment associated with schizophrenia occurs when the second metric is reduced by the first predetermined margin from the first metric, and wherein the first metric and the second metric are Multnomah Community Ability Scale (MCAS) values.

26. The method according to any one of claims 21 to 24, wherein: The improvement in the functional impairment associated with schizophrenia occurs when the second metric increases from the first metric by the second predetermined margin, and wherein the first metric and the second metric are Lawton Instrumental Activities of Daily Living (IADL) scale values.

27. The method according to any one of claims 21 to 24, wherein: The improvement in the functional impairment associated with schizophrenia occurs when the second metric increases from the first metric by the second predetermined margin, and wherein the first metric and the second metric are Personal and Social Performance (PSP) scale values.

28. The method according to any one of claims 21 to 24, wherein: The improvement in the functional impairment associated with schizophrenia occurs when the second metric is reduced by the first predetermined margin from the first metric, and wherein the first metric and the second metric are World Health Organization Disability Assessment Schedule 2.0 (WHO-DAS 2.0) scale values.

29. The method according to any one of claims 21 to 24, wherein: The improvement in the functional impairment associated with schizophrenia occurs when the second metric is reduced from the first metric by the first predetermined margin, and wherein the first metric and the second metric are Columbia-Suicidality Severity Rating Scale (C-SSRS) values.

30. The method according to any one of claims 21 to 29, wherein: The plurality of sessions further includes the second session for the virtual function training at a first time instance, including displaying a third image of a second setting having (i) a third prompt for a second query identifying a second character in the second setting; and (ii) identifying a third set of interactive elements corresponding to a plurality of responses to the second role based on a plurality of parameters, wherein at least one of the plurality of parameters is modified based on an execution metric for the user using the response received from the user during the second session at a second time instance prior to the first time instance.

31. The method according to claim 30, wherein: The plurality of parameters include at least one of: (i) type of content modality, (ii) context of the setting in the image, (iii) number of characters in the setting, (iv) prompt type, (v) response difficulty level, (vi) response type, or (vii) number of responses.

32. The method according to any one of claims 21 to 31 further includes determining, by the computing system, for at least one of the multiple sessions, a transition from one tier to another tier based on execution metrics of the user across one or more of the multiple sessions.

33. The method according to any one of claims 21 to 32, wherein: providing the first conversation further comprises (i) displaying a first image of social cues having a set of interactive elements identifying corresponding multiple types of cues associated with the first image, and (ii) receiving a selection of one of the multiple types of social cues by the user via at least one interactive element of the second set of interactive elements, Wherein, the plurality of social cues of the first image in the first session for the cognitive training layer further include at least one of: (a) head movement, (b) body language, (c) gesture, or (d) eye contact.

34. The method according to any one of claims 21 to 33, wherein: The second session for the virtual functional training layer further includes displaying a plurality of images with the settings of the character according to a defined sequence.

35. The method according to any one of claims 21 to 34, wherein: The third session for the functional training layer further includes displaying a third prompt for the user to select a time to provide a message prompting the user to perform the activity.

36. The method according to any one of claims 21 to 35, wherein: The plurality of sessions is provided over a period of between 2 weeks and 10 weeks.

37. The method according to any one of claims 21 to 36, wherein: the user is receiving treatment at least partially concurrently with at least one of the plurality of sessions, wherein the treatment includes at least one of a psychosocial intervention or a medication for treating schizophrenia, Wherein, the drug comprises at least one of the following: haloperidol, chlorpromazine, fluphenazine, perphenazine, loracetam, thioridazine, trifluoperazine, aripiprazole, risperidone, clozapine, quetiapine, olanzapine, ziprasidone, lurasidone, paliperidone or imeperidine.

38. A method for presenting an interactive session to address a user's verbal recall and cognitive association impairments, comprising: identifying, by a computing system, a plurality of sessions to address an impairment associated with a condition of a user, each session of the plurality of sessions including a corresponding tier of a plurality of tiers for the user; providing, by the computing system, a first session for a cognitive training layer associated with a verbal memory skill by presenting one or more first audio recordings, the one or more first audio recordings being employed by the user to recall one or more words of a plurality of words; Providing, by the computing system, a second session for the virtual functional training layer for the user to apply the verbal memory skill in a virtual setting, comprising: (i) presenting a second audio recording of a speech sample having a set of interactive elements that (a) identify a first prompt of a query associated with the speech sample and (b) identify a corresponding plurality of responses, (ii) receiving a first response from the plurality of responses selected by the user via at least one interactive element in the set of interactive elements, and (iii) providing feedback to the user based on the query and the response to the speech sample; as well as A third session for the functional training layer is provided by the computing system for the user to apply the verbal memory skill, including (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a second response associated with the performance of the activity.

39. The method of claim 38, further comprising: generating, by the computing system, an execution metric for the user based on the first response received from the user at a first time instance during the second session; modifying, by the computing system based on the execution metric, at least one parameter of a plurality of parameters defining presentation of at least one of an audio recording, a prompt, and an interactive element for the virtual functional training layer; as well as The second session for the virtual functional training layer is provided by the computing system at a second time instance, including presenting a third audio recording of speech samples between characters in a social setting, having a third prompt for (i) identifying a second query associated with the speech samples of the characters in the social setting, and (ii) identifying a second set of interaction elements corresponding to a plurality of responses based on the plurality of parameters.

40. The method of claim 39, wherein: The plurality of parameters include at least one of: (i) a type of content modality, (ii) a context of a social setting in the audio recording, (iii) a number of characters in the social setting, (iv) a prompt type, (v) a response difficulty level, (vi) a response type, or (vii) a number of responses.

41. The method according to any one of claims 38 to 40, wherein: Providing the second session for the virtual functional training layer further includes rendering the second audio recording according to a plurality of parameters, Wherein, the plurality of parameters include at least one of: (a) inclusion of interference, (b) the ability to repeat the second audio recording, (c) modification of speed, (d) the time between each word, (e) the number of words in each sentence, (f) the length of the audio recording, or (g) the ability to control the interference.

42. The method according to any one of claims 38 to 41, further comprising: generating, by the computing system, an execution metric for the user based on a correct selection rate in one or more sessions for the cognitive training layer; as well as A determination is made by the computing system to transition the user from the cognitive training layer to the virtual functional training layer in response to the execution metric satisfying a threshold.

43. The method according to any one of claims 38 to 42, further comprising: generating, by the computing system, an execution metric for the user based on a correct response rate in one or more sessions for the virtual function training layer; as well as A determination is made by the computing system to transition the user from the virtual functional training layer to the functional training layer in response to the execution metric satisfying a threshold.

44. A method according to any one of claims 38 to 43, wherein: Providing the first session further comprises: identifying a set of records from a plurality of records to present to the user, each record in the plurality of records corresponding to one or more words; presenting the set of records to the user according to a format defining a context in which the one or more words of each record in the set of records are presented; displaying an interface to prompt the user to select at least one word from a plurality of words as presented in the set of records; and A selection of at least one word is received by the user via the interface.

45. The method according to any one of claims 38 to 44, wherein: The third session for the functional training layer further includes displaying a third prompt for the user to select a time to provide a message prompting the user to perform the activity.

46. ​​The method of any one of claims 38 to 45, further comprising identifying, by the computing system, a time to provide one of the plurality of sessions to the user based on a session schedule.

47. A method according to any one of claims 38 to 46, wherein: the condition of the user comprises schizophrenia, wherein the user is receiving treatment at least partially concurrently with at least one of the first session, the second session, or the third session, wherein the treatment comprises at least one of a psychosocial intervention or a medication for treating schizophrenia, and Wherein, the drug comprises at least one of the following: haloperidol, chlorpromazine, fluphenazine, perphenazine, loracetam, thioridazine, trifluoperazine, aripiprazole, risperidone, clozapine, quetiapine, olanzapine, ziprasidone, lurasidone, paliperidone or imeperidine.

48. A system for presenting an interactive session to address a user's verbal recall and cognitive association impairments, comprising: A computing system having one or more processors coupled to a memory, configured to: identifying a plurality of sessions to address an impairment associated with a condition of a user, each session of the plurality of sessions including a corresponding layer of a plurality of layers for the user; providing a first session for a cognitive training layer associated with a verbal memory skill by presenting one or more first audio recordings, the user employing the one or more first audio recordings to recall one or more words of a plurality of words; Providing a second session for the virtual functional training layer for the user to apply the verbal memory skills in a virtual social setting, including: (i) presenting a second audio recording of a speech sample having a set of interactive elements that (a) identify a first prompt of a query associated with the speech sample and (b) identify a corresponding plurality of responses, (ii) receiving a first response from the plurality of responses selected by the user via at least one interactive element in the set of interactive elements, and (iii) providing feedback to the user based on the query and the response to the speech sample; as well as Providing a third session for the functional training layer for the user to apply the verbal memory skill includes (i) displaying a second prompt to guide the user to perform an activity, and (ii) receiving a second response associated with the performance of the activity.

49. The system of claim 48, wherein: The computing system is further configured to generating an execution metric for the user based on the first response received from the user at a first time instance during the second session; modifying at least one parameter of a plurality of parameters defining presentation of at least one of an audio recording, a prompt, and an interactive element for the virtual functional training layer based on the performance metric; as well as Providing a second session for the virtual functional training layer at a second time instance includes presenting a third audio recording of speech samples between characters in the social setting, having a third prompt for (i) identifying a second query associated with the speech samples of the characters in the social setting, and (ii) identifying a second set of interaction elements corresponding to a plurality of responses based on the plurality of parameters.

50. A system according to claim 48 or claim 49, wherein: The plurality of parameters include at least one of: (i) a modal type of the content, (ii) a context of a social setting in the audio recording, (iii) a number of characters in the social setting, (iv) a prompt type, (v) a response difficulty level, (vi) a response type, or (vii) a number of responses.

51. A system according to any one of claims 48 to 50, wherein: The computing system is further configured to render the second audio recording according to a plurality of parameters, Wherein, the plurality of parameters include at least one of: (a) inclusion of interference, (b) the ability to repeat the second audio recording, (c) modification of speed, (d) the time between each word, (e) the number of words in each sentence, (f) the length of the audio recording, or (g) the ability to control the interference.

52. A system according to any one of claims 48 to 51, wherein: The computing system is further configured to: generating an execution metric for the user based on a correct selection rate in one or more sessions for the cognitive training layer; and In response to the execution metric satisfying a threshold, a determination is made to transition the user from the cognitive training layer to the virtual functional training layer.

53. A system according to any one of claims 48 to 52, wherein: The computing system is further configured to: generating an execution metric for the user based on a correct response rate in one or more sessions for the virtual function training layer; and In response to the execution metric satisfying a threshold, a determination is made to transition the user from the virtual functional training layer to the functional training layer.

54. A system according to any one of claims 48 to 53, wherein: The computing system is further configured to provide the first session by: identifying a set of records from a plurality of records to present to the user, each record in the plurality of records corresponding to one or more words; presenting the set of records to the user according to a format defining a context in which the one or more words of each record in the set of records are presented; displaying an interface to prompt the user to select at least one word from a plurality of words as presented in the set of records; as well as A selection of at least one word is received by the user via the interface.

55. A system according to any one of claims 48 to 54, wherein: The third session for the functional training layer further includes displaying a third prompt for the user to select a time to provide a message prompting the user to perform the activity.

56. A system according to any one of claims 48 to 55, wherein: The computing system is further configured to identify a time to provide one of the plurality of sessions to the user based on a session schedule.

57. A system according to any one of claims 48 to 56, wherein: The condition of the user includes schizophrenia, wherein the user is receiving treatment at least partially concurrently with at least one of the first session, the second session, or the third session, wherein the treatment includes at least one of a psychosocial intervention or a medication to treat schizophrenia.

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