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Three High School Students Go to Washington — with an Award-Winning App for Cognitive Deficit Testing



A TRIP TO DC TO RECEIVE AN AWARD (left to right): Isabella Aslarus, Dr. Daniel Press, Massachusetts State Senator Katherine Clark, Seth Amarasinghe, Ellison Lim, and Dr. Chun Lim.

Three high school student created an award-winning app, which includes tests to check for prosopagnosia, spacial neglect and executive function.

Daniel Press, MD, a cognitive neurologist and associate professor of neurology at Beth Israel Deaconess Medical Center in Boston, keeps his “toolkit” in a blue tote bag that his father gave him 25 years ago.

The tote bag, filled with things such as flash cards of famous faces, is meant to be a handy go-to resource for assessing a patient for cognitive deficits. But Dr. Press doesn't always have the bag with him when he needs it, which got him thinking: Wouldn't it be helpful to have a digital-age version of his old-fashioned toolkit?

Now Dr. Press has one, thanks to three tech-savvy high school students who took him up on his idea. They developed an iPad app, called CNToolkit for Cognitive Neurology Tool Kit, which includes tests to check for prosopagnosia, spacial neglect and executive function, among other things.

The efforts of Isabella Aslarus, Seth Amarasinghe, and Ellison Lim — all juniors at Weston High School outside Boston — won them recognition from the Congressional App Challenge, a nationwide competition for high school students sponsored by members of the US House of Representatives. The competition is meant to encourage students to get involved in coding and computer science.

Isabella, Seth, and Ellison won at the district level, and made a trip to Washington, DC, along with other winners from around the country.

Why the need for the app? “The goal is to make our jobs easier and to better treat patients,” said Dr. Press, who finds the new app to be easy to operate and convenient. He said that while there already are brain-related apps aimed at the general public (such as Lumosity) and an app version of the Mini-Mental Status Exam, the CNToolkit enables doctors to test specific cognitive realms using just one program. The app currently encompasses nine tests, including a letter cancellation test, a test for object neglect, a short naming test, a test for semantic knowledge, and trail-making tests.

“I saw a patient two weeks ago who reported life-long difficulty in recognizing faces,” Dr. Press said. “With the app, the patient was only able to recognize two of 15 famous faces, confirming severe prosopagnosia.”

Isabella, Seth, and Ellison are no strangers to technology or, in one of the cases, neurology. Ellison's father, Chun Lim, MD, PhD, is Dr. Press's colleague in the cognitive neurology unit at Beth Israel, and was also interested in the idea of developing a digital toolbox for neurologists. The three high school friends worked on the project last summer and on into the school year.

“I hope it will be used by doctors all around,” said Ellison, who has been friends with Seth since grade school and got to know Isabella when they were freshmen in AP computer science class.

Isabella said that when the project began she knew little about neurology, though she was intrigued by the topics of sleep and memory. She and Seth, who had previously done some computer programming for Dr. Lim, had begun teaching themselves the Apple coding language SWIFT with the hopes of building their own app.

Isabella and Seth did the coding for CNToolkit, and Ellison focused on various logistics. They learned a lot about the brain in the process.

“It's really interesting how damaging or changing one part of the brain has an impact on people's lives,” said Isabella. “The brain is a complicated organ that totally determines who you are as a person.”

Seth said he's developed a “great appreciation for what neurologists do.”


The three students grew up in families with a technology bent. In addition to his neurologist dad, Ellison's mom is a computer scientist at Massachusetts Institute of Technology. Both of Isabella's parents are computer scientists — one at MIT and the other at Northeastern University — and Seth's parents are a computer scientist (at MIT) and a chief financial officer. Seth's father started to teach him coding when he was about 8 or 9.

Seth said students should approach learning to code the same as they would with learning a foreign language. “If you put in the time and effort, it comes,” he said.

The students are continuing to expand and refine their app. Their next goal is to develop normative data so that doctors can see how their patient's performance compares. They also want to “create a battery based on the individual tests to allow for a more comprehensive screening test,” Dr. Press said.

The students work on the app during an independent study period at school and also meet up at each other's homes on Sundays.

Seth said so far it's been a low-budget project: food is their primary expense. “That stacks up pretty quickly,” he said.

Dr. Press said CNToolbox, which went live in March, has been downloaded a few dozen times, and he said the app is getting good reviews by colleagues who have tried it. He said digital tools such as CNToolkit are bound to play an increasing role in the doctor's office and hospitals. He added that given there are only 1,500 neurologists in the country, the app might be welcome by general practice doctors who see patients with stroke, dementia and other cognitive problems.

“I see these tools as supplemental to what we already do,” Dr. Press said. An app can't make a diagnosis, but it can help the doctor make sense of a patient's signs and symptoms.


•. The iPad app can be downloaded for free:
    •. YouTube video on the app: