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Early Intervention Speech Therapy

One Three-Year-Old’s Journey

Published December 13, 2011 9:08 AM by Stephanie Bruno-Dowling

Over the last year, I have watched one of the children on my caseload truly grow into a bright little preschool school student who desperately wants to communicate with others. When he first entered our school, he had just turned three and although he seemed to comprehend many concepts in the world around him, recent testing did not reflect this. In addition, he would often have outbursts and outright refusals to comply during classroom lessons. Behavior issues and little to no expressive language plagued his daily performance in the classroom.

As time went on and my little friend learned the routines of the classroom and experienced some true successes within his educational setting, a change began to occur. He began to willingly choose to participate in speech class and other activities throughout his day. All of his teachers and therapists began to see a change and almost a hunger in his eyes. I especially started to see this transformation during our speech therapy sessions. He was increasingly cooperative and would follow my commands demonstrating his understanding of various vocabulary and age appropriate concepts.

As his attention and focus began to improve at a steadfast pace, his speech articulation seemed to be in slow motion. He would raise his hand to answer, but nothing would come out. He would practice sounds, syllables and key vocabulary words over and over, yet had extreme difficulty imitating modeled speech and retaining skills in this area from one day to the next. The gap between his receptive language and expressive speech skills seemed to grow wider each day.

Once we returned from summer break and began to prepare for our upcoming re-evaluations and annual IEP meetings, this little boy was at the top of our list. I called his parents and told them my apraxia suspicions, sharing that I would like to complete a full speech and language assessment at this time to ensure that his educational placement was still appropriate and to begin the process for obtaining augmentative communication. His parents were delighted to hear of their son's progress and also shared the same concerns and frustrations regarding his articulation and expressive language.

Throughout the fall, testing was completed and the results looked much different than those gathered just over a year ago. We held his ER/IEP meeting to review all the results, draft and sign new goals and change his placement to a classroom with less supports and interventions.

In addition, I met with our Augmentative Communication County Representative to review this student's case and place an order for a device that would be solely for him to use within his school setting. After careful discussion and analysis, we both decided that an iPad would be an appropriate tool to use with this student. We will be receiving it after our Christmas break and will have 8 weeks to trial it. Both the family and I are very excited to have this opportunity for their little boy!

Using an iPad with a child this age is still very new for me and I have been reading Angela Desideri's AT and AAC: Practical Tips and Strategies blog on the ADVANCE for SLPs website, which is full of helpful tips. If other SLPs out there would like to write in and share suggestions, app tips and any other pointers that you think may be helpful for me when working with this little boy and the iPad, please share! I welcome all your comments!

Thank you!



When I turn the screen off on my iponhe and lock it, (not turn it off completely) it makes this weird high-pitched chirping noise, it's loud and it starts chirping really high and quickly and slowly starts to chirp deeper and slower. Then it will suddenly stop. It only lasts a few seconds and doesn't happen whn he iPhone is on vibrate, (duh)Why is it doing this and how can I get it to stop?Why is

mhay mhay, VSHzLfrPAhKu - BitfWwRCif, OpWvgkkepw June 11, 2012 3:25 PM
bcyKarzt NC

Thank you for sharing!!

Lisa - awesome resources you have provided for us!! Thank you!!

stephanie bruno December 22, 2011 7:38 AM

Here are the apps I use the most-in no order, just went through my ipad and jotted them down.  Some are free.  Some are not-but worth paying for.

Toca Boca Tea Party

Toca Boca Store

Toca Boca Hair Christmas

Most of the apps from

Match it up 1, 2, 3

Families 1, 2,

Alligator apps has some nice ones-sign up for their free email to get free apps

Adventures for Kids

Monkey Thinks

Old Mac HD (from duck duck moose)

Wheels on bus HD (from duck duck moose)

Iblower apps (there are several free)   Hint:  they are really sound activiated.  I use them for those minimally vocal kids.

I like books-37  free (gives you 37 free books-great topics, photos and reads to kids)  Search for it this way and you get all 37 books at once- instead of searching for each individually

Monster at the end of this book (I love this app.  I got it free from Starbucks-but it is wonderful, I would have paid for it)

Toy Story Read along book/app free.  Love it

iwrite words lite

Articpix  I like this app.  It’s one of the pricier ones.  Phonopix I don’t like as much-you can truly set articpix to do phono by only choosing the sounds/positions you want.

Wordslapps.  I like this app because you can upload pictures and create your own receptive “find the” categories.   I use it a lot-I uploaded students pictures (to see if child knew who everyone was), I snapped pictures from our weekly abc books-and quizzed kid on them (great vocabulary tool!)

First Phrases Lite-  I will probably pay for the full version of this app soon

Fun with Directions Lite - I will probably pay for the full version of this app soon

Picture the Sentence LIte I will probably pay for the full version of this app soon

I hear Ewe (for some reason the kids love this one)

FUN (reinforers):

Fireworks 1, 2, 3 (also can be used for sentence building)

Bubbles HD

Paint sparkles

Peekaboo HD.  

Talking Tom (he repeats back what you say… there IS a way to turn off the “violence” in settings (you can punch him and knock him out)  

Lisa December 21, 2011 2:31 PM

I will look at my ipad for the apps I use the most....and post it soon (I also work for in an IU prek class)  

I don't have any recommendations on aac work slp ipad does not have anything like proloquo2go-because "we are supposed to use them for therapy, no communication"

I wanted to point out a website

Every day they list apps that are free (that were not yesterday).

There is a lot of junk-but I have found MANY preschool apps, all the "eye contact" apps and even a few SLP apps free at some point over the last few months.

Well worth a daily check in.  The website defauits to the "ipod" list (but those are also ok on the ipad!) near the top is a tab to see the Ipad apps (shorter list, but sometimes different).  

Lisa December 20, 2011 11:11 AM

Try the new "go Talk" app.  It's only around 80 dollars. It's not as extensive as Proloquo but might be a good stepping stone.

Amy , , SLP Public school December 19, 2011 10:39 AM
Rock Valley IA

Proloquo is a great program for use with a single student. I have it on my iPad, but it's a pain to switch back and forth from one student to another because you have to save each student' to your computer before you reload another student's. Another simpler app is Sounding Board. It is also a Speech Generating Device that can be customized and at $40, it's more reasonable. It is made by AbleNet, I think and you can add to it, so the basic one is much simpler than Proloquo. Check them out on iTunes. I also have quite a few great apps for building vocabulary, like My PlayHouse and some of the Milo apps for verbs and location words. There are also apps that ask "wh" questions and most give a choice of answers. For a non-verbal or minimally verbal child, there are lots of animal apps with the animal sounds. For a child who is beginning to talk, I also use some of the Talking apps, but prefer the hippo because the kids tend to want to be aggressive with some of the others, and the others can be rude at times. Good luck.

Penny December 17, 2011 5:59 PM

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About this Blog

    Stephanie Bruno Dowling, M.S. CCC-SLP
    Occupation: Speech-Language Pathologist
    Setting: Early Intervention in Delaware County, PA
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