Slow Down for Conversation Paceboard
Hot on the heels of Speech Pacesetter, Aptus Speech & Language Therapy has released another great app to help people slow their rate of speech. This app takes the traditional pacing board and modernizes it, adding helpful visuals, settings, and topics to help those with Parkinson's disease, fast rate of speech, dysarthria, apraxia of speech, and decreased intelligibility.
Conversation Paceboard ($3.99 for iPad) features 6 golden buttons arranged in 2 rows. A slider at the bottom adjusts how long the user must press each button before moving on, from 0 to 1.5 seconds. Depending on the therapy goal, the user can press and hold one button for each syllable or word as they speak. As each button is pressed and held, it fills with color and then displays a checkmark. If the user moves off the button too quickly, the words "Too Quick!" flash up on the button. The app also includes 200 questions divided into topic areas (travel, sports, food, thought-provoking, etc) that can be selected individually or randomized. The question text appears at the top with arrow buttons to move forward and back. If you have other stimuli to use, you can set the app to "none" to just use the pacing buttons.
What I love about this app is that it takes advantage of the touch screen so well. The thing a pacing board could never do was keep the user on each space long enough to slow them down if they move their hand quickly. This app forces the user to slow down, but if they move off too quickly, the feedback is non-invasive, allowing them to keep speaking. I also appreciate the nod to the old rainbow pacing boards as each button turns a different color of the rainbow, while the app maintains a mature interface. Moving in clockwise circles around the screen allows users to pace their speech for as long as it lasts with no artificial stop/start point.
Several of the questions elicit a simple yes/no or single-word response from the client, which doesn't help with the pacing technique, requiring further probing or simply choosing another question. Pressing and holding isn't intuitive, but the info screen explains the technique well. It would also be nice to see an iPhone version so clients can more easily use the technique outside of the clinic on their own device. Ideally, the app would track how many "too quick" messages flashed up during a session, but data tracking is a lot to ask of a $4 app.
The pacing board is an evidence-based treatment technique for palilalia and hypokinetic dysarthria associated with Parkinson's Disease. One consideration when using a pacing strategy is that the tool is needed to maintain the rate unless the strategy is successfully transferred or generalized. It can also create more robotic-sounding speech as each-syll-a-ble-is-said-at-the-same-rate. I didn't get the chance to use this app with a patient with Parkinson's, but I can imagine some users' hand tremors might make it hard to press and hold the buttons.
If you work with people with dysarthria, Parkinson's, or other clients who need to slow their rate of speech, Conversation Paceboard is a wonderful app to add to your toolkit.