First, I want to say how excited I am to be back blogging after a few very busy months away. There are many more apps and tips to share with you in 2014 from my perspective working with the adult population in speech pathology. So without further ado, let's look at a new app!
Word Vault - Word Lists is a handy new app from Home-Speech-Home that I was recently given the chance to try out. This universal iOS app is a tool for therapists providing speech and language therapy to any age of client priced at $9.99. The no-frills interface is easy to navigate and provides access to tens of thousands of words and stimuli for a variety of therapy goals. The app is divided into four separate "vaults", each containing several lists of words and stimuli.
Word Vault is primarily a well-organized and searchable list of words - ideal for articulation, dysarthria, or apraxia therapy. Open either the Articulation Vault or Phonology Vault from the Home screen to find words by sound. Once a sound list is loaded, the words can be filtered by initial, medial, and fina position as well as syllable length. The display's font size and number of columns are also adjustable, allowing for low-vision use and controlling the amount of scrolling or distraction on screen.
For apraxia stimuli, look to a section of words called "Non-sense Syllables" in which consonants are paired with each of six vowels in a set order. The lists of "Multisyllabic Words" in the Phonology Vault are also helpful when looking for longer words on the fly. Clinicians treating dysarthria will appreciate having
"Minimal Pairs" listed out for each sound pair, right at their fingertips.
The Language Vault holds lists of words sorted by part of speech, but there are also pages and pages of other language stimuli: analogies, synonyms, categories, 1-4 step and conditional directions, multiple meanings, sequencing, and even short stories. The Social Vault holds conversation starters, idioms, proverbs, problem scenarios, and jokes ("Why wouldn't the crab share his sweets? Because he was a little shellfish!") - ideal for cognitive-communication goals in R CVA and TBI clients.
There are two fantastic features built into this app, aside from the plentiful content, that users will certainly appreciate. First, any list you bring up can be easily emailed off the device, so sending homework to your client is easier than ever. The second feature of note is that up to eight screens at a time can be pre-loaded for fast switching between lists. This can cut out navigation time in a group setting, when working with a client with multiple goals, or when there is no time to prep between clients.
The only caveat is that many of the language stimuli (problem solving, short stories, following directions, story starters, etc) are written for children. I wouldn't ask my stroke patients to tell a story about a "slimy monster, spaceship, and moon" to work on verbal expression, nor would I ask them to "stand up and then jump up and down two times" to practice auditory comprehension. As with any therapy materials, you'll want to pre-screen the items to make sure they're appropriate for your clients. Also note there are no sounds in this app, but there is a LOT of text.
All of the word lists and language stimuli are available for free on the developer's website, but having the Word Vault app installed on your iDevice so you can access, filter, email, and adjust the display of so many lists without network access just makes sense.
This app offers a great starting point for a child with childhood apraxia of speech (CAS). It offers a variety of levels of CV sequences and is organized by the approximate developmental sequence of consonants. When working with children with CAS any approach should incorporate the principles of motor learning, if you are unfamiliar with the principles of motor learning please visit apraxia-kids.org . There are lots of opportunities to focus on motor learning especially the at the pre-practice through practice stages including random and blocked practice depending on which stage you choose. The stages are set up as follows:
Level 1-This level presents one syllable at a time to learn what each illustration is (receptive) and how to produce it (expressive). Start at this level each time a new consonant group is selected. This level can also be used when using the app to teach new phonemes.
Levels 2-8 should only be used if a user can produce the single syllables in Level 1.
Level 2-This requires the production of three repetitions of one syllable. Production of the third repetition should be just as clear as the first.
Level 3-This level requires the production of five clear repetitions of the same syllable.
Level 4-In this level the user produces four repetitions of the same syllable then must change to a different syllable at the end, containing the same initial sound, but a different vowel. Making these subtle changes in articulation is an important aspect of motor planning for speech.
Level 5-This level contains two syllables that alternate back and forth in the sequence.
Level 6-The syllables in this sequence start with the same consonant sound, differ in the vowel, and have a random arrangement within the sequence.
Level 7-This is a random arrangement of syllables with varied consonant and vowel sound, but all consonants are from the chosen consonant group.
Level 8-This is a random combination of any of the syllables that have been worked on through Level 7. There may be syllables that represent different consonant groups within the same sequence; therefore the user must have worked through Level 7 for at least two consonant groups before moving on to Level 8.
Data tracking was a recent update that is offered via in app purchase for $4.99, which allows you to track multiple clients as well as share data via email with parents.
As I mentioned earlier this app offers a great starting point for child who is only making CV combinations which for most children with CAS is where you would most likely start. However children might quickly outgrow the app which is where their Apraxia Words app would come. Apraxia Words offers the next set of word shapes to target. Ideally, I would like to see them combine both apps to make one that works from the CV stage on up.
Speech Therapy for Apraxia - NACD Home Speech Therapist $4.99 for iPad
The developer has provided me with 5 codes to give away. Want a copy? Please comment below for a chance to win!
I have always advocated that apps designed for kids should not be used with adults in speech therapy. Rules usually have exceptions, and my biggest exception to this rule has always been My PlayHome. Now, with the new My PlayHome Stores, there are two exceptions.
My PlayHome (universal iOS, $3.99, free lite version; Android, $2.99) is a virtual dollhouse with a living room, kitchen, kids' bedroom, master bedroom with walk-in closet, full bathroom, and backyard. Each scene is filled with elements that can be manipulated in realistic ways: the TV turns on and off, the curtains open and close changing the light in the room, the carrots in the garden grow when you water them, and the toilet flushes when you touch it. Characters can be added to interact with the environment: eating the food in the kitchen, drying off from the shower with the towel, trying on the clothes in the closets, and more.
My PlayHome Stores (universal iOS, $1.99) is the brand-new addition, allowing characters from the house to go around the corner to the stores on a street filled with an ice cream parlor, a clothing store, a produce market, a grocery store, and an ATM. Each store has interactive features and employees, increasing the number of topics to discuss and act out. These apps work seamlessly together, with characters from one moving into the other, bringing home their new clothes from the shop or taking a coffee along for the errands.
These apps work nicely for aphasia and cognitive therapy because they bring all the functional vocabulary of the home and community into the clinic, allowing clients to talk about and "act out" everyday activities from the therapy table. Most adults have no qualms about using the app when it is introduced as a structured activity. Here are examples of ways to target a variety of goals using the PlayHome apps in speech therapy:
Word Comprehension (in the back yard): Touch the watering can. Point to the tire swing. Find the trampoline.
Following Directions (in the kitchen): 1-step: Open the fridge. 2-step: Open the fridge and take out a slice of pizza. 3-step: Open the fridge, take out the milk, and pour a bowl of cereal.
Understanding Prepositions (in the bathroom): Put the rubber duck under the sink. Put the toothpaste next to the razor.
Sequencing (in the house): Before you go to the kitchen, turn off the stereo.
After you flush the toilet, brush your teeth. Turn on the lamp before you close the curtains.
Naming in Context (in the living room): chair, coffee table, TV, stereo, fish tank, fish food, CDs, vase, flower, apple, book, plant, lamp, curtains, cat, pictures, frames, clock, window, door, ottoman, area rug, light switch, shelves
Problem Solving & Reasoning (in the house): What might happen if we left the refrigerator door open? What can we do to turn off the music? What will make it brighter in this room?
Executive Functioning (both apps): Give the client a list of errands to run in "town," such as picking up some milk, bananas, juice, cash, and flowers at the stores. Add constraints such as first brushing teeth, changing clothes, and eating breakfast. Aid the client as they make a list of tasks, schedule time for each, estimate a budget for the errands, and plan a logical order. Once they've executed the tasks, review if it went as planned or what could be changed.
Barrier Game: Pick a room/store, arrange the items and people a certain way, then snap a screenshot (press power + home). Print out the screenshot from your Photos app, or email it so it can be seen on another screen.
- Receptive: Give the client the iPad with a "tidied" room, then give verbal or written instructions on which people to add to the room, where they should go, and which elements to change or reposition so that they can arrange the screen to look like your screenshot. Compare and discuss where things went wrong.
- Expressive: Give the client the screenshot to reference. Have them give you instructions on how to set the scene by describing each element's position. Great for using names, pronouns, and prepositions.
- Memory: After studying a screenshot, the client has to arrange a scene to match what they saw in the picture. Add a delay or distraction to increase the difficulty, or add items from other rooms/stores for an additional problem-solving element.
Text-to-speech (TTS) apps convert typed text to voice output, similar to the Lightwriter dedicated AAC device. This type of app is useful for someone with intact literacy, language and cognitive skills; good manual control for typing; and adequate vision for small text. The user would most likely need this type of app because of a voice or speech impairment such as laryngitis, head or neck cancer, ALS, severe dysarthria, or verbal apraxia. While some picture-based AAC apps have text-to-speech as a component, the majority of TTS apps available do not include symbols.
I've taken a look at several key features in the top TTS apps to compare how each app stacks up to help you decide which is best for your clients. The apps included in this feature analysis are Speak it! Text to Speech, Assistive Express (formerly known as Assistive Chat), Predictable, and Verbally (free and premium). For comparison, I've also looked at the built-in features of iDevices, using the Notes app combined with the accessibility feature of Speak Selection to achieve the same TTS functionality without an additional app.
Format & Price:
Speak it! Text to Speech: Universal iPhone & iPad, $1.99
Assistive Express: Universal iPhone & iPad, $24.99
Predictable: Universal iPhone & iPad, $159.99
Verbally: iPad only, Landscape orientation only, free
Verbally Premium: iPad only, Landscape orientation only, $99.99
Notes: Universal iPhone & iPad, free
Speak it! Text to Speech: none
Assistive Express: yes, up to 6 words
Predictable: yes, up to 5 words on screen at a time with several more available
Verbally: yes, up to 4 words
Verbally Premium: yes, up to 4 words
Phrase Storage & History:
Speak it! Text to Speech: can save phrases and audio files, no history
Assistive Express: can save phrases to Favorites and access last 40 utterances
Predictable: can save phrases to categories and access history
Verbally: a few commonly used words and phrases are stored, but no ability to add phrases to the app for quick access - must upgrade for this functionality
Verbally Premium: can save phrases and access history
Notes: stores all words/phrases typed into the app, can delete lines
Speak it! Text to Speech: email saved audio files
Assistive Express: email, Twitter, Facebook, or copy to clipboard
Predictable: email, Facebook, Twitter; copy to clipboard coming in next version
Verbally Premium: email
Notes: email, print, or copy to clipboard
Speak it! Text to Speech: 2 male and 2 female voices (US & UK accent) with option to purchase several more for $1 each, high-quality Acapela voices with rate and volume control
Assistive Express: 1 male, 1 female, and 1 child voice (US accent) from Acapela, rate and volume control
Predictable: 4 male and 5 female voices (US, UK, & AUS accents), Loquendo voices from Nuance, pitch and rate are adjustable
Verbally: 1 male and 1 female low-quality synthesized voice
Verbally Premium: 1 male, 1 female, and 1 child voice (US accent) from Acapela; rate, pitch, and volume controls
Notes: built-in iOS voice (1 per dialect) with rate control in Settings app
Speak it! Text to Speech: Built-in QWERTY
Assistive Express: Built-in QWERTY
Predictable: Custom QWERTY, ABCDEF, and high-frequency layout for scanning (options appear in the Settings app, not in the Predictable app itself)
Verbally: Custom QWERTY and Left/Right ABCDEF
Verbally Premium: Custom QWERTY and Left/Right ABCDEF
Notes: Built-in QWERTY
Speak it! Text to Speech: includes instruction on how to use this app while speaking on an iPhone call using the speakerphone
Assistive Express: additional settings for font size and when to speak; word prediction can be turned off
Predictable: accessible for scanning with a switch; includes limited symbol support and handwriting recognition
Verbally: Steady Hands setting lets users slide over the keyboard and only select on release; Premium features are visible with pop-up ads to upgrade when touched
Notes: must first select the text you wish to speak, which can be fussy
Conclusion: The best value for money for a universal app with word prediction, quality voices, and phrase storage is Assistive Express. If the user's condition is degenerative and physical access may deteriorate, Predictable is worth considering for its switch scanning capabilities. Speak it! is an inexpensive option without word prediction for those who type faster than they think, or for just a brief period of vocal rest.
Most articulation apps are designed to appeal to children, so it can be difficult to find one with appropriate content and design to use with adults with dysarthria or apraxia. For some time now, my go-to app for working on speech sound impairments has been Pocket Artic.
Pocket SLP's Pocket Artic ($9.99 universal iOS app, see note on Android at the bottom) features real photos, recorded voice, and thousands of stimuli for a variety of sounds. Each user profile is set up to store target sounds, preferred level (word/phrase/sentence), and data. If there is no time or desire to save a profile for a user, the QuickQuiz mode allows quick access to the materials. The app features 19 consonant phonemes, s/l/r blends, and six r-controlled vowels. Onscreen toggles between initial, medial, and final positions, as well as word, phrase, and sentence levels, make for easy adjustments during therapy. Score each production using the correct/approximate/incorrect buttons on screen, and take advantage of the built-in recording feature. If the client needs more information about the sound, press the "i" button to access a diagram of the tongue and palate similar to the Speech Tutor app.
There are a few issues with this app that detract from usability. Not all audio files match the printed text exactly, tripping up clients as they practice. It can also be difficult to remember to swipe right-to-left to change stimuli because the flipping animation makes it appear that an upward swipe would change the page. Getting started with the app is something that must be learned, as the home screen doesn't offer a clear direction. Perhaps the biggest problem with Pocket Artic is that it is missing the phonemes /w, zh, y, h/; these sounds have the common element that they don't appear in all positions of English words, but they are common speech targets. While many reviewers have experienced some crashes with various versions of this app, the developers have responded with 15 updates in 3 years.
For Android users, there is an older version of this app available on the Google Play store. It costs a bit more, comes in separate phone and tablet versions, and is called Pocket SLP. It does not have all the same features and bug fixes as the latest iOS version.
Which apps do you use for articulation goals with your adult speech clients?
Handwriting comes more naturally than typing for many adults and is likely to be better preserved after neurological injury or disease. For those who have lost their ability to speak, a voice-output app may be the best way to be heard. However, nearly all voice-output communication apps require the user to type in a message, leaving those without keyboarding skills in the lurch. Two AAC apps offer writers a chance to hear their words by converting handwriting to text, then text to speech.
HandySpeech (universal iOS app for $29.99) excels at recognizing print, script and mixed case writing and outputting it in high-quality artificial speech. Voices can be male or female in US or UK English accents; 11 other languages are available for in-app purchase of $2.99 each. The app requires an Internet connection (wifi or 3G) for speech output, though if none is available, the user can work around the problem by selecting the text and making use of the device's text-to-speech function.
There are many settings to help the app better recognize handwriting, including the ability to exclude letter shapes that are rarely or never used. Users can type directly into the app if desired, as well as paste text from other apps. A great feature of this relatively low-cost AAC app is the ability to store phrases for quick communication. Unfortunately, the only way to save phrases is to type them in through the settings, excluding the handwriting user from the process of storing messages.
Handwriting-to-speech is one of many features included in the full-service AAC app Predictable (universal iOS app for $159.99). While Predictable lacks the variety of settings to improve handwriting recognition, it offers the ability to use the voice when the device is not connected to the Internet. You can also easily output your message to email, Facebook, Twitter and SMS, or add it to the stored phrases list. Unfortunately, this app's useful word prediction feature does not work when using handwriting input. It is also difficult to insert spaces between words when combining handwritten phrases.
For an app that turns handwriting to text without the voice output, please look back at my previous post on MyScript Memo.
Vocal intensity, or volume, is frequently a target of adult speech therapy. Clients with Parkinson's disease often speak too softly, those with TBI may speak too loudly or too softly, and clients with dysarthria from stroke may be too loud or too quiet. Speaking too softly can make it difficult to communicate effectively, while speaking too loudly can be socially inappropriate or convey the wrong sentiment.
While many clients will need specialized voice training, such as LSVT, to increase their volume, others may benefit from a simple visual reminder of how loudly or softly they are speaking to modify their volume. While there are several apps that measure volume, there are a few that do a nice job of showing an acceptable range for therapeutic purposes.
Voice-o-Meter: A universal iOS app for only $0.99, this app was developed by an SLP. This app allows you to set a range of target volume in dB and shows the current volume with an arrow moving up and down along the range. There are scoring buttons to collect data on whatever your goal is. Results can then be emailed at the end of the session. An optional chime will sound when the volume reaches the upper limit. The advantages of this app include clear visuals, flexible data tracking, and price.
Inside Voice: A free universal iOS app that is not particularly elegant in its design, but achieves its purpose. Pinch or expand the circle to the target range and let the app "listen" as it draws lines in green or red to reflect whether the volume is inside the circle or outside, a nice visual for using your "inside" voice. When the volume is repeatedly outside the circle, an alarm will sound. There are no values associated with the acceptable range, but as ambient noise and distance from the device vary, this is usually not a problem. There is no data collection, but the app is suitable for home use or as a subtle reminder.
Three apps I've mentioned in previous posts warrant another mention on this topic. Decibel 10th (free, universal iOS) suits the needs of those who want data. The display reads out the volume in dB and shows a graph. Detailed data can be exported. SpeechPrompts ($19.99, universal iOS) has very flexible visuals and the easiest adjustment of acceptable levels on the fly, but is missing data collection. Bla|Bla|Bla (free, universal iOS) won't give you any data either, but it is fun and encourages louder volumes.
Noise Meter (free, Android) is an overly complex app for everyday therapy needs, but it's worth mentioning because it has the unique feature of giving a vibration when noise exceeds a set range. For clients who need a subtle reminder to keep their voices down, the quick buzz may be enough. I would love to see this feature added to one of the iPhone apps above for discreet reminders during other therapy tasks.
Language Lab: Spin & Speak -Social Skills targets language and social skills. This is created by both Speech With Milo and PRC (Prentke-Romich Company) who have a few other apps targeting language/AAC use as well. This app is very similar to Speech With Milo's Articulation Board Game however instead of speech sounds different social scenarios pop up and the student must provide an answer for the question. Game play allows for up to 5 players to play at once and data tracking is provided for percent correct, incorrect, and assisted.
The categories of social questions asked follows the functions in the QUAD profile that are based on M.A.K Halliday's Explorations in the Functions of Language. These categories include: Requesting/Instrumental, Directing Activities/ Regulatory, Information Exchange/ Interactional, Personal, Discovery/Heuristic, and Imaginative.
Below are some examples of the type of questions that are asked. They are incredibly relevant to children's daily social routines.
Now I know what you're thinking. The student's I work with do not use an augmentative communication device device so should I buy this app? The answer is yes! Just because it's developed by PRC does not mean you cannot use it with any children working on their language or social skills. However if you are going to use it with an augmentative communicators, this app focuses on all six stages of language development making it a great app to use. If you are interested in learning more about the six stages of language development please visit http://www.aaclanguagelab.com/.
Language Lab: Spin & Speak -Social Skills is available on the iPad for $4.99Related Content Box – BLOGS (BOTTOM) Box Description – BOTTOM HORIZONTAL WITH TITLE AND BLURB
AAC (alternative and augmentative communication) for aphasia is a challenging area of practice for many Speech-Language Pathologists. Whereas most AAC devices and apps help those who have difficulty physically speaking, people with aphasia need help overcoming the underlying language disorder on top of any speech difficulties. Traditional grid displays organized by part of speech are usually unhelpful given the demands they place on grammar, working memory, and categorization.
One AAC format that is aphasia-friendly is Visual Scene Display (VSD). The concept behind VSD is to show a picture of a detailed scene and either surround the picture with messages related to it, or designate hotspots in the picture that express a message. Here are four apps that offer VSD functionality, popular for users with autism as well as aphasia:
Scene Speak (iPad only, $9.99) allows you to build books of visual scenes, adding recorded audio, text to speech, and text to each hotspot. Scenes can also be linked together by hotspots. Unique features include a built-in Internet photo search and word highlighting as scene labels are read aloud.
Scene & Heard (universal iOS app, $49.99, free Lite version) offers similar functionality with over 10,000 built-in symbols to augment the scenes as well as the ability to add video to hotspots.
Autismate (iPad only, $149.99) adds to the previous features with grid-based AAC options, a shared content library, social stories, and GPS functionality.
Touch Chat (separate iPhone & iPad versions, $149.99, Lite version for $9.99) offers more traditional grid-based AAC with the option to add scenes with printed messages around the edges that produce phrases or link to grids. You'll find the VSD options as part of the MultiChat 15 Student vocab set.
Some ideas for creating visual scenes for people with aphasia include:
- Rooms from their house to express needs related to each area
- Picture menus from favorite restaurants to help with ordering
- Family photos with each person's face made into a hotspot explaining who they are
- Vacation photos that tell a story about a trip or experience
- Add hotspots to screenshots from other apps to make them speak: symbol grids made with Custom Boards, family trees made with Popplet, a medication schedule made with Pillboxie, a typical daily schedule from Calendar, a satellite map of the neighborhood taken from Maps
For more information on Visual Scene Displays, there is a free webcast you can watch along with several low-tech VSD resources from University of Nebraska. For general AAC assessment tools for people with aphasia, Garrett and Lasker have provided amazing resources. The blog PrAACtical AAC has also recently published several posts on using AAC with people with aphasia, including written choices, communication books and questions to ask when making them, and AAC assessment.
In week three of Aphasia Awareness Month, we'll look at a powerful tool in aphasia therapy: script training. The literature is full of support for the benefits of people with aphasia writing and learning scripts. These natural pieces of discourse should be written in conjunction with the person with aphasia, and contain dialogue that sounds natural and can be used frequently. Rehearsing the script over and over until it becomes automatic can help with social interaction, confidence, and participation. Scripts can be monologues or dialogues to initiate a topic or respond to frequent questions. The number and length of conversational turns as well as the content should be fully customized to the needs and abilities of the person who will be using them.
Specialized computer software such as AphasiaScriptsTM and low-tech devices like talking photo albums have been used to help clients learn and rehearse their scripts. Some people with aphasia are able to read aloud, practicing scripts with just written words; others need audio or video to practice with in unison. There are a few solid options to train scripts on iDevices using apps.
SpeakinMotion's VASTtx Therapy Samples app offers a selection of common phrases and sentences ($9.99 iOS universal app) featuring a video of a speaking mouth with subtitles. There are a few generic scripts for ordering food, making phone calls, telling jokes, and singing songs within the app, as well as an example script of a woman giving her personal history. Customized script can be ordered through the website.
For do-it-yourselfers, Story Creator is a free universal iOS app that can be used for creating scripts. This app enables you to create books with text, photos, videos, or drawings on each page. By recording your own mouth movement video and separate audio, you can set up a script for a client that offers the added feature of highlighting each word as it is spoken. While recording your own mouth is a bit tricky, doing it yourself allows for easy editing of the script as therapy progresses.
One really nice feature of having a script saved on a client's iPhone is that it can be used anywhere with a discrete earbud headphone. Many people speak while looking at their phones, and now people with aphasia can do the same, receiving video and audio support as they appear to be speaking independently. Once the script is mastered, the supports can be faded to reveal a more confident communicator.
Listen Up Bear is a fun app based on the classic kids tune "The Bear Went Over the Mountain," but in this version it is not to see what he can see but instead to hear what he can hear! The app itself is designed by a speech-language pathologist from Canada but who is currently practicing in Mexico.
The premise of the app is fairly simple: you wake up the bear in his cave and he ventures out and up the mountain to see what he can hear and along the way encounters the animals he hears. The animals that the bear can potentially hear are: a bee, cat, chicken, monkey, duck, dog, frog, owl and a sheep. You have the option to select from the real animal sounds or have your client record their own version of the sounds, which is of course perfect for speech therapy and sound approximations. There are lots of opportunities to target early developing consonants from the cat's "meow" to the sheep's "baaaah" or just target some vowel approximations like the monkey's "oo ee" or the owl's "ooooo." You can even work on sequencing skills by taking screen shots of the animals and cutting them out or even predicating skills by having the child try to predict the next animal they are going to hear.
When the child hears the sounds, a screen pops up with multiple choices of four animals to choose from in order to find out which animal it really is! There is also an option to choose from about nine different languages from English to French to Mandarin.
Listen Up Bear- $1.99 available for iPad
On week two of Aphasia Awareness Month, we'll look at two apps that can be used to explore semantic networks. These apps provide powerful visual aids for working with synonyms and semantic features.
Popplet is a universal iOS app ($4.99, free Lite version) that allows you to easily create word webs by generating and connecting "popples": boxes that can contain drawings, text or photos. Brainstorm synonyms for a word, list associates for an abstract concept, or use the semantic feature analysis technique for naming deficits at the level of the lemma. Here are a verb semantic feature analysis network (Wambaugh & Ferguson, 2007) and a semantic associate map for an abstract concept (Kiran et al., 2009) made with Popplet:
Popplet creations can be saved or emailed as PDF or JPEG for printing. This app also makes it easy to create family trees, a very useful tool to augment communication for clients with aphasia. Create the tree, save the image, and then insert it into a photo book app like the one I'll discuss next week.
For pre-made webs of synonyms, check out the Wordflex Touch Dictionary app (iPad only for $11.99). Look up any word, then explore the various parts of speech, phrases it is used in, multiple meanings, and derivatives. Many words also have pronunciation notes and sound files. Those with word-finding difficulties may find the word they're looking for by exploring the webs of related words. Students working on using more colorful vocabulary can benefit as well: look up "thing" or another generic term to find a plethora of suitable substitutes. It takes up nearly 2 GB of space, so make sure you have room for it before downloading.
If If neither of these apps meets your needs, remember there are semantic feature and phonological component questions built around over 450 pictures in Naming TherAppy (universal iOS with free trial) for circumlocution as discussed in February.
June is Aphasia Awareness Month, so I'll be highlighting apps for aphasia over the next four weeks, including therapy apps and augmentative supports.
Last August I showed you two text-based conversation starter apps, but for aphasia therapy we often need picture-based prompts to elicit descriptions and stimulate discussion. Here are two that are perfect for the purpose:
Timeline - Art Museum is a free app for iOS and Android showcasing a few pieces of artwork by 80 famous artists, offering in-app purchases of each artist's full collection. Many of these pictures provide rich stimulus for picture description and discussion. I recommend purchasing the Norman Rockwell package for $0.99 to gain access to 228 high-quality images depicting people engaged in everyday life. These classic Americana scenes from 1914-1969 appeal to older clients who may remember reading the Saturday Evening Post. The pictures can be used to elicit inferences, descriptions, humor, narratives, and reminiscences.
Conversation TherAppy is a universal app for iOS that contains over 300 photos and 3000 questions to start conversations with speech therapy clients and target a variety of goals. The scenes depict everyday activities, current topics, and safety situations with ten question types surrounding each picture. It can be used in groups with scoring for up to 6 players and has age filters for use with older children and teens as well as adults. Score how often a client uses their word-finding strategies or how independently they conveyed the answer for easy outcome measures. The full app is $24.99; a lite version is available for free. Disclosure: I developed this app through Tactus Therapy Solutions along with nine other apps that can be used in stroke rehab.
I love that both of these apps provide visual stimuli that are not childish, hold the clients' interest, and can trigger discussions of personal narratives and opinions. In contrast to apps that allow for independent practice, these apps require at least two people to use effectively, encouraging natural conversation. When using either of these apps in a group situation, it may help to connect your device to a projector so everyone can see the details in each picture. With a bit of guidance in how to cued their loved ones, family members can use these apps for home practice.
Two copies of Conversation TherAppy will be given away at random next week to people who comment below.
Most "reminder" apps help people remember future events, but those with memory impairments need help remembering past events. Did I feed the dog or remember to lock the door? It's Done is an app designed for those with short-term memory loss (e.g. TBI, dementia) to remind users what they've already done.
It's Done allows users to input a number of routine daily tasks as well as unique events to mark as completed. The app can give reminders as well as notify others when a task is completed via text message or email. Concerned spouses or children may find it reassuring to receive these notifications that their loved ones are taking care of themselves.
As with any cognitive aid, the most difficulty part can be remembering to use it; the user must set up each task and remember to check it off when it's done. While this adds an extra unfamiliar step to every task, it may be worth it for the peace of mind it provides later, and the act of marking it done may aid memory as well. Though this app is only available for iPhone, it is the most appropriate device given the need for frequent use and portability. It's Done is available for $2.99 on the App Store, and there are reports of an Android version in the works.
This app was mentioned several times during the ASHA Special Interest Group 2 web chat on May 16 entitled "Making Cognitive Connections Using Cognitive Prosthetics and Apps" with Michelle Ranae Wild. Her website focuses on training people with brain injury to use apps as cognitive prosthetics. There are a number of app reviews as well as monthly webinars that demonstrate different apps. Each webinar is archived, so you can watch all the past videos anytime. You can scroll through the entire web chat archive if you have an ASHA website login.
If you work with children with autism or have difficulty regulating their emotions, you most likely have come across The Zones of Regulation.
The Zones of Regulation itself is a curriculum that was developed by an occupational therapist named Leah Kuypers. She specializes in autism, ADHD and anxiety and developed the Zones, which incorporates Social Thinking concepts, to help teach these children self-regulation. The Zones app was developed to support the program and acts as a companion.
There are four colored zones — Red, Yellow, Green, and Blue — that help describe how the child is feeling.
To engage with the app you select one of four characters and your mission is to learn about the zones as you encounter events presented to you as questions. You will use your knowledge of the zones to answer questions to earn coins.
As you earn coins, you can use them to upgrade your character's shoes and clothes. You will also gain knowledge to put in to your Zones of Regulation Tool Box. To trigger one of these events you simply walk your character into a colored "magic circle" which is pictured below.
Below is an example of a triggered event and the question that is asked.
As you gain knowledge about the zones and add to your toolbox you eventually will become a Zones of Regulations ultimate legend. When this is achieved a new part of the town is unlocked which allows you to play the Stop, Opt, and Go mini game. In the mini game you collect coins and must answer questions at each stop sign.
Overall I think this app will make a good companion piece to the full curriculum. It offers another way to access the content and to gauge if the child is learning and using it effectively. I would discourage buying it if the child you are using it with is not already using the Zones or has a good working knowledge of them.
The Zones of Regulation App is available for $4.99 on Apple, Google, and Amazon products!