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!

One app that employs OCR technology to recognize text in photos is OCR Scanner by Smart Mobile Software, available on App Store and Google Play. The recognized characters are displayed in plain text that can be copied, emailed, or read aloud within the app. The app works best when the picture only contains text displayed on a plain background. Five scans per day are included in the free app; unlimited scans are available through in-app purchase or you can buy the unlimited version of the app called Mobile OCR Pro for $2.99.

While this is the most accurate OCR app I have tried, there are several other OCR apps of varying quality, and even some that will translate from other languages or read the text automatically. More important than any specific app is the idea of using the technology that I want to share. OCR is a technology that has been steadily improving over the years, and while it is still not perfect, it can save hours of typing and improve the lives of people with communication impairments.

With this technology, people who have trouble reading can take a photo of a greeting card, the instructions on the back of a food package, or a sign in the community, and hear the text read aloud.  I've heard too many stories of patients receiving a letter in the mail about an important test or deadline that they missed because they couldn't read it.  Perhaps stories like this will become a thing of the past.

Once you've downloaded the app, make sure you have your Text to Speech turned on: go into the Settings app, select General, scroll down to Accessibility, touch Speak Selection, set it to ON, and on turn Highlight Words.  Now when you go into the OCR app, take or select a picture of the text you want to hear, and press Convert. When the converted text appears, select the portion you want to hear and press Speak. Most OCR apps require Internet connectivity to work, so be sure to use this on a 3G device or when connected to wifi.

Android users may also want to look at Mobile112, an app developed expressly to help those with dyslexia and language learning disorders to hear text read aloud through OCR.  There is a free trial, an inexpensive lite version, and the full version is $30.

Every student of communication disorders learns the International Phonetic Alphabet (IPA) at some point in her education. I recently found two outstanding free apps that are unique amongst IPA apps for using North American English and games to encourage learning. Both focus only on vowels, but let's be honest - the consonants are the easy part. If you're in school or need a refresher for transcription, check out these 2 apps:

EAC Vowels 1 Lite - English Accent Coach (EAC) gives users near-full functionality in this free lite app ($0.99 full version). This iPhone app offers a chance to hear American English vowel sounds - pronounced after /h/ - when you tap the phonetic symbol in the practice mode. Once you feel ready, there's a game to play! The app plays one of the vowel sounds, and you have to touch the symbol on the vowel chart that matches it. Turn on "Extra Vowels" in the settings to practice diphthongs as well. 

EAC Echo Lite - This app offers the same vowel practice mode as Vowels 1, but the game is different. Just like the Simon memory game, players press each of 4 vowel sounds in the same evolving sequence as they are played. The full version offers more settings and difficulty for $2.99.  Personally, I prefer the game in Vowels, but download them both to see which you prefer. Both apps are sized for iPhone but work on iPad.

These apps remind us that games make learning even dry materials fun and give us increased tolerance for more repetitions. We should be incorporating game-like challenges into therapy for all ages to keep up motivation and interest when the material may be boring.

To make notes on screenshots or use them in other ways, you will need an annotation or whiteboard app. My favorites are Bamboo Paper, Notability, Skitch, and Doodle Buddy, all of which allow you to import pictures and write or draw on top of them.  They also serve as virtual whiteboards in that you can write or draw on a blank screen. All of these are free or low-cost on iOS, and both Skitch and Bamboo Paper are also available for Android. Here are some handy things you can do with these apps to use screenshots in therapy:

Naming: First take a screenshot of the scene you want, crop the target area in the Photos app, then open it in an annotating app to add labels. Clients can practice naming body parts, things in a room, or anything that is displayed on the screen. You can even take a screenshot of a grid-based AAC display, remove the labels, and then work on naming.

Learning an App: Most apps are designed to be intuitive, but for the brain injured, elderly, or memory-impaired, using an app independently may require extra instruction. Take screenshots of each step, put them in a document with instructions, and print it out for a more traditional user manual the client can reference.

Sharing: Sometimes clients with aphasia have wonderful supported conversations using a whiteboard to write words and draw. When the conversation is over, the information is often lost. Using a whiteboard app, these conversations can now be shared with family or saved by the clinician. While some apps have export options built-in, any work in any app can be saved or emailed by taking a quick screenshot.

Monitoring Progress: The results of some apps flash up quickly and disappear, while others don't have score exporting capabilities. Take screenshots of scores to help with writing progress notes, or ask your client to email you screenshots of their work from home.

Self-Awareness: Use a screenshot of a finished exercise to review the results with the client, building self-awareness and executive functioning skills.  For example, using a screenshot of a finished cancellation task from Visual Attention TherAppy, you can review the missed targets, bringing further awareness to the neglect or repeating the exercise.

Home Program: Take a screenshot of your client's home screen and print it. Mark which apps should be used and how often, adding a tracking log if so desired. Setting up a home program in this more traditional way helps people accustomed to paper-based exercises bridge the gap to a tablet-based exercise program.

Maps & Directions: Draw your own directions on maps, highlight multiple stops along the route, or let clients draw on maps to support their conversation. Take a screenshot of a Google map or floor plan and use your annotating app to draw on top of it. Skitch has a map feature built-in.

Memory Aid: Take a screenshot anytime you want to remember something you're looking at on-screen. I often use this method to capture Facebook group conversations, tweets I want to remember, or pins on Pinterest that catch my eye. Sure, all these apps have ways of saving favorites, but then I have to remember which app I saw it in. Now I just check my photos and find the memory. Evernote can also help you organize these photos.

How do you use screenshots in your therapy?

iReadWrite offers these 8 powerful features:

Text-to-Speech with Dual-Color Highlighting

• Text is highlighted in one color while the word being read is highlighted in another color
• Helps with focus and reading comprehension

Word Prediction

• Word suggestions are made on the left side of the screen as you type
• Words predicted using context and phonetics

Phonetic Spell Checker

• Allows identification and correction of spelling errors, including phonetic and flexible spelling errors
• Programmed for common errors seen with dyslexia
• Analyzes surrounding words to help make better suggestions

Sounds Like and Confusable Word Checker

• Checks words that sound the same as well as words that are confused easily
• Possible choices are shown on the left side of the screen
• i.e two, to, too

Text and Picture Dictionary

• Provides text definitions for selected words
• Provides images to help expand comprehension

Background and Text Colors

• Full customization of text size and type
• Customization of background and text colors ground and Text Colors

Choice of Voices and Fonts

• Variety of male and female voices to choose
• Variety of readable fonts including OpenDyslexic
• OpenDyslexic is an open sourced front created to increase readability for readers with dyslexia

Import Documents

• This one of the App's few weaknesses as it will only read .txt and .rtf file formats
• The conversion process to .txt or .rtf is simple but could be complicated for a younger student

This app is very well designed and should be a powerful tool for a personal iPad or for a classroom iPad.  For those of you who recommend Assistive Technology this will be a welcomed software tool to add to your recommendations list.

iReadWrite is currently available for the introductory price of $19.99 (normally $29.99)

Spinal cord injury, stroke, and hundreds of congenital and acquired disorders impair the use of hands--an essential body part for using touch-screen technology. A handful of apps are switch-accessible, but these consist mainly of AAC apps and some early childhood books and games (Jane Farrell keeps a list here). For all other apps, these users are out of luck for now. However, there is at least one app that shows potential for readers.

MagicReader is a free, ad-supported app for iPad released by the Japanese developer GimmiQ about a year ago. The app uses the iPad's camera to recognize a face, and then track head movement, allowing users to turn the pages of books. The app currently only supports PDF files and compressed comic book files (there are several comics available free in-app), but the developer promises to support more formats soon. After importing a PDF through iTunes or email, you need to find the right distance and lighting to optimize the facial recognition. Once the app reliably finds your face, it is fairly simple to turn the pages forward and back with a turn of the head, even while wearing clear glasses. Two blue stars at the top light up when the app has found your face, letting you know you can turn your head to turn the page. Looking upwards navigates in and out of the library.

The uses for disability populations is currently limited in that the app requires a 45 degree turn of the head rather than tracking only eye movements. Of course users will still need assistance in opening the app unless they have a more sophisticated set-up. When I first used the app, it took some time to find just the right distance, head turn speed, and lighting conditions for reliable turning, and sometimes the pages flipped when I wasn't ready or just looked up from the tablet. I tend to read a lot of PDF files, but most people read e-books, which are not yet supported. 

When the iPad is mounted on a wheelchair or supported on a stand, this app could be of great use to many people. For stroke survivors who can hold the device in one hand, they can now use their heads to turn the page instead of setting it down to touch the screen. The description recommends the app for those reading recipes while cooking, musicians turning sheet music, parents reading while holding babies, and even people reading while eating.

This app may be useful in your practice now, but more than that, I think it shows the potential for alternative means of accessing tablet technology. Given that the app's FAQ states a paid version is coming, it's probably worthwhile to download MagicReader now while it's free.

This app was designed for children who are picky eaters or that may have certain food sensitivities. The app acts as a "what food have I tried" tracker along with the ability to give a score to each food that is tried. There is built in multiuser which is helpful for feeding groups and there are over 100 food to choose from with the ability to add your own.  The food group could use a little better organization as it is currently setup as one long list to scroll through but it still works fine.

The app encourages you to earn stickers for 34 different "groups" of food that you have tried. For example you can earn the "red" sticker for four different red foods that were tried or you can earn the "french" sticker for trying goat cheese, asparagus, almonds, and green beans. To rate the food you give each item a score.

The scores are broken down into: not tried yet, yummy, maybe next time, and so- so. You can then review eachtype of score to see what was tried or to see some of those questionable foods that need to be tasted again.

Choose My Foods, $.99  in the App Store for iPhone/iPad, is recommended for anyone working with a child who is a picky eater or has a sensory sensitivity to certain foods.

Swallow ID is the only app I've used personally, but all four apps appear to function in the same way. Swallow ID features the lateral view, posterior view, and superior view of the swallow, each in three modes: structure ID, animation, and video for a total of nine views. In structure ID mode, the user can touch any part of the pictured anatomy for a detailed description of the feature. The language is medical, suitable for student or professional education rather than patient learning.

The animations and video are the most valuable parts of this app for patient education. The animation shows a blue water bolus travel through the view you've selected. The video mode shows either a video fluoroscopy (MBS) or endoscopic (FEES) view of the selected view.  After reviewing the anatomical landmarks, it's easy to show a patient what the bolus transit should look like, and then how it looks on actual tests. While the clinician can then point out what might go wrong, the other apps in this series step in to illustrate the dysphagia.

Oral Disorders features the same 3 modes, while the views include normal, bolus loss, "dysphagia," and nasal regurgitation. Residue Disorders shows structures, animations, and videos for normal, valecular residue, pharyngeal residue, pyriform residue, and delayed swallow. The final app, Aspiration Disorders, showcases normal aspiration, silent aspiration, and penetration in addition to the normal view.

The apps feature high-quality drawings, animations, and videos, in addition to detailed information. While these apps are fairly simple, a few instructions about how to use them would be a useful addition. Sold as 4 separate apps, they really could be packaged as one: every app includes the normal swallow and the same layout.  It's unlikely an SLP would need to educate or learn about just one set of disorders, so why not integrate them into a single app?

Comparing the Blue Tree series to the Dysphagia app, there is no clear winner. The Blue Tree series features structure labels and real videos, but Dysphagia has speed control.  The Dysphagia app has a more attractive package, giving users access to all the swallowing disorders at once for only $10, whereas the Blue Tree series requires 4 purchases totaling $20 to demonstrate each dysfunction. Dysphagia focuses on the cause of the dysphagia (e. g. pharyngeal contraction, hyolaryngeal excursion) while the Blue Tree series organizes the graphics by sign/symptom (e.g. nasal regurgitation, vallecular residue).  Both approaches to dysphagia education are valuable for both students and clients as teaching tools.

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.

 Guess and Know is a fun Jeopardy like game for your iPad. Any Jeopardy like game of course  comes with tons of potential for speech and language therapy.  The app allows for three rounds of play with six categories per round and up to five questions per category. The categories of obviously limitless and can be used to target articulation, pragmatics, vocabulary, etc...  In the picture below Action Words, Emotions, and Animals are used as example categories to demonstrate the potential.  There is also an option to select a "bonus" questions which is the equivalent of the "daily double" of Jeopardy where an amount can be wagered and either earned or lost depending on the outcome of the individual's answer. 

In edit mode it allows you to import pictures and create the questions and answers or email the game. You also have the option to select your "bonus" questions.

If you have multiple iOS devices available the Guess and Know Companion App acts as the buzzer when paired with the iPad app. If you are feeling rather adventurous you can then mirror through Apple TV to a big screen or use an AV cord to send it via projector so a whole classroom is able to play.

Guess and Know for iPad $4.99

Guess and Know Companion for iPhone/iPad $.99

When targeting agrammatism in therapy, there are several apps for children that focus on individual components of grammar: pronouns, conjunctions, verb tenses, and agreement. However, one app stands out as a great resource for adults who want to practice making complete sentences without childish accouterments. SentenceBuilder Teen by Mobile Education Store is available for iPad for $5.99, or you can add the Teen modules to the original SentenceBuilder app for children through in-app purchase.

SentenceBuilder Teen guides users through constructing sentences with 3 levels of difficulty and 100 photos. A rotating dial must be moved to line up the correct sentence elements to accurately describe the picture. The harder the difficulty, the more parts of the sentence and the more options there are. This Teen edition has pictures of teenagers doing everyday activities. You have the choice between the "Girl" and "Boy" packs for more relevant activities and interests for each gender, but both are appropriate for adults and can be used interchangeably.

I really appreciate how the stats are recorded by user and according to how many tries it took to get it right. That app is missing an option to export the stats in an email, as well as a guest user profile to avoid entering personal information. While the primary activity of the app is a non-verbal exercise, a skilled therapist can use this app to elicit a lot of verbal expression, oral reading, and expanded descriptions. For more advanced clients, I've covered over the words once we've chosen them and then asked the client to write the sentence from memory.

Which apps do you use for grammar and syntax with adult clients?

Platform: Apple devices are the top pick for SLPs due to the sheer number of apps available for speech pathology on iOS devices. Android devices, which include Kindle Fire, Nook, and Samsung Galaxy Tab, are the next most popular choice due to lower cost, though the number of speech-specific apps pales in comparison. You'll find a list of SLP apps available for Android on a blog called Speech Therapists Don't Get Apples. BlackBerry and Windows also make touch-screen tablets and phones, but the dearth of SLP apps available for these platforms makes these devices impractical. Assuming you choose to go with an Apple device to make use of all the great apps Jeremy and I discuss here every week, then you have made one decision, but have several more ahead of you.

Model: Apple has 4 touch-screen devices: iPad, iPad mini, iPhone, and iPod touch. The 9.7" iPad is the best choice if you work with older clients, people with poor manual dexterity or vision, or groups. However, if you're considering the device for AAC or strictly personal use, you may want to use a 7.9" iPad mini so it can truly go everywhere. The 4" iPhone and iPod touch are not as practical for therapy, but are well-suited for AAC devices and home practice; the former also working as a phone, adding a monthly bill with the added functionality. Please note that some apps are designed for iPad only and will not run on an iPhone or iPod touch; all apps will work on an iPad or iPad mini, though they may need to be enlarged to fill the screen.

Version: If you plan to have the device awhile, I recommend getting the newest model you can afford. Each new version offers new features (e.g. camera, Retina display, voice recognition) and should guarantee compatibility with new operating systems for longer. New releases often bring price-drops in the last model, so it's worth researching rumors online if you're looking for a bargain or want to ensure buying the latest version. 

Storage: Since you can't add memory to an iOS device, buying one with a hard drive big enough for all your apps, music, files, movies, and photos is an important consideration - what sounds big now may not be so useful in a few years. Sizes range from 16 GB to 128 GB, and some popular speech apps are over 1 GB each. If you want to identify the "space hogs" on your device, you can go into Settings -> General -> Usage to see a list of apps sorted from biggest to smallest. If you plan to use your device for therapy or to trial AAC programs, then "bigger is better" is the rule to follow. If you're recommending a device for a client who only needs a small number of apps, then the basic models are likely okay.

Connectivity: All the devices use Wi-Fi to connect to the Internet, but you can pay extra for wireless data capabilities (3G/cellular) on the iPad and iPad mini, both when purchasing the device and when using the service. It's important to know where you'll be using the device, the availability of Wi-Fi, and if there's a budget for monthly data bills after the initial purchase when considering this feature.

Price: The cheapest new iOS devices are currently the 4^th generation iPod touch and a contract-bound iPhone5 at $199. The iPad mini starts at $329, the iPad2 is still available for $399, and the latest iPad starts at $499, going as high as $929 for 128 GB and cellular. Refurbished and used devices are available through Apple and other sites for reduced prices. Apple offers a quick comparison of iPad or iPhone features and prices on their website. Don't forget to budget for a good case, apps, and the optional warranty when making your purchase.

Based on how you plan to use the device, your budget, and your data needs, this information should help you understand the choices to make your decision. Now all you have left to choose is color!

Memory Train-$1.99

Memory Train by Piikea Street takes children on a train ride with Spacey the elephant. The train rides by different objects and you need to remember different characteristics of those objects. Was the ball green or blue? Did the house of a square or circle door? It offers ten levels and get easier or harder depending on the accuracy of the user. You have the ability to choose up to four profiles to track data and progress along the railroad line.

Kakako 123-Free

Kakako 123 is an app that targets both visual memory and auditory memory using numbers. You are shown with up to 10 numbers at a time with the options of visual, auditory, or presentations using both. You then have to input the numbers you saw or heard with the keypad provided.

Attention-Free

Attention targets visual memory skills by showing you a picture and then taking away multiple items in the picture. Your job is to figure out what items are missing by tapping the area on the screen where it used to be. You have 10 seconds to remember all the objects. The app comes free with 2 scenes and 10 levels of play.

Northern Speech Services' Dysphagia is an essential app for every SLP working with adults with swallowing dysfunction. It provides images of the anatomy seen in a video fluoroscopic swallow study (VFSS or MBS), with videos of a normal swallow in two views and several types of impairments in an adult.

The images are the ones used in the MBSImP^TM program for standardizing FVSS interpretation and reporting. Using a barium-white bolus, the app allows clinicians to show their patients what will happen in the VFSS and what aspiration and penetration look like. The animations can be slowed down, paused, and enlarged.

The normal swallow is shown in lateral and anterior-posterior (AP) views. Impairments shown in the lateral view include penetration with aspiration, impaired bolus transport, poor tongue base retraction, pharyngeal swallow initiation delay, decreased hyoid excursion, poor epiglottic inversion, and impaired PES opening. Impaired pharyngeal constriction is shown in the AP view to highlight unilateral weakness. While these impairments do not always occur in isolation, they are often best seen this way for patient education, student learning, or staff in-servicing.

This app is wonderful for providing patient education before going into the study, but it's even better for demonstrating the study results when the video is not available. The app's illustrations are in full color with translucent landmark anatomy, often easier for clients to understand than the black and white fluoroscopic images of the actual study. With added explanation, clinicians could also use the app to explain various dysphagia exercises.

The app is 10 animated swallows with speed control for playback. There is no explanation of what causes these impairments, no recommended exercises to remediate these impairments, nor even labels of anatomical structures. A knowledgeable clinician will have to add her own explanations and make recommendations based on the dysphagia literature; the app is simply a tool to assist in patient, student, or family education to better visualize various impairments.

Dysphagia is a universal app (iPad & iPhone) on iOS and Android for $9.99.  For iOS users, Northern Speech Services also sells an app called Normal Swallow for $3.99, containing only the two normal swallows that are part of the Dysphagia app. If you already own the Dysphagia app, the Normal Swallow app is redundant.