Apps, Language Therapy, Worth Every Penny

Super Dee-Duper Therapy Apps!

In honor of the fact that Super Duper is marking all their apps down to only $1.99 between May 1st and May 7th for Better Speech and Hearing Month, I wanted to post a review of 2 of their apps that I think are great!  All of the apps in this family give you the ability to keep data or correct/incorrect responses.  Additionally, they are customizable and allow you to choose which flash cards you want for each client and which you want to leave out or save for later (isn’t customization the best?!?!).

What’s Being Said

This app reminds me of a spin-off of part of the TNL (Test of Narrative Language): where the child must generate a narrative based on what’s happening in the picture.  In this case, the child is expected to generate language about what they think is being said by the character(s) on the card.  Although this might seem like a limited task, there are a huge number of possibilities for language skills you can target with an app like this!  Below are some of my ideas:

Rather than just asking the client to fill in the thought bubbles, ask them to tell you a story about what happened/is happening/and will happen based around what they see on the card.  They can still incorporate the task of filling in the conversation bubbles, but you also will get all kinds of information about the syntactic organization of their sentences and paragraphs, their use of transitions, the relevance of their ideas, their descriptive vocabulary, and their lexical variety!  With a simple card like the ant/picnic one above, you might even cue the child with the beginning of the story: “I’m going to start a story about this card.  I’ll tell the beginning, and then I want you to tell me the rest!  Ready? A man and a woman went for a picnic on a hot, sunny day.  They decided to go for a walk before lunch, but left all their food on the blanket while they were gone.  In the meantime, 2 ants came across the blanket and picnic basket.  Can you finish this story?”  You can always ask the client what they think the ants are saying to each other if they forget to fill in the bubbles!  Language, language, language!

Use this deck as a quick criterion-referenced activity to look at mental flexibility (part of a child’s developing executive function skills).  With a card like the one above, you can begin by asking the client to tell you what each character is likely saying.  THEN, throw a wrench in the scene by explaining that their initial conclusion may not be accurate (for example, the lady inside the house is actually telling the pizza delivery lady that she didn’t order a pizza at all).  See if your client can readjust his or her thinking quickly in order to change the conversation components of the card to match your new scenario!

Let’s Predict

This app was designed to help clients practice their understanding and expression of what is likely to happen next.  Prediction is a critical skill for general language development (we do this all the time during conversations with other people), but it’s also extremely important for academic success.  The ability to predict is linked to one’s ability to make inferences, as both require the child to “read” the scene and make assumptions about abstract actions that may or may not take place.

In addition to simply asking the child to predict what’s likely to happen next based on what they see on the card, try asking him/her to tell you what they think happened right before this AND what they think will happen next.  Synthesizing a single scene into a more cohesive “story” will help your client in all kinds of classroom tasks that similarly require synthesis of information across activities/classes/topics!  Encourage the client to look for clues in the scene to help them figure out what happened before the scene and what’s likely to happen next.

YOU (as the clinician) can be the one making the predictions!  BUT instead of making accurate predictions, create silly ones that don’t make total sense based on the clues in the picture.  The client’s task is to tell you why your prediction is unlikely to take place and to correct it into an accurate prediction! For example, if you were using the card above, you might tell the child that you predict the man is going to grill some chicken.  Their job is to consider the clues (eggs, milk, flour) and (hopefully) correct your prediction to one that makes more sense: the man is going to bake cookies!

Double up on the functionality of this app and use it for verb awareness!  Focus on what the character(s) is/are doing in each picture!  Shoot for less common verbs (e.g. “spreading jelly” rather than “making a sandwich”).

I hope these ideas make your next therapy session with your Super Duper apps THAT MUCH BETTER!!!

A Good Laugh, Just for Students

Abbrev. Please!

Have you ever noticed how many acronyms exist in the world of speech-language pathology?  I never really thought about it until today, while sitting in my motor speech disorders class.  In a mere 3 powerpoint slides, we threw around at least 8 acronyms.  Insanity.  In all honesty, I love abbrevs and acros, assuming I am mildly successful in remember what they mean (that’s abbreviations and acronyms for anyone who hasn’t quite caught on…).  Now that I had begun thinking about the somewhat unbelievable rate of acro-usage going on in my department, I decided to keep track of all the ones I heard and/or used during a single day at UW (The University of Washington).  Rather than just list them all-which I’ve done at the bottom anyway-I decided to create sentences with them.  How many do you know without cheating and looking at the list at the end of the post?


ID is the new MR in the APA literature.

After learning about his Dx, the stressed grad student checked Jimmy’s file for Hx of Sx as well as previous Ax and Tx done in the schools.  She also made sure to take note of his current Rx list.

If you’re diagnosed with PD, you might consider LSVT or DBS, since both options have EBP to support them.

ABR is a step in the process of identifying kids who may be candidates for a CI down the road.

SLI can be misdiagnosed in CLD kids who may exhibit a “difference” rather than a “disorder.”

The interdisciplinary clinic staffed a SLP, an OT, a PT, and an ABA specialist to help address the needs of their clients with ASD, who often require specialized Rf schedules and items.

After his TBI, he began seeing a SLT regularly to help him adjust to using an AAC device.

UL UMN damage typically doesn’t cause many speech impairments, since most CN’s receive bilateral UMN input.

MS and ALS are disorders that affect both BL LMNs and BL UMNs (thereby impairing the DAP and IAP).

She wrote her SOAP notes after a session with her client who has CP.

So…how many do you know off the top of your head?  It’s amazing to think that we talk in code during so much of the day!  I guess speeding up our talking leaves all the more time for paperwork 😉  Below is the list in case you want it for a reference!

PD: Parkinson’s Disease

DBS: deep brain stimulation

LSVT: Lee Silverman Voice Treatment

APA: American Psychological Association

Ax: Assessment

Tx: Treatment

Dx: Diagnosis

HX: History

Sx: Symptoms

Rx: Prescription

MR: Mental retardation (OLD term)

ID: Intellectual disability (NEW term)

CI: Cochlear implant

EBP: Evidence-based practice

CLD: Culturally and linguistically different

SLI: Specific language impairment

SLP: Speech-language pathologist

SLT: Speech-language therapist

OT: Occupational therapist

PT: Physical therapist

ABR: Auditory brainstem response

ABA: Applied behavior analysis

ASD: Autism spectrum disorder

TBI: Traumatic brain injury

UL: Unilateral

BL: Bilateral

UMN: Upper motor neuron

LMN: Lower motor neuron

CN: Cranial nerve

DAP: Direct Activation Pathway

IAP: Indirect Activation Pathway

MS: Multiple Sclerosis

ALS: Amyotrophic lateral sclerosis

CP: Cerebral palsy

SOAP: Subjective, Objective, Assessment, Plan

AAC: Augmentative and alternative communication

Rf: Reinforcement

Apps, Language Therapy, Worth Every Penny

Get Ready for Some Language Adventuring!

It’s been a while since I last reviewed an app, so I think it’s high time for such a blog post (you have dysphagia and motor speech disorders exams to blame for that)!  Smarty Ears has a new(ish) app out called Language Adventures ($19.99 in the iTunes App Store).  I was fortunate enough to win a copy of it through a Facebook contest that TherapyApp 411 held a few weeks back, and I’m excited to share some of the great features this app has to offer!  Language Adventures is a language board game app that targets synonyms, antonyms, and/or multiple meanings in both receptive and expressive modalities!

First and foremost, a HUGE Thank you to Barbara Fernandes and the rest of the Smart Ears brainteam for adding video tutorials to all their apps!  I know, I know…all technology should just be “intuitive” these days right?  WRONG!  We all find ourselves caught in the trap of thinking we know exactly how an app is supposed to run, only to find out that we’ve been neglecting some of the coolestmost exciting features all along simply because we never took the time to learn how to access them.  Usually this happens as soon as we give the iPad to a client and give them the freedom to “figure the app out”…a million times better and faster than we did!  Smarty Ears makes it so easy to learn all the perks of their apps through clear, concise, and accessible tutorials!  (Woot Woot)

The Language Adventures game will support 1-4 students, so it’s a great option for individual therapy and group therapy alike!  Adding a new student/client is easy: just enter their name, DOB, grade level, target items (synonyms, antonyms, and/or multiple meanings), and target language mode (receptive or expressive).  You can even add a photo or avatar to represent each student (and who doesn’t love seeing themselves when an app is opened?!?!).  Yes…I did name my pretend student “Fro” (can you tell someone was craving fro-yo when she was testing out this app?).  The game can be played at 3 different levels, so never fear: this game will grow with your clients and be more than just a one-hit wonder!

The app itself is designed as a board game!  Brilliant!  For each turn, the client taps the dice to determine how many spaces they can move on the board.  In order to cause their piece to advance, they must click on the square that correctly corresponds with the number rolled on the dice (Hey-o…math too!).  Best part of rolling dice on an Ipad? They never fall off the table!!!!! As soon as the correct box is chosen and the piece moves forward, a language question will appear for the client.  If you chose to target all 3 language skills, they will appear in random order throughout the game; otherwise all the questions will relate to your designated skill determined for the kiddo.

If you are working on receptive language skills, 4 possible answer choices will appear for the child to choose from.  When working on expressive skills, the question is open-ended and the child must generate their own response that you can then mark as accurate or incorrect (Yup, this app collects your data for you too).

In the settings tab, you have the ability to turn audio-reading of questions on or off as well as to choose the consequence that occurs when an incorrect choice is made during receptive language questions.  Luckily for you, you’ll never need to worry about adjusting trivial things like the background music or minor features…in fact, the snappy music will keep you and your client(s) jammin’ through your whole session 🙂  All in all, I highly recommend this app for targeting the specific language skills it incorporates.  Your clients are sure to love the board game concept, and you’re bound to love all the great learning opportunities this app provides for language!

Language Therapy, Random Therapy Ideas

“Block” Out Time for Fun Therapy!

Looking for a great activity to test any or all of the following?

  • Reception and Expression of Locatives
  • Independently Initiated Instructions Produced by Your Peds Client
  • Shape Awareness
  • Color Awareness
  • Ability to Follow Directions
  • Size Differentiation

Start With: 

  • Some kind of barrier (a portable easel works well for this).  In my example I used 2 cook books…perhaps not the ideal barrier, but no easels lying around my house…
  • 2 identical sets of blocks (one set for you and one set for the child).  In each set, no 2 blocks should be the same.  You might include one big brown square block, one small blue square block, one tall red cylindrical block, one large green triangular block, one small orange triangular block, one yellow circular block, etc.  This is all assuming you want to gather information about shape, color, AND size differentiation in the child.  You can just as easily isolate one of these concepts (like shapes) by only including one color of blocks in various shapes, but without any repeats based on size (i.e. one square, one triangle, one cylinder, one circle, one bridge).  Each of the 2 identical sets might look something like this:

The Set-Up: Put the barrier between you and the child, and then distribute the 2 sets of blocks (1 set for you and 1 set for him/her).  Give them a minute to look through their blocks, so they become familiar with each one.  Make sure they know the names of the shapes before you start the activity, or you’ll be double-sad!

Ready, Set, GO: 

  • In stage 1, YOU (the SLP) will be the builder and the client is the listener.  Each time you put a block down, you describe where you put it based on locative terms that are relative either to the barrier or to other blocks.  The client should then follow that direction on their side with their blocks.  An example of directions might look like this:
  1. Put the big brown square next to the barrier.
  2. Put the big brown triangle next to the big brown square.
  3. Put the little yellow circle on top of the big brown square.
  4. Put the red cylinder between the big brown square and the big brown triangle
  5. …on and on until all the blocks are in place
  6. THEN, you remove the barrier and talk about whether the formations are the same or different.  ***REMEMBER*** the formations can be different even if the kid followed your directions correctly.  There’s more than one way to put something “next to” another thing (you can always add in right/left if the client is at that level), so encourage discussion about the fact that they might look a little different, but they still have blocks in the right places compared to other blocks.  See my picture for an example of how this might play out: different-looking formations, but technically both are correct!

  • In stage 2, you let the client be the one giving the directions, and you try to follow what they say.  Once all the blocks have been placed, remove the barrier once again and discuss the outcomes.

Kids are really likely to buy into this activity, and you’ll be gathering all kinds of fantastic data!  Depending on the complexity you choose to imbed into the activity, you can get some rich information about lots of different language concepts!  Enjoy!

Language Therapy

Top Five Ways to Encourage Spontaneous Language

This is a phenomenal post that appeared on LiveSpeakLove, a blog created by Lisa Geary.  I think the obscenely ridiculous “laughing pig” was the highlight of my day.  In all seriousness, her ideas for spontaneous language production are great for parents, grad students, and clinicians alike!

Top Five Ways to Encourage Spontaneous Language.

A Good Laugh, Language Therapy, Random Therapy Ideas

Mission Impossible

One of my fellow cohort-mates sent out a Facebook plea the other day asking for topic suggestions to elicit lots of language from a client during her upcoming eval session.  Based on his file, he was 13 yrs old, coming in for a voice/artic eval (I know…odd combo), and his interests ranged from “I dunno” to “whatever.”  To all you male SLPs out there (yes, all 8 of you), maybe you have a secret arsenal of conversation topics to get boys in this age range spouting off language.  For the rest of us though, this is a dreaded demographic for eliciting lots of connected speech for later analysis.  My friend’s post was met with a myriad of responses…some truly helpful and others downright hilarious!

Although she generated a handful of decent suggestions from the wonderful world of social networking, we all tossed out some ideas later that day in our computer lab.  I thought I would share some of the good ones from that conversation in case you are ever stuck trying to think of fun ways to elicit lots of language from a client this age!

  • Client versus Wild: Have 2 baskets/hats/jars: in one you have pieces of paper listing out common tools, household items, survival items, and the occasional funny wildcard.  In the other you have pieces of paper with possible survival settings on them (i.e. post-zombie invasion New York, deserted island, volcanic mountain mid-eruption, etc.).  You tell the client they can choose 3 slips of paper from the “items” jar and one slip of paper from the “settings” jar. Based on their setting and their available items, they have to tell you how they would use those 3 items to survive in their selected setting.  I have no doubt that boy and girls in this age range would be excited about this game!
  • Quote Detective: if you have any inkling of the client’s favorite book or series, this idea might be a big hit.  You open the book to any old page and read off part of a paragraph or scene (from that page).  It’s the client’s job to describe to you what has happened just before this in the book and what will happen right after it in the book.  You’ll get lots of language and they’ll get in the competitive spirit of being tested on a favorite read!
  • How-To Guide: Bring up a popular video game in conversation and claim that you really like to play it.  BUT, when you go to describe it to the client, describe it incorrectly (I would be verrrrrry good at this!).  I can pretty much guarantee they’ll be chomping at the bit to correct you (which will give you lots of complex language…we hope).
SLP in the News

Using Algorithms to Diagnose Autism Faster

Online Tool for Faster Autism Diagnosis

This is a very interesting, quick article about a new autism diagnostic tool developed by Dennis Wall and his team from Harvard.  Considering the rise in ASD prevalence, it will be fascinating to follow this new tool to see whether it holds up as a reliable and valid means of diagnosing children on the Autism spectrum.

Has anyone used the Autworks survey yet?  I’d love to hear feedback!