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SLP Mommy of Apraxia: June 2013

Tuesday, June 25, 2013

Speech FlipBook App Review

Speech FlipBook by TACTUS Therapy is a versatile app more suited for use with older children or adults.  It is in a flip book format seen below. It has the option to flip each section of the word (onset, nucleus, and coda), or to flip the entire word.
It contains literally every sound and consonant cluster found in words, allowing practice at the single syllable level.  It is completely customizable, allowing you to choose any consonant, vowel, or consonant cluster combination you want in any position of  the word.

The dark blue tab is the initial sounds you can choose from.  You can choose all of them as shown, or highlight the ones you do not want to use.  The light blue tab contains the list of available initial blends you can choose from.

The purple tab below shows the vowels.

 The yellow tab contains your final consonant singleton choices, and finally the red tab contains your final consonant cluster choices.    As you can see, these tabs allow you to customize a seemingly endless word list that you can create specifically for the client's needs.

The settings tab allows for additional options.  You can choose to have the letters shown in upper or lower case, you can put in a blank page if you choose not to use all three sections of the word and want to just work on CV words for example, and you can also choose to use real words, nonsense words, or both.  This is important in reading programs, because when  child can read nonsense words, they usually have the phonics skills they need to be good decoders.  If not, it helps them gain these phonics skills.  You can also edit the word list if you choose.

 For use with apraxia, it allows the client to practice sequencing sounds from the CV level (i.e bow), CVC level (shown left), all the way to complex syllable structures such as CCVCC (i.e switch).  In the options, you can choose any sounds in any position to keep or hide, and you can also choose to use only specific words.  This is a nice alternative for older clients including adults with apraxia, who may find most apraxia apps geared toward younger children.

For use with reading, this app would be a good compliment to reading programs that use phonics principles such as Orton Gillingham approaches and the Wilson Reading Program.  Most SPED teachers have flash cards like this in which they switch out the sounds; however, kids love working on the iPad and I can see how they would like learning their digraphs or consonant clusters in this format.  I could also see this working well in a classroom in which each student has their own iPad, which is becoming more of a reality.
In therapy the other day, I used it to work on phonemic awareness with an 8th grade student. I chose to flip by sound and kept the same nucleus and coda, and just had her flip the initial sound to get practice with rhyming.
As an SLP, I could also use this app when working on accent reduction with adult clients.

Other features include:
Playback and record function
Choice to show or not show the actual spelling of the word at the bottom

What I Like
This app has all the sound and sound combinations an SLP, parent, or teacher could need to work on any sounds in all positions of words.  There is also an IPA option (International Phonetic Alphabet), which is nice for those SLP's working on accent reduction.  It is versatile in that it can be used by SLP's, parents, and teachers.  It's an affordable app that can compliment therapy and reading programs.
What It's Missing
This app doesn't have a lot of bells and whistles.  For those with older clients or students though, it may be just what you need so they don't feel what they are working on is "too babyish."  (For those in the special education field, we've all heard this at one point or another).
There isn't a data collection feature, or ability to store and save different user data.

Overall this app delivers what is says, which is an affordable tool to compliment therapy and reading intervention for older children and adults.

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Sunday, June 23, 2013

"Ashlynn Happy..... Papa's House"

 It's no secret that my dad is the pushover.  Don't get me wrong, he could lay down the law when he had to; but when it came to playing my dad is the person to sweet talk.  Ever since Ashlynn was a little baby, my dad would play ball with her.  It started out almost as a game of fetch, but each time she gets better and better. 

After Jace was born when she was 2 1/2 and still wasn't really talking, he came over to see the kids.  He hadn't seen Ashlynn in a while.  He no sooner walked in the door and she went running for a ball.  That day he went home and told my mom that he didn't think Ashlynn remembered him.  I was incredulous!  Was he kidding?  Ashlynn NEVER just went and grabbed a ball whenever someone walked in the house!!  She knew exactly who he was. 

Fast forward almost a year later.  My husband and I were going to drop the kids off at Grandma and Grandpa's so we could celebrate our 8th wedding anniversary.  The whole ride there she was talking about "papa's house."  When we rounded the corner of their street she announced, "Ashlynn happy.  Ashlynn papa's house.  Ashlynn play ball....papa's house." 

Ashlynn has told me she was happy before when I asked her if she was happy, or we were reading a book about characters who were happy.  I've never heard her say out of the blue, and perfectly in context that she was happy....and THEN tell me why she was happy.

It made me tear up, maybe for multiple reasons.  The first and most obvious being that she had communicated to me that she was happy in context without prompting.  The second being that I related to her like no one else could.  Growing up we didn't have a lot of money, but I did have a dad who cared about me and who liked to play ball, and I was the richest girl in the world for that.  I always knew if I begged long enough (which never was very long), he would give in and go play.  I remember how happy I was to play catch with him, and especially to practice basketball with him when I got older.  I'm so happy my daughter gets to experience that too.
So today, despite having a great anniversary with my incredible husband, the sweetest words spoken were

"Ashlynn happy...play ball......papa's house."

Friday, June 21, 2013

Articulation Station App Review

Articulation Station is a comprehensive articulation app that I use quite a bit in therapy.  You can choose to purchase each consonant deck separately to save on cost. As you can see from this screen shot, I haven't purchased all of the sounds myself; however, I did purchase 'l' 'r' and 's' because those decks also contain blends, which I do use a lot in therapy.
I chose 'P' for the purposes of showing you all the things you can do with this app. First, you can choose to work on the sound in three different contexts: word, sentence, or story level.

At the word level, you can choose flashcards or choose to play a matching game.
Once you've chosen your activity, you can isolate a sound position: initial, medial, or final.  There is also an option to sort the words in ascending syllable complexity. The app allows you to collect data by touching the green check or red X buttons seen on the left, and automatically calculates a percentage and puts it into a chart that you can email to yourself.  There is also an option to calculate word approximations that you can turn on in the settings menu if you choose. I've used this option with my kids who have difficulty with 'r.'
The is a group setting option that allows you to use this app with more than one child which is nice from an SLP perspective.  The kids' names will be shown at the top in little tabs (not pictured here) if you are working with a group.
The second option allows the child to practice the words in a sentence. There is an option to rotate the words in one sentence seen on the left (rotating) or to practice the words in a different sentence (unique). The first option is nice for my kids who may not be strong readers, but are at the sentence level in practicing their speech sounds, because they can remember the sentence and still get practice saying their sounds by reading at the sentence level. The second option is equally as nice for my stronger readers to practice saying their words correctly in a variety of sentences, promoting greater carryover. However, I can still use it with my younger kiddos because there is always an option to press the screen, and the words/sentences/stories will be read for them first allowing them to repeat if necessary.
Finally, there is a third setting for stories.  Once again, you have two options to choose from in this setting as well: Level 1 and Level 2.  Level 1 has a the story set in a rebus or picture format (on left) to help beginning readers practice their target sounds at a story level.  Level 2 is for a more proficient reader, and includes the target words in text. As mentioned above, there is always the option to touch the screen and have it read first if necessary.  The story modes also have comprehension questions at the end, which works on receptive language, but also requires the child to use one of the target sounds in their answer. This is also great to promote carryover, because it helps the child practice saying their sounds in a spontaneous production.

Other features this app includes is a record/playback function, which is personally a must have for me.  I think it's powerful to have the kids hear themselves say it.  Depending on their level, I might also have them score themselves.

You can also modify the word lists, and include your own custom images.  However, custom images are only available if you have all the sound decks.

Pros: Honestly, this is one of my favorite articulation therapy apps.  It contains almost every feature I can think of, with the option to turn any of them off or on depending on your preference.  I love the pictures, I like all the options, I like the ability to scaffold the sound productions for one syllable words  all the way up to the story level, and to be able to put them in the varying positions of the words.

Cons: For me, there aren't really any cons for me.  If I was being picky, it would be nice if the kids could make a profile that included their picture, but they usually recognize their name, so this isn't a deal breaker. There also isn't really a game or little reward, but the app is so colorful with interesting pictures and lots going on that my kids don't seem to mind or get bored.

Since a lot of my readers deal with apraxia, I have to say I don't feel like this is the best app for apraxia, especially for those kids in the early CV, VC stages of production.  It doesn't contain a lot of words with these basic syllable shapes, and it doesn't have options for blocked practice like the apraxia apps will.  However, it's important to note this app isn't marketed as an apraxia app either.  It's marketed as an articulation app, and I think for that purpose, it's fantastic.  In fact, it's probably my favorite.

I would definitely recommend this app for SLP's and parents to use with kids who have articulation and phonological processing delays.

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Tuesday, June 18, 2013

How to teach toddlers their colors, interesting article I found on pinterest.


On pinterest, I ran across this interesting article.  It basically says that children learn their colors faster by saying "the balloon is read" instead of "the red balloon."  In English, we usually put the adjective before the noun, so our kiddos don't get a lot of practice with learning it this way.

I thought it was interesting from an SLP standpoint too though, because many language processing kiddos struggle with describing activities anyway.  In therapy, we do exactly this.  We sort items and then say "the puppy is little, the elephant is big etc.  Only after they get the concept, can they start practicing putting the adjective in front of the noun.  Makes sense for learning colors too.


Wednesday, June 12, 2013

Speech Stickers App Review

Speech Stickers is the first app that I downloaded for Ashlynn (my daughter with apraxia) when she had first turned three.  I chose it because it was cheap, and said it was developed for children with apraxia.  The app is simple in design with not a lot of bells and whistles; however, my daughter did actually enjoy practicing her speech with this app.

The app is set up for kids in the very early stage of apraxia therapy.  The child can practice sounds in isolation and in CV(consonant-vowel) and VC(vowel-consonant) combos. The app is based around blocked practice with a lot of repetition that is necessary for apraxia therapy.
After you pick your sound or sound combo, you can then decide how many times times the child has to say it before they get a "sticker" or a little animation as a reward.  Then, the child chooses between five characters on the bottom, all of which have a different pitch to their voice.  This is a bonus too, because children with apraxia have difficulty with "prosody" or the rhythm of speech.  The characters' mouths model the correct placement.  The above picture is showing 'm.'  Below the characters are modeling 'mo.' This is also great because it gives the kids a visual cue for the correct mouth posture.
A scoring bar at the top help score and keep track of data. You must press the green check or the red x to move onto the next practice sound.  The app is designed so that the bar can also turn upside down so that the therapist can discreetly score; however, my daughter picked up on this in a heartbeat and would push the buttons haphazardly just so she could move on.  Once you reach the set number you earn a "sticker" or reward.  You can choose from eight stickers seen below:
They are so simple, but my daughter loved them.  I chose the bus just so you can get an idea of the animation.

What I Love: 
- Works on early developing syllable structures
- It really helped us work on final consonants when my daughter wasn't adding them.  Helped us get the final 'n' and final 't'
- Gives a reward in the form of a short animation that is interesting to kids
- Models different pitches and inflections, which is difficult for kids with apraxia

What it's Missing
- I would like the option for the child to record their voice
- As an SLP, I would appreciate the option to email the data
- It doesn't include more complex syllable structures such as CVC and CVCV, so it's only applicable for the early stages of therapy

This app was helpful during the early stages of therapy, when Ashlynn was struggling to sequence basic syllable structures.  She had just turned three, and was motivated to practice speech.  In addition, she loved the sticker rewards.  It did help us get those final consonants that she was struggling with too.
As an SLP, I have also used this app with a five year old, and he enjoyed it too.  For the price, I would recommend this app if you have a kiddo in the early stages of therapy.

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Tuesday, June 11, 2013

ApraxiaVille app review

ApraxiaVille is an app from Smarty Ears, and is the newest speech app that I have downloaded to use at work and with Ashlynn my daughter with CAS.
To get started, you create your players.  You can make an avatar, or import your own picture.  The application allows up to four players, which is nice from an SLP perspective, since you can use it during group therapy.
Next, you choose your activity from a list of three.  The first activity is the sound windows, which allows the child to practice a sound.
The avatar gives the child a visual and audio cue on how to say the sound.  In the upper right corner is a camera, and if you press it, the child can see themselves in the window as they try to mimic how to say the sound.  I was a little skeptical about this, but I tried it with Ashlynn (my daughter who is 3 and 1/2) on a sound she hasn't been able to say.  /f/  I have cued her and showed her the current production many times, but she loved seeing it on the avatar and then looking at herself in the camera.  Guess what?  We have /f/ in isolation!  Wahoo!

The next activity is the Farm house.  In this activity, you can choose from a variety of syllable structures and sound groups.  This is exactly how apraxia therapy is usually structured, from easier consonant vowel combinations all the way to four syllable words.

What I really like, is that you can customize it for the child.  For example, they have consonant groups, but if your child can't produce one of them, you can go to settings and just choose the words you want your child to work on.  You can also add your own words and pictures to the rotation, which is also awesome.  My daughter has a tendency to drop medial 'n' and 'd.'  She really likes Mickey Mouse Clubhouse, so I added pictures of Minnie and Toodles. Then you can record the name to correspond with the picture.  I also think this would be great if you wanted your child to practice family member names, pet names, etc.

Once in the farm house, you can practice the words.  A scoring system is set up above each child's picture to record data.  There is a record feature in the chimney to record and playback the child's production, and there are the avatars on the body of the barn to model appropriate production for a sound if needed.  After the activity, you can obtain a spreadsheet that collects the data with the option to email it.  I love this option as an SLP.

Finally, the last activity is the Words Farm, where you can choose 2-3 words to practice.  This is great for doing targeted blocked and/or randomized practice necessary when using a motor based approach to therapy.  This activity only allows one child, but again there is a record/play function, and you can take data that will be generated into a spreadsheet at the end of the activity.

What I Love:
- Has practice items on a syllable structure hierarchy used with apraxia therapy
- Can customize sound and syllable combinations to only include those in the child's repertoire
- Allows for adding your own additional pictures from your child's own life with ability to record
- Avatar's give visual and auditory cues with a camera feature so the child can immediately practice
- The second activity allows up to four players, which is helpful in group therapy
- Data collection feature that is automatically generated into a spreadsheet and can be emailed and/or shared electronically

What it's Missing
- Though the app is colorful and visually appealing to kids, there really isn't any game or reward to it.  It would be nice to have some fun reinforcement for practicing the words.

Overall impressions
Overall, I think this is a great app for young kids with Childhood Apraxia of Speech.  I would recommend this application to parents and SLP's.

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Sunday, June 9, 2013

Switching private SLP's

So I made the decision to discontinue private services through the SLP that was seeing Ashlynn.  I am very appreciative of all that she did; however, I feel like we had hit a wall with her therapy style.  Her style was to have my 3 1/2 year old daughter sit in a chair across from her for the entire 30 minutes.  The first 15 minutes she would do Kaufman cards, and the last 15 minutes she would play with a fun toy and have my daughter request and comment on it.  However, it was very controlled and my daughter couldn't hold it and had to do it all her way.  If Ashlynn threw a temper tantrum, she would look at me and tell me that when she has kids they are going to hate her because she won't put up with that.

Ya, well, good luck lady.  Kids throw them whether you "put up with them" or not.  It's called being a toddler.

After a couple months of this, my daughter was pretty over it.  The first 15 minutes turned into more like 20-25 just trying to get her to say the cards.  Apraxia therapy can be boring, but my goodness, I needed her to get creative!  I did bring up that maybe we could put it in a more naturalistic setting, having them play etc.  In her defense, she did try; but she still had Ashlynn sitting in a chair.  If she didn't get something accomplished, she just told me to do it at home.

Well, I tried to be polite, but I informed her that as a school based SLP, I don't have the luxury of having my carryover plan include parents doing homework.  I have to get creative!  Kids need to be having fun, and besides, that's how they learn the best!

I had a great mentor whose therapy plans usually included 3-4 different activities in one thirty minute session. They were multi-sensory in nature, which are methods that involve using any sensory and motor input available to enhance verbal skills.  This usually involves some type of play activity that might have them throwing a bean bag, walking like a crab, or even using felt and velcro boards just to do something different with those same old picture cards.

David Hammer, a well known CAS expert out of Pittsburgh does this as well.  I've been to a couple of his presentations now and he shows a lot of video.  I rarely see a child required to sit in a chair across from him. He has them doing puppet shows, hitting the cards with a nerf gun after they say their sound, or tossing bean bags in and out of a huge dinosaur's mouth aiming at the artic cards.  He has them banging on drums to represent each sound or syllable etc.  This is the way to promote carryover, and I could see this SLP wasn't going to do that.  She may have known the Kaufman method, but her therapy style wasn't what I was looking for.

That's the thing.  There are always going to be reading programs, math programs, and speech programs out there, but teaching style or therapy style plays a big if not bigger part in facilitating change.

When I was an SLPA (assistant SLP), I worked under a lot of supervisors and was able to see a lot of different styles.  All therapists are qualified and trained professionals that will most likely get the job done, it's just some got the job done a lot faster.  That's the kind of SLP I strive to be, and that's who my mentor is.

Since it's summer and my mentor is off, I"m switching Ashlynn to her.  I know Ashlynn would have progressed, but I need her to progress faster, which means I need someone more multi-sensory.  This is where I have seen my mentor shine and I'm excited for Ashlynn to start with her.

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Monday, June 3, 2013

Jumping on her bed? Break every spring girl!

At the beginning of her preschool school year after she had just turned three, I went to observe her classroom.  I went for a lot of reasons, mostly to make sure I liked the classroom and to make sure her needs were going to be met.
I left the observation in tears.  Not because I was disappointed in the classroom.  Not because I was disappointed in the teacher or the therapists.  No, I left crying with a broken heart.  You see there was an obstacle course in class that included Ashlynn jumping on a trampoline with a bar, and then crawling like a bear around a table.  She couldn't do any of it. I watched all the other kids jump enthusiastically and then do their best bear crawl.  When it was Ashlynn's turn, she needed help to get up on the tramp.  Then, instead of jumping, she just marched her little legs up and down.  Big smile and beautiful energy, but no jumping.  Not even close to jumping really.  She needed help getting down and in fact she almost fell.  Then, as she went to do her bear crawl, the teacher had to hold her core for her to even get up on her legs.
It makes me tear up even now.  It just wasn't fair.  Why couldn't she jump like the other kids?
Well, today, just 6 short months later, we went to her preschool picnic to celebrate the last day of school.  There was that trampoline that just a half a year earlier she could only march on.  Well, she stood in line with that same big smile, that same beautiful energy; and when it was her turn she got up on that tramp WITHOUT anyone's help, and she jumped, and she jumped, and she jumped some more.  And....when it was time to get off, she got down without anyone's help.
As I sat on the side watching, I realized that I'm the one that has it all wrong.  The only thing that changed was that my daughter could now jump, but that wasn't the real story.  The real story was that despite being different or not, or needing help or not, or being able to even do it or not, she always DID it.  She did it with a smile, a giggle, and that beautiful aura she carries around with her teaching me life is what you make it; and when it's what you make it, you WILL MAKE IT.
She amazes me everyday.  I still hate that she has it.  I still hate that it seems like she has to scratch and crawl for every achievement she makes, but I'm beginning to realize she WILL always do anything she sets her heart to doing and I am so proud of her.
Oh, and one more thing.  As she went down for her nap today I heard noise coming from her room.  When I went to check on her, she was holding her bed rail jumping up and down like she was on that trampoline.  I told her to lay down like any sensible mother would, but inside I was thinking, "Keep jumping Ashlynn!  Break every spring!"