Monday, May 27, 2013

App Review: Speech FlipBook


When I heard about Tactus Therapy's new App, Speech FlipBook, I was immediately intrigued.  As a pediatric therapist, I am always on the lookout for new tools that will allow me to be a more efficient therapist, and I suspected that the Speech FlipBook would be one of those tools.  And it turns out, I was right!

As Tactus Therapy clearly states in their introduction to Speech FlipBook, this app isn't a therapy program; in other words, it's not designed to be given to a child to use independently. It doesn't have fancy graphics, songs, or games.  But what it does have is so much more.

Speech FlipBook is wonderfully versatile tool for systematically creating sound and word lists to be used to address speech sound disorders such as apraxia and dysarthria.  It's also a great tool for developing phonological awareness skills.  By far, the best thing about Speech FlipBook is the flexible, thorough nature of the app. Using the settings carefully designed by Tactus Therapy, you can use this app to create words lists with any type of given criteria. Want words that just begin with bilabial (lip) sounds? Okay! Want words that only have "oo" and "ee" vowels? You got it! Words that have bilabial (lip) sounds in the initial (beginning) position of a word, "oo" and "ee" vowels in the middle, and tongue tip alveolar sounds (t, d, n) in the final position of a words? Sure thing. Want real words? Okay! Want non-words? You bet. Truly, I am amazed by how much thought must have gone into creating this app to make it so easy to generate word lists given highly specific criteria.


Once you've created the word lists that fit your specifications, you can quickly flip through those words lists during intervention sessions. I love, love, LOVE the fact that you can flip either the whole word (moon, beat, boot) OR flip one sound at a time. Say, for example, you had a child who was working on producing /t/ final words.  You could set the app to generate words that end only in "t." Then, you could choose to just flip through the different beginning phonemes but leave the vowel and "t" the same (wheat, neat, heat, feet, seat, cheat, meet), or you could choose to leave the initial and final consonant the same and just flip the vowel (meet, mat, mutt, met, mitt). OR you could choose to change the initial consonant and the vowel, but leave the final /t/ in place.  Fabulous flexibility.


So where do I see using this nifty app for speech and language intervention? There are a wide variety of ways; generating and using words lists for articulation/phonology therapy and working on phonological awareness are just the tip of the iceberg. Personally, I see this app being the most helpful when working with children who have a diagnosis of developmental apraxia of speech.  One of the defining characteristics of apraxia of speech is difficulty in combining sounds into syllables and words.  Children with apraxia of speech benefit from intervention that is systematically designed to address this core deficit.  So, when I am working with children who have a diagnosis of apraxia of speech, I change only one aspect of a word first.  For example, after establishing production of consonant vowel (CV) and consonant-vowel-consonant-vowel (CVCV) syllables, I begin to work on words with consonant-vowel-consonant (CVC) syllable shape.  The trick, though, is that I don't just work on any old CVC word; on the contrary, I pick CVC words in a precise and systematic way. I chose words that contain phonemes the child is able to produce and then... 
  • First, I pick words have the same consonant in both initial and final position (mom),until the child has mastered production of those words
  • Then, I pick words that have the same place of articulation but differ only in manner (mop),until the child has mastered production those words
  • Then, I pick words that transition from one place to another in place of articulation, but only stick to one movement pattern - say, bilabial (m, p, b) to alveolar (n, t, d).  This gives me words like man, pan, mad, bad, etc. 
  • Then I move to another movement pattern - often alveolar to bilabial (tap, dip). And so on.
Speech FlipBook is clearly an amazing match for an intervention program like this - with this app, it is super duper easy to systematically select and maneuver through these target words during treatment sessions. Further, Speech FlipBook allows the user to hear the individual sounds in each word (d...i...p) and/or to hear the word blended together (dip); this can be a useful way for children with apraxia of speech to work toward blending the sounds together into a word.  And, the user also has the option of recording his production of the word for playback. This is a fantastic way to provide a child with immediate and powerful feedback about his/her word production.

There are only a couple real drawbacks to this app. The first is that it doesn't contain pictures, so, if you are using it to obtain independent productions from an individual, that individual needs to be a reader.  This limits the use of this app with preschoolers. However, I still use the app to help myself generate words lists to be used with preschoolers - I just generate pictures off of those word lists to be used with the child.  The second drawback is that this app is limited to words that are one syllable. While it is powerful tool for children with apraxia of speech, it is not the only tool an SLP needs to generate words for this population, as it does not include multi-syllabic words.

In the end, though, Speech FlipBook is absolutely a wonderful tool to have in my SLP toolbox.  It provides me with the means to make my therapy sessions  more efficient for a variety of children on my caseload and is a fantastic addition to the apps on which I rely as a pediatric SLP.



Advertising Disclaimer: Tactus Therapy provided me with a free version of Speech FlipBook to review. However, my opinions about the products I blog about are my own.

Monday, May 20, 2013

Pictures, Autism & Creative Language: Using Pictures to Increase Creative Language Use

Pictures and Autism: Using Pictures To Teach Creative Language
Note: This post was orginally published on as a Guest Post by me on Joy's Autism Blog. I'm sharing it here again for my Child Talk readers!
 
Over the past thirteen years of working as a pediatric speech-language therapist, I’ve found that pictures can be a highly effective tool for working with children who have a diagnosis of autism. Children with autism are often highly visual and concrete learners; pictures have a way of slowing language down and making it more concrete. I use pictures in a wide variety of ways, but today I want to share with you how I use pictures to facilitate multi-word phrases with children who are just learning to use language creatively.

Most children with autism use echolalic speech. We think that this is because their brains process information as whole chunks—something we call being a gestalt learner. As a result, many of the children I work with have learned whole phrases that they use without actually understanding that each of the words in the phrase has individual meaning. For example, I’ll often see young children with autism say, “do you want to swing?” when they actually mean “I want to swing.” They do this because this is what they’ve heard asked of them when they were standing in front of a swing that they wanted to swing on. Not understanding that each word has specific individual meaning, they just repeat the whole phrase they heard in an attempt to communicate what they want.

One of my strongest beliefs as a speech-language therapist is that we need to teach children with autism that they can create meaning through putting words into a wide variety of short sentences. This is the generative aspect of language that makes it so that we can all create sentences we have never heard before, and it’s an essential aspect of language development. Without it, children are left to memorize sentences for specific situations and this highly limits their language skills.  When I work with children with autism, I make sure that they are using a wide variety of two-word phrases (see my list of early developing two word phrases here).

As a speech-language therapist, I will ofen use pictures to show relationships between words in phrases so that children can actually see how changing words changes meaning.  Once they get this idea, the possibilities are endless! The actual pictures and words I use with a child vary depending on that child and his interests, but the general process I use goes a little something like this:

First, I find a situation where a child needs to create specific two-word phrases to communicate his specific wants. I look for a situation that is highly motivating for a child, one in which each specific phrase would be important to that child. Take, for example, a child who *loves* to play with a ball and hammer toy. His ball and hammer toy has a green ball, a red ball, a blue ball, and a yellow ball.  and he knows which ball he wants. Given this situation I would:
  • Make a picture to represent “ball” as well as pictures to represent each of the colors.
  • Place a Velcro strip on the front of a binder, and put Velcro on the back of all the pictures as well.
  • Get out the ball and hammer toy and place it on the floor next to the pictures.
  • Hold up the balls and allow the child to reach for one so I know which one he wants.
  • Quick create the phrase on the Velcro strip that matches the ball he wants. Say, for example, he wants the green ball. I would put the picture for "green" and the picture for "ball" next to each other on the front of the binder, creating a small picture sentence ("green ball").
  • Point to each picture as I say the word in the phrase (“green ball”).
  • Have the child imitate me.
  • Give him the green ball.
  • Repeat the process, exchanging the color word on the velcro strip to represent the color ball the child wants.
  • As quickly as I can, I back off of prompting him to create the sentences and let him create the sentences on his own.
  • And, as quickly as I can, I get rid of the pictures and let him just use his verbal words.
The ball activity is just one of hundreds of activities where something like this would work. You might use this strategy to teach your child to create the phrase “eat + (food item)” or “watch + (movie)” or “play + (name of computer game)” or “go (location).” The key lies in finding an activity that allows you to teach your child that he need to mix and match words together to create his own sentences that have meaning to him. Once he understands the power of creative language, he’s well on his way to being an advanced communicator.