Apps to Use with a Two-Year-Old, Possibly on the Spectrum

A colleague asked for my suggestions for apps a parent can use with a 2 year old. She wrote, "I need some advice on a brand new client of mine.  I met him for the first time this week.  I will be seeing him at his preschool for one hour a week. This boy is 2 y.o..  His dad has an iPad and says that he enjoys using it.  (I don't own an iPad).  Once this boy warms up to you, he does "speak" but you can understand one single thing he says.  It is all jargon.  I am questioning whether he may be on the ASD spectrum.  I am wondering if there are any apps I can suggest to the parents for them to use at home and/or to use in therapy if they will "lend" me the iPad for the sessions.  I am not technology savvy when it comes to Apps and I would greatly appreciate any advice on where to start with this boy in terms of technology recommendations.  (and any other Tx recommendations!).  HELP!"

I wrote back and asked what the short-term goals were. She answered, "Some of his Short-Term goals include:  use 10 gestures/signs in songs/play; use mama or dada; answer simple questions with single words; name pix in a book; name snack given choice of 2."

Here were my suggestions:
Nonverbal communication: Toddler Sign (iSpeech), Pics Aloud, Smart Hands

Books: I Like Books---these are wonderful apps. There is a whole series of these iBooks.

Answer simple questions: Kindergarten.com has a few apps you might want to look at. The pictures lend themselves to asking simple questions.

Snacks: I would use the real thing instead of an app for this one.

Talking: Chippy Talk, Talking Gina, Talking Anya, Talking Ben. These apps could be used to encourage the child make sounds/say words.

Others: Spot the Animals, Peekaboo Pets, Baby

I also suggested that she instruct the parents on how to best stimulate speech and language development interactively. I would show them what is done during sessions and ask them to do the same. I have handouts I give to the parents to help them. I offered to email the suggestions. If any follower of this blog would like the same, please let me know and I will post it as a blog.


 

Diary of an App--meeting the team

Last week I met with the team with whom I'll be working. In addition to Alison, my project manager, I met with Brandon, the Creative Director, and Adam the Illustrator/Animator. We had a productive 2 hour meeting. We discussed what the app will target and the age range of the target group. This initial meeting turned out to be extremely important. During the discussion, I discovered that one of the original ideas for bringing the app to users would not work. I don't want to reveal what the issue was, but I will say that had this been discovered later in the process, it would have meant a change of course that would have been more costly and time consuming. I am waiting to hear back from one of the team members about proceeding in our new direction.

Shape and Color Apps

There are a multitude of apps available for shapes and colors. 

The shape app that is the most fun is Giggle Spittles. Giggle Spittles are three alien creatures that drop down from a brick wall. As they drop they they make a whizzing sound and then a bouncing sound when they hit the ground.  There is a different shape on the belly of each Giggle Spittle. The shape on the alien needs to be matched with the shape that appears on the brick wall. The child needs to touch the belly of the alien that matches the shape on the wall. When the alien's belly is touched, the alien laughs, the belly distends, and the alien belches out the shape. The child moves the now floating shape onto its matching shape on the wall.  After the child has successfully matches the shapes, the screen automatically changes to scene with a animals. The child is instructed to touch a specific shape found within the scene. The free app is limited to circle, square and triangle. More shapes are available for $1.99. Ages: 3+. Rating: ++++

Shapes by Kindergarten.com presents four shapes---circle, triangle, square, rectangle---as photographs of common objects, such as a stamp for square, a slice of pizza for triangle and so on. Accompanying each frame, is the narration, "The ____(name of the object) is ______(shape)." I like the association of shape with a real object. However, some shapes are inaccurately named and thus can mislead. For instance, 2 dimensional shapes are named as one dimensional:  a road cone is presented as a triangle, a typewriter as square, and grocery bag full of groceries as a rectangle. I prefer that a goal be worked on as cleanly as possible. By that I mean that if the child needs to learn the names of basic shapes, then drawings of shapes are sufficient. If one wishes to draw associations between common objects and shapes then this app is the one to use. Ages: 3+. Rating: ++

Kids Place has two free apps for colors: Baby Hot Air Balloons and Baby colors. The apps teach colors using either balloons or hot air balloons that appear out of a heavenly horizon and bounce around on the screen in the sky or above a beach and blue body of water. Depending on the app clouds that look like genies float across the screen, different colored bubbles shoot up in geyser like fashion out of the sand or sky, float around, or erupt in a sphere before they disappear and the process starts over again. The background also changes with zen like environmental sounds and musical accompaniment. The effect is somewhat mesmerizing. Tapping the screen changes the color of the balloon. The narrator speaks with a British accent. Free when I downloaded them, these apps are now $.99. Ages: 2-4. Rating: ++

Shapes and Colors offers learning in Chinese or English. Colors are presented in a variety of different shapes. The app has learn and play options. The learn option presents a color highlighted by an object of that color and 8 shapes below it. The word for the color is written in English and Chinese. The play option has 24 shapes and colors on the screen. A voice says, "Please select the _________ blocks." The blank is either a color or shaped named. The child has to then tap on all the shapes, among the 24, of that color or shape named. There is a visible timer that counts down from 120 seconds to 0. Thus, the child needs to work as quickly as possible finding all the shapes or colors named. The instruction varies throughout the time available. The child's score is visible on the screen as he/she works. Once the game is completed, a screen appears allowing the child to build a picture on an empty screen using a variety of different objects.  Or, one can click the x and return to the main screen. This app is free. Ages: 3-6. Rating: +++

Abby The Train Driver, by developer CF Corp, instructs the child to tap on a toy of a specific color. Tapping on the correct color, transfers the object to a train. The train waits until each of its three wagons has an object before it chugs away. The settings option allows one to select the minimum number of toys to display (1-4 on the free version, up to 10 on the $1.99 upgrade) and the colors (there are 11). Fortunately, one can opt out of the music and sounds that can be distracting and annoying. Ages: 2-4. Rating: ++

Baby Shapes, by GrasshopperApps, offers different colored silhouettes of common and inventive shapes such a lightening bolt and shamrock, making this a vocabulary app as much as a shape app. The settings option allows one to select the minimum and maximum number of items to display and customization of items and sounds. One can also select from a library of shapes to display. This app was free when I downloaded it, but is now available for $.99. This is a nominal price to pay for a creative app that allows beyond the presentation of simple basic apps. Ages: 3+. Rating: +++

Speak Colors, by RWH Technology, offers seven basic colors--black, blue, green, orange, red, white, yellow. These colors appear at the top of the screen. Tap on a color and a big square turns that color. Next to the colored square is a picture of a common object of the same or similar color (a vibrant blue square was demonstrated in the form of a light blue dress). If one taps on either square, an audio setup button appears. Tap on the green arrow and hear a dull sounding voice name the color or object. A better option is the exclamation point button. It allows you to record your voice naming the color and object. This app is free.
Ages: 2-4. Rating: +

Diary of an app development---The start

For those of you who have been following my blogs, you know that I have been critical of a good number of apps that have been developed specifically for speech and language therapy. Well, I have decided to put my money where my mouth is and develop an app that utilizes the animation and interactivity abilities of the iPad. I would like to take you on this journey with me in the hopes that you too may decide to develop your own great apps.

My journey began a few weeks ago. I contacted a number of companies to get an idea of the cost of developing a speech/language app. I found companies by googling "app development," "app developers," and "app development companies."

Pricing was all over the map.
The most reasonable was about $5000 and the costliest $40,000. The contact people tended to be in sales. This does not suggest that they were not knowledgeable. They were, but to a point. Some issues were beyond their expertise and they needed to consult with their tech department. Some expressed interest but did not reply after a few back and forth emails. Then, out of the blue I got a cold call from a local company that does web design and management. I may have sounded a little irritated with the woman because I do not like marketers calling. But she called in the midst of my search and used the words "web design." I told her I was interested in developing an app. A few days later, I was sitting in the conference room with one of the owners, Earl. The minute he started talking it was clear that Earl was a knowledgeable software guy. He immediately understood where I was headed and offered his own ideas based on his expertise. He was also enthusiastic about my ideas. His expertise talked to my comfort level. Earl did a great job translating tech know-how into terms I could understand.

My Decision
I decided to go with Earl's company. His price was not the best. But my thinking is that, since this is my very first app, working with a company close by will offer me greater insight into the process. By sitting down with the people who will do the work, rather than conducting all interactions via computer or telephone, I am hoping to get better picture of what it takes to bring my idea to fruition.

The Contract/Agreement
Earl and I went back and forth a few times about the terms of the agreement until we found the sweet spot to satisfy us both. Two of the sticking points were cost and payment terms. Yesterday I signed the contract. I was assigned a project manager, Allison. She will be the link between me and those people working on my app.

My next blog will give more details about the project.

Analogies app

The other day I downloaded another Grasshopper Apps app. Little Solver targets analogies, not verbal analogies, but rather shape figural analogies. The analogies start out simple but quickly advance to analogies that I found challenging. Good spatial recognition skills are helpful. At first glance, one might question its usability for speech paths. I thought about this and it occurred to me that this app could be used to elicit language.

The app presents analogies in four square fashion with the blank-is-to-blank visuals in the two upper quadrants. The two bottom quadrants have the blank-is-to-? visuals. At the most basic level, this app could be used to elicit conversation about shapes, similarities and differences. At at more advanced level, the child could explain what picture, among the four choices works best to complete the analogy and why. Discussion could ensue as to why an different choice may be better. This type of discussion would encourage the child to use reasoning skills, comparing, contrasting and descriptive abilities.

There are two scoring features. At the top of each analogy screen are three red hearts. If an incorrect answer is selected, a heart turns gray.  It is possible to return a heart to red by correctly answering a set number of analogies correctly. The game stops after the three hearts have turned gray, at which point a score screen appears. The total score is given as a percentage. Below the total score are the levels by number and name, the number of attempts at each level and the accuracy at each level. It is also possible to retrieve scores by tapping on the pause button on the screen of every analogy. The scoring is for the existing game only. One cannot input names to track progress over time.

Cost: Free for a limited time
Ages: 6 to adult
Rating: ++++
Developer: Grasshopper Apps 
Website: www.grasshopperapps.com

ASHA Leader article on apps

"Apps: An Emerging Tool for SLPs" by Jessica Gosnell, MS, CCC-SLP, in the latest issue of the ASHA leader, discusses apps and their use in our field. One of the points she makes is that speech apps should not take the place of an SLP. She may be correct, for now.

There is no doubt that technology has the ability to change the way we provide services and for many of us the change has already begun. Having said that, there is no speech or language app available now (by now I have downloaded about 500) dedicated solely towards remediation of speech or language problems that is a game changer. The speech and language apps that are available are electronic products of the paper materials available through catalogs. The apps are unimaginative and many are costly. This is hugely disappointing since they make little to no use of the interactivity potential of the devices. Actually, some of the best apps are free and can be easily adapted to therapy, primarily for vocabulary, language elicitation and as motivational tools.

There are a few reasons that iDevices can only be used as an adjunct to therapy and not as a replacement for an SLP, for now. As mentioned above, there are no apps up to the task. Speech recognition technology is not advanced enough to accurately and consistently determine if a sound is correctly produced. Children and their ways are also problematic. Children tend to tap all over the screen rather than selectively tap to learn. They tend to gravitate towards the easy rather than the challenge. We, on the other hand, challenge the child to stay focused and to move on to the next challenging level.

There likely will come a time when technology will be used in place of an SLP for certain types of therapy. I, for one, do not have a problem with that. Our services will need to evolve along with the technology.

Minimal Pairs App

Minimal Pairs by SLP Tech Tools has a number of features I like. It allows for the tracking of up to 75 clients. Once you input the client's name and grade, the date, time, process targeted and the total correct/ incorrect, scores are tracked for each client for each session. All of this information is inputted automatically by the app, relieving the speech path of doing this tedious work. On the screen where one finds the child's scores, there is also a section for writing notes. For speech paths working in the schools with huge caseloads, this is a time saver. Adding and deleting clients is easy. The app offers clearly identifiable picture(s) on a solid blue background. There are session setting buttons that one can set to on/off to show or not the word with pictures, allow or not allow a spoken voice for pictures, enable VGA output and randomly shuffle or not shuffle minimal pairs. 

Navigating the app can be challenging until one gets accustomed to the layout. There are eight process targeted: final consonant deletion, cluster reduction for /s/ and /l/ clusters, stopping (/t/ for /s/, /d/ for /z/, /p/ for /f/ and /b/ for /v/,  deaffrication (/t/ for "ch" and "sh" for "ch" , fronting, prevocalic voicing (/b/ for /p/, /d/ for /t/, /g/ for /k/, /v/ for /f/, and /z/ for /s/, depalatization (/t/ for "sh" and /s/ for "sh"), and gliding (/w/ or /j/ for /l/, and /w/ for /r/). For each process, one selects a session format: auditory training, contrast drill or target drill (an auditory bombardment type drill). Within each format are lists of words to select. All are checked. Tapping on a word removes the check mark. Pictures will not appear for those words not checked. Some targeted sounds have a number of word choices while others can present as few as three.

There are a few icons at the top of the session screens. Right and left arrows, when tapped, move to the previous screen or the next screen, respectively. Between the arrows is a red box with an X to be tapped when the child's response is incorrect, a green box with an upside down check mark to be tapped when the child's response is correct, and blue box with the word END written upside down to be tapped to terminate the task. I was confused as to why the check mark and word END were upside down. Elizabeth Strata, the app developer clarified, "The “upside down” control panel was deliberate.  In working with other apps we noticed how easy it is for kids to change pictures and have the word repeat, uncontrollably. So, we designed SLP Minimal Pairs (SLPMP) with the control panel at the top, facing the therapist and away from the child. That way it takes only a little effort to keep busy fingers away from taking over the session." The blue rectangular box is designed to allow the user to change session type. Let's say one is working on auditory training and wishes to switch to contrast or target drill, one taps on a specific part of the rectangle. This takes some getting used to, but it does allow one to change to a different training session rapidly. In contrast drill there is also a yellow button that when tapped rotates between contrasting words/pictures pairs. A word of caution: a child left unsupervised will be able to  tap and move between drills just for the fun of tapping and changing screens, with little to no learning taking place. This possibility might have been avoided by offering a session option button that would allow the user to turn on/off the ability to switch between sessions.

As one might expect with taped presentations, the risk for sound distortions/omissions is high. In a minimal pairs task, it is essential that all sounds be clearly produced. Sometimes that requires exaggerating sounds. This is not the case in a number of instances. The clarity of the /p/ is particularly problematic. It frequently is omitted or sounds like a click. Other sounds for which production is not always clear are /k/, /b/, /v/, /n/, /m/, /z/, "ng," and "j." When I mentioned this to Ms. Strata, she noted, "We expect the therapist will interact with the child, using the app is [sic] an aid for interaction and not a substitute for the therapist."

The cost of this app at $29.99 is high. However, in all fairness, the price of this app is the same as comparable apps and $10.00 cheaper than another articulation app on the market. At this price, on a device with the abilities of the iPad, I would expect a more fun and interactive app. But this is a criticism I have of the latest spate of speech and language apps  that do nothing more than put pictures to iPad and call it a day. I would be more likely to consider an app of this kind if it were priced below $10.00, and that would be primarily for the scoring/tracking feature if I were using it with multiple children at once, or if I could purchase the processes separately for less than $3.00 each.

Ages: 3 years and up
Cost: $29.99
Rating: +++
Website: wwww.slptechtools.com