Tackling Those Stubborn /k/ and /g/ Sounds

For those of you who have been stymied by those hard to treat /k/ and /g/ sounds, I share tips on my website: http://helpmetalkright.com/index.phpoption=com_content&view=category&layout=blog&id=27&Itemid=289

Videos and Signing Are Included in This Vocabulary App

Vocabulary Builder 2 by BumbleBee Kids: This vocabulary app offers 23 words appropriate for the developmental ages 12 months to 3 years. The product description states that the app is appropriate for late talkers, children with autism or PDD and children with speech delays. I question its value with the last group, but more about that later.

The vocabulary is presented in two ways: picture cards and video. Each vocabulary picture card has a video associated with it that demonstrates different ways the item may look, how it is used and places it may be found. There is also an option for viewing the ASL sign version of the picture. 

Real items are used in photos and its written word is below it. The photos clearly depict each item. To the right of the photo are four buttons. The top bottom is a picture of a television. That button takes one to the video. The second button is a thumbs up sign. Tap on it and a screen shows someone signing the word as the word is said. The third button is a question mark. Tap on it and a screen appears with item. A narrator asks a question, the question is answered and followed by a demonstration. For example, for the vocabulary item "bib," the narrator asks, "What does a baby do with a bib?" The question is answered by a child who says, "A baby wears a bib." A video of the mom putting the bib on the baby follows. The last button has a picture of a girl's head. Tap on it and a screen follows with a closeup of a woman saying the word. 

I guess I am an SLP stickler. As a stickler, I noticed numerous issues with the app. The first issue is, if the vocabulary word is a singular such as "balloon," I prefer to see one of that item. Multiples changes the word to "balloons." The videos in this app do not make this distinction. The video shows single as well as multiple balloons and all fall under the word "balloon." When I work with children who have delays I prefer to work on one concept at a time. Mixing up single and plural muddies up the waters a bit for me, unless I am working on the singular/plural concepts, and it may cause confusion for some children. Another issue, I think that the lesson, of learning a specific word, gets lost in the rapid sequence of videos. A counter argument might be that the videos demonstrate the various settings and uses for the selected vocabulary word. That is a good thing. Perhaps if the video sequences had longer pause time between them I might have felt otherwise. The videos in this app are also problematic because the audio is not always in sync with the visuals. Sometimes the audio was delayed or partially came through. In some parts the mouth movements were not in sync with the speaker's mouth movements. I found other issues with the videos. I felt that often the narration was fast and the words were not always clearly articulated. This brings me to the question, how does this app benefit children with speech delays? I cannot really say.

I praise the developer's attempt to bring real life scenarios to the learning of vocabulary thus expanding the child's understanding of each word. The inclusion of the signing option is a nice plus and adds to the varied presentations of words. 

This app comes in at 500MB making it one of the largest I have. This may be a consideration for those who have little room left on their iPads. 

Ages: 12-36 months and children with delayed vocabularies

Cost: $24.99

Developer: BumbleBee Kids @ www.bumblebeekids.com

Rating: ++

A Fun and Clever Word Game

Chain of Thought: developed by Jay and Julie Bacal
It has been a while since I have reviewed an app. Yes, there has been a lot going on but that is not an excuse. I think the primary reason is lack of motivation. Then I opened this app that had been sitting on my iPad for many months and to my surprise it hooked me.

Chain of Thought is a fun and clever word game whose object is to segue one word into another to form a different meaning. The segued words are compound words or two word phrases. In the screen shot below, "mountain" would be correctly paired with "lion" that would correctly be paired with "king," king with "bed," and so on. Clues to the correct word selection are offered by tapping on the question mark. Clues can be used up and earned.




Points are given for words correctly combined and points subtracted for incorrect matches. Each game is also timed. Quick thinkers are rewarded with flashes of words like, "Incredible!!" Words of encouragement are offered when scores are not great. If words are incorrectly matched, the screen turns into an ominous storm with a thundercloud showing the number of points deducted. At the end of each game, players are given 0-5 stars based on one's performance. Scores for each round, the number of hints left, the round being played, the game number for the rounds and the player's total score are shown at the top of the screen.

The graphics on this app are fun, be they the colorful stardust for correct answers or the ominous thundercloud throwing out lightening for errors.

I would use this app with children ages 10+ to build vocabulary, help with the comprehension of commonly used/heard phrases, forming associations and reading skills. Aphasic adults, who are able to read, may find this a fun way to improve their associative and communication skills. I would also recommend this app for students who are learning English as a second language. When you are not using this in therapy, it is a fun game just to play.

Note: Since this app was not specifically developed for therapy, there is no database.
Ages: 10-adult
Rating: +++++
Developer website: bestdamnapps.com
Cost: Free for the Sunrise Level (comprised of five games). The seven other levels can be purchased for $3.99 or $.99 each.

Stuttering During the Preschool Years Helping families understand this condition early on.

I would like to share the article I wrote that was featured in Advance for Speech and Hearing on July 21, 2014. The link is http://speech-language-pathology-audiology.advanceweb.com/Features/Articles/Stuttering-During-the-Preschool-Years.aspx

The formative preschool years, when a child's speech and language skills progress by leaps and bounds, is also the time when the seeds of stuttering often take root. Ignored or inadvertently fertilized, the roots of stuttering grow longer and stronger until the growing child is unable to uproot it.

Those of us who have worked with adults who stutter understand the enormity of their struggle to speak fluently. When working with someone who stutters, it is easy to lose sight of the time when it began to take root. That begs the question as to how we can help children during those critical preschool years? Perhaps the answer is not complicated.

Over the nearly 40 years I have worked as a clinician, I have been keenly aware of the significant role parents play in the progress of their children during therapy. When parents understand their child's disorder and commit to doing their part to help their child, their child's progress is positively affected. When it comes to helping the preschool child who stutters, the assistance of the parents is paramount. I have found that when parents follow my suggestions, the child may learn to regain fluency without my direct intervention.

Working closely with parents is a process that starts with the initial parent interview. The initial interview gives me the opportunity to learn about the parent's understanding of the stuttering, how they react to hearing their child stutter, and their perceptions of the problem. When I first meet with the parents, I ask them general questions about the child's development and health. I then ask them questions specific to their child's speech. I write as they answer the following questions:

1. When did the child begin stuttering?

2. Who was the first person to notice the stutter?

3. Are there any family members who stutter? If yes, who?

4. What do they feel caused the child to begin stuttering?

5. How do they feel their child feels about his/her stuttering (frustrated, refuses to talk, embarrassed, angry, doesn't seem to care)?

6. Does the child avoid certain words, change words, avoid talking, lose his/her temper, or hit other children?

7. Does any of the following happen when the child is trying to get his/her words out: blink his or her eyes, move his or her eyes sideways, lips quiver, he or she inhales deeply, his or her body stiffens, his or her head jerks, and he or she stamps or taps her foot? I will ask the parents if there is anything else they have noticed the child do when stuttering.

8. Is the child's speech better in the morning, after school, at night, when talking to a pet, when talking to a specific person, when relaxed, when playing with, when reciting (numbers, nursery rhyme, alphabet), when singing? Are there other times when the child's speech is better?

9. Is the child's speech worse in the morning, after school, at night, when talking to a pet, when talking to a specific person, when relaxed, when playing with a certain person, when tired, hungry, frustrated, anxious, angry, stressed, excited, or afraid? Are there other times when the child's speech is worse?

10. What has been said or done to help the child stop stuttering?

11. How concerned are you about your child's speech (not concerned at all, somewhat concerned, very concerned, extremely concerned)?

12. How well does the child get along with mother, father, brother(s), sister(s) and anyone else living in the home?

13. What does the child enjoy doing?

14. What does the child dislike doing?

I ask each parent to reply to the questions. It is surprising how many parents have different viewpoints, opinions and perceptions of the child's speech. Thus, it is important to hear what each has to say. This type of interview gives me the leeway to ask them to expand on a response if I need clarification or to ask another question based on their response. If an adult, other than a parent, cares for the child during the day, I ask the adult to respond to the questions as well. If the parent or caregiver cannot attend the session, I telephone the person and write his/her answers on the form.

After I have completed the questionnaire, I spend time talking with the preschooler. The parent is welcome to stay in the room and engage with the child. I listen carefully to the child's speech and record it. I note the type of stuttering (repetitions, prolongations, hesitations), the frequency of the stuttering and if there are any secondary stuttering behaviors. I observe the parent-child interactions. Based on the responses the parents gave during the interview and my observations, I decide if the child needs therapy or if I can work with the parents and hold off on therapy. If I feel comfortable holding off on therapy, I ask the parents if they are in agreement and if they feel they can the implement the suggestions I share with them. The suggestions can be specific to the family dynamics I learn about from our interview. However, the generic suggestions are:

1. Avoid offering their child advice on how to talk, such as slow down, take your time, breathe before you talk, relax, stop talking that way, say it the way I do, and think before you talk.
2. Avoid finishing your child's sentences or words for him or her, talking for him or her, or interrupting him or her when he or she is speaking.
3. Avoid calling their child a "stutterer."
4. Avoid getting upset when their child stutters.
5. Do not tease or mock their child's speech.
6. Avoid asking their child to recite or perform in front of others.
7. Get down to the child's level, make eye contact and listen, without interrupting, to what the child has said.
8. Comment on what the child says not how he or she has said it.

We do not yet have a cure for stuttering. However, what we help families understand and do during the preschool years can make a difference and may be the closest opportunity we have for a cure at this time.

Mirla G. Raz a certified and licensed speech-language pathologist, lives and works in Scottsdale, Ariz.. She has worked extensively with the pediatric population remediating speech sound disorders, language disorders and stuttering. Raz recently published Preschool Stuttering: What Parents Can Do. Her popular Help Me Talk Right series of books have been used by parents and professionals throughout world. Information about the books and her blog can be found on her website, http://www.helpmetalkright.com

How a Speech Pathologist Became an Author

I am going to deviate again from my usual app review postings with this post.

Since publishing my books, numerous SLPs have told me that they have ideas for books. They ask me if is difficult to self-publish, how I got started, and a host of other questions. I thought I would use this forum and my website to talk about being a speech pathologist and author. Feel free to send me questions and I will answer them as best as I can on this blog. Below is my first installment.

I began writing writing my first Help Me Talk Right book in 1990. I had just separated from my partner, and sister, with whom I had shared a private practice. She kept the practice and I moved on. At the time, I had two small children and decided to take some time off before opening my own private practice. One day, I got a phone call from a friend whose daughter had a lisp (she said the "th" sound instead of the "s" sound so that "sun" was said "thun"). She wanted to know what she could do to help her child without spending a lot of money. This was not the first time a parent wanted to know how to correct her child's speech on her own. My friend asked me if there were any books available to help her. I told her there were none. But then I thought, why not give parents what they want if it will help their children speak better? Why not write a book that was a complete therapy manual for teaching a child to say the "s" sound? This was certainly preferable to parents trying to correct their child's speech without guidance, doing it incorrectly, resulting in failure and frustration for parent and child. I spoke with my friend. We agreed that I would write each week's therapy lesson for her and she would give me feedback on how the lesson went. If there was something she did not understand, I would resend the lesson with a clearer explanation. If the lesson went well and the child accomplished the goal for that lesson, I would write the next lesson and wait to hear from her. We went back and forth in this manner until the day came when her daughter completed all the lessons and was using the "s" in conversation all the time. Success! I now had a complete program that would work for parents in just 15 lessons.

My next job was to find an illustrator to make the pictures for the lessons' worksheets. Up to this point I had used pictures from materials I had purchased. I could not use them in my own work. I called the art department at the local university and told them about my project and illustration needs. They gave me the name of a student. Chris agreed illustrate the pictures for my first book. Next I needed to find someone to edit the book for errors and then a typesetter. Lastly, I needed to find a printer. I decided to go to a local printer in order to be more involved in the process. I did a first small run of 500 copies. When the printer handed me my completed book, I felt as if I were holding my baby. That may sound silly, but that was the feeling. I had given birth to a book!

Since the publication of my first book, How to Teach a Child to Say the "S" Sound in 15 Easy Lessons, I have self-published 3 more. I now have How to Teach a Child to Say the "R" Sound in 15 Easy Lessons, How to Teach a Child to Say the "L" Sound in 15 Easy Lessons, and most recently Preschool Stuttering: What Parents Can Do.

A Good App to Help with Speech Rate

Turtle Talk: by Aptus Speech & Language Therapy. I recently reviewed Keywords Understanding by this same developer. I am more impressed with Turtle Talk. This app is simple in nature but it does the job in a way I think children will respond to and enjoy. This app is designed to help children reduce their rate of speech and pace themselves. However, I would also use this with children whose speech may be too slow.

The app consists of one screen with six turtles holding cell phones.  The child presses on a turtle and says a syllable or word. Once the turtle has completely filled with color and turned around, the child moves on to the next turtle. If the child releases the turtle before the turtle has turned around, the words "Too Quick" flashes. There is a slider bar at the bottom of the screen that can be adjusted to the desired speed by moving the bar dot right or left. The turtle fills with color at a rate specific to the adjustment on the slider bar.

The app developer states that this app can be used for children who have "imprecise articulation." I was not sure what the developer meant by "imprecise articulation” so I queried the developer. Ms. Qurran wrote, "Imprecise articulation is unclear speech e.g. some sounds may not be accurate particularly if the child is talking too fast."

The app offers a selection of conversation categories. They are: Activities & Cultural Things, Family, Friends & Pets, School, Opinions, More About You, and If Questions. One can also opt for no categories or a random presentation. If a category is selected, a question or topic discussion is written at the top of the screen. 

My standard rate reduction tool had been "speeding tickets." Now, here is an app that I feel will replace those speeding tickets.

Age: 4-8

Rating:+++

Developer: Aptus Speech and Language Therapy

Cost: $4.99

A Basic Following Directions App

Keywords Understanding: This app, developed by Aptus Speech and Language Therapy, is essentially a following directions/auditory comprehension app.  One can work on simple one step instructions, such as "Which one is (color or size)?" or "Touch the (object)." One can increase the complexity by adding color + size to the task such as "Touch the small yellow bag" and further by making it a two-step instruction like, "Point to the small yellow bag and the big pink hat." The next level of difficulty adds the temporal concepts before and/or after to the instruction. One can select to focus on one or the other concept, its position at the start or middle of the sentence, or both alternating the position in the instruction such as:

Touch the butterfly before you touch the bag.

Touch the butterfly after you touch the bag.

Before you touch the butterfly touch the bag.

After you touch the butterfly touch the bag.

Incorrect selections are Xed accompanied by the plucking of a guitar string (if audio feedback is chosen in options) and correct selections are checked along with a tinkling sound (again, if audio feedback is selected). I like the 29 clear and brightly colored photos of objects. In addition to the objects are  five primary color and two temporal concept choices—before and after.  One can select the number of trials of the task. The number selected appears on each screen.The child's score is shown with number correct shown along with the number of trials: 2/5 = two out of five trials correct, and the error(s) such as "pink box for green box." One can select audio feedback, only positive feedback or no feedback. Mode options are audio + text, audio only, or text only. There is no database, record or reward options. I asked the developer about this. Because this app was designed to be used by adults, as well as children, the developer felt it best to not include rewards.

This app is straightforward and unadorned. Am I enthusiastic? Not Really. This app reminds me of the apps available when the iPad first entered the market. Apps have come a long way since then. It is left to be seen how this one will do in the competitive app market.

Ages: 3-5
Rating:++
Developer's Website: under construction
Cost: $11.99