Wednesday, September 19, 2012

Review: Speech Therapy for Apraxia by NACD - iPad App

Speech Therapy for Apraxia iPad App by NACD and Blue Whale App Development: A Review

I purchased this app in order to evaluate it. It is very reasonably priced in the app store for only $4.99.

Detailed Description

Blue Whale is offering their Speech Therapy for Apraxia iPad app for $4.99 at the app store. I find the app to be rather soothing and visually appealing as did my children. The pictures are sweet and the interface is simple. Let's look at what the app does in more detail.

This app allows you to work with one group of phonemes at a time. /b/, /p/, and /m/ are grouped together. /d/, /n/, and /t/ are grouped together. /g/, /k/, and /h/ are grouped together. /w/ is on its own. /f/ and /v/ are grouped. /s/ and /z/ are grouped. /sh/, /ch/, and /J/ are grouped. Finally,, /l/ and /r/ are grouped. They are grouped roughly by developmental sequence and place of articulation. I particularly like the simple, just thorough enough, and easily understandable explanations on the options screens.


Once you've chosen your phoneme set, you are taken to a screen that lets you choose a difficulty level. There are eight difficulty levels that progress in a very logical manner from level one (still CV syllables, but presented in groups of five with a variety of vowels and pulling from two sets of consonants rather than one).



That's it. Once you've made those two choices (consonant group and initial difficulty level) the practice session begins. The stimuli appear on the page. They are a mix of nonsense syllables and real words.


Very young children will have trouble learning the nonsense CV combinations even though the developers make each two letter combination a unique font/color which is a nice touch. However, if the child cannot say the syllable spontaneously, all they have to do is tap on it to hear a model. The child repeats all the syllables and then swipes their finger to move to a new page of randomly chosen (within the structure of the difficulty level) stimuli. When they reach the end of the stimuli the final page allows the therapist to choose to repeat the same difficulty level or to move on to the next.

The program does not track data at all. There is no mechanism for data tracking and therefore keeping track of separate students is unnecessary. It is purely a simple, elegant method of practicing at the syllable level with severely apraxic children.

My 3 1/2 year old daughter was easily able to "play" this speech game independently. I see it as having a place in a therapy room. It would allow you to have one child happily drilling productions while you work with another child individually before switching. At $4.99 it is a very reasonable program to recommend to parents as well

Pros, Cons, and Bottom Line


If you have any children at all on your caseload who need drill at the CV level, this app is a great deal. It is perfect for introducing a new phoneme to apraxic children. It would be great practice for a phonological process or artic child who is struggling to learn a new consonant in initial position.

This app is extremely comprehensive in what it does: CV syllables in an increasing hierarchy of difficulty. They've included pictures of real words where possible and made the visual cues unique when a real picture did not apply.

Here's my bottom line. If you ever need to drill at the syllable level and you like incorporating iPad work into your speech room grab this app. At the price, it will be worth every penny. If you rarely work at the CV level and prefer to skip straight to simple CV, VC, and CVC real words than you won't find anything useful in this app.

Tuesday, September 18, 2012

Final L: Free Speech Therapy Articulation Picture Cards


Final /l/ Card Set

To download click on the image to open it full size. Then right click on the image, choose "save as" and save the page to your computer.


I recommend you print on cardstock and laminate for durability.




Description

This articulation picture card set is designed to be more comprehensive than the typical sets you might find elsewhere. The target audience for this set is young children or children with more severe speech delays that need intensive practice with final /l/ at a one-syllable level. No blends or vocalic /r/ sounds are included in this set. The set pairs the final /l/ with as many different vowel sounds as possible to maximize co-articulation variety.

Key Features

  • This set includes 24 therapy cards with the target word and picture on the front, and the difficulty level and a carrier phrase on the back.
  • The words are all VC or CVC in syllable shape.
  • The words are easily understood by or easily taught to young children.
  • Combines the target sound with a variety of vowel sounds.
  • Words are sorted by difficulty level for an easy progression from easy to hard.

Permissions

I give permission to copy, print, or distribute this card set provided that:

  1. Each copy makes clear that I am the document's author.
  2. No copies are altered without my express consent.
  3. No one makes a profit from these copies.
  4. Electronic copies contain a live link back to my original and print copies not for merely personal use contain the URL of my original.

Looking for Feedback

I would love to hear back from anyone who uses this card set. Let me know if you find errors or there is anything you would change. Comment on this page, or send me an email at testyyettrying(at)gmail(dot)com.

Where can I find more?

More sets are on my Free Speech Therapy Articulation Cards page. Other card sets include /p, b, t, d, m, n, h, f, v, k, g, w, s, z, l, th, ch, sh, s-blends, and l-blends/ and more sets are being added regularly.


What kinds of activities can I do with this cardset?

  1. 10 Card Set Game and Activity Ideas
  2. Simple Speech Card Puzzles
  3. Speech Card Stories
  4. Speech Card Caterpillar
  5. Speech Card Game: What's Hiding?
  6. Speech Card Game: Speech Switcheroo (An Uno-Style Game)
  7. Speech Card Set Activity: Magnetic Speech Cards
  8. Speech Card Game: Speech Fours
  9. Speech Card Game: Old Maid
  10. Speech Card Set Activity: Bang!
  11. Speech Card Set Activity: What's Hiding Behind Door Number...?
  12. Speech Card Set Activity: Customizing a Homework Sheet
  13. Speech Card Set Activity: Making a Simple Sentence Flipbook
  14. Speech Game: Find-It
  15. Speech Card Set Activity: Speech Art Collage
  16. Speech Card Set Activity: Speech Crowns

Monday, September 17, 2012

Case Study of Apraxia - Audio Samples from 21 - 30 months

About a year ago I pulled a bunch of speech samples from home videos and posted them on the website. A lot of people had trouble making the audio links work so I'm reposting them now in a single post for anyone who is interested in hearing what Ava sounded like just before starting therapy and through the first few months of progress. These samples begin with a short video taken at 21 months of age just before she started therapy. There is a monthly audio sample between 21-26 months and then a final sample at 30 months.

Let's begin with a frame of reference for this age group. Even dated research used a cutoff criteria of not having a spoken vocabulary of at least 50 words by the age of two to qualify children as "late talkers". More current research shows that the average number of words girls produce at 24 months is 346 and boys produce 252. A vocabulary of below 92 for girls and 63 for boys puts a 24 month old at the 10th percentile.

This is one speech delayed child with suspected Childhood Apraxia of Speech. As I know now, Ava's apraxia is mild and she made (and is continuing to make) swift progress in therapy. Do not listen to these samples and think that your student/child should sound just like Ava at the same age. All children are different. Their speech problems are different and their responses to therapy are different. I'm reposting these because I remember searching for some examples when Ava was first being diagnosed and wanting to hear some examples of other children who were struggling with severe speech delay. This is just one example of what a speech delay sounds like and the way the speech changed over time with excellent therapy. She went from almost no sounds/words at 21 months to singing a fairly recognizable rendition of a nursery rhyme at 30 months. I wanted to document that progress.

It has come to my attention that Blogger posts these videos/audios in flash format which does not play in Safari (on the iPad/iPhone) so you'll need to view/listen to these on a PC. Sorry!

Speech Sample - Ava - 21 months old - Childhood Apraxia of Speech before therapy

This is a video I took while reading a book with a 21 month old Ava before bed. At this time she had about four consonants, three vowels, and four "words" in her spoken repertoire. It was fairly obvious that she would be getting anywhere near 46-342 more words in the next three months. This is a good example of how to use picture books to encourage a speech delayed child to vocalize. Turn the book reading into a "conversation" by asking questions and pausing for a contribution from your child.


Speech Sample - Ava - 21 months old

Here's something from about three weeks later. Ava has found something interesting on the floor. It looks like a sticker of an eye that has fallen off of something and she is pointing to it and "talking" to her Daddy about it.

This was taken about two weeks before she was evaluated by early intervention, about four weeks before a private SLP and I began speech therapy, and about six weeks before she began receiving speech services through early intervention.

It was however, after I had accepted that there was a significant delay and that I needed to schedule evaluations. I began to consciously try to encourage more vocalizations and one method of doing that is to "echo" back what you hear from your child. You hear my husband doing that with Ava during this clip.


Speech Sample - Ava - 22 months old

Here's something from about one month after the last sample. At this point Ava had qualified for early intervention services, but hadn't begun receiving them yet. I was not yet doing structured speech therapy with her at home, but she had seen a private speech therapist for a few sessions.

Ava was laying on a blanket and I put my head beside her. She was quite offended that I was trying to share her blanket and was trying to persuade me to move off. She keeps pointing to a spot off of the blanket and telling me to move "there" while I keep pointing to a spot on the blanket and insisting that I stay. After quite a bit of back and forth I tell her I'll get off if she says "please" (we had taught her the sign for please and I'm actually asking her to use the sign). She uses the sign and I move.

During this interaction I am focusing on getting as many conversational turns in as possible without frustrating her. I've made the situation into a game where she is vocalizing over and over for me. In this one minute interaction I get 10 utterances and a sign. There -may- have even been one two-word utterance of "No, there!", but I can't swear that she really intended two words of if her Daddy and I were reading too much into that one.


Speech Sample - Ava - 23 months old

Again, this is about one month after the last sample. At this point Ava was about six weeks into receiving speech services. Ava and I were laying on the floor and she was making some observations about the striped shirt I was wearing.

This speech sample shows a great deal of change. At 22 months, Ava produced 10 utterances in a little under a minute. Those utterances included four different words. She used one consonant (/d/) and three vowels (/Ɛ/, /Λ/, /OƱ/). In the 23 month sample she produces 13 utterances total in just over a minute. Two of them are two-word utterances. Nine different words are used. She went from using one consonant to using seven. In the last sample she used three vowel sounds and in this one she uses six vowel sounds.


Speech Sample - Ava - 25 months old

This is about six weeks after the last sample. It is a bit of a therapy session I was doing with Ava. We were using a few of the Kaufman Cards. She had just turned 25 months old.

In the previous sample, Ava used the following consonants: /b, d, t, m, n, w, j/. All but one of those (mama) were used in one-syllable CV words.

In this sample Ava produces five different two-syllable words. Four of them were imitated correctly and one was imitated incorrectly, but still with a two-syllable non-reduplicated word. She uses /b, d t, p, m, n, h/ in this sample. She has added the /p/ and /h/ syllables in the six weeks since the last sample. She has also moved from productions that were primarily the CV syllable shape to productions that are non-reduplicated CVCV in syllable shape which is much more complex.


Speech Sample - Ava - 25 months old

This sample was taken three weeks after the last one. Ava is almost 26 months old. The most striking thing to notice here is how Ava moved to using multi-word utterances. In this sample she produces 10 utterances. 2 of those are one word (both two-syllable). 5 of those are three words (4 syllables per utterance). One utterance was four words long (5 syllables)! This is a huge increase in average sentence length in three weeks.


Speech Sample - Ava - 26 months old

This is the last monthly sample I have. It was taken about three weeks after the last one and Ava is 26 months old. At this point Ava was about four months into receiving speech services. Ava was asking me to get something down from a shelf.

In the last audio sample Ava produced 10 utterances in a little under half a minute. Those utterances included seven different words and ranged from 1 word (two syllable) utterances to 4 word (five syllable utterances). In this sample, Ava produces 13 utterances in a little under 30 seconds. These utterances include 12 different words and range from on word (one syllable) utterances to 5 word (5 syllable)utterances. The average number of words per utterance in the last sample was 2.2. In this sample it increased to 2.42. More importantly, there was significantly more diversity to the utterances in this sample.


Speech Sample - Ava - 30 months old

This is a short audio clip I pulled from a home video of Ava singing to me as we were swing on a deck swing. I was using the front facing camera on my phone and Ava was entranced at watching herself sing. First I got her version of the ABC song twice. Then I asked for the Itsy Bitsy Spider, then Row, Row, Row Your Boat, and finally Hush Little Baby. It was so adorable.

Here is a small audio clip from the concert. She decided to sing the Itsy Bitsy Spider as the Itsy Bitsy Butterfly instead, as she explains at the end.

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