iOS App: ICOON Global Picture Dictionary

ICOON App

ICOON App on iTunes ($0.99, sometimes Free)

What it is: Aimed at travelers ICOON provides a pictorial phrase book for the purpose of cross-language communication. It is simple to use and includes 12 categories that range from the basic/every-day (Hygiene, Health, Clothing, Food) to the travel-related (Measurements, World and Accommodation).

Screen Shot 1 shows a view of the categories, which is on the first screen of this app. Screen Shot 2 shows the view from inside a category ("Hygiene"), and Screen Shot 3 a specific item (toothbrush and toothpaste from the "Hygiene" category).

Screen Shot 1

How we can use it in Tx: When it comes to language goals,
pictures are always useful. Pictures divided into relevant categories are even more useful as one can make decisions about complexity level of vocabulary tasks based on context.

For word-finding goals, vocabulary that is relevant to the immediate environment of your client or is basic for their ADLs (e.g., food, hygiene, clothing) would be easiest. Emotions and Leisure a little more difficult, and Travel and World categories likely most
complex.

Language goals can be addressed in a variety of ways including confrontational naming, categorizing (top-down starting with the category and thinking of items then going over them, or bottom-up starting with items and determining categories). Pictures can replace word lists for motor speech and intelligibility practice. The picture lists easily lend themselves to various Q/A tasks, from simplest y/n to more open ended.

Screen Shot 2

The app could also be used to assess appropriateness of AAC using pictures. Does your client recognize the pictures? Are they able to read the category names? Their AAC needs are not likely to be fully met with this app (unless there is no symbolic dysfunction, and your client is only limited d/t voice issues) but you will be able to assess needs and abilities to determine what AAC app WOULD work if any.

Goals we can target in Tx with this app: Language goals
including word-finding, categorizing, question/answer and descriptions, speech goals that address dysarthria, apraxia and anything that affects intelligibility, and AAC (specifically to help assess needs and appropriateness).

Some specific examples:

Screen Shot 3

1. I recently had a client who has an existing Dx of severe expressive aphasia as well as a Dx for severe dementia. I have been working with her on pictures, and she is now able to generate around 30% (on a good day) of simple vocab from pictures. I show her a picture and ask what it is. I try to keep the pictures for each session from within the same category to help with context. If she is not able to generate the word, I give her a choice ("is this a toothbrush or a comb?"). She is able to reply with >90% accuracy. When we started she had <50% acc just repeating words. Her ability to express her needs has increased, and I have been able to educate staff re strategies to communicate with her (to ask her y/n questions as she demonstrates fairly high accuracy answering these).

2. S/P stroke client with expression limited to yes and no and conflicting reports of accuracy re same. These every day vocab pictures were useful in determining the severity of his symbolic dysfunction and helped determine that he is appropriate for an AAC device, and is able to navigate across categories to find his needs.

3. Used this app for a short task in a session with a high functioning language client presenting with mild word-finding issues at conversation level. This app was used to provide stim to jump-start conversations on a variety of topics.

Android app: JABtalk (AAC, free)

JABtalk for Android devices

This program is currently free from JABstone, and is available from Android Market, Amazon App Store, & the Nook Store

What it is:  Originally developed as an AAC device for kids. It is fully customizable, and you can create categories and words with images and sounds for each. If your device supports a microphone you can record the words and categories right on it (Amazon's Kindle doesn't, but BN's nook tablet does and the more expensive Android tablets do as well). If you're using a device without microphone you can import sound files into your library and use them within this program (it'll take longer to prep a communication board that way, but it's doable). When it comes to images, you can take a photo if your device has a camera (Kindle and Nook do not), you can import images on any of the devices, and you can do an image internet search directly from within this program on any of the devices. There's talk of adding sentence building to following releases too.

How we can use it in Tx: I had fun building a default communication board with basic needs for my target population (call button, wheelchair, glasses, dentures, pain scale, yes/no, etc.). I carry this in my Nook as part of my default materials to always have with me. You can also make a language/word-building/problem solving task out of creating a new board with a patient that does not need an AAC device, but can use the practice thinking of common and safety-related objects.

Goals we can target in Tx with this app: Word finding, problem solving, AAC

Some specific examples:

1. Put together a menu for the three daily meals and write a goal for pt to use the device to order their meals (an AAC goal)

2. Have pt locate words within nested categories (e.g., apple would be inside foods & drinks/snacks/fruit) with certain % accuracy (a problem-solving goal)

3. Have a pt (who may not need AAC device) come up with as many suggestions for what to put in a given category (e.g., clothes or snacks) as they can (a word-naming goal)