Word List Generator (a quick update)

In March I wrote a post titled "App Wishlist: Word list Generator". Until "there's an app for that", here is a web version: Word List Generator (part of the Free-Reading project, www.free-reading.net). This engine allows you to generate a word list by selecting various parameters. The ones relevant to us include word length (or number of syllables), CVC form, and initial sounds. I would have liked to also control medial context and specific phoneme parameters, but until there's something better, this can help.

I would use this to create word lists for word-level (obviously) tasks for voice practice, fluency, exercises for coordinating speech and breathing, and especially to practice intelligibility strategies.

iPhone app: MouthOff

MouthOff App

MouthOff app in iTunes (currently free)

What it is: Purely entertainment, and yet it has been the most used app on my work iPod lately. This app has 58 reactive cartoon mouths. You pick a mouth, hold your iPhone or iPod Touch in front of your mouth, and talk (laugh, scream, whatever). The mouth moves in reaction to the sounds you make... or in reaction to any noise in a room, so in a loud room the mouths will move a lot. But in a quieter room it will match movements to your sound and make it look like the cartoon mouth is doing your talking.

How we can use it in Tx: For the most part, I use it for motivation, and frankly, to de-crabbify even the most annoyed nurses or CNAs at my SNF. This can make every person laugh out loud with delight. Sometimes the tasks we do with our patients are tedious... especially when it comes to mostly OMEs or airway protection exercises... this can just make it fun. But, being that it reacts to sound--and the louder the sound the bigger the reaction--it CAN be used for Tx with voice patients to work on volume and duration mostly. As such, it can be used much like the bla | bla | bla sound-reactive app I discuss in a previous post (see the bla | bla | bla post from 3/11/11) which lately I've been using with an MS patient with some great results.

Goals we can target with this app: I'm sticking with motivation building as an important goal (if not one I actually write for a pt); also voice, dysarthria, phonation, intonation and prosody with, for example, MS or PD patients.

Some specific examples: I think you'll see that everyone gets a kick out of this. Lately I've been walking into pts' rooms with this app in front of my mouth and just giving them a giggle before we get started. But here's a couple more ideas.

1. Play with one of the cartoon mouths with the pt to determine its maximum reaction (open mouth or tongue out, or whatever else it may be for the particular cartoon). Then have the pt look at the screen and repeat words trying to get the maximum response to either each syllable or to the stressed syllable. Write a goal for % volume at word or syllable level.

2. A more amusing variation on the first suggestion: have the pt do the same but instead of looking at the screen watching the mouth, have them hold the device in front of their own mouth in front of a mirror.

3. I feel this app can come in handy for OMEs... but I haven't quite put my finger on how yet. It'll come to me later this week I'm sure.

iPhone/iPad app Dragon Dictation (Free)

Dragon Dictation Free App

Dragon Dictation for iPhone/iPad/iPod-touch from iTunes

What it is: A rather well known application that translates speech to text. You speak into it, and it gives you a text version of what you said. I've noticed that sometimes it recognizes raised intonation as questions, but normally, I just say "question mark" or "comma" if I want those included in the text. It is quite good and amazingly accurate if you speak clearly with relatively little background noise. It lets you easily bring up a keyboard if anything needs to be corrected, and even has drop down choices for some common homophones (like if it wrote "do" and you select it, it may automatically suggest "due" instead). The application also makes up a database of names in your address-book to help recognize these in your speech and spell them right. You can then export the speech you dictated into a text message, an email, some of the social networking programs, or lets you copy it for pasting (like into a note or whatever else you choose).

How we can use it in Tx: In some ways, this application is a measure of clarity and intelligibility. Granted, the clarity and intelligibility for this app needs to be superior to what would be required in normal conversation, but that's not a bad thing for treatment purposes. A patient that is working on intelligibility, volume, or slowing down their speech can practice with this app. Whether the patient is working on word-, phrase- or sentence- level, they can practice saying a list of words or phrases to see how many of the dictated words were clear enough for the application to transcribe. Makes it pretty easy to quantify progress as well. It is also quite delightful how good this app is at transcribing speech, which helps build motivation. This is a good companion to the Bla | Bla | Bla sound reactive app which helps work on volume and timing (see my write-up of the Bla | Bla | Bla app from March 11, 2012).

Goals we can target in Tx with this app: Intelligibility, pacing (especially slowing speech down at sentence or conversation level), volume, phoneme accuracy... and well, most dysarthria related goals. My PD patients have found it challenging but fun.

Some specific examples:

1. For word-level intelligibility or phoneme accuracy goals, start with a list of common words that target the phonemes in question, or a range of phonemes. I suggest dividing your list up by syllable length (so have a list of monosyllabic words, disyllabic, and longer). Have pt pronounce each word, and quantify success by how many trials got transcribed accurately. You can have each word said 5 times, and find % that were transcribed correctly, or just do the full list with each word once, and take % of correct words from the whole list. The transcription errors produced by the app should also help highlight the problem areas, especially for monosyllabic words (if a word is longer and one or two phonemes are off target, the app may still figure out what word it is, but shorter words rely on less context and more accurate production to transcribe). As such, you could use this app for evaluation purposes (an informal look at what sounds may be toughest for a patient, if so indicated).

2. For sentence-level pacing goals, have pt read a sentence or paragraph into the app and check on % of the sentence that was correctly transcribed into text. The feedback to the patient is very quick, and it may be helpful to see a visual of just how much of one's speech is misunderstood due to fast speaking. Putting pauses between words will up accuracy very quickly, and that would also be a good visual for the patient.

Well, you get the picture. Patient speaks into the app, the app returns with a text of what it was able to transcribe from the pt's speech. Accuracy is easily quantifiable, and suggestions can be made to improve the accuracy. Strategies are discussed, practiced, and pt tries again. Hopefully, accuracy goes up.

App Wishlist: Word List Generator

There are a few dedicated apps for speech therapy, most of which are too expensive for me to consider for their one dedicated use. I prefer random FREE apps that I can utilize to address a variety of goals. But there are a few dedicated apps I'd consider paying for. One such app would be a WORD LIST GENERATOR.

What it would be: I'd like to see an app that would let me input parameters (inclusion/exclusion of certain sounds or clusters of sounds, their location in the word such as word-initial, medial, intervocalic, final, and syllable numbers) and spit out a list of, preferably common, words. I'd like for this app to use the built in dictionary in iPhone/iPad so that I wouldn't be tied to a WiFi connection to use this app (I'm not sure if there is such a thing in Android devices, but if yes, then the same requirement).

What I would use it for: I would use it to address intelligibility and voice goals mostly, for PD patients and any other dysarthrias. If there were semantic parameters included, I could also generate words to use for language goals.

Is it possible there is already such a thing and I don't know about it? If so, let me know!

iPhone/iPad app Bla | Bla | Bla: A Sound Reactive App

Bla | Bla | Bla free app

Bla | Bla | Bla - Sound Reactive app Available in iTunes

What it is: 16 cute faces that react to sound, for example by opening their eyes and mouth wider, varying their reaction to correspond to the volume of the sound: The louder the sound, the greater the reaction from the faces. The length of the reaction also corresponds to the sound: The longer the sound, the longer the face is held in reaction mode. This app is free and it works on iPhone, iPad and iPod-touch. This is one of the apps that, for Tx,  works just as well on a small device (iPod or iPhone) and does not require the iPad to be useful. Oh and it's super fun to watch the faces change in response to sound!

How we can use it in Tx: While this is not a measure of clarity or intelligibility, it can be a useful visual feedback tool to show a patient how loud their speech, or part of their speech is, or how long they hold a vowel, or how much stress they put on one syllable as compared to another. I had a patient who would trail off on all but the first syllable except when using this app. And as I note above, it really is very amusing to watch the faces change: my pts enjoyed it a lot, and some liked getting to pick which face to use.

Goals we can target in Tx with this app: Intelligibility, dysarthria, stress/intonation, volume, voice, phonation, to name a few. I've used it with patients with Parkinson's, MS, and others with mild dysarthria.

Some specific examples (not an exhaustive list):

1. After going over intelligibility strategies of putting stress on each syllable and exaggerating each sound, a pt can practice a word list, starting with some automatic ones like days of the week, with the goal of getting maximum reaction from the app's faces for each syllable (not trailing off). Accuracy can be measured by how many of the words got equally strong reactions from the app's faces for each syllable.

2. For a pt with flat affect or disordered prosody, write a goal to practice phrases and mark the stressed elements with prolongation and increased volume, as measured by the reaction from this app. The list of phrases could include ones where the word emphasized is the only difference (minimal pairs with respect to prosody); e.g., "I want SOUP for lunch" vs. "I want soup for LUNCH" (the first meaning I want soup and not something else, the second one meaning I want it for lunch, not for dinner). The emphasis on the word in CAPS should be apparent from the Bla | Bla | Bla app's reaction to volume and duration. Accuracy can be measured by how many reps it took to get the reaction on the correct words.

3. For a pt with goals to increase vocal intensity, can write a goal to elicit maximum response from the app's faces to a list of words or phrases. It is easy to see what maximum response is for each included face by making a soft sound followed by a loud one and comparing the response. Then the pt can work towards getting the maximum response, which would entail speaking louder. Accuracy can be measured by what % of the pt's speech got maximum response from the app's face.

4. Pacing goals, for pts who need to work on slowing their speech, could also be addressed I think. I haven't had a chance to try this with a pt, but I imagine you could write a goal for the pt to space out the face's responses to syllables (since vowels are the loudest parts of speech, those are the ones the app's faces respond to). If speech is too quick, the face doesn't "rest" as much between reactions, so spacing these out can be a visual indicator of the speed of one's speech.

5. Another thing I haven't tried but feel could be appropriate is using this app with fluency/stuttering pts. Visual indicator of volume and speed can help pace and shape prosody. Affecting these characteristics of speech has been shown to increase fluency (using metronomes and delayed feedback all provide auditory feedback on pacing and affect prosody, but visual feedback, in the form of pointing to a word being read for example, has also been shown to be effective). Therefore using visual feedback such as this app to increase awareness of prosody and pacing to shape fluency is within supported reason, so to speak.