Android and iOS app: Constant Therapy

Constant Therapy App

Apps: iPad Constant Therapy app on iTunes (free)
Android Constant Therapy app on Google Play (free)
Website: constanttherapy.com

What it is: A Speech Therapy tool for Cognitive-Communicative rehab. The app includes a large variety of language and cognitive tasks that can be customized to complexity level of your clients. It is free for clinicians, researchers and students; clients have to buy a subscription.

Here is how it works: As a clinician you would have this app on your device (again, for you an account is free). When you have a client with cog-com goals, you would create an account for them on your device (this is all still free). You would choose appropriate tasks customized to your client's diagnosis and severity, functional needs and skills.

The variety of their tasks is extremely satisfying. For language they have tasks for auditory compr, naming, writing, reading and sentence planning; for cognition they have attention, visual processing, mental flexibility, memory, problem solving and executive skill tasks. This list does not do justice to the variety and creativity of these tasks. I'm not sure the exact number but I counted 34 language tasks and 31 cognition tasks. To get a better idea very quickly, I urge you to hop over to this page and just glance at these tasks (when you mouse-over any task, it shows you a screen shot): http://constanttherapy.com/constant-therapy-tasks.

In Tx: The program allows you to select which tasks to use with your client, and at the level of each task you can adjust the complexity. You then get a baseline for each task for the individual client, and the program continues to keep track of progress (as well as usage). There's too many activities that address a large variety of goals to go into detail here. What I can say is that the activities I've seen and tried are created almost exactly how I would have conceptualized them, and I found it was very intuitive how to explain the clinical justification for spending time on these to patients and their families. Also, CT's website discusses Evidence Based Practice (EBP) implementation.

Outside Tx: You can select the tasks you want as "homework" for your client. This is where their own subscription becomes beneficial: The clients that can continue to complete these tasks outside of the therapy session can purchase a subscription (http://constanttherapy.com/pricing). They should do it using the account you create for them in session, so that the homework you assign can show up in their account, and their progress with tasks in sessions and on their own can be tracked (from within the account of the clinician that originally created their login). This extends your therapy outside the session: you, the SLP, are making clinically-informed choices re which tasks are most appropriate and beneficial, and are able to modify your decision based on progress feedback. Very few tools allow this kind of flexibility for clinicians to address patient needs beyond the therapy session.

My experience: I've used it only with adults for both cognitive and language intervention. I found it extremely age-appropriate, interesting and motivating. My clients seemed to enjoy the tasks, and I can't say enough about the ability to track progress in such an individualized (per client, per goal, per task) manner. A few outpatients have purchased a subscription and they (and their spouses) report good motivation to work on tasks at home.

Bottom line: I can absolutely recommend this program/service to both clinicians and clients. For the clinician, you will find this to be one of your most used apps on your tablet. For the client, based on the prices in 2014-2015 the feedback I've received is that it is well worth it.

iPad app: Move & Match

Move & Match App

Move & Match app on iTunes (US $1.99)

What it is: Listed in the "Education" category, this app lets you create elements on a background and move them around freely. Elements can only be rectangular, but they can hold photos/pictures or words, they can be custom sized (as can the text within), they have a variety of background colors, and they can be cloned. If this description doesn't do much for your imagination, look at the screen images of examples I threw together really quickly (or look at the developers' examples of uses in iTunes via the link above).

Within the app you make a project file for each exercise that you create, and hence can build yourself a nice database of go-to tasks for a variety of goals. The developers also have a selection of pre-created projects that you can download off Dropbox directly into the app and use (this is accessible via the "i" information screen within the app).

Screen Image 1: Closed paragraph

How we can use it in Tx: This app allows easy creation of a host of closed-exercises that require either filling in the blank from provided choices (like in Screen Image 1), multiple choice answers, any kind of matching, or word/sentence building. For cogn goals you can create sequencing and sorting tasks. If you take the time you can build some useful visuospatial/executive function tasks such as completing a pattern or an analogy (you'd need to create some images externally--via an image editor and then get the pictures on your iPad first). I discuss some of these suggestions in the "specific examples" section below. But really, the possibilities are endless... just about anything you do with worksheets that involves multiple choice can be replicated and expanded on using this app!

Goals we can target in Tx with this app: Language and word finding goals through a variety of fill-in-blank, closed paragraph, matching, word/sentence building or multiple choice tasks. Higher level cogn goals like planning, sequencing and reasoning. Sequencing and sorting either words, numbers or images (e.g., photographs of various stages of some activity, just like photo sorting cards but all in one screen). You can make simple math problems with multiple choice answers (there's actually a few of these ready-made and freely available from the developers already). You can create a background monthly calendar with fill-in elements to work on orientation and recall.

Screen Image 2: Sequencing photos and/or text

Some specific examples:

1. Sequencing/sorting: As I mention above, you can take photos of various stages of an activity (e.g., doing laundry, heating up a pizza, making ice cubes, etc.). You can import pictures from your album which means you can use your camera or do image searches online, save them to album, and use them from album. Once you have enough steps to sequence you just let the client move them around into the correct order. You can also make text elements to sort or sequence (e.g., months, numbers, days of the week, or steps of an activity listed in text instead of as photos). See Screen Image 2 of a quick and dirty example where I use photos I took for another app I reviewed recently, but also added text that can be moved and reordered.

2. For language goals you can create just about any matching exercise you can come up with. Antonyms, synonyms, definitions, pictures of items and their names... etc.

Screen Image 3: Categorizing text and/or images

3. Categorizing task: create a few headings (e.g., furniture, food, countries, etc.) and a bunch of words or images that fit in each of these and have your client drag the words around to place them under the appropriate category name. See Screen Image 3 for a quick and dirty example I made for this task. The images I just downloaded after a very quick google search, and, you can see at the bottom of the screen the elements waiting to be sorted.

4. Scanning activity: create a whole bunch of elements (icons or words or letters or numbers or even just squares with colors) and direct your client to find (and, for example, move to a specific side of the screen) all the elements that fit some set of criteria (e.g., all the blue squares, or all the blue squares with "r").

Screen Image 4: Calendar

5. Orientation/recall: use an image of a calendar (in my example in Screen Image 4 I used a weekly view of the iPad Calendar that was blank) and add some elements that can be moved around (visitors, routines like therapy and meals, etc.). Work on today, or recall yesterday. I like the weekly view for this because it has all this room to hold the collection of elements while the client decides if to use them and where to put them in the daily list.

There's just too many things you can do with this app to list them all... Since these projects can be saved and shared, maybe if there's enough SLPs using this app we can have our own section on the developer's Dropbox down the road... or find some other way to share amongst ourselves. I know I plan to create a whole load of projects in this app, and although some may take great time and effort, I know I'll use them a lot.

iPad app: Kokako 123 Audio and Visual Training

Kokako 123 App

Kokako 123 Audio and Visual Training app on iTunes (free)

What it is: Described as a game to "help auditory/visual training". This app's description on iTunes specifies that it is not intended to replace therapy, but to go hand in hand with it by providing repetitive practice to enhance skills. It definitely is targeted at children, but manageably so.

The game only does one thing: it gives a series of cards with numbers one at a time (see screen image 1) and asks the user to repeat them by using the keypad to enter each number below its card. One of the best things about it is that the user can choose what order to put the numbers in (same order they were presented from left to right, or backwards from right to left, or random).

Screen Image 1

Settings for this game include choices for how many cards will be presented (from 1 to 8; the example in the screen shots has 4 cards), and for how to present the cards (visually by flipping them over, auditory presentation where you can choose one of two male voices, or both visual and auditory). There is also a setting for how much time to space in ms between cards as they are presented.

Screen Image 2

Once user puts in the sequence and presses "go" feedback re accuracy is presented. As you can see in screen image 2, feedback includes which cards were correct, how long the turn took, and a count of how many turns were correct (screen shot 2 says "0" because not all 4 numbers were correct).

The themes are rather childish (you can choose car, flower or star; I have it set to the least annoying star) and there's a happy or sad star that comes up at the end of each turn. Not overwhelming, but nevertheless, it's there.

How we can use it in Tx: Set the activity to fit your client's needs in terms of how many numbers to remember (start with 3, and increase complexity to 4, 5 or even 6 if you think it's appropriate for your client's level).

Depending on the goals decide if you want the target number list presented orally or visually, and how fast. Maybe you'd like to have the client repeat each number as it is presented? That's a good memory strategy, and if you decide to go that path you may want to put in a longer delay between cards. Then have the client either tell you the sequence to enter or, if they have the dexterity, have them enter the numbers using the keypad.

What's nice is that you can also use this as a memory/mental manipulation activity and ask for the sequence backwards (since you can enter the answer in any order you want). You could also ask for the number sequence to be repeated in ascending or descending order. If you have the capability, you can enter the numbers in their correct spots; otherwise you can just enter the numbers in ascending or descending order and not worry about the game telling you the answer is incorrect--since it will flip the cards over at the end you'll be able to check accuracy that all numbers were recalled.

Goals we can target in Tx with this app: You can customize the settings and activity to target memory, immediate recall, spaced recall, working memory, attention,  and visual & auditory processing to a lesser extent.

Some specific examples:

The memory and attention activities are limited to numbers which is rather rote, so you don't want to spend too much time doing only this activity, but it can be useful for a short task or two.

1. As I mention above, if you want to work on memory and mental manipulation you can ask for the sequence of numbers to be given backwards or in ascending or descending order. If you ask for the numbers in reverse order, you can just enter them in reverse order and let the app tell you how accurate you were. If you do ascending or descending, you can just ignore the app's feedback on accuracy (since the game expects the numbers to be entered in their correct spots, not just be the correct ones) and judge for yourself when the cards are turned over whether all the numbers presented are accounted for. Should be just as effective and simple enough (except for the frowny star that will show up).

2. For spaced retrieval: you would think that you'd be able to use the running timer on the screen during the turn to space out input from output, but in fact this timer doesn't run during the turn--it merely returns the total time it took once the turn is over (and "go" is pressed). So you'll need your own watch/timer to space out this task. But otherwise, it's doable (although frankly, I'm not a fan of doing context-free numbers in this sort of activity).

3. If you are not working on mental manipulation that involves returning the numbers in a specific sequence, you can--like advised in #1 above--just ignore the accuracy of the order of the replies, and focus only on whether the client remembered all the items on the list. Again, you would not use the game's accuracy feedback for this and just keep track of it separately.

4. Brain-training: for the regular (not rehab-patient) population, this game can provide great training for memory and focus. Since you can set the game to provide you with a sequence of up to 8 numbers, with very little delay between them, visual or read, you can really set the task up to challenge anyone's function. You can also make yourself give the numbers back in ascending or descending sequence while getting them in their correct slots. And you can motivate yourself to return the answer faster each time as well.

iPad app: ScrapPad - Scrapbook for iPad (for sequencing)

ScrapPad App

ScrapPad - Scrapbook for iPad on iTunes (free!)

What it is: A sophisticated easy to use, and fun, scrapbooking application. It provides a variety of backgrounds, borders, embellishments and stickers (organized by themes like holidays, seasons, etc.). You can import images from your album (or take new ones from within the app with your camera), resize, move and rotate them however you want (except cropping--I didn't see that capability in the app; but there's native cropping in iOS already).

The app responds very smoothly to repositioning, rotating and resizing elements. You can work on the canvass with the tools at your ready or in full screen mode taking advantage of more space.

When you've made your creation you can email it, save (I'm assuming each page separately) to your album, share on FB, or send it to the app publishers to print (for a fee of course). They do not include the option to save your creation as PDF or some other format that can be read in iBooks, which is too bad for the scrapbooker, but not a big deal for our uses.

Screen Image 1

How we can use it in Tx: One obvious use for this app is to create family albums, logs, memory books and the like (much like what I wrote about in my review of My Story from 3/3/2012). I won't elaborate on that idea as it's fairly intuitive. My more interesting idea for this app though, is to use it for sequencing.

There's a few apps out there that are dedicated to sequencing tasks, where a user is presented with 3-6 step common tasks, with an image for each step, and asked to put the steps in sequence. I haven't seen any free apps for this, but here's a review from "Speaking of Apps" of a $4.99 app dedicated to sequencing called Making Sequences. It sounds great and the price tag is not too bad for a Tx-dedicated app. But it only comes with 15 sequences.

So here's what I did. I created my own sequence photos. For this review I very quickly made 2 sets of 3-step tasks (one making the bed, another folding laundry). I could have just as easily downloaded clipart. I put both of my tasks together to simulate what the screen would look like with a 6-step task (but if I was using each of these I'd have only the 3 steps of each task on the screen at a time).

I added all 6 photos to my scrapPad canvass, resized them for best fit and rotated them for proper aspect. I switched to full screen mode and basically created a space where the photos can smoothly be moved around as needed (see Screen Image 1). And there you have it: a sequence task. The reason it works so well is that (1) you can use the full screen so there's no dedicated sequencing app out there that can beat the real estate available for the task; and (2) the dragging/placing of the elements (the single photos) is so very smooth. They don't "snap to", but neither do photo cards you would use for this task if you didn't have an electronic version. There's also no music, no grading, no animation. It's just an improvement on the low-tech version in the sense that it's a lot easier to quickly make new sequences, and if you want, you can make them with images from the client's immediate environment.

Screen Image 2

One can make a page for each task, and create a "scrapbook" with as many sequencing tasks as they bother making with no limits. You can size the images to your liking (I wanted to make them as large as possible while still having enough room to move them around). You can also add titles to each page (if you want to add context; I like to ask my pts what the task is before they start sequencing, but some need the context to perform the task).

Just to show the full potential of this app (so well beyond what I'd use it for) here's a scrapbooked (albeit hideously... I'm not much for scrapbooking) version of my 6 pictures on the canvass with the tools open, and the "export" window open so you can see the options it comes with (Screen Image 2).

Goals we can target in Tx with this app: Memory/STM and orientation goals (which I didn't discuss much but they are fairly obvious), focus and direction following, spatial reasoning if you want to do some actual scrap-booking tasks, and the one I suggest it for: sequencing and sorting.

Some specific examples:

1) For sequencing--the main use of this app I recommend--snap some photos of common daily activities, even specific activities of your client if you feel it's appropriate, import them into the app and size them so all steps of the sequenced task can fit, then move to full screen and let the client order the steps. Just as I describe above. There's really no end to the possibilities.

2) For sorting, download or snap photos of elements you can sort (items or animals that vary in size or number, people that vary in age, foods that vary in size or calories, whatever you can think of... just keep it clear) and create a task just like the sequencing one. Save these and over time you'll have a ton of fun sequencing and sorting activities in one place.

3) A fun STM task that allows for use of memory strategies is to create a page for a specific event or season (e.g., for Easter or a birthday). Create it with the pt, discussing the various elements you're putting in there and color decisions, etc.; make all decisions explicit and together. Then find some filler task you can do for 5-10min (whatever you think is appropriate) and return to this task: ask for recall of the creation you made together, and carefully use cues as needed to get as much recall as possible (cues can range from visual to discussing some of the decisions you made together, etc.).

iPad App: A Memory Game

A Memory Game App

A Memory Game on iTunes (free)

What it is: Basic memory/concentration game where you start with 20 "face down" cards, and picking 2 at a time try to match pairs. When pairs are found, they are removed from the board. It is one of the few memory/concentration game apps I've found that is not targeted at children with cute pictures of animals and such. The images are crisp and clear and definitely favor adults. There's no distractions such as unnecessary animation. Very basic, very clean, and I can't believe it's free!

Screen image 1: playing with flags

You can play the game using flags or symbols. The first is flags of countries where the card shows both the flag and the name of the country (see screen image 1). Symbols are black and white simple images such as pencil, flower, airplane, etc. (see screen image 2); they are all very clear and easy to tell apart, but there is no text or color.

As you play the game keeps track of your tries and how many pairs have been cleared. At the end of a game you're presented with a message that tells you how many moves it took you to clear the board.

How we can use it in Tx: Obviously the way to use it is let your client play this game. I would consider the flags option as the more basic, easier, level. Flag images come with context: the name of the country is provided which gives a player something to hold on to in memory. There's also colors that help visually distinguish each card. The symbols option is definitely more complex as there is no text, and there are no colors. A player would have to name the image and hold on to just that word and location to continue matching.

Screen image 2: playing with symbols

The flag option provides you with plenty of opportunity not only for various cuing levels, but also to practice various memory strategies. As a card is opened the flag and country that is presented can be discussed. What do you know about that country? What continent is it in? Are you familiar with that region? Have you ever been there or wanted to go there? Did you recognize the flag? Do you like the colors of the particular flag? And references can be made to the location of the card itself (e.g., this country is a southern country, and hey, it's at the top of our board... it should have been at the bottom). OK, I'm reaching here, but my point is that this simple set of images presents us with lots of opportunities to model and practice memory strategies.

Goals we can target with this app: Memory (STM and to an extent working memory) obviously; certainly some scanning/visual field neglect. Focus/attention and following directions, as well as categorizing to an extent as part of flag/country discussion.

Some specific examples: I don't know that specific examples are needed in this case: just play the game using flags option, and decide on the level of cuing you want to provide. If you are targeting specific memory strategies (like repeating or visualizing) you can write goals for implementing those strategies while playing this game. And you can use the stats provided at the end if you want to help you measure accuracy and progress.

Brain-training: For the regular (not rehab-patient) population, this game can provide great training for memory. If you want it more challenging, certainly use the symbols option over the flag one. On the other hand, with just 20 cards, this will never get TOO challenging, just fun.

iPad App: Cursive Writing HD

Cursive Writing HD app

Cursive Writing HD app on iTunes ($0.99, periodically free for a limited time)

What it is: Practice cursive writing by tracing at the level of letters (capitals or lower case), words, or sentences (where you can type your own sentence and have it presented in traceable format). There's a few settings that can be adjusted like color and thickness, but in general it's a one-trick pony: have written material presented so you can practice tracing it.

How we can use it in Tx: Decide on the complexity level you need (letter, word, sentence) and have your client practice tracing, preferably using a stylus rather than their finger. There's not a ton of different uses for this, and not a ton of pts that would need it. But right now I actually do have a pt that wants to work on her handwriting because it's harder for her to write than it used to be before her stroke. She has no problems reading, and she likes to write only in cursive. She has a hard time holding a writing utensil and pressing down enough to make clear markings on a page. Using a stylus to trace the letters on an iPad circumvents the problems with strength and gravity (where she is holding her paper up and trying to write with the pen's tip pointing up). She was used her nice handwriting and really wants to have it back. She has also forgotten how to write a few of the cursive letters (particularly capitals of some cursive letters, like Q and G). This app was just made for her.

Goals we can target with this app: Like I said, one-trick pony... so mostly writing, and as far as language goes, symbolic dysfunction to a point (if it's beyond very mild dysfunction, cursive is probably not the writing you'd work on). I think tasks can be implemented for field-neglect goals and, obviously, reading.

Some specific examples:

1. Writing: Choose the level you need to work on (letters, words, sentences) and, well, do.

2. For reading goals, if they are for very mild dysfunction with high-functioning pts, you can use this app to generate cursive sentences for pts to practice reading. Anything more severe than mild should probably not be addressed in cursive form.

3. For visual field neglect goals practicing tracing letters, words or sentences (especially sentences) may help work on both strong and neglected sides; you can assess how much cuing is needed to address the weaker side.

iPad/iPhone App: Christmas Delights

Christmas Delights App

Christmas Delights app on iTunes ($0.99, sometimes free)

What it is: An app that lets you decorate a tree, with a few choices of trees and backgrounds (additional options as part of in-app purchases, but not really necessary for our needs). The ornaments that come with this app are sufficient in variety of colors and types. The lights have a dynamic display (they light up and dim) so the effect is rewarding. The resulting decorated tree can be saved and printed or emailed (or shared on social media, as with everything else in this world these days). Here is the emailed card of the tree I decorated with the app:

How we can use it in Tx: I would turn off the sound (there's a variety of holiday themed music as background; unless you want to provide competing stimuli to work on focus, I'd keep it quiet). Then you can either let the client free-form decorate a tree and put presents under it, or you can request the client follow a particular color scheme or other directions.

Goals we can target with this app: I think this would be a great task for visual field neglect needs, especially motivating at this time of year although I imagine this would still be fun any time. You can work on direction-following (written or oral) and memory if you give one or two step directions verbally. Attention and focus, with competing stimuli if you want to keep the music on. Sequencing and sorting can be implemented (see examples below). Temporal orientation if you talk about the holidays in general.

Some specific examples:

1. For visual field neglect goals simply let the pt decorate the tree and cue as needed to avoid neglecting the weaker side.

2. For direction-following goals provide written directions at the complexity level your goal targets, and assess ability to follow them. For example, specify what type and/or color of decorations should go at the top of the tree, what in the middle, what at the bottom. Maybe specify how many rows and how many decorations per row at various heights of the tree. How many gifts and what color wrapping... etc.

3. For memory goals give directions in 1 or 2 steps at a time verbally; have the pt repeat the directions (e.g., "put a yellow ball on the tree, then a red one" or "put 2 blue bows at the top of the tree") then follow them from memory. You can control the difficulty level of the task by how many details are included in the directions.

4. For sequencing goals you can give directions that involve sequencing, for example asking a pt to put one ornament at the top, then 2, then 3 with each row towards the bottom having one more decoration than the previous row.

5. For sorting you can include requests that involve sorting ornaments by color or shape or type.

Just have fun with it. Anything is better than crossing out specific letters or numbers on a page... right?

iPad/iPhone App: Micromedex Drug Information (Free)

Micromedex Drug Info App

Micromedex Drug Information on iTunes (free)

A database of medications (generic and trade names) that includes information on 4500+ search terms. Once downloaded to your device, you can access the information offline (don't need an internet connection/wifi).

This is a great resource for information we could use, such as precautions, contraindications, common and serious adverse effects, drug interactions and loads more. It's hard to believe this app is free!

I've been using this app as a basic quick check of medications' effect on swallowing function. For example, a dysphagia pt of mine was recently put on an antidepressant that has xerostomia listed as one of its side-effects. I had noticed a slight increase in stasis, and now I have at least one explanation for why, along with a good idea of how to treat it. It's not making me an expert on medications by any means, but this information came in useful for my clinical decision making. Over time, I'm sure I'll just have a basic idea of which class of meds is relevant to my scope of practice... but for now, I can look stuff up quickly and easily on my iPhone.

iPad/iPhone App: NumberOne Brain

NumberOne Brain app

NumberOne Brain app on iTunes (free)

What it is: A matching game where you are asked to locate a target number on a board tiled with several numbers (5-10 of them, see screen image #1). Very simple, but it gets more and more complex as you play: you have to learn to ignore competing stim to find the number you need.

Screen Image #1

As you can see from the screen image at a maximally simple point in the game (the start), the tiles are spaced so there's only one per column. Visual complexity is increased by adding more tiles to choose from, and/or lining them up to have more than one per column. Also, proximity of visually similar number tiles (to the target number) can add complexity, as can the extent of similarity between the tiles (so instead of maximally different from the target number as in the screen image, you may get 101, 110, 1, 211 and 11). The colors of the tiles may also work to draw your attention away from the correct answer, and at a more difficult level an incorrect tile may compete for your attention by shaking a bit. Possibly there's something in the sound as well, but I never play games like this with sound on. Either way, this is a great way to exercise your focus and quite fun as well.

Screen Image #2

How we can use it in Tx: There are several difficulty options available for this game, and as usual I recommend the simplest: "easy". All game play gets more complicated the better you do during the round though. Also, as usual I recommend playing this without the sound unless you have a pt with very high fxn that could use the extra competing stim.

One thing to keep in mind about this game is that, although a fairly simple concept and pretty fun to play, it is timed and graded, although as of March 2013 the grading can be turned off per new update. A round lasts a certain length, and you lose seconds when making mistakes, and I think gain some if have a good run. Here's an example of the summary that shows up at the end of a round if grading is not turned off (screen image #2). Some of the data is worth having, and may even be useful to us for keeping track of progress. However, the school-like grading of "brain level" is not for use in therapy (the original version of this app I reviewed did not allow grading to be switched off, and that's where the screen image is from). The new version does allow you to avoid this grading, which is a huge bonus for our uses! A great thank you to the developers for this, and their update re the matter on this post!

Goals we can target with this app: Attention, focus, following directions, scanning and visual field neglect goals, and of course memory goals (I suggest a way to focus on memory below). A pt with severe symbolic dysfunction may benefit from number matching as well, but they may need too much time for each match to get any real use out of this game. Worth a try.

Some specific examples: There's not really a lot of things you can vary in playing this game. You can vary the level of cues provided to help pt find matching tiles, and you can focus on specific results and/or progress. So for example:

1. If you're working on scanning and field neglect then accuracy becomes an important goal, and you should consider the number of mistakes per round. However, you should also pay attention to how many of those mistakes were due to competing stim from the dominant side.

2. If you're working on focus/attention, pay closer attention to what kind of competing stim interfered most (was it color, was it motion, was it placement, etc.).

3. Here's an idea for how to work on memory goals: Every time a new target number appears, after the pt has looked at it, pause the game (the screen will turn black, covering up the playing board). Check for immediate recall of the target number. If appropriate, distract the pt with something and then check for delayed recall. Then go back to the board, let the pt find the match, and do the same for the next target number (or skip one or two numbers, then pause for the following one to check recall). If you want to up the difficulty, upon pause ask to recall the current target number and the previous one.

4. Brain-training: for the regular (not rehab-patient) population, this game can provide great training for attention and focus, reflexes, scanning, and to some extent memory. For this population the graded summary may be a great motivator to do better each time you play.

iPhone/iPad app: Speed Match

Speed Match App

Speed Match on iTunes ($0.99, sometimes free)

What it is: a game where you are presented with two columns of 5 icons, and you have to remove them by matching icons from each column. Sometimes there's a few icons that are the same in both columns, sometimes only one (as in the screen shot here). Once you've matched and removed all the icons you win the round.

While playing, you can swipe a tile off the board from either column as needed, and these tiles are replaced by different ones. There is no "punishment" for doing this except for wasting time if you do it too often. There are no untimed rounds, sadly. There are several levels: you get the same total time to complete the rounds (4 minutes) and with each level you have a larger number of tiles to clear. The easiest is 25 tiles, then 50, 100, 125 and 150.

Screen Shot

As I mentioned already, all levels are timed. Additional challenges include that you can only mismatch 3 times (see 1 of the 3 spaces under the time left in the screen shot is lit up); once you mismatch 3 times the round ends. Waiting too long between matches will also cost a "mismatch" light. There are also several selections of tile styles, but I think the ones in the screen shot (the default ones) are probably easiest.

One other thing: this game is optimized for the iPhone/iPod screen sizes, but works really well in x2 mode on the iPad. I recommend only using the larger iPad screen in Tx.

How we can use it in Tx: I have written the developers and asked if they'd consider adding an untimed mode that could be used for practice or younger players in general, and our target population in particular. But until such a mode is added, I envision using the easiest level (matching 25 tiles) and setting realistic goals of how many tiles to remove before the clock runs out rather than expecting a pt to clear the board completely. You can vary the level of support provided to reach the goal. You can also make it maximally simple by finding a match yourself, and then touching the pair-able tile on one side, and asking the pt to find that tile on the other side. But remember, to play this you can't select tiles, you have to be actively/continuously touching both at the same time (however, you can be touching one side and take time before touching the other side; the tile will be removed once both sides are touched).

Goals we can target with this app: attention and focus, following directions, problem solving, scanning and visual field neglect, and of course memory.

Some specific examples:

1. For memory goals, the therapist can find a pair-able tile, bring it to the pt's attention and ask for the pair, then cover the tile up (thereby "selecting" the tile by touching it, so when the paired tile is touched it is removed) for the pt to find the matching tile from memory. Set a goal for how many tiles you want matched before the round ends (either due to time running out or 3 errors).

2. For visual field neglect just playing this game and having to simultaneously touch tiles from both sides is a great activity. A variation could be having the ST find the pairs and, like in #1 above, pointing out a tile on the pt's stronger visual side (but not covering it up like in #1, just pointing at it) and having the pt find the corresponding tile on the neglected side.

3. To target problem solving make a goal that involves removing unmatchable tiles while looking for matches. For example, tell the pt to remove 2 tiles they consider in their way every time they are stuck looking for a match. On the go reasoning is required to make these decisions (play the game for a bit and you'll see yourself).

4. To target direction following the ST, again, can be the one locating the matches, and communicating which tiles to touch to the pt. This information can be communicated by describing the tile (shape, color) or their location in the column (at the very top, halfway down, etc.) or both. This will take quite a bit of time so don't expect to clear too many tiles before time runs out. Maybe if an untimed mode is added.... :-)

4. Brain-training: for the regular (not rehab-patient) population, this game can provide great stimulation for attention/focus, memory, reflexes, scanning, decision-making and prioritizing. It's kind of addicting, but for short bursts of game playing (not one of those games you'll find yourself wasting your whole day on).

iPad/iPhone App: NxtApp

NxtApp App

NxtApp on iTunes ($0.99, free sometimes)

What it is: A mental math puzzle where you have to find the next number in a sequence using basic math. For example, you may get the following screen: 5, 8, 11, 14, ___ and you have to solve for the missing number. Using simple math (in this case addition) and logic you deduce that the missing number is 17 (each number is the sum of the previous number + 3). The missing number in the sequence is not always the final one, it can be any of the numbers.

In each round you get 10 sequences to solve, although instead of just counting how many you solved correctly (which would have been much better) the round stops with the first error. But it lets you restart the round immediately so it's not a huge problem... it just means that if you want an accuracy % you'll need to keep track manually. There is a timer that runs while the sequence is being solved, but thankfully there does not appear to be a limit to how long one takes.
 
There are several categories of level difficulty: The first listed is "beginner" but it's actually a link to a different app from the same seller, intended for kids. The next level is called category 1, and it includes additions (+) and subtractions (-), category 2 multiplications (x) and divisions (÷), category 3 can have x, + or -, category 4 has powers, +, and -, category 5 has powers and x, category 6 is more powers and 7 is mystery. So as you can tell, the task gets more complex with each category.

How we can use it in Tx: When it's a game like this, simply have your pt play the game and adjust your cuing as needed. For most pts the most appropriate category would probably be 1 (limited to + and - math operations). For most pts when the operation that makes the sequence is adding or subtracting more than single digits (for example a sequence such as 2, 13, 24, 35 where each number is the previous + 11) they may need a pen and paper to calculate. And pts with reasoning goals may need additional cuing to determine what to calculate (to subtract the preceding number from the one that follows it).

Goals we can target with this app: Problem-solving, reasoning and specifically math goals, obviously sequencing goals, direction following and focus (focusing on a math problem in competing noise is quite the task), and of course memory--especially working memory--if the pt can do at least some of the task in their head (thereby having to retain the numbers and operations in memory).

Some specific examples:

1. For memory goals, play this game with the therapist looking at the screen and the pt having to solve the sequence either mentally or (more likely since some of the operations are a little harder) by writing the sequences down but from memory. That is, open a new sequence problem and read it to the pt all at once ("5, 8, 11, blank, 17"). The pt then has to remember all 5 numbers and repeat them before writing them down. If the pt couldn't repeat the sequence correctly immediately after it's read out, the therapist can read it again, and the pt can repeat it again. Repeat as needed until the correct sequence is repeated back, and then have the pt write it down. You can vary this task and make it easier by only reading out 3 or 4 numbers at a time. This way you are working on retaining lists of numbers (and subsequently writing them down) as part of a larger task making the list-repeating feel a little less rote.

2. For reasoning, sequencing and math goals simply play the game and choose the level of cuing your pt needs. The math required to solve each puzzle is fairly basic, but the logic and reasoning skills to figure out how to solve it may be rather difficult for many of our pts. Whichever of these goals is yours, pay attention to the cuing needed for that specific skill (i.e., your pt may need max cues to figure out which numbers to subtract or add to figure out the answer, and what to do with the answer when it's figured out, but may be able to independently carry out the actual math operation once it's determined).

3. Brain-training: for the regular (not rehab-patient) population, this is a great math and logic puzzle to train your mental math abilities. Try to beat the clock and do it quickly or aim for accuracy over speed.

iPad app: CountBattle

CountBattle App

CountBattle app on iTunes ($0.99, sometimes free)

What it is: A very simple sequencing game: you get circles numbered consecutively from 1 to 15, and you simply have to tap them in order, the main objective being to do it the fastest you can. There's 3 levels (easy, normal and hard). The easy level spreads the numbered circles throughout the screen and doesn't move them. Normal and hard levels involve random repositioning of the circles as you play. If you tap outside a circle or in the wrong order, you get moved back one number (so if you were on "7" and tapped "13" by mistake, you're now on "6").

You can play on your own, or two people can simultaneously play in split screen. See screenshots on right. The first screenshot shows the game with one player; the numbers that have been selected in order are dimmed, and the ones still to be tapped are brighter. The screenshot below it shows the game in split screen, where two sequences of 1-15 numbers are presented, one in reddish tones, one in bluish.

How we can use it in Tx: I envision it as a useful activity for any number of executive function, field neglect and aphasia related goals. For most patients you'd probably use the easy level (where numbers stay put) and full screen ("one player"). For more advanced patients you could use the normal level where numbers reposition randomly. Since there's no time limit on this task (you try to get the best time possible, but there's no limit in how long one takes) the more difficult level--while definitely a complex task--is still usable. You can also up the complexity of the task by asking the pt to play in split screen ("2 players") in easy mode (numbers don't move around).

Goals we can target with this app: scanning, sequencing, number recognition, field neglect, direction following, focus, and divided attention.

Some specific examples:

1. For a divided attention goal select 2 players for a split-screen task, and set it on easy level. The numbers for each side of the screen point towards the edge they are near (see the screenshot on the right: the two sets of numbers are right-side-up for the side of the screen they are on). Decide how you want to play the game (either set the iPad in a way that all the numbers are on their sides, but none are upside down, or let one of the colors be upside down and count that as another level of complexity for this task). Ask the pt to proceed on both sets at the same pace (so tap "1" on blues, then "1" on reds; then "2" on blues, then "2" on reds, etc.). A more complex version would be to do a few at a time (in 3's for example, doing 1-3 on blues, same on reds, then 4-6 on each, etc.). There's many variations.

2. For a simple scanning (or sequencing, or number recognition) task ask the pt to play the game in simplest mode (easy level, 1 player) and then try to beat their own time on a 2nd or 3rd attempt.

3. Brain-training: for the regular (not rehab-patient) population, playing any of these levels, trying to get the best time, is good scanning and memory practice. The non-disordered player is likely to scan the screen quickly and mental-note where the numbers are so as to play faster. I find it fun and challenging myself.

iPad/iPhone app: Writers App

Writers App

"Writers App" app in iTunes (usually $0.99, sometimes free)

What it is: An application to help authors plan a story/novel. A place to enter notes about characters, places, the plot, individual chapters, etc., and to keep it in an organized database. It is very intuitive to use, and does not require each field to have content.

You start out by adding a story (you can work on several at once, each with its own entry). For each story you then add relevant details: a title, information about the story (synopsis, premise, plot), chapters, characters, places, and there's room for further notes. You can add as many characters (or chapters, or places) as you want. For each character there are fields for name, general info (role, occupation), attributes such as strengths and weaknesses, habits, biography, hobbies, personality, and physical characteristics (hair, age, eyes, etc.), and of course further notes. Each entry for "Places" also expands to the name of place, about it, environment, description, characteristics and further notes.

So as you can see, it's structured but has a lot of fields and room for freestyle notes. There's no customization for the fields (I'm sure future updates will include this; it is always something users request once they start using an app like this). There's also no way to include pictures, and I'm not sure there ever will be, but if needed that can be added via export: Currently there's only one way to export, which is to email yourself the list: whatever level you export from, will include the info on that level and below it. So if you export from one character's view, you will only get the info for that character; if you export from the main story level, you will get everything you have entered for the entire story (all the characters, places, etc.). The emailed text can be copied and pasted into a simple document, and if needed pictures can be added. Format nicely and print.

How we can use it in Tx: This is a great tool to keep track of characters and plot twists for an author in the planning stages of their great novel... And for us, it's a great tool to help pts slowly put together their own life story. While there are a few fields in this application that won't play a role (and may confuse a pt if they are doing this independently) I think this is a great tool to use *with* the SLP to work on reminiscing, map out one's family members, one's life story, and even better--all of these. Since the information is so well fragmented into characters, places, story... we can concentrate on one section at a time (for several sessions, as needed). And the best part is that the resulting information from these sessions can be printed for the patient to keep.

This may not be the perfect app for doing this, but it's a nice start. And it lets you keep a list of what the pt has already contributed, go over it in future sessions, and proceed from there. And of course this can also be achieved with just a pad and paper, or any number of note-taking apps (some that also allow pictures and sound attachments). But I like the organization of this one that makes this open-ended task into a structured exercise, easier to follow through with and to pick up where you left off in future sessions.

Goals we can target with this app: Memory goals mostly, and since it uses a pt's personal information about their life and family, one hopes there's increased motivation to participate in the task. Sequencing and categorization, attention and question/answer goals are addressed almost inherently as part of the task, and there could be added focus on these goals as needed. For example, a pt could be asked to recall something from grade school, something from high school, something from college (if they attended) or military service (or whatever else they did after HS) and work on sequencing these stories into chapters (which came first in life, which later). Orientation is also addressed as part of discussing previous events, younger age, different locations (that was then, this is now).

Some specific examples:

1. Reminiscing: for a pt that isn't able to remember a lot about their own life, you can create a chapter for certain decades (20's, 30's, 40's, 50's, 60's...) and think of famous characters from each era (Marilyn Monroe, Shirley Temple, Churchill, Charlie Chaplin, etc.). and famous events... If you don't remember much from your grade school history classes you can do some minimal research online and find enough famous events and people for each decade within minutes, surely. Or you can do the research together with your pt, and let them participate and recall some of these milestones. I had a pt who had a really hard time remembering anything about his own life, with LTM and STM goals. I brought in a reminiscing task with pictures of famous events or people from various decades, and we went through them. My pt said he won't remember any of it when we started, but as we went through my list he did in fact recall quite a few of the events and people, and had a few bits of information to contribute about them, some even from personal experiences. It was a very successful session that left both of us smiling.

2. External memory cues: work on a pt's family tree using this app by adding each family member as their own character. Go over each character on multiple occasions trying to get pt to recall additional attributes; maybe add descriptions based on photos in the pt's room... You can get additional info from visiting family members if possible. Just have fun with it. And this is certainly something you will want to export, format, and print for the pt when you are done.

3. Write a pt's life story, especially if it's a pt who has lived in several places. Write a chapter for each time in their life (as I mention above, one for grade school, one for high school, etc.) and again, let them fill in bits and pieces over several sessions (give the specifics recalled previously and ask for more detailed info, e.g. "so last time we talked about your time in the army and you mentioned you were stationed in Italy. How long were you there?").

iPad/iPhone app: Hemispheres

Hemispheres App

Hemispheres app in iTunes (regularly $0.99, sometimes free)

What it is: Solve simple math problems while mixing two colors together. On their own, each of these tasks is simple, but carrying them out at the same time is quite a bit less simple, as your brain must switch between the two problems, simultaneously engaging the logical/math and creative hemispheres. Talk about split attention task! This task is timed, which ups the difficulty level.

How we can use it in Tx: There is no easy or relaxed level, so expect pts to only be able to get through the first couple of problems (the game ends with the third error on either side; running out of time counts as an error as well). But even a couple of rounds of this game can be useful, and it's definitely something to use with higher functioning pts.

Goals we can target with this app: Attention, focus, math, and to a certain extent visual field neglect since the problems presented by the app are side-by-side, so attention to each side is needed. It is definitely a worthy brain-training tool as well.

Some specific examples: Since this app only has one level and the tasks are timed, there is not really a way to make the task simpler. Therefore, I would be weary of giving it to pts working on the very simple or basic skills. I would target pts with more advanced goals.

1. The most obvious use is for a split-attention task for higher functioning individuals with mild executive function deficits. Set as goal trying to get through as many of the problems as possible (i.e., get the highest possible score).

2. For field neglect goals, instruct the pt to focus on the weaker side's problem (e.g., for left neglect have them only solve the left-sided problem, ignoring the one on right). This will make for a short round, as concentrating only on one side will ensure the other side will run out of time and add to the count of errors, ending the round after 3. But solving 3 problems on the weak side with competing stimulus from the strong side is actually not a bad task, especially since the game can be restarted as many times as wanted (so you can ask to solve the 3 problems at a time, x5 for the entire activity).

3. Brain-training: for the regular (not rehab-patient) population, switching between the hemisphere-heavy tasks makes for a great exercise of multitasking, prioritizing, attention and focus skills.

iPad/iPhone app: Numbers Addict Free

Numbers Addict App

Numbers Addict Free app in iTunes

What it is: A simple matching and adding game that could not be more fun (or addicting for that matter). It's reminiscent of Tetris, where balls with numbers (each number has its own color so it's easier to recognize) are stacked along a grid of 5 columns, 8 rows. You can see the next 3 balls that need to be stacked (see screen shot below).

There are 3 difficulty levels, and the "easy" one has no time limit: the balls don't drop until you place them, but a new row of balls appears at the bottom every few rounds. You have to match by number to pop them (remove them from the grid), and you need that number of balls to pop them. So you need two 2's, three 3's, four 4's, etc. to clear them. The first levels start with 1-5, and after a few completed levels you get the 6, then the 7, up to 9. You can also move two balls together to create a ball of the sum: if you move the "2" to the "1", it becomes a light blue "3" ball. The sum has to be within the limit of the highest number on that level (so on a level where you only have 1-5, you cannot make a 6 or above). You're scored by total number popped, so six 6's will give you a higher score than two 2's. There's also a paid ad-free version of this game.

Screen Shot Level 1

How we can use it in Tx: Assume you will only use the "easy" relaxed level that has no time limit, and most likely only the first few rounds of it (where you don't have to match anything above a 5). And let the pt play this game (preferably on a larger device like an iPad). Cue as needed, depending on your goals. In the specific examples section below I make some suggestions.

Goals we can target with this app: Attention and focus, following directions, math, problem-solving, scanning, sequencing, and sorting are the main ones.

Specific examples:

1. If you want to target sorting and/or visual neglect and scanning, direct the pt to sort the numbers in adjoining columns (so only put the 1's in the first column, the 2's in the second, and the 3's in the third... etc.). For added complexity ask the pt to predict when a column will get cleared (e.g., when you add the 4th "4" ball to its stack).

2. To target higher level reasoning and math, for higher functioning pts, make the game's goal to add together as many balls as possible (e.g., drag the middle "4" to the "1" below it in the screen shot to create a "5") to direct attention to the more complex possibilities within the game playing than just matching numbers and colors.

3. For a cool scanning and problem solving task ask the pt to fill up the grid with balls allowing as few as possible to pop. It's not possible to control this altogether because every few balls that are placed a new line of balls appears from below, and some of those may create a match. But the pt's task would be to go for the lowest score possible by placing the balls under their control in a way that doesn't allow two 2's or three 3's, etc. This would be a scanning-intensive task.

4. Brain-training: this is also a great app in general for exercising one's multitasking, math, problem solving, reflexes, planning ahead, prioritizing, attention and focus skills.

iPad/iPhone app: Match Panic

Match Panic app

Match Panic app in iTunes (was free for a while, now $1.99)

What it is: It is a matching game, where various tiles queue up in the middle of the screen, and you tap the right or the left to match them. Each level starts with just two tile images (see screen image #1), and every two levels or so one more is added at some point in the level (see screen image #2). It is timed, so if you don't finish a level in 30 seconds, you get a score but you don't move up to the next level (that is the only consequence). If a tile is matched to the wrong side, it turns into a sad face for a second (and costs a second of your allotted time).

Screen image #1

There's powerups too, which may add or reduce complexity of the task as they may affect the queue, e.g., by turning all visible tiles to the same shape, or "blowing up" the next few tiles in the queue, reducing the number of total tiles to be matched for that level. Powerups are a reward for a high scoring round, so a slow player isn't going to encounter this complication often. Don't let the "panic" in the app's name fool you: it's only panicky if you are gung ho about moving up levels and matching quickly. If you're playing the game in a more casual manner, there's nothing in particular that rushes you (other than the fact that the timer may run out before the level is finished, but if your goal is to play one level, no big).

Screen image #2

How we can use it in Tx: Pretty much assume you will only use the first 1-4 levels of this game, although there's nothing specific you have to do to select this. Just keep the goals simple. Turn off the sound so there's no "countdown" sound at the end of a level, and trust me, the music is super annoying anyway. It is designed to make the game feel more urgent (gives it that "panicky" flare) so it's best avoided.

This type of visual matching to right/left is a fairly good exercise for lateral neglect issues. This task is very similar to some divided attention activities that involve canceling a specific word or letter from a pageful of words/letters. Following directions is built-in, and memory plays a role as matching is easiest if one remembers the tiles on each side instead of having to compare each tile. As the number of tile shapes increases, so does the complexity of each of these tasks, including memory.

Goals we can target in Tx with this app: Following directions, sequencing, sorting, focus/attention, divided attention, scanning, visual neglect, and of course memory. This is also a great app for brain-training for the general population.

Some specific examples: Although this is a simple one-dimensional activity, I think it can be used in a variety of ways for different fxn levels and goals. Here are some examples.

1. For a slow, focused approach, possibly for a lower-fxn pt, prioritize accuracy of matching rather than total tiles matched, and ask the pt to take their time but send the fewest possible tiles to the wrong side. Let the progress be as slow as it needs to be, and set as goal for the task a limited number of tiles (10 or 20, for example). Have the pt count out each tile that is matched, and keep track of how many were initially matched incorrectly (then you can calculate % accuracy easily).

2. For a more advanced pt you can prioritize overall completion: Don't count how many were matched incorrectly (although that will play a role as each incorrect match reduces the level's time) and ask the pt to go through as much of the queue as possible in the allotted time. Calculate accuracy by points scored (since it's difficult to calculate percent of queue completed--you only see a piece of the queue at a time with no hint as to how much of it is still to come; if they ever add a % completed counter to this game it would be even better for Tx).

3. For visual neglect goals prioritize the neglected side, and ask the pt to say out loud the tile on that side each time it is encountered. So for example, focusing on the left side of the level in Screen image #1, each time a cactus is encountered have the pt say "cactus" before touching the left side. That way, not only is matching required on the weaker side, but it's also emphasized verbally.

4. Brain-training: This app is also great for normally (or close to normally) functioning individuals who want to get some cognitive training. This kind of thing is now popular with sites such as Lumosity, with more popping up. Everyone wants a piece of this neuroplasticity performance training. And if you feel the need for brain training, an app like this matching one will certainly do the trick as an attention-enhancing activity much like those offered on the paid "brain training" sites.

Dropbox Free App for Any Device

Dropbox free app

Free app for your iOS devices via iTunes, Android device via Android Market, Kindle from Amazon App store, Nook from Barnes & Noble, and your computer or mobile device (including Windows, Mac, Linux and Blackberry) from dropbox.com.

What it is: Dropbox is cloud storage. That means your files sit on a server accessible to you from your computer, phone and other devices via the Dropbox software or the web (you can just as easily view and manage your Dropbox files using a web browser by going to www.dropbox.com and signing in). Anyone who signs up gets free 2GB of space, and it's expandable up to 18GB via referrals (500MB per referral). If you create an account using a referral (for example, using this link which would be a referral from me: Get Dropbox) you get an extra 500MB free, as does the referring party. You can also have a paid account, starting with 50GB for $10/month (& a lot more per referral). I think most users find the free account sufficient (you can have more than one account if you need, but you can only link one account at a time to a device or computer; you can access as many accounts as you want if you're using a web browser). Your files are password protected and safe. You can also share specific files or folders with other Dropbox users, or make them public to share on the web (or via, say, Facebook).

Why would you need cloud storage? Here are my main uses for it:
1. Backing up files
2. Archiving files
3. Sharing files
4. Accessing files

I use it to backup up files quickly (in case something happens to my computer), archive files off my phone (e.g., photos if want to remove them from the phone but don't want to delete them and haven't had a chance to copy them to my PC yet), share files with others, and most importantly, make some of my files accessible to myself at any time from anywhere.

One of the beautiful things about Dropbox is its amazing integration into a variety of applications for Android and Apple devices. There are a ton of 3rd party applications that include export to or save to Dropbox options.

There's also a ton of 3rd party programs that integrate with Dropbox and let you CREATE, EDIT, export as PDFs, and EMAIL your Dropbox files. It's like having a portable hard drive that you can access from anywhere without having to actually port it.

How is it relevant to ST? While this app is not involved in any direct Tx, it is where I keep a backup of all my materials; if I do need to print a worksheet, I can access these files from any web browser and print to an attached computer. I don't have to plug in a flash drive or configure printing from my device. As long as there is a computer attached to a printer, and it has a web browser, I can log in to my Dropbox account, print any file, and log out.

In a previous post I described how I carry all my materials using a Nook Tablet, and that I have a copy of all these materials on Dropbox (here's a link to that post: Device: Nook Tablet). It's one of the fastest ways to get my documents into a device like Nook, iPad or a smartphone. Between the device I carry that is loaded with the PDFs I use in treatment, and nearly universal access to my materials via Dropbox, I have ALL of my resources at my fingertips.

Examples: There's not really specific examples of how I use this in Tx because this is about access to all my materials. But here are some examples of where I've benefited from having all my materials on Dropbox:

1. In one of my facilities, the only way to print is via the tech's laptop, and she's the only one with access to it. So when I need something I access Dropbox via my iPhone app, find the files I need and email them to the tech. This creates minimum interruption in the tech's work flow to get my materials printed.

2. I like to have all my materials on my Nook. I had made an updated document for a cogn eval I was using, and saved it to the folder where I keep these resources on my PC--a Dropbox folder. I forgot to hook my tablet up to the PC to transfer the file, and needed it at work the following day. Logged into dropbox in a room that has wifi, and copied to my local files on the Nook. Ready to use in pt's rooms (where there's no access to wifi).

3. I needed some materials printed, and the only computer attached to printer at one of my facilities is really old, slow, and its USB port is broken. But it has a browser, so I logged into Dropbox using the browser, and printed my files. Even if I could have used my flashdrive (which I also carry everywhere; I'm a bit OCD) it would have taken longer. But as such, I don't really need my flashdrive or have to worry about keeping its files synched.

4. I have a folder on Dropbox I share with other SLPs, and we use it as a convenient way to share resources with each other.

Well, you get the picture. No matter what device you use if any, if you have files on Dropbox, you can always access them from any computer or device with internet connection.