iOS App: Winky Think Logic Puzzles

Winky Think Logic App

Winky Think Logic Puzzles App on iTunes ($2.99, sometimes free)

What it is: A collection of 180 logic puzzles that involve very simple to mod difficulty levels. The puzzles all consist of variously shaped and colored tiles that need to be positioned in specific spots. Sometimes it's as simple as moving a tile to its designated spot, sometimes several tiles to several spots, and sometimes there's obstacles to overcome and sequencing to determine. Solutions require single - to - multi steps to reach, with skills that tap into shape and color recognition, path determination, figuring out the outcome of various objects in the puzzles, etc.

Screen Shot 1 shows a simple level where you have to choose the correct shape to move to the center. Screen Shot 2 shows a simple level where there's some restriction on movement, and more than one target shape - so one has to move the tiles in sequence to place them. Subsequent levels include some additional problem solving. It never gets too difficult and it's pretty fun. If you get stuck, you can restart a level at any point - there's no timer and no points to lose; you just keep solving until it's solved.

Screen Shot 1

How we can use it in Tx: There's no settings to consider except whether or not you want music. If you are working on focus and need some distracting stim, you can keep the music on.

The levels are made more complex by the addition of obstacles, and multi-step solutions to the puzzle. A few levels require the use of more than one finger--I'd skip those levels in therapy unless you have a very highly functioning and dexterous individual. There's also a few levels at the end of the game where very precise movement is required (the obstacles cannot be "touched" by the tiles); I'd skip those as well as they may just frustrate more than help. But overall, levels are realistically solvable, especially with some cuing.

Screen Shot 2

You get to move up levels as you solve them (solve one, get to move on to subsequent levels) but once solved, you can reuse the levels. So, I would recommend solving ahead (as far as you plan to use with any client; or all 180 puzzles - it's fun). That way you can skip over levels that aren't appropriate for a particular client, and not worry about any subsequent levels being locked. Otherwise, just choose levels and play.

One issue that may arise is that solving some of the levels may require dexterity beyond the ability of your client. In such cases you can either skip that level, or split the task into parts that would still provide experience with the problem solving and the planning: the client may solve the puzzle by making a plan (e.g., for screen shot 2, figure out the sequence in which tiles need to be dragged into the track), and then verbalizing directions for someone else (likely the clinician) to carry out the plan. Then the dexterity of maneuvering the tiles would be left to the participant without deficits in this area.

Goals we can target in Tx with this app: Direction following, problem solving, reasoning, symbolic dysfunction, visual field neglect or other visual-field dysfunctions (like hemianopsia--to get used to scanning back and forth to compensate), sequencing, sorting, focus/attention, categorizing, planning, and of course spatial reasoning. And of course, as per my usual logic, memory.

Some specific examples:

1. As noted above, if you have a client who lacks the dexterity to maneuver the tiles in any or all levels, you can separate the task into manageable bits and remove the part that requires skill beyond your client's reach: the client can make a plan to solve the puzzle, verbalize it (or discuss it), then provide directions for another person to carry it out. The clinician, or another client if you're working in a group, can maneuver the tiles.

2. You can use this as a break between other tasks, or as its own task for a certain part of your session. To document skill and progress I would keep track of the cuing required and the number of steps that were needed to solve each puzzle to determine the difficulty of the task at each level. You might also note if the multi steps were homogenous: That is, were they the same step each time, as in sequencing the order like the puzzle in screen shot 2, or heterogeneous steps, as when one tile needs to be put on a spot that opens an obstacle or has to be maneuvered to a spot that allows it to change colors. I would consider heterogeneous steps more complex. For someone with symbolic dysfunction, you 'd want to also keep track of how many colors and/or shape choices were provided and how much cuing they needed to pick the correct shape/color (e.g., in the puzzle shown in screen shot 1).

3. Memory: you can show the solution to a min/mod difficult puzzle, and then ask your client to re-solve the puzzle using their reasoning and their memory of your solution. See, I can ALWAYS involve memory goals.

All in all, I think you can have a lot of fun with this puzzle both for direct Tx and for a motivating and useful break between other tasks you have planned.

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: 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.).

iOS/Android App: Counting Dots

Counting Dots App

Counting Dots on iTunes ($0.99)
There's also a version for Androids on Google Play (same price)

What it is: It is described as a colorful counting game for kids. The colors are vibrant but crisp and clean (if nobody told me it was for children, I'd just think of the layout as modern). Popping sounds and vibrations can be shut off as well. The task is one of counting, where you can count by 1's, 5's or 10's, and you can start with any number you choose (so if you start with "5" and count by 5's you'll get 5, 10, 15, 20, etc, just like in the screen image below; and if you start with "2" and count by 5's you'll get 2, 7, 12, 17, etc.).

A player is presented with dots in various colors and sizes with numbers on them, and the task is to select them in ascending order. The game playing happens in levels of increasing number of dots. First you're given one dot. When you clear that (by selecting the one dot) you are given 2 dots. When you clear those, you are presented with 3, and so on.

The background colors and dot colors are different each turn. The dots overlap, but the correct answer is always visible (though sometimes hidden by the previous answer). The sizes vary randomly (so 80 may be tiny and 85 large; but all fully legible and selectable). If you touch the wrong dot it shakes for a split second, nothing else happens. So there's no error reporting, there's no scoring and as far as I can tell, there's no end.

How we can use it in Tx: I'd shut off sounds and vibrations in the settings, and set the difficult appropriately for each client. Here's my opinion of settings ranging from easiest to most complex given the parameters of this app:

1. Starting with 1 or any number, and counting by 1's (1, 2, 3, 4, etc.)
2. Counting by 10's, starting with 10 (10, 20, 30, 40, etc.)
3. Counting by 5's starting with 5 (5, 10, 15, 20, 25, etc.)
4. Counting by 10's starting with something other than 10, for example 3 (3, 13, 23, 33, etc.)
5. Counting by 5's starting with any number between 1 and 4, for example 2 (2, 7, 12, 17, etc.)

Using an iPad with its larger screen is probably best. Ask the patient to perform the task (select the dots in ascending order, with a greater number of dots presented each after the previous one is cleared). You can keep track of accuracy by counting errors (error stats, as I mention above, are not kept; but the incorrectly pressed dot does shake for a split second providing a quick but not distracting or discouraging visual of an error if a therapist is watching for it). Maybe stop the game either after a certain time limit (play it for 5 minutes, for example, and note how many levels have been achieved in that time) or after the pt seems to get stuck a lot (hits the wrong dot several turns in a row). Definitely try to stop before frustration sets in, but do try to get to a level that is challenging for your client.

Goals we can target with this app: Sequencing obviously, providing a range of difficulty levels for this task. Certainly math (on the simpler level, although you'd be surprised how challenging it can be to sort the dots in ascending order as you get into the higher numbers). Memory (STM, working-memory) are addressed: it is actually pretty challenging to remember where you are in the sequence once you've been playing for a while, especially with distraction of colors and sizes of the dots. Visual field neglect and scanning are incorporated as the dots are spread across the screen, and again, the colors and sizes can provide competing stim. And if there's competing stim, focus and attention play a role as well as direction following. I wouldn't spend too long on this task, but it's a nice 5 minute exercise that can address a number of goals.

Some specific examples (or in this case, rather, just notes):

1. If you are working on memory goals, then note the fluency with which the sequence is carried out. That is, to play this game smoothly the player must remember what number they are on. If, however, they forget, they can still carry the task out by scanning the screen and finding the smallest number to select. So it would be up to us to see which strategy is being used.

2. If you are working on visual neglect or scanning, note accuracy involving the weaker side compared to the stronger.

3. Patients with focus goals will probably be most distracted by size differences between the dots. You may also want to add another layer to the task, where if a smaller number has a larger circle your client must somehow acknowledge it (verbally, for example) which will provide a divided attention aspect to the exercise.

4. For a reasoning/problem-solving (and math) goal you could set up the starting number and intervals, and let the client start playing with the goal of figuring out what the sequence is counted by (1, 5, or 10). Difficulty levels for this type of exercise are similar to those listed above, although it is fairly limited in that respect.

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?

iPhone app: Oh, My Word! 2

Oh My Word! 2 App

OhMyWord2 app in iTunes (free)

What it is: Dubbed a prettier and more interesting version of hangman, this is a game where you guess a common 5 letter word based on being given two words that would flank it if listed in alphabetical order. You enter a 5 letter word as your guess, and if it's not the target word, your guess replaces one of the flanking clue words, getting you closer to the target. For example in the screen image below, the target word if listed alphabetically would be between GYROS and OFFER. So the hidden word must start with G, H, I, J, K, L, M, N or O. Put in a few guesses of words starting with these letters, and you narrow it down to a word that in alphabetic order would be between LIMPS and LINKS and must therefore start with LI- (see screen image 2, below).

Screen Image 1

There are several levels at which this game can be played, including a relaxed (called "classic") un-timed easy level where you are given 50 guesses, and the goal is to see how many words you can find within that number of guesses. There's also hints where you can request to be shown one of the letters in the hidden word. After playing this game several times (ok, a whole lot of times... this is a fun game!) I can attest to the fact that the target words indeed are common.

How we can use it in Tx: Access to an un-timed level with truly common words makes this a useful Tx tool. Definitions do not enter into the game. It is more about word recognition and letter sequencing in alphabetic order. Word-finding in the traditional sense normally involves coming up with the word for a specific item, and as such the definition is an integral part. Coming up with words that start with a specific letter (or sequence of letters) is a skill that combines language and reasoning, but still relies on word familiarity and ability to access stored words. For my acute pts with Aphasia I developed a mini word recognition game: I would put two cards with consonants in front of a pt, for example "p" and "g" and then give them cards with all 5 vowels, and ask them to choose the vowels that would form a real word if placed between the the two consonants; so in this example 'e' (peg), 'i' (pig), and 'u' (pug). And I'd ask the pt to also tell me what each word means (often they would choose a vowel that does not make a word, and realize so when they couldn't come up with a definition). It was a multi-step simple word finding activity that first required to recognize the word, then access its meaning. In the same manner for this app, since the words are common, supplemental tasks involving word meanings can be incorporated for those pts who need it.

Screen Image 2

Goals we can target with this app: Word-finding and naming, language, reasoning, sequencing (since alphabetical order plays a large role in this game), question/answer goals (simple y/n where you ask the pt if this letter comes before that one, or if this word precedes or follows the other in the dictionary). For verbal expression deficits reading the words aloud could also be added, incorporating apraxia, dysarthria, voice, intelligibility goals as part of a fun activity.

Some specific examples:

1. For a pt working on using intelligibility strategies at word-level, this game can provide a nice set of short words to practice strategies on. Many of the words have consonant clusters, which provide great practice for exaggerating movements. And since this is a fun thinking activity, it is easier to gauge level of cuing needed to use the intelligibility strategies at word-level (since usually, a word-level task involves a rote list of words and the drill-like manner of the exercise often reminds the pt to use strategies; not that it's a bad thing to have this built-in reminder--in fact it is a great way to get the strategies practiced--but it's nice to have a halfway point where the exercise is still word-level, but the focus is elsewhere and strategy use is less in the forefront of one's mind.

2. For a pt with sequencing goals, this game is a great practice involving alphabetic order. If coming up with words is too difficult for the pt, the ST can focus only on the alphabetic sequence of letters and make word suggestions for the pt to respond. If the two flanking words are GHOST and ICONS, for example, ask the pt what letters come between G and I. If that's too hard, make it a Y/N question: Does K come between G and I? Does H? Then ascertain which letters the target word can start with (in this case G, H, I). Now say you've entered HORSE, and now the flanking words are HORSE and ICONS. What letters can our word start with? (H or I). If it's an H word, what 2nd letter can it be? (O-Z) If it's an I word, what 2nd letter can it be? (A-C). Anyway, you get the picture, just focus on sequences and then suggest the words to guess with.

3. For a pt with higher level language goals, just play the game. Add/reduce cuing as needed to come up with word guesses, and if relevant to pt's goals, ask for definitions of all suggested words.

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.

iPad/iPhone app: Occupied

Occupied

Occupied app from iTunes ($0.99; was free for a while)

What it is: A sorting game where you have to get plane passengers to the correct, um, bathroom. The levels are timed (always a bit of a bummer for treatment's sake) but start out simple with just men and women and the two corresponding bathrooms. It doesn't require a lot of dexterity, and accuracy can be measured by how many passengers were correctly directed in the allotted time. Following levels get a little harder, first with the bathrooms themselves moving (switching sides, so sometimes the women's room is on the right, sometimes the men's, and you can see them trade places), then the passengers are all kids who need to be sorted quicker or they run off; the next level includes a third type of passenger (babies, who need to be directed to their own area) and then the bathrooms start moving on the screen so dexterity becomes an issue (as is motion sickness.. not part of the game, but what I get from trying to play at these levels). So I would recommend only the first 3 or 4 levels for Tx, which should be plenty. There are additional scenarios and more difficult level settings, but those don't interest me for therapy.

As an aside, I sent an email to the developers explaining how I plan to use their game for cognitive therapy, and why, and asking if they'd consider adding a simple, slower, or untimed set of levels for rehab purposes. Who knows, their response may be positive... although I can see how adding a set of levels for such a small specialized market may not be worth their trouble.

How we can use it in Tx: There's really only one way to use it, which is let the pts play the game. As I mention above, I'd stick with just the first 3 or 4 easy levels. The game provides feedback regarding accuracy of each completed level (% better or worse from previous attempt) which can be noted for the pt if you want, assuming it's the same pt completing the level (i.e., being compared to self and not another pt).

Goals we can target in Tx with this app: Attention, focus, scanning, reasoning, categorization, following-directions

Specific examples: Since there's only one way to use this app--that is, to play the game--there's no need for specific examples. However, goals can be worded to reflect each pt's intervention needs:

1. For a pt with left-neglect, the target of playing this game could be to match the accuracy of the right-sided sorting to that of the left side (e.g., for the first level if the men's room is on the left, then the goal would be to approximate accuracy of getting men to their destination to the accuracy of getting women to theirs).

2. For an attention goal, target overall accuracy of whatever levels are played.

3. For direction-following goals, pay attention to the amount of cuing needed to initiate and carry out each new level (since each new level involves a slight change in instructions).

4. Brain-training: this is also a great app in general for exercising one's attention, focus, and reaction time.

iPad app: More Cookies!

More Cookies App

More cookies (free for a short time, usually $0.99) from iTunes

What it is: Bake virtual cookies using a recipe or "pre-made" dough; add ingredients, mix, cut into shapes, bake and decorate. If you want you can save your creations to your album, email them, or "eat" them. With the recipe option you choose the type of cookie you want to make, and then drag ingredients to a mixing bowl (with extra steps like cracking the eggs) and then swirl your finger to mix the dough. With "pre-made" you also get to choose the type of cookie, and with some you have to roll out the dough and cut it in to shapes, and with others just drag pieces of cookie dough to the pan. With both options you have to lay the cookies in the pan (if you're not careful how you lay them out, you may not fit them all) and then bake them, followed by decorating (you have a ton of options for icing, sprinkles, candy, fruit/nuts, and weird stuff).

Here is my creation for the purpose of this blog: it was a pre-made version of sugar cookies, cut into bunny shape, with yellow frosting, purple sugar sprinkles, and gummy brains!! What, I'd totally eat it!!

How we can use it in Tx: The most obvious way to use this is as a direction-following task. The app provides some of the directions (add ingredients, mix, roll out dough, cut into shapes, place on pan, bake, decorate...) and we can provide additional ones that can also be more open-ended (frost with any of the choices, add some sprinkles and a couple of candies, or more specific like "add two nuts and 3 candies"). Some sequencing can be implemented in the decorating part.

Reasoning can also be involved in requesting a batch of cookies appropriate for, say, a holiday that occurs at the end of October. Access to the "weird stuff" for decorating (things like bacon, jalapenos and fried egg) opens up possibilities for question/answer tasks, decision making, and explaining why to use or not use a particular ingredient.

I think I can even get some memory work out of this app: the "from scratch" option shows recipes for the cookies. One needn't remember the amount needed of each ingredient to play, but a pt could be asked to look over the recipe, and for example remember how much vanilla or how many eggs were needed; then when the cookies are done and decorated delayed recall could be assessed.

Even scanning and sorting can be addressed by decorating a cookie with a lot of different things and one weird one, and asking the pt to search for the it or count how many marshmallows there are, or something similar. Decorating the cookies and laying them out in a pan to bake can address visual field neglect deficits.

For an extra bit of fun I would save pictures of the virtual cookies and print them for the pt, especially if the cookies are "prepared" for an upcoming holiday.

Goals we can target in Tx with this app: Direction following, sequencing, memory, question/answer, reasoning/problem-solving, scanning.

Some specific examples:

I give some ideas in the "How we can use it" section above, but here are some more specific examples:

1. For sequencing and/or scanning goals: Create a cookie with 1 of one topping (say, 1 marshmallow), 2 of another (say gummy bears), 3 of another (chocolate chip), 4 of another and 5 of yet another. Ask pt to list the toppings in order of how many there is of each from lowest to highest.

2. For memory (immediate, short term, delayed or spaced retrieval) goals: Start with the making cookies from scratch option, and while scanning the recipe tell the pt to remember how many total ingredients were needed (or how many ingredients that add sweetness to the recipe there are). Tell the pt that after the cookies are made and decorated you will ask for this information (or, if you're working on spaced retrieval, ask for this information as soon as you move to the next screen, then with each next step and again at the end).

3. For direction-following goals: In the "from scratch" option where ingredients are added to the bowl one at a time, ask the pt to add all the dry ingredients first and then all the wet ones.

4. For problem-solving/reasoning goals: Give a scenario that involves an occasion (either a specific holiday, or the time of year for one so the pt has to figure that part out first, or another type of occasion) and ask the pt to decorate cookies for that occasion, choosing the most appropriate shapes and colors.

5. For visual field neglect goals: Work on spacing the cookies on the pan before baking, making sure the whole pan is used (you can bake up to 12 cookies at a time, so ask the pt to fit all 12 in... this would require extra care). Draw attention to the neglected side of the cookie, and make sure it is decorated the same as the strong side. Or request specific differences between the two sides to require attention to both (e.g., make a gingerbread man and frost the left side of his body one color and the right another).

iPhone app: Appzilla (90 apps in 1), free app

Appzilla free app

Appzilla! 90 apps in 1 in iTunes

What it is: A utility app with a little bit of everything... it's almost easier to sum up what it isn't. There are 90 mini apps in Appzilla, each does just one thing, and don't expect all of them to be useful. But some of them are rather good, which is amazing for a free app. Herein I will comment on the mini-apps that may be useful for ST, but to be sure there's quite a few utilities included that are useful to anyone, just not relevant to therapy (like area code look-up, currency converter, and battery life gauge). Since there are so many of these utilities, and most have limited uses, the format of this post will be a little different than usual. I briefly sum up the basic uses and goals that can be addressed by each utility rather than have a separate heading for goals and treatment suggestions as I usually do. But I'll try to give examples, especially for those utilities that seem far fetched as useful :-). Expect to constantly be amazed that this collection of utilities is free!

List of utilities included in Appzilla that may be useful for Speech Therapy:

Note: Some of these utils that gather information from the internet (like dictionary and news related ones) will need a server connection to work (if you use your iPhone you're fine, if you use iPod-touch or iPad, you'll need to be connected to wifi). Most of the utils don't need it though. I'll try to note which do below.

1. Bleep button (no, really): Just a button that you touch and it bleeps. Can be useful as part of a host of activities that we already do. For example, a memory/focus/attention task where a pt has to react to a specific suit or number or card in a deck: this bleep could be used as the manifestation of said reaction (i.e., pt presses the bleep button every time they see a red card or a spade as the cards are drawn one at a time). Another example is for a sorting/categorizing task, where the pt shuffles through cards with common pictures on them, and presses "bleep" for pictures that belong to certain categories (I like to have household items in pictures, and ask the pt to name each item--working on word-finding--and also pick out the ones that belong in a particular room in the house, say the kitchen).

2. Buzzer: Basically the same as the bleep one, but with a red button for buzzer sound and a green one with a ding. I wouldn't use them for their seemingly intended purpose (red for wrong and green for right) but a variation of the tasks I mention above could work: if a pt is looking for red cards in a deck, press the red buzzer for black and the green ding for red. This would be an easier task than just pressing one "bleep" button for red because having to respond to each card would make it easier to remember to respond... so it can be implemented for the simpler versions of the same goals.

3. Coin flip: I haven't thought of anything yet, but I *know* there's something I can do with it in Tx.

4. Cook timer: This thing is awesome: it has a picture of 4 electric stove burners and 2 oven doors. You activate each and a timer starts for that cooker. I love time-management games (you know, where you play the cook and customers ask for specific foods and you have to put them together in a certain order, taking care of all the customers... like the free and super fun iPad game "Order up" or the iPhone game "Bonnie's Brunch") and I think they would be useful for a host of cogn-comm goals, but they tend to be difficult and complicated. Using this utility is not as fun, but it can be a lot less stressful: the task would be to pretend you're cooking a meal and have to cook 2, 3 or 4 different things that each take different times to prep and cook. It would be great to have hard copies of pictures of foods... so for example you have to get the buns ready then you can put the hamburger on the stove and cook for 3 minutes, and in the meantime get the pasta ready and cook that for 4. That's a lot of directions to sort through (problem-solving, sequencing, direction following, reasoning) and would require some extra prep of materials, but once ready it can be adjusted to a lot of goals and a lot of deficit levels (make it simpler, make it more complex).

5. VU meter: Amazing that it is part of a free package! Visual feedback to sound levels... what can't you do with it in speech therapy?! For specific ideas see one of my previous blog entries, about the Bla | Bla | Bla app.

6. Dice roll: A few weeks ago I bought a game on Amazon called "math dice" (actually, I bought the Math Dice Jr. version, linked here, because it came with bigger dice and a carrying pouch). In this game you roll the 12-sided target die to get a number, and then roll the other 5 dice and try to reach the target number using addition and subtraction only; the more dice you use in your calculation to reach the target number, the more spaces you get to move on the progress board. I've used it in Tx for memory (to recall rules), problem-solving, reasoning, sequencing and more specific math-related goals if called for. If I don't have the game with me, I can make a virtual version of it using this utility. And loads of other game-like tasks could use this utility if you don't have dice available (I don't know about you, but my phone is always with me while my lucky dice I don't tend to bring to work...).

7. Dictionary: There's always a reason to have one around... I believe this one needs a server connection to function.

8. Drum pad: I don't know what I'm gonna do with it yet, but I'm sure it'll come in handy... eventually.

9. Grill timer: Variation of the cook timer but with only 4 burners (and link to cooking times for various foods). Could be used similarly to what I wrote in #4 above.

10. Hearing test: You'd think it's useful (if not particularly clinical) but it's mostly for high frequency sounds. Still, it's relevant to our field so I figured I'd mention it.

11. Facts, GoogNews, Horoscope, Hot Topics, Lyrics: These are examples of included utils that can be used to generate conversation topics if needed. Sometimes you just need free-style open-ended conversation (to address anything from pragmatics to focus to memory to voice and fluency). I think all of these require a server connections to function.

12. Match it: 4 x 5 card memory game with a choice of themes for the pictures. It keeps track of time, but doesn't limit players in how much time they can use, which makes it much more accessible for memory-impaired pts. It's super cute, and likely the only memory game you'd need.

13. Metronome: I can't believe there's a free one included! I was looking for one for an SLP friend a few weeks ago and couldn't find a good free one... and here it is in this generous collection of utilities. Its uses are obvious for pacing and fluency.

14. Reaction time: A simple game where you have to tap the screen as fast as you can when the light turns to green (options are green, yellow and red). I don't know if I'd use it all that much, but I can see it coming in handy at some point... Even if just as a memory/focus/attention task (goal for pt to remember to tap the screen when the green light comes on).

15. Rhymes: Give it a word and it'll look up rhymes (needs network connection or wifi to function). There's plenty that can be done with this... I used it with a pt when we were composing a simple poem together (honestly, it was a functional task and very appropriate for that pt... but this post is already getting long so you'll just have to trust me on that hahaha).

16. Tally: You can keep track of up to 4 tallies, where you just touch the screen for each tally to add to it. You can use it to keep track of just about anything; for example, if you want to keep track of % correct items on a task, you can select 2 items to score, keep track of correct ones on the first, and of all items on the second, and at the end see what percentage the first is from the second count. When I do problem solving scenarios, I keep track of % problems ID'ed and % solutions provided; with this tool I'd choose 3 tallies to keep track of, make the first ID, the 2nd solving, and the 3rd total scenarios. At the end of the task I'd have a very quick idea of task accuracy. If you're doing a stuttering eval you can keep track of disfluencies; pretty much anything, this tool will let you count it faster than keeping track on paper, and without alerting the pt to what you're keeping track of (or how many they got right or wrong). Very simple and efficient.

17. Translator: English/Spanish only; may need server connection to function.

18. Trip Wire: Sound activated where you select the trigger threshold, and it sounds a buzzer if there is sound louder than the threshold. Yet another visual feedback to sound tool that can be used for pts with voice or fluency goals.