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: 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.