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).