The Most Useful Apps for SLPs Working with Older Adults
By Stephanie Frazee, MS, CCC-SLP
Speech-Language Pathologist
As an SLP working with the older adult population, each patient and therapy session can be vastly different from the next due to a variety of treatment areas that you cover. Despite the inherent challenges, your goal is to provide effective, individualized treatment that is tailored to each patient’s needs and personal goals. Particularly if you are an SLP who travels to patients’ homes or different facilities, you may be wondering, “How can I carry all of these different materials with me?” One way to streamline these materials is through the usage of digital applications (apps) on devices such as an iPad or tablet. Incorporating apps into therapy sessions can allow you to have a variety of therapeutic activities and stimuli at your fingertips.
The Added Benefits of Using Apps with Your Older Adult Patients
Not only can the usage of apps help you as a clinician, but it can also increase your patients’ engagement and motivation during therapeutic activities. Although using apps with the geriatric population may not be the first thought that comes to mind we have to consider: Is this a result of ageism? Contrary to some beliefs, technology is not only for the “young,” and attempting to introduce technology into your skilled treatment may actually be well-received by patients within the geriatric population. Some of these patients have devices such as iPads and tablets that they have received as gifts or purchased themselves. Some may be proficient with usage of these devices, while others may say that they haven’t received sufficient instruction and they feel at a loss. Regardless of the situation, decreased familiarity with these devices does not necessarily mean that the interest is not present.
In addition to increasing engagement, the usage of apps can provide more opportunities for carryover. When you implement home exercise programs or suggest carryover activities for your patients, don’t you try to identify activities that are easy for patients and family members to replicate and complete within their daily schedule? If completing practice is as simple as turning on a tablet, selecting an app, and beginning an activity, patients may be more likely to engage in carryover activities. Apps can eliminate the setup required to allow a patient to engage in practice within the home and the upset caused by a patient’s misplacement of provided handouts or materials.
There are also various apps available that provide patients with feedback regarding their performance, allowing for more independent practice when caregivers or family are not available. Several apps enable the patient to send reports to their SLPs. This promotes accountability and allows the clinician to track the patient’s progress. Above all, interactive apps can make practice a bit more…fun! Your patients are more likely to participate in activities that are not only challenging but enjoyable.
There are so many apps available to SLPs, but here are some you should check out right away:
The App for Speech and Voice Treatment You Should Try Right Now
Created by Northwest Parkinson’s Foundation
Available on iOS (only available on iPad)
FREE
What This App Does for You
This application provides biofeedback to promote the achievement of adequate vocal intensity during the production of words, phrases, and sentences. Under the “Practice Your Speech” section, the app includes two activities: Words & Phrases and Reading & Conversation. An individual is prompted to read target stimuli aloud while referring to visual feedback. A color-changing bar that stretches across the top of the screen in response to increased vocal intensity lets the patient know if they have achieved the target vocal intensity. The bar turns green when vocal intensity falls within the designated “target zone.” Throughout the activity, the patient’s face is visible on the screen through the usage of the iPad camera. Four words or phrases are presented at a time within the Words & Phrases mode, while the Reading & Conversation activity allows for an ongoing view of biofeedback until the patient or clinician selects “end.” Temporary audio/video recording is also obtained for review after the exercise. Speaking tips are available for an individual’s review prior to practice, as well.
Why You’ll Love this App
This application is primarily targeted for individuals with Parkinson’s disease, but it is easy to incorporate into treatment sessions with individuals with various motor speech and/or voice disorders. The presentation of biofeedback is a great way to increase a patient’s self-awareness and ability to monitor their own performance, which is a huge part of that “independence” we all hope our patients can achieve.
Although words, phrases, and sentences are pre-loaded into the application, the Reading/Conversation mode allows for the usage of any stimuli. Consider using personally relevant stimuli such as a magazine article from a patient’s personal collection. Beyond the treatment session itself, this application is also ideal for promoting home practice. Rather than having a patient read a given set of stimuli aloud and hope that a caregiver or family member can provide feedback to ensure the usage of learned strategies or techniques, this application allows your patient to engage in more independent practice since feedback is automatically provided.
Developed based on concerns reported by an individual with Parkinson’s who wished to obtain real-time feedback of his vocal intensity and articulatory movements (information regarding the development of this app can be found within the “About the App” section within the app), this app is ideal for promoting the effectiveness of your patients’ communication. The versatility, ease of use, and interactive nature make this app ideal for clinicians, caregivers, and patients alike.
What Could be Improved in This App
Although I incorporate usage of this application into many of my treatment sessions, there are certainly areas for improvement. The biggest barrier to its use for home practice is its availability solely for iOS on the iPad. Additionally, the pre-loaded words, phrases, and sentences generally lack any organization of the hierarchy of stimuli. This pre-loaded list is also limited, leading to the repetition of stimuli during practice. Ideally, the ability to add personally relevant, functional words, phrases, and/or sentences within the Words & Phrases section would make this application stand out even more, but there are a few shortcomings expected from a free application.
Practical Considerations
Speak Up for Parkinson’s is quite easy to integrate into your sessions due to the overall simplicity of the application’s framework and clear opportunities for patient and clinician review of performance after the completion of trials. Some level of self-awareness should be developed prior to usage of this application to make it the most meaningful (i.e., this application may be difficult to successfully utilize with an individual with significant cognitive impairment). Although the application primarily targets vocal intensity, its usage can be applied to promote articulatory precision (e.g., visual feedback of movement of articulators to ensure usage of over-exaggerated speech strategy), promote awareness of posture during speech production, and assist with identification of qualities of voice production (e.g., hoarse or breathy quality, etc.)
The App for Language Treatment You Should Try Right Now
Created by Tactus Therapy Solutions Ltd.
$24.99 (Frequently on sale around the time of the ASHA Convention)
What This App Does for You
The Naming Therapy app is primarily designed to target expressive language at the level of word retrieval. The app includes four sections:
- “Naming Test” screener, which can be utilized to obtain basic information regarding a patient’s confrontation naming abilities for photos
- “Naming Practice,” which allows for engagement in confrontation naming with hierarchical cues
- “Describe,” which allows the patient to provide a verbal description of a given photo based on established features
- “Flashcards,” which contains 700+ photos.
Why You’ll Love this App
If you haven’t heard of Tactus Therapy apps, I strongly urge you to explore their website and vast app offerings. Evidence-based practice is woven into every section of this app, from the integration of the cueing hierarchy to opportunities for engagement in semantic feature analysis (SFA) through the “Describe” section. After the “Naming” activity, data is provided to allow the clinician to track what cue was required to elicit the patient’s production of the target word.
Another feature is the ability to include customized, personally relevant photos for naming or description practice. Additionally, this application is so versatile that several naming skills can be targeted. For example, you can use the “Naming” activity to provide a patient with semantic cues to promote responsive naming (while shielding the visual stimuli from their view).
Naming Therapy is also ideal for home practice as cues are available to promote a patient’s success and minimize frustration. Results can also be sent to the clinician’s e-mail to track performance and adherence to the Home Exercise Program.
What Could Be Improved in this App
There isn’t much I would change with this app. One area for improvement lies in the “Describe” section. The activity within this section allows for a provision of visual and semantic cues to promote the patient’s generation of a verbal description of the given target, but these cues might not be sufficient for some patients to engage in independent practice. Further semantic cueing and/or feedback of performance may be required. Its cost may hinder some patients and family members from purchasing this app for home practice, but it’s reasonably priced given its versatility.
Practical Considerations
This application is a great and easy way to incorporate evidence-based practice into treatment for individuals with aphasia and/or word-retrieval difficulties related to cognitive-communication disorders. The photos are clear and can be enlarged to view detail (e.g. texture of given item), and the app layout is simple for patients and clinicians to use. This application is a “must-have” for both the new and seasoned clinicians. I know I’d much rather carry around an iPad than a deck of 700+ photo cards!
The App for Cognitive Treatment You Should Try Right Now
Created by Tactus Therapy Solutions Ltd.
$4.99 (Frequently on sale around the time of the ASHA Convention)
What This App Does for You
This app allows for the integration of spaced retrieval to promote recall of target stimuli at increasing intervals. The clinician enters the target and starts the timer to begin guided spaced retrieval practice. Written instructions are given to the clinician based on a recording of a patient’s incorrect or correct response (e.g., to provide a correct response and ask the question again if an incorrect response is given). Once practice is completed, a detailed report is generated which indicates correct responses at each given interval and the maximum interval at which the correct response was given. Up to three questions can be loaded into the application at a time.
Why You’ll Love this App
Tactus Therapy has done it again by integrating evidence-based practice in an application that is clinician and patient-friendly. It is a great way to incorporate spaced retrieval when working with patients with memory impairment without having to set a new timer at each interval which can be time-consuming and distracting. With this application, the clinician is given an auditory reminder (a ring) when it is time to ask the patient the target question. You can quickly input whether or not the response was correct, and continue to engage with the patient. Having the target question displayed also ensures that you consistently provide the same target question to promote the effectiveness of spaced retrieval.
What Could be Improved in this App
This application is relatively simple and straightforward, but there are a few areas for improvement. While the app allows to utilize up to three targets, an option to create patient “accounts” is not available. This feature would allow for the management of patient-specific targets without forcing the clinician to re-enter target questions during each session. Additionally, while the app generates a well-written and clear e-mail of results, an option to store data within the app would be a great way to monitor progress in one location. These limitations are expected from a low-cost app, but I, personally, would pay a bit more to have these features included in the application.
Practical Considerations
This app is a great way to get started with spaced retrieval, but some knowledge in this treatment approach is recommended prior to attempting to utilize the app. Tactus Therapy has some great resources on their website to guide a clinician on this journey, but even more, training may be helpful. Personally, I found that I was more comfortable implementing spaced retrieval into my treatment sessions after taking a MedBridge CEU course that provided various examples and discussed barriers to effective implementation. However, when selecting a patient who is appropriate for spaced retrieval, the app does provide some guidance to help you with this decision making (e.g., if the patient receives three consecutive incorrect responses on the lowest interval, the app informs you that the treatment approach may not be appropriate). Additionally, it’s important to note that while usage of this application can facilitate improved recall and carryover of specific targets outside of sessions, usage of this app by family or caregivers is not recommended due to the need for implementation of spaced retrieval bit a skilled professional.