How To Use Apps Clinically in The Treatment of Aphasia

How to Use Apps Clinically in the
Treatment of Aphasia
Audrey L. Holland, Ph.D.,1 Pat Weinberg, M.A.,1 and
Janice Dittelman, M.S., CCC-SLP1
ABSTRACT
This article is designed to provide aphasia clinicians with some
Downloaded by: Instituto Politécnico de Setúbal. Copyrighted material.

general guidelines for selecting apps that are appropriate for individuals
on their caseloads. Further, it provides a template, consisting of some
things we have learned while we have instituted the use of apps at the
Adler Aphasia Center in Maywood, NJ and at the Carondelet Aphasia
Program in Tucson, AZ, in the hopes that clinicians who are interested
in using this technology can profit from our experiences.
KEYWORDS: Apps, App Store, iTunes, platform/device, use of

apps
Learning Outcomes: As a result of this activity, the reader will be able to (1) select the appropriate
platform/device, (2) locate and judge apps, (3) select apps appropriate for each persons with aphasia,
(4) integrate apps in practical/real-world situations, and (5) encourage involvement of family and friends in the
use of apps.
W hen this article first began to take the hill, and he is still there, eternally rolling his
shape, we intended it to be a guide for clinicians, stone in the endless task that will never be done.
to aid them in recommending apps for their Recommending apps today meant modifying
adult clients with neurogenic communication the list soon thereafter. This is because there are
disorders who were interested in being taught so many of them, and the number is only
how to turn their cellphones and tablet devices growing. (Apple reports that the App Store
into communication aids. We almost immedi- has roughly 500,000 apps available through that
ately began to feel like King Sisyphus, who was platform.) So instead, this article is a strategy
condemned to rolling a huge boulder to the top paper concerning how to ensure not only that
of a steep hill. Each day, when he finished and appropriate apps are being selected for use by
stopped rolling the boulder, it rolled back down various aphasic clients but also how to increase
1
Department of Speech, Hearing and Language Sciences, Semin Speech Lang 2012;33:223–233. Copyright # 2012
University of Arizona, Tucson, Arizona. by Thieme Medical Publishers, Inc., 333 Seventh Avenue,
Address for correspondence and reprint requests: New York, NY 10001, USA. Tel: +1(212) 584-4662.
Audrey L. Holland, Ph.D., 4945 E. Commissary Court, DOI: http://dx.doi.org/10.1055/s-0032-1320042.
Tucson AZ 85712 (e-mail: aholland166@gmail.com). ISSN 0734-0478.
Technology and the Adult-Focused SLP; Guest Editor,
Audrey L. Holland, Ph.D.
223
224 SEMINARS IN SPEECH AND LANGUAGE/VOLUME 33, NUMBER 3 2012
the likelihood that apps are used, for clinical more explicitly in Table 1, along with some
language training, as well as for use in the others we find useful. However, bear in mind
communicative world. We will discuss how to that because of the constant changing of app
find and judge apps, then how to introduce apps availability, our listing in Table 1 is simply
to persons with aphasia (PWA) and their illustrative, and likely to be outdated even by
families, and then once there is buy-in, how the time this article is in the hands of journal
to assure their use in the real world. We will end readers. Nevertheless, it reflects a sampling of
with some real-life examples of successful, useful apps for individuals with aphasia. A
personalized app usage.† friend who works with autistic children, and
who is a real “app guru,” reports that she begins
her working days with a visit to iTunes or the
HOW TO FIND AND JUDGE APPS App Store seeking what has come on the market
It is perhaps important to point out that the for her clients since yesterday. This is a useful
majority of apps with potential utility in aphasia practice for aphasia treatment, although once a
have been designed for other disability groups, week is probably sufficient. We suggest looking

most notably autism. Therefore, the potentially in the App Store under the category headings
useful inventory is actually much larger than the “education,” “productivity,” and “medical,”
really useful apps for aphasia. Nonetheless, although “games” might be worth looking at
there are several apps that may be beneficial as well. If you cannot find it there, go to iTunes.
for aphasia treatment which are as follows: Some, such as “Hanging with Friends” can be
(1) some apps are used to improve basic useful clinically, and there is no law against
speech/language capabilities, providing tar- aphasic people having fun with apps. There is
geted drills, practice, or exercises used as sup- also no reason why playing games like “Angry
ports for traditional, impairment-based Birds” with one’s grandchildren should be
treatment. For individuals who live in remote limited to people with intact language. (It
settings, these apps may be used to replace one- also probably helps eye-hand coordination,
to-one treatment. (2) Others are used to com- and improves one’s status as a cool grandparent
municate spoken, written or visual messages to as well.)
others, or to facilitate or clarify otherwise
unclear communication attempts made by
PWA to others. These apps function as com- GETTING STARTED
munication support, and provide augmentative/ The above suggests how to find apps. It says
alternative communication available in portable virtually nothing about how to select apps that
and economical form. (3) There are several apps might be useful in the management of aphasia,
that are not specifically designed for language- a far more critical and demanding concern.
disabled persons that may be useful in accessing We, as well as several other clinicians, we have
or tracking medical information related to made the mistake of “discovering” the world of
aphasia. (4) Finally, some built-in features of apps, loading up our iPads or Touches with all
the platform itself may be considered as apps in the free ones that look remotely interesting,
the management of aphasia. An example here peppering them with a few that we consider
might be Google images. within our “price range” (in ALH’s case, that
Throughout this article, we will be refer- is $20 or thereabouts). We then explore what
ring to example apps, which will be described we have amassed, pick out 10 or more likely
candidates, and lay them out for people with
aphasia to choose from. This is not a good
† We are mostly Apple people, and in our work, use iPod idea.
Touches, Mac Computers, and iPads in our work. Apple has There are many reasons for this being less
been in the forefront of app development for educational
than wise. The most important, in our experi-
uses, and the majority of apps for aphasia can be found
either in the App Store or in iTunes. However, this is in no ence, is that very few clients approach apps (on
way meant to limit the reader’s use to these platforms. But their own, or with proddings by clinicians and
in this article, they will be the featured devices. families) with an objective idea of what their
HOW TO USE APPS CLINICALLY IN THE TREATMENT OF APHASIA/HOLLAND ET AL 225
Table 1 Some Apps We Have Found Useful: Name, Source, Cost, Platform, Description
Name: Angry Birds

Source: iTunes
Cost: $.99
Platform: Compatible with iPhone, iPod Touch, and iPad. Requires iOS 4.0 or later.
Description: A simple game to play. The birds, angry that the pigs stole their eggs, seek revenge.
Name: Aphasia Corner http://aphasiacorner.com/app

Source: http://aphasiacorner.com/app/stories and
http://aphasiacorner.com/app/activities/phrases
Cost: Free
Platform: Compatible with iPhone, Ipod Touch, and iPad. Web app is available for PC and Mac computers.
Description: Transcripts of National Public Radio news stories that are read aloud as you follow the printed
transcript. Also, an app with printed phrases that you can select to hear and practice repeating.

Name: App Store
Source: web browser
Cost: Free
Platform: Compatible with iPhone, iPod Touch, and iPad.
Description: App distribution system for iPad, iPhone, and iPod Touch.
Name: Dragon Dictation

Source: iTunes
Cost: Free.
Description: Text to speech. This app can be used to target reading and writing skills. User can send e-mails.
Name: Drawing Board

Source: iTunes
Cost: $.99
Description: This app can be used to draw pictures or write words.
Name: Drawing Pad

Source: iTunes
Cost: Free
Platform: Compatible with iPad. Requires iOS 4.0 or later.
Description: User can draw pictures or write words. Nice selection of writing tools, colors.
Work cannot be saved.
Name: Easy speak

Source: iTunes
Cost: $1.99
Platform: Compatible with iPhone, iPod Touch, and iPad. Requires iOS 3.1.3 or later.
Description: Text to speech.
Name: Easy writer

Source: itunes
Cost: Free
Description: Write and respond to e-mails with landscape keyboard.
(Continued )
Table 1 (Continued )
Name: Google maps

Source: built-in the devices.
Cost: Free
Platform: Compatible with iPhone, iPod Touch, and iPad on iOS.
Description: User can locate addresses; PWA can show someone where s/he is going. User can zoom into
street view.
Name: Hanging with friends

Source: iTunes
Cost: free
Description: Word game played on your device with another person on their device. Good for social
interaction, spelling, and reading words.

Name: iConverse
Source: iTunes
Cost: $9.99
Description: Six basic needs icons are available with auditory and visual stimuli. A section is available for
user to create his/her own frequently used phrases with pictures.
Name: iSay
Source: iTunes
Cost: Free
Description: This app is designed to enhance auditory and visual memory skills.
Name: iTunes
Source: Web browser
Cost: Free
Description: A primary Web site to obtain and manage apps.
Name: Locabulary Lite

Source: iTunes
Cost: Free
Description: The user can select from three categories with the option to add your own. The restaurant
selection includes items from McDonald’s and Starbucks which are useful to practice or play when you
place your order.
Name: Magnetic ABC

Source: iTunes
Cost: $1.99
Platform: Compatible with iPad. Requires 4.0 or later.
Description: The user can drag letters, numbers or figures to the board to create a message.
Name: Phrase Board

Source: iTunes
Cost: Free
(Continued )
Platform: Compatible with iPad. Requires iOS 5.0 or later.

Description: User can write a message or draw a picture. Option is available to e-mail your message.
Name: Pictello
Source: iTunes
Cost: $18.99
Description: User can create talking photo albums customized with your own photographs and voice.
This app is simple to use.
Name: Skype
Source: iTunes
Cost: Free

Description: Audio and/or video “phone” that allows you to call others on Skype.
Name: Small Talk Aphasia series: Lingraphica

Source: iTunes
Cost: Free
Description: Can choose to download male or female voice. Apps in iTunes include SmallTalk Basic
Communication, SmallTalk Phonemes, SmallTalk Conversational Phrases, SmallTalk Oral Motor Exercises,
SmallTalk Letters, numbers, colors, and SmallTalk Days, Months, Dates.
Name: Speakinmotion: Visually Assisted Speech Technology

Source: App Store
Cost: $9.99
Description: View close-up video of oral movements as the word or phrase is spoken; in some cases, written
cues are available.
Name: Speak it
Source: iTunes
Cost: $1.99
Description: Text to speech. Select the text you wish spoken.
Name: SpeakPad
Source: iTunes
Cost: Free
Platform: Compatible with iPad.
Description: Text to speech.
Name: Tactus Therapy Solutions

Source: App Store
Cost: $24.99 for each of the five TherAppy apps
Description: Apps include: Comprehension TherAppy (auditory and reading comprehension), Naming
TherAppy, Writing TherAppy, and Reading TherAppy.
(Continued )
Name: Talk Assist

Source: iTunes
Cost: Free
Description: Text-to-speech. User can save phrases.
Name: Talking Tom

Source: iTunes
Cost: Free
Description: Tom is a friendly cat who repeats everything you say and responds with his own sounds when
touched.
Name: Tap To Talk

Source: iTunes
Cost: Free
Description: An album of pictures is provided or you can create your own. The word is said aloud when the
picture is selected. Geared toward children.
Name: Text to speech

Source: App Store
Cost: Free
Description: Text to speech. You can change the speed to suit your needs.
VAST: see speakinmotion
Name: Verbally
Source: iTunes
Cost: Free
Description: This app contains a keyboard and a core grid of words and phrases to create printed and auditory
messages. The complex grid might be confusing.
Name: VocaBeansLite
Source: iTunes
Cost: Free. Full version is $9.99
Description: This app provides pictures with printed words said aloud when selected. It can be customized
with your own pictures and phrases, and your own voice.
Name: Words with Friends

Source: iTunes
Cost: Free
Description: This app allows you to tap to talk and play scrabble with your friends.
†
The ASHA Leader provides periodic commentary on apps that are usable across the domain of communication
disorders. This site is managed by Judith Custer.
devices and its apps can or cannot do for them. on laptops, or who have owned their device for
This is true even if some clients already use e- some time and have watched family members
mail or have worked with impairment focused use it. An even more typical case might be the
software such as Parrot1 or Bungalow2 products person with aphasia who is still “shopping
about” and exploring, using your or your clinic’s Lending each type of device through one’s
equipment to do so. workplace is probably the best way to deter-
Further, clients may be skeptical about this mine what best suits a particular client’s
new stuff, or even afraid to use it. And, as in all needs and wants.
other areas of clinical speech pathology, client Even clients who might have used lap-
buy-in is essential. This is often true when it tops or desktops with aphasia software might
comes to PWA using their devices and its apps not be ready to take what is a rather giant
outside the clinic. So how can buy-in be leap to using apps as communication supple-
achieved? ments. One helpful way to introduce apps to
such clients might be by using them for home
practice of language skills as get-acclimated
ACHIEVING BUY-IN apps, even if the goal of a client’s ultimate use
There are a few steps involved in getting might be as communicative aids.
individuals appropriately interested in what 2. Most individuals need to learn the basic

hand-held devices and apps can do for them. operations of their device, such as shutting
To us, this is a process not unlike that of it down and monitoring the battery level as
developing self-efficacy, in this case, of learning well as learning relevant gestures such as
to feel comfortable using iPads, Touches, or swiping, tapping, and pinching.
other devices before moving into more ad- 3. A clinician who is diligent about searching
vanced use. These steps are summarized below. for new relevant apps will have a large,
potentially unmanageable collection of
1. The first step is to determine if the client in apps on his or her own iPad or Touch. We
question is indeed a candidate for using apps believe the starting place should be one or
at all. That is, does the PWA have a problem perhaps, two apps, carefully chosen both to
that is likely to benefit from the use of apps? meet a client’s interests/needs, and your
Apps are not a panacea for aphasia by any assessment of his or her capabilities. At the
means, either as impairment-focused prac- Adler Center, we noticed in one of our
tice devices, or as ways to enhance commu- earliest group sessions to introduce apps,
nication and participation in society. So the that the biggest hit, and the real ice-breaker
first questions concern how you expect to see was not a speech app at all, but Talking Tom;
your clients use the apps that you will help even our most impaired could get Tom to
them to select? As a way to practice language mimic him. Once the ice is broken, then it
tasks at home? To help them navigate more becomes easier to move ahead. This app was
effectively in everyday life? Hard on the heels also a success because there were only a few
of that one is how does the PWA him or simple steps to operate the app and the steps
herself expect to use them? Are there families were consistent and never changed. In many
or friends to support their use, largely by apps, there is a lack of consistency in terms of
understanding how to use them themselves, the steps needed to manipulate or maneuver
or be willing to learn? Finally, is the client’s through it. This lack of consistency results in
home amenable to app use, that is, does the confusion for the PWA. It is best to find apps
home have Wi-Fi. that have basic, simple steps or can be
Such questions take precedence even modified to just a couple of steps that the
over what sort of platform is most appropri- PWA can then use independently.
ate for clients. In our experience, tablets have 4. We see two general directions in which app
a distinct advantage over devices such as the use in aphasia can go. One is toward using
iPod Touch in terms of keyboard size. This apps as training tools, perhaps for re-estab-
might be especially important for individuals lishing language skills impaired by aphasia.
who have right hemiplegia, while smaller A useful family of apps here would be those
devices have advantages in portability. iPads developed by Tactus Therapy Solutions
seem to have a distinctively higher appeal. (see Table 1) particularly because they can
be geared to severity levels, and by the time Another good starting place might be e-
this is published, customized at least in part mail. Once a device is purchased, then creating
to personally relevant words. Lingraphica a Gmail account is painless and fast (and can be
also provides apps for language impairment done with clinician help). The PWA is now in a
focused therapy. The other direction is to- position to practice with few chosen corre-
ward using apps to enhance everyday com- spondents (including the clinician who asks
munication directly. In our view, this is a for a commitment, say, of two e-mails per
critical distinction. However, before that week from the client). This form of communi-
decision is made—and again—this is not cating is not only a good ice-breaker, but one
entirely the clinician’s decision, but a joint that has real-world consequences.
decision among aphasic person and family, There are many more ways to initiate usage;
and clinician—it is probably worthwhile to the above were merely intended to illustrate the
demonstrate to PWAs (and for many fami- necessity of familiarizing a novice user with
lies) the potential utility of apps overall. these new devices and apps. For example, the
Starbucks/McDonald’s/Locabulary trip above

may be used or repeated in more challenging
INTO THE REAL WORLD ways with other apps at other stores. It is
What follows is an example of how to accom- possible also to develop appropriate individually
plish app usage in an aphasia group, designed determined scripts using apps such as Pictello or
for potential users of apps in their daily life. The Visually Assisted Speech Technology (VAST)
app Locabulary Lite (LL in what follows) seems for this purpose. If this is done, then the
almost perfectly designed for such a demon- individual becomes responsible for speaking
stration. LL features two well-known places— his own message rather than relying on LL.
McDonald’s and Starbucks. It includes full
menus for both sites, as well as several prere- ENSURING USAGE
corded, useful leader phrases, which can be put However, this is still not a matter of wishing
together so that an individual can order, for clients well and sending them off to conquer
example, from the Starbucks menu—“I would cyberspace. Helping clients to use apps that are
like Cappucino grande,” which is spoken loudly appropriate for them typically requires a lot
and clearly enough by the app to permit the more hands-on intervention. We believe that
PWA to order what he might wish. (LL also three additional tactics can help to assure
contains a clear and simple assistance vocabu- success. The first is to ascertain that families
lary so that it could be used to communicate and involved friends or staffs play a role as well,
sentences as complicated as “I need to go to the both by understanding what is going on and
handicapped entrance.”) However, the task at becoming familiar with the apps themselves. It
hand in this group activity is ordering at the is also wise to encourage PWAs always to carry
chosen place. Before an expedition, group their devices with them and not only use them
members decide on which place they choose in therapy—family and caregivers can then
to go, and then plan what they intend to order reinforce its use beyond structured therapy.
there. They then go on a field trip in which they Third, we believe that asking clients systemati-
order, with their respective devices, what they cally to devote a self-chosen amount of time to
wish. Success, of course, is determined by practicing at home and to keep a record of that
whether or not each person receives his chosen practice is important. This is not “homework”
drink (or burger). This is likely to require in the school sense, but rather a form of
practice before the actual trip (and perhaps a contractual commitment on an adult level.
trip by the clinician to Starbucks or McDonald’s
to explain what is going to happen and when). It
also can be embellished in a few ways, such as APPLYING APPS
“prizes” for the people who actually get what In what follows, we will detail how a few
they ordered, etc. selected apps have been used successfully by
clients. This is not meant to be exhaustive, nor their client be a likely VAST candidate. Each
is it meant to be a testimonial to the apps that PWA was seen over the course of a 6-week
are featured. It merely illustrates the importance period of practice using three generic scripts on
of matching apps to clients, as well as the kind topics (making scrambled eggs, weather in
of practice that might ensure use, and thus lead southern United States, etc.). They practiced
to successful outcomes. It also provides a few each script for two successive weeks of the
guidelines concerning data collection geared to 6-week training period. Participants were re-
addressing functional outcomes of app usage. quired to practice at home for 30 minutes,
Once apps and the platforms on which they 5 days a week. They were monitored by
run are demystified, the real work begins. Much clinicians either using Skype or home visits,
like more traditional treatment, practice at usage and by internal VAST record keeping. Mas-
can become a focus (at least partially) of treat- tery of the scripts, as well as generalization to
ment. Elsewhere in this issue, McCall3 describes untrained scripts was compared at the study’s
how she integrates app usage in her everyday end and again 6 weeks later. This is a very
group sessions and interactions with PWA at workable model for VAST treatment, as

the Snyder Center for Aphasic Life Enhance- Fridriksson’s data indicate, and can be extend-
ment (SCALE) in Baltimore, MD. We will not ed for use with individually tailored scripts as
reiterate McCall’s information here, but simply well. Further, the structure of the study sat-
remind readers that practice for group partici- isfies requirements for systematic data collec-
pation and then use of the apps in groups is a tion that ultimately can inform the scientific
particularly viable approach. But there are others community of the power of apps in the man-
as well. In what follows, we will describe a few agement of aphasia.
communication-oriented applications. At the Adler Aphasia Center, we use
Similar to SCALE’s in-program usage, Pictello, iConverse, and various Small Talk
Stroke Comeback Center in Vienna, VA uses Lingraphica apps as approaches to the incor-
VAST technology in their VAST group. On a poration of personally relevant scripts into the
more individually tailored basis, Fridriksson verbal repertoires of several aphasic clients.
et al4 have recently completed a study of 13 Both Pictello and iConverse can incorporate
aphasic individuals with moderate/severe photographs and icons as prompts; all are
Broca’s aphasia and apraxia of speech using simple to use. The SLP is responsible for
the speech entrainment¥ approach embodied entering personalized information into the
in VAST. This approach requires the aphasic PWA’s device but a family member or care-
speaker to mimic the lip placement of a giver can be trained on how to customize
speaker seen on the app while simultaneously information Scripts are prepared in a manner
hearing what is being said. Fridriksson et al described elsewhere.5 The goal is for the
were primarily interested in using neuroim- PWA to become proficient in using their
aging to better understand the mechanism scripts either through independent recall or
whereby this approach is effective for many by navigating between entire script and indi-
speakers, and to this end participants under- vidual scripted lines using their device as
went functional magnetic resonance imaging needed. We always emphasize using speech
scanning at baseline, when training was com- before using the iPad. We look for generali-
pleted, and again 6 weeks later. It is beyond zation not only of the script content in its
the scope of this article to discuss the imaging entirety (with or without app help) but to each
data. PWA’s ability to use some of the scripted
Nevertheless, their training model is an words spontaneously in other contexts. It
excellent one for clinicians to follow, should should be noted that some of the short
phrases available on Small Talk Aphasia
apps, as well as those available on Aphasia-
¥ Fridriksson uses “entrainment” in the sense that speech
appears to be pulled along (entrained) by the combined Corner, are acceptable for script-like
presence of auditory and explicit speech models such as practice and training in individuals with
VAST. more severe language problems. We are
gathering ongoing data as to the effectiveness aforementioned Tactus reading app is basic.
of our approaches. A potentially interesting Both Tactus and Lingraphica apps provide
combination of approaches might be to use simple auditory comprehension work. But as
Tactus’ spaced retrieval (SR) app to guide for comprehension in less controlled situa-
initial script practice, and thus make scripting tions, to our knowledge, the only higher level
approaches more likely to be effective with approach consists of National Public Radio
disorders such as primary progressive aphasia, Stories, which can be controlled for speaking
mild cognitive impairment, or early stage speed, and highlights written text as it is
dementia on which most of the validating spoken. This app is available through Aphasia
work with SR has been done.6 Corner.
Many aspects of aphasia remain unad-
dressed by apps. It is interesting that, to our
THE STATE OF APPS FOR way of thinking, more is available at the usage
REAL–WORLD USAGE IN READING, than at the impairment level of aphasic disabil-
WRITING, AND COMPREHENSION ity. Regardless, aphasia management is a fertile

We have found more apps useful than just this field for both enterprising clinicians and app
handful for speaking skills and ways to augment developers.
them in aphasia. The following have also been
useful for some of our clients. These include
text-to-speech apps such as Speak it!, Easy SUCCESS STORIES: SOME
Speak, and Talk Assist. All are easy to use. A SURPRISES AND A CAUTIONARY
client’s perception of which is preferred might NOTE
depend on the quality of its speech or the We close with a few very different “success
simplicity with which he and his clinician can stories” from individuals who have discovered
figure out how to assure correct pronunciation the value of this burgeoning technology in their
of nonstandard words and names. own unique ways.
To this point, we have been discussing apps
that involve production skills in aphasia, and
ways to augment or enhance them. There are Sometimes Favorite Apps Can Be
probably even more apps that address reading Surprises
and writing issues as well as difficulties in Jose already had an iPod for listening to music,
comprehension. Speech to text is an essential and he knew how to use it. However, when he
adjunct for persons with writing disabilities. entered the app world, it became apparent that
Speech-to-text apps have special appeal for the fingers that were nimble on a piano were not
enhancing e-mailing, list making, letter writ- accommodated by it. He used the clinic iPad
ing, or other writing tasks that affect quality of and decided that it was a better match for his
life. For individuals who have relatively intact fingers and his needs. He has experimented
speaking skills, they can function as effective with a variety of apps over the past year, and
time savers in their writing attempts. Dragon surprisingly, what he finds most useful is Goo-
Dictation and SpeakPad are good examples. gle Maps. Jose is an independent man, who
For persons whose writing skills are extensively despite his severe aphasia, still drives and is
compromised, apps can be used for writing constantly on the go. Google Maps has become
practice. Perhaps the most useful are drawing his way to communicate where he has or is
pad, which permits individuals to write or draw going to his family. He uses other apps more
with their fingers and easy writer, a tracing conventionally, with names of his extensive
program, or Tactus writing. family being the most important of his needs.
Although there are myriad apps for read-
ing, the majority are geared toward teaching
reading to children. To our way of thinking, The Storyteller
these are largely inappropriate for adults with It is clear, almost from the moment you meet
aphasia (as well as for adult literacy). The him, that before his stroke Morry was a
gregarious, life-of-the-party type of person. speech, and have not bought into augmenta-
With his limited spontaneous speech, his best tion. But Len is still hanging out with his fellow
stories were unavailable to him until they were Touchers, who form the center of his social life,
entered into his iTouch using VAST technolo- and sending (somewhat aphasic) e-mails to his
gy. They are again accessible through VAST. friends across the country.
One of Morry’s biggest problems is that there
are so many of them that it is sometimes quite
time-consuming for him to access the one he CONCLUSIONS
wants. We have chosen these rather unusual examples
primarily because before we got into the apps
business, we had at least a notion of what
You Never Know, so Do Not success might mean. That is, we would find
Underestimate It appropriate apps, teach their use, expect them
Frank is an enigma. He was very interested in to be practiced, and finally make an impact on
using an iPad. He bought one, even though his real-world usage by individuals with aphasia.

clinician felt he was not a candidate for its use. And without a doubt there are many of those
He made limited progress in its management among PWA app users. But it is instructive to
over a 6-week term, and his clinician has found know as well that clinicians cannot always know
no apps that are useful to him. He uses his iPad or predict what others might view as success.
primarily to open his favorite newspapers that
have been bookmarked for him. But he carries it
everywhere, and is delighted to own it. We ACKNOWLEDGMENT
suspect that one of its most attractive features is The authors wish to thank the Robert and John
that it enhances his image as a techy. Dircks Foundation for their generosity in mak-
ing iPads available to the Adler Aphasia Center,
Maywood NJ.
Success Sometimes Has a Dark Side
Len has become an experienced Lingraphica
App user, and has many personal stories on his REFERENCES
iPod Touch. He displays them proudly and
likes to use them as springboards for his con- 1. Weiner F. Parrot Software. http://parrotsoftware.
versations with others. He hangs out with a com/
group of other “Touchers” and there is a lovely 2. Nichols C, Brancewicz T. Bungalow Software.
http://www.bungalowsoftware.com/
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How To Use Apps Clinically in The Treatment of Aphasia

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How To Use Apps Clinically in The Treatment of Aphasia

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How to Use Apps Clinically in the

This article is designed to provide aphasia clinicians with some

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KEYWORDS: Apps, App Store, iTunes, platform/device, use of

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Name: Angry Birds

Name: Aphasia Corner http://aphasiacorner.com/app

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Name: Dragon Dictation

Name: Drawing Board

Name: Drawing Pad

Name: Easy speak

Name: Easy writer

Name: Google maps

Name: Hanging with friends

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Name: Locabulary Lite

Name: Magnetic ABC

Name: Phrase Board

Platform: Compatible with iPad. Requires iOS 5.0 or later.

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Name: Small Talk Aphasia series: Lingraphica

Name: Speakinmotion: Visually Assisted Speech Technology

Name: Tactus Therapy Solutions

Name: Talk Assist

Name: Talking Tom

Name: Tap To Talk

Downloaded by: Instituto Politécnico de Setúbal. Copyrighted material.

Name: Text to speech

Name: Words with Friends

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