Guest Post - Professional Apraxia-EZ app review

I'm sure it seems a little hard core to be posting a product review on New Year's Eve, so let me explain; Like many people, I like to think about what the new year might hold, and what I can resolve to do to make things happen. 
I don't smoke, I'm not too bothered about diet because at my age I find if I don't eat the right things, my body quickly tells me to cop on - and the regular visits of the wine fairy will be addressed later in January.


What I do resolve to do is get a bit more of a handle on Gracie's vocal approximations. When typical children learn to speak they move through the sounds like Bababaaba, Dadadaddda, and there is a natural progression as the baby talk eventually turns into speech.


Gracie did not say any babble and as you know, did not produce a recognisable word until she was six so her mouth did not "learn" to make each core sound.
She had little or no clinical therapy for many years, and access to a speech and language pathologist on a consistent basis was rarer still. I did what I could as a parent; but it takes a professional to identify and correctly reinforce the right approximation consistently, while supervising everyone else in her environment to do the same. This is called an Apraxia program. You can't do this at home! (but oh boy did we try!)


Thankfully, this year we had the exact combination of quality speech therapy and the right behavioural reinforcement in her ABA school; and with regular measurement and sharing of data she made great progress. 


And then the Therapist got a promotion and left. (story of my life!!)


When I heard that there was an App for implementing an Apraxia Program I was very curious. I asked an old friend, who has a speech therapy business to take a look at it and do a review. 
Disclaimer: Marijke who has written the review below has worked with Gracie in the past and knows her issues well. However, she has assessed this in relation to her current practice and as you can see, across a number of clients, not including Gracie.


 As I said, this a skill set that you simply cannot acquire from a book and I find all the shorthand symbols on Gracie's reports difficult to follow and the therapists had to translate them for me phon-et-ic-ally.
I would still be very interested in seeing if the parent App was more user friendly.


But what follows is a truly professional review. 
Best Wishes to all of you for a progressively improving 2012.  
Lisa xx"


Apraxia-EZ app review





Marijke Morris, Speech & Language Therapist



The Apraxia Picture Sound Cards APSC Pro was developed by a Speech and Language Pathologist. The app was created for individuals with Childhood Apraxia of Speech (CAS) and severe phonological disorders. This version is the professional version, designed for speech and language therapists to create multiple entries for different students.


The pro app costs $299.99 and is mainly designed to support the Speech-EZ® Apraxia Program. It is mentioned in the app description on the app store and the developer’s website that it supports the Program. The parent version costs $179.99. I am reviewing the professional version of the app from a therapist’s point of view. The only difference between the parent and the pro version is that the parent version is for a single user and with the pro you can track multiple students. I am not a certified Speech-EZ® Apraxia Program practitioner, but was informed by the developer that if I purchased the manual, I would be able to use the app in clinical practice.

The target population is quite small, which means this app is not appropriate for frequent use for therapists, unless they have a specialised caseload of CAS and severe phonological disorders only.

The picture flashcards are very clear and colourful. When you press on the picture, the picture flips over to reveal the text. A few children found it reinforcing to look at the text and were motivated to activate the flip themselves. Some children were often more motivated to flip through the pictures, and needed constant supervision to say the target word. It would have been useful to have a recording facility on the app, for children to self-monitor, and for therapists and parents to share feedback.

The therapist cues and elicits the target words and rates it on the app out of 3, using a smile, neutral face or frown symbol. Parents may find it difficult to rate their child’s speech accurately and this needs to be taken into account if the app is used as part of a home programme. If a target word needs to be repeated, it also skews the data of the session, as the rating is only connected to the sound position, not the target word. The data can be stored and emailed to the parents. This was usually very effective in tracking data, but I found that the data was completely incorrect for one of my therapy sessions, so manual back-up data is also recommended for therapy tracking.

Target sounds can be selected for the picture cards on their position in the word, whether final or initial position. Target sounds are not available in the medial position. Tap-to-play audio is also available, but it should be noted that it is in an American accent, not suitable in the UK and Ireland. Some target words are also American vocabulary, for example “pail” instead of “bucket”.

The hand cue cards contain video footage to demonstrate the hand cues and would be useful if you are not using a different set of visual cues in therapy already.

App Summary

Skill(s) Targeted
  • Target speech sound practice within words
Age/Grade Levels Targeted
  • Children
How to Activate
  • Isolated finger point
Type of Device
  • iPad
Cost
  • $299.99 (excl. manual)
  • Manual $95 (required)
Would you recommend this App?
  • No – the price makes this app poor value for money. There are other cheaper apps that can be easily adapted to serve the same purpose. It would not be suitable in a core vocabulary approach. The target words and audio are American, and not suitable for children outside the US. (This could easily be rectified with localisation, as done by other app developers).




Comments

Maddy said…
Very interesting. Any suggestions as to which other cheaper apps might be adapted?midito
Best to contact Marijke at Catts on Facebook or Twitter Maddy- I will post the question there. I'm still interested in testing the parent one as we might not get a new speech therapist for Grace for months and I'll have to do it myself again. xx
CATTS said…
Hi Maddy and Lisa,
It may be best for me to comment here, as I might not have made it clear in the review. The app description states correctly that it can't be seen in lieu of speech therapy. I have to caution parents on using this app without the help of a speech therapist. The same would be true when adapting other apps.

You would be able to use it as a home programme, with a speech therapist providing you with the target sound and position, as well as the therapist regularly reviewing progress. You may do more damage than good by using a programme yourself.

The parent version of the EZ Apraxia app only differs from the professional version in how many students' data can be tracked. I would not recommend it, as the adapted apps may give you more scope for practice and would be significantly cheaper.

The apps that can be adapted are for example ArtikPix (you only pay for the sounds you use) and Articulation! These apps were not designed for apraxia, but with a therapist's help you can identify goals and a way of eliciting the target words with visual cueing. I'll keep an eye out for any other apps as I go along.

Please feel free to contact me at mmorris@catts.ie if you have any questions or concerns. I'd be glad to help.

Marijke Morris

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