Talking Temptations- Strategies and a few apps that promote the urge to speak

June 7, 2012

During speech therapy sessions with children and adults with severely impaired communication skills, one of my primary challenges is setting up situations that promote the urge to talk. As parents, therapists and educators, when helping individuals who have significant communication challenges, we need to set up an environment that gives the individual a reason to talk and make sure to give individuals enough wait time so that they can initiate speech.  Most of us often know what a person is trying to say and help meet their needs to avoid conflict or make life easier, but there are times that it is more appropriate and therapeutic to actively intervene so that there is more of a reason for the person to initiate a communicate attempt.

There are quite a few methods for doing this. We can sabotage the situation- place something in full view but out of reach that we know the person wants, give them something broken that they need to have fixed or engage them in a pleasurable activity such as swinging on a swing, listening to music or playing a fun game- then suddenly stop the activity. Lots of praise for communicative attempts is critical to promote communication- as is providing frequent opportunities for communication during enjoyable activities. If communication does break down- we try to give just enough help for success. It’s important once the communication is repaired- to then review what happened and practice what the individual could have done or said to communicate the desired message.

I use these techniques with a wide range of individuals- young and not so young individuals with autism spectrum disorder ( ASD), adults with aphasia and individuals with dementia or other cognitive challenges. The initiation of communication is critical for quality of life- and often quite a challenge to establish.

I encourage families, teachers and therapists to create situations throughout the day during everyday activities such as morning rituals, mealtimes, work/school and leisure activities.

When using the iPad- I have recently been using quite a wide variety of apps to create these temptations. Of course- the selection depends on the interests and motivations of the client. For individuals with more advanced communication abilities- these same apps can be used to give each other directions or describe what has happened in the app or what they are about to do.

Here are a few of the apps I have recently been using to generate or improve communicative interactions:

YouTube-    on my iPad I have saved many great videos in the “favorites” section for easy viewing. At times I might pause them engage in comments about what we see. I may offer written word choices using paper/pencil, include targeted vocabulary in an AAC app or provide hands on prompting to facilitate accurate verbal productions. Older clients often like “Dancing with the Stars” , while younger ones often respond to amusing Disney clips or favorite singers. Whenever possible I try to find funny clips to promote enjoyment.


Cut the Rope or Where’s My Water– These two apps are very popular with just about all clients. I hold the iPad and encourage clients to say words such as “dig” , “cut” etc prior to interacting with the app. Hand over hand guidance may be needed for individuals with limb apraxia- but many people young and old love these apps.

  My PlayHome and Cookie Doodle- These apps are not “drill and practice” , but offer motivating ways to engage clients with motivating fun activies. I try hard not to have individuals repeat what I say- but facilitate their production of utterances to make things happen. An example might be “Dad on swing” , “Baby bounce” or “eat cookie.”

Below I have listed a a few websites, blogs and videos that do a great job of presenting ideas about how to create communication temptations and facilitate communicative interactions. I am sure there are many more.

Top 5 Ways to Encourage Spontaneous Language

Communication Temptations: How Use Your Environment to Get Your Child Talking

8 Ways to get your Child to Speak

Communication Temptations

How to make communication temptations really work

Activities to Encourage Speech and Language Development

If you know of other sites or videos that illustrate the use of communication temptations to encourage verbal initiative- please email me at


Using Free Online Humorous Videos to Enhance Speech Therapy

February 20, 2012


Golden Loves Guitar

Mr. Bean Goes to the Swimming Pool( small ad first)

Mr Bean Goes to the Dentist

Two Dogs in a Restaurant

In past newsletters I mentioned quite a few drill and practice programs and apps that I frequently use to improve speech, language and cognition as well as more open-ended/creative products to work on goals such as initiation, turn taking, novel sentence formulation, asking questions, following directions and play.

I realize that not everyone has an iDevice. Today I want to share wtih you some free online videos I have been using in therapy. They can be accessed with an iDevice or just about any computer, tablet or Smartphone that has Internet access. I have selected them because they are generally just a few minutes long and involve humor. I generally watch the entire video once then pause it frequently to interact with my client on a wide variety of goals as we view it again.

Some goals I may have for this session may include:

  • Improving joint attention to a task
  • Naming items pictured or pointing to appropriate pictures on an AAC device or printed out
  • Formulating sentences to describe what they saw
  • Remembering details shown
  • Asking and answering questions about what happened on the video
  • Discussing displayed emotions and practice analyzing the perspective of others
  • Reflecting on other situations/scenarios peopel have encountered similar to the one pictured.
I’d love to hear from you if you have favorite humorous videos that you use as part of your therapy or just enjoy watching. I find that these videos keep sessions fun and interactive:) They provide a great source of material to stimulate conversation and progress toward goals:)

e2 B o o k R e v i e w The Ultimate Guide to Assistive Technology in Special Education

February 20, 2012

January/February 2012

Book by Joan L. Green, M.A., CCC-SLP

Published by Prufrock Press, 2011
Format: 221 pages, 10×7 inches, paperbound; also available in
electronic versions
Joan L. Green must be something of a pack rat when it comes to gathering information about hardware and
software in the category of assistive technology. We’d love to know whether her office desk is covered with little notes
and pieces of paper about the hundreds of resources she covers in her book The Ultimate Guide to Assistive Technology
in Special Education, or whether she’s just fiercely well-organized electronically. Green, a speech and language pathologist, offers her
compendium of assistive technologies in order to “empower individuals with literacy, learning, and communication differences.” Among the groups whose lives she hopes to improve are those with autism, learning differences, and cognitive deficits. Her goal is to create opportunities and remove performance barriers. Covering a Range of Challenges The first three chapters provide an overview of the power of technology, the benefits of assistive technology, and the various classes of hardware and software useful in assistive technology. (Chapter 2, on benefits, is available online at the Prufrock website.) Those are followed by seven chapters covering A.T. that can help with specific challenges:

• Verbal expression (two chapters)
• Auditory comprehension
• Reading comprehension
• Reading skills
• Written expression
• Cognition, learning, and memory.

The book concludes with chapters on games and online activities; Internet communication and learning tools;
and adapted e-mail, search engines, and browsers.

A Sample Chapter

A look at a sample chapter gives a good idea of Green’s approach in her book. The chapter “Treatment
and Technology to Improve Written Expression” opens by identifying when written expression may be a problem —
for example, in those with LDs, strokes, or other cognitive challenges. Green then lists the skills involved in written
expression and suggests that low-tech options such as pencil grips be considered as well as high-tech. After stressing why written writing skills are important, she then presents strategies and resources to improve writing, starting with software and apps for drill-and-practice. For each of 16 drill-and-practice writing A.T. apps, the chapter provides the app name, platform (Apple, Window,
etc), price, and bullet-point descriptions of the features of the app. Here’s an example:

Story Patch By Haywoodsoft
• Apple app
• This is a story creator designed with the goal of
helping kids create stories on their own or with
the help of a template.
• The user first titles the story, then selects a
theme such as “a trip to the zoo” or builds his
story independently.
• If the templates are used, questions are
presented with possible answers and the user
selects her response to create a unique story.
• There is an image library with more than 800
images grouped into 47 categories to create
settings for each page.
• A character designer or personal pictures can be
used to create the characters in the story.
• $4.99

The chapter continues with sections on:
• Software to improve spelling
• Word processors as a way to help the writing process
• Picture-based and talking word processors
• Word prediction programs
• Dictionaries
• Graphic organizers
• Technology to help with the physical aspect of writing
and typing
• Speech-to-text and voice recognition
• Additional tools to help with written expression.

All in all, the chapter covers over 70 tools

Putting A.T. to Work
Realizing that a book captures technology as it was at a particular moment in time, Green describes her book as a
starting point, recommending that readers visit the websites cited within the book for up-to-date information. Green
also offers an e-newsletter and a couple websites which can help keep aspiring A.T. consumers current. Green also notes
that obtaining professional guidance may be desirable depending on the condition being addressed.

This book is likely to prove to be a useful starting point for many parents and educators of twice-exceptional children in
the search for resources to help those children overcome their challenges

Assistive Technology for the 2e ( Twice Exceptional) Learner- Interview of Joan L. Green and how she helps students

February 20, 2012

( This article was written by J. Mark Bade as a Featured Topic in the newletter  Assistive Technology for the 2 e Learner ) in the Jan/Feb, 2012 issue)

Are you looking for a way to help that gifted child you raise or teach who has an executive function disorder?  How about the one with a reading problem? Or the one with an expressive language disorder?Joan Green

Joan L. Green, of the Washington, DC, area, is the go-to person for many parents, therapists, and schools who need to figure out what’s in that lengthy evaluation they’ve received about a gifted child who just isn’t achieving in one or more areas. Without the right intervention, that child could wind up in a downward spiral that affects both academic abilities and self-esteem.

Green’s specialty is the application of assistive technology (A.T.) to speech, language, literacy, and cognitive difficulties that may interfere with learning and personal growth. She is a speech and language pathologist with a master’s degree from Northwestern University’s School of Speech, who began her career in the late 1980s working with adults who had had strokes or head injuries. As computer technology improved, tools became available that empowered patients to work on their own, with immediate feedback from the  program. For example, Green successfully used a program meant to teach English as a second language to help her clients who suffered from aphasia, which involves problems understanding or expressing language.

With the advent of the Internet and the spread of computers into just about every household, such assistive technology became much more sophisticated, available, and affordable. Today, says Green, she has explored about 1600 applications to find the “treasures” that might help her clients — and that’s just for Apple’s iPad, which she thinks is a great tool.

A.T. and 2e Kids

The twice-exceptional children Green sees are gifted, of course, and tend to have good technical skills. That’s an advantage, because they pick up on things fast, says Green, helping avoid that downward spiral.
Most of the interventions Green offers are short-term, but she is also available for the long haul if that’s what’s needed. She fits the scope of her services to the need and to the family’s budget, and makes an effort to emphasize free or economical A.T. choices. Her goal is to empower parents, students, therapists, and other education professionals with the knowledge of cutting-edge affordable technologies. She helps people find the right tools and strategies for implementing a recommended intervention, all while making life as easy as possible for everyone involved.

Successful implementation, she says, is critical. “You can’t just give someone a product or a list of potential technology tools and expect them to be able to use them without help knowing which is best and how and when to use the technology.”

When the parents of a 2e child come to Green, she will usually receive evaluation reports containing recommendations for using assistive technology. Green’ advantage, she says, is that there are not that many people who can implement those recommendations. Her success stems from the way she can combine her knowledge of:

  • Communication disorders
  • Psychology (for example, motivation)
  • The educational process
  • The use of assistive technology hardware and software to address communication disorders.

Finding “The App for That”

A typical case may start with a half-hour phone conversation between Green and the parents. The parents then make available the reports and documentation Green needs to fully understand other professionals’ appraisals of the child’s situation.

Next may come a two-hour in-person or online brainstorming session with the parents about potential ways to address the child’s needs; the parents, after all, have good insight into the child’s interests, routines, and motivation. Green may show and suggest potential assistive technology tools at this point.

Joan Green’s favorite A.T. tools include the following:

  • Apple’s iPad with its bounty of apps
  • Notability, a note-taking app for the iPad. It includes audio recording, word processing, handwriting, and PDF annotation.
  • The Livescribe smartpen, which records audio at the same time it’s being used to take notes on special paper. The notes and audio are synchronized. Tapping the pen on the notes takes you to that part of the audio recording.
  • Google Apps, an in-the-cloud collection of “email and collaboration tools” that includes word processing and other common “office” tools. Green especially likes the sharable calendar features, handy for students with executive function issues.
  • WordQ+SpeakQ, a writing solution integrating word prediction, text to speech, and voice recognition.

Then, in individual in-person sessions with the student, Green will help the student learn the tools needed to implement the intervention strategies. This session may take place in Joan’s office in Potomac, Maryland, or in the student’s own home or school in the greater Washington, DC area. For example, she might choose a drill-and-practice tool combined with a word retrieval tool to improve skills in spelling. Another strategy might involve a word prediction tool or text-to-speech to help improve a student’s expressive skills. The areas in which Green uses technology to improve student behavior include:

  • Following directions
  • Learning grammar and punctuation
  • Speaking more clearly
  • Enhancing spelling and vocabulary
  • Practicing writing
  • Studying for tests
  • Researching on the Internet
  • Improving organization, sequencing, and reasoning.

Green’s use of A.T. is not limited to interventions to accommodate a specific learning challenge. She may also implement interventions that focus on augmenting a student’s learning in a particular topic by enhancing the student’s interest and motivation. Not only does technology make the intervention fun, says Green, the right technology can also get around the I-don’t-want-to-be-different problem. Carrying around an iPad rather than a laptop for in-class accommodations, for example, is “cool.” Such interventions may play to a student’s strengths, helping to keep the student engaged in school and enhancing self-esteem.

A.T. for Teachers

Sometimes Green goes into the student’s classroom to observe and may have one-on-one sessions with the student’s teacher to explain the intervention and the tools used. Or, she may present to a group of teachers at school.

Green says that most parents now realize how assistive technology can help their children and expect schools to use that technology. Teachers, however, obviously face lots of demands on their time and may have trouble keeping up with the explosion in A.T. solutions. That’s where Green can help the school, perhaps by assessing the school’s technological capabilities, determining gaps in those capabilities, and suggesting alternative ways to achieve goals, like differentiated instruction, in the classroom. By projecting her iPad screen, Green can demonstrate for the staff how to use technology tools and how to find useful resources on the Internet.

And A.T. for Professionals

Green also presents to other professionals on the topic, which she views as one way to keep up with technology — by making sure her presentation is up to date every time.

Green has written a book on assistive technology which is reviewed elsewhere in this newsletter. She also offers a free e-newsletter on the topic, featuring applications and programs with good value. Interested readers may sign up for it at

Joan L. Green may be reached through her website, by e-mail at, or by phone at 301.602.2899. She Tweets under @jgreenslp Text Box: 2e 

Reviews sites to learn more about iDevice Apps

January 15, 2012

I have been speaking quite a bit to private therapy practices, SLP associations, schools, hospitals and families about the iPad. I have added it to my frequently used collection of “technology tools” and bring it out with just about all of my clients in addition to a laptop computer and online interactive sites.

Once you take the plunge and shell out a considerable amount of money to purchase an iPad- the challenge becomes how to use it. What is all the hype about? Was it worth the investment? There are currently hundreds of thousands of apps. Which are best for you and your situation? How should you configure you iPad and what is the best way to do it? I help individuals and organizations, in person as well as online, learn about strategies and apps that are most appropriate for their situation- but I also strive to teach people how to continue this learning process since new apps and features are coming out every day. There are also many ways to use the iPad to help individuals who have communication, cognitive and learning challenges. The calendar, cameras, online access and features such as the contact list can be very helpful.

In my newsletters (which are free and you can sign up to receive them at, I write about some of my top picks for apps which are the best value for a wide range of people as well as my top picks for  individuals with specific challenges . I have only skimmed the surface with regard to helpful ways the iDevices can help people. Many people ask me what I do to learn about the apps. How do I keep up with it all? I subscribe to many listserves, blogs, and newsletters. I also connect online with Facebook and LinkedIn Groups. I probably spend at least 5-10 hours a week trying out new technologies/apps. As I prepare for new clients or to give a presentation- I make sure I am up to date on the latest technologies.To me it is fun- I really enjoy it. Finding tools to help others improve their lives is one of the activities I most enjoy about being a speech- language pathologist. I want to empower people to help themselves.

Here are a few of my favorite online resources which review apps that are helpful for individuals with communication, cognitive and literacy challenges. Check them out and let me know what you think…. these sites tend to be well organized and updated. They each have a different focus and are written by individuals or organizations with different sets of experiences, strengths and professions. Some are produced by parents, some by SLPs or teachers and some by organizations.

I’d love to hear from you at which sites you find most helpful. I will try my best to add to this list as appropriate.

Although the lists and blogs mentioned below are extremely helpful, it can  be overwhelming. If you would like a personalized in-person session in the Washington, DC area, an online coaching sessions anywhere on the globe or to find out about upcoming workshops and webinars- please send an email to, make a reservation at or go to for more information.

Once you select one of the above sites and find a few you think might be helpful- keep the following tips in mind…

Reviews- On the iTunes store there are often helpful reviews and ratings shared by users of the app that can shed unique insights on how they use the app. I also often do a Google search for reviews of the app.

Company Website-Most app pages include a link to the developer’s website. Check it out. Some have reviews on their site and provide instructions and videos on their site or linke to You Tube demo or instructional videos.

Free and Lite Version– Many of the more expensive apps offer limited versions of their product which are a great way to find out if the app is a good match for your situation. Sometimes the difference is that here are no advertisements or requests for in app purchases.

Intended Use- Some apps are produced solely for entertainment and reinforcement, some to improve specific behaviors and some to compensate for areas of weakness. There are apps that are more appropriate for children and others for adults. Some apps are best used by professionals and others are fine for the individuals with the impairments to use on their own. I have found that how I use the app with a client is often at least as important as the quality of the app itself.

Two New App Goldmines by Tactus Therapy

September 15, 2011

I spend a great deal of time trying out new Apple apps- and currently have over 900.  It’s hard to believe that iTunes currently features over 425,000 apps. There are very few apps which are created specifically to help adults who have aphasia. Tactus Therapy Solutions has recently released two which are wonderful! I find myself using them daily in therapy with adults as well as children who have a wide variety of language and learning challenges. They are a great extension to traditional speech therapy techniques and make it much easier for families to practice at home with guidance about the most appropriate way to configure the apps. They each cost $24.99 and are well worth it!


 Naming TherAppy     

This app is very helpful for children and adults who have word retrieval challenges.

  • The home screen presents four modes: Naming Practice, Describe, Naming Test, and Flashcards.
  • In the upper right corner is the Settings button which will allow you to choose your desired number of trials, the email address to which you want results to be sent, and the Child-Friendly toggle button which takes out pictures that contain alcohol, violence, and adult themes.
  • The upper left corner holds the Info button and contains the basic instructions the user needs in order to use the app. So far I find myself using the “naming practice” mode the most.
  • This app includes over 400 high quality pictured nouns with a flexible cueing hierarchy and optional scoring.
  • The nouns are divided into 10 categories and one or more can be selected for targeted practice.
  • The voice output is a high quality male voice with a neutral accent in slow natural speech to facilitate comprehension.
  • Scoring allows a therapist or partner to indicate when the word is correct or incorrect. The app records which cue was used to get the correct answers and produces a score report for email.

Naming Practice Cueing Hierarchy:

Description: plays a short definition and works as a semantic cue
First Letter: shows the first letter of the target word
Whole Word/Written Word cue: shows the complete written word above the picture
Phrase completion: plays a phrase that the client can complete by supplying the target word
First Sound/Phonemic cue: plays the first sound of the target word
Repetition: plays the entire spoke word for the client to repeat

Describe Cueing Hierarchy
This activity includes over 460 pictures with 4-6 question prompts, with each prompt programmed to be appropriate to the picture currently being shown. The Describe Mode offers questions based on semantic properties such as location, function, smell, color, texture, appearance, shape, size, person, time, sound, taste, sound, category, and association.



I find that I am using Comprehension TherAppy daily with adults and children who have aphasia, auditory processing issues and a variety of attention and cognitive challenges. The pictures and voice are very high quality and there are many ways that this app can be configured to work toward goals. Many nouns are initially includes and expansion packs can be purchased with verbs and adjectives.
There are 3 modes:

  • Listen“: match an auditory stimulus (spoken word) to a picture
  • Read“: match a written stimulus (printed word) to a picture
  • Listen & Read“: match an auditory stimulus (spoken word) to a written word
  • 10 categories of nouns are available  including animals, foods, objects, concepts, places, people, body parts and more. Specific categories can be selected.
  • Users are able to determine the number of photos on the screen (2-6) or the “Auto” feature can be selected to automatically adjust the field size based on performance
  • There are 3 levels of difficulty which adjust the relatedness of foils (semantic and phonemic) to move from Easy to Hard
  • Automatic scoring tracks success and progress on-screen

I look forward to new releases in the near future for Tactus Therapy Solutions. Writing TherAppy will soon be available.

To learn about other ways technology can be used to help adults or children who have a wide range of communication, cognitive, literacy and learning challenges – check out my website at, contact me at or buy my newest book titled The Ultimate Guide to Assistive Technology in Special Education which is full of info about computer software, iPad apps and other tools and strategies which are helpful for improving speaking, understanding, reading, writing and thinking  for adults as well as children.

Signing Time Apple App

June 1, 2011

There are many sign language apps available and several which are targeted toward helping young children. I have recently been working with a few young children who are using signs/gestures to facilitate the development of expressive language.  I have also been helping a couple of speech-language pathologists explore apps to help make speech therapy more fun and everyone has really been enjoying this app when I show it to them.

 Signing time app

Lately, I find myself using Signing Time app the most often. It was produced by Rachel Colemen. According to her website, prior to producing this series of products, Rachel was writing music and performing with her folk rock band. She then had a child who at the age of 14 months was found to be deaf. She mmediately began to study American Sign Language and to teach it to her daughter. As it says on her blog, by the time her daughter was 18 months old, her sign language vocabulary far surpassed the spoken vocabulary of hearing children her same age. Rachel had a second daughter who was born with spina bifida and cerebral palsy. Rachel was told this daughter would never speak, but after much work- after two years of no communication, Rachel’s second daughter Lucy began to sign along with Signing Time, despite her physical challenges. Shortly thereafter, Lucy started talking. At age five, Lucy attended mainstream Kindergarten, something Rachel never imagined possible.

The application contains a collection of 48 flash cards with  accompanying video demonstrations and an explanation of how to perform the sign and tips on how to remember it. It also includes very engaging music videos. After watching the videos a couple of times they begin to learn the signs and are stimulated to use their voices to interact with what they see on the screen.

From the main menu, users can search a list of signs or type in a word. There are only basic signs included. Other apps are more appropriate for more extensive dictionaries. A unique feature of this app is that there is a challenge section in which you select one of 4 possible meanings of the pictured sign. Progress can be tracked.

Other Sign Language apps I have used include:

Baby Sign

Baby Signing

Smart hands