The New Mobile iDevice Operating System -iOS6: Helpful Features and a Warning

September 20, 2012

As of yesterday, Sept.19, Apple has their newest mobile operating system available in the desktop iTunes app or online for iPhone 3GS and newer, iPad 2, iPad 3, and the fourth generation iPod touch. Apple is adding about 200 updates to the new operating system. Some of the features are not available on all of the devices- especially the older ones. Here is a link with more detailed information

There are quite a few new features that I am especially looking forward to using with my iPhone and iPad- but I am going to hold off for a while on installing iOS6. I want to play it safe and wait for all the app developers to catch up with the changes prior to downloading this new operating system so that I avoid bugs and crashes. It’s hard to believe- but Apple keeps app developers in the dark until shortly before it releases new devices and operating systems and then there is a race to update the apps so that they will work properly.

Here are few of the changes I am most looking forward to trying:

Guided Access – This feature will enable us to limit the device to a single app by disabling the home button or restrict touch on certain parts of the screen. This will be a great solution for those of us who help individuals who keep exiting the apps we want to be working on. It will help users stay on task and avoid closing apps by mistake. I believe that this feature was added with kids on the Autism spectrum in mind- but I also work with many adults who have cognitive challenges for whom this feature will be very helpful.
Highlighting words as they are said aloud– Research has proven that reading skills improve and individuals with reading disabilities are helped when words are highlighted as text is read aloud. For many years I have used a wide variety of software that provides these types of assistance for students with learning differences as well as for adults who have aphasia. This feature is now going to be included with this new operating system. I am not sure if each word will be individually highlighted or the sentence will be highlighted- but am looking forward to giving this feature a try.
Facetime will work with 3G– Facetime is an iDevice app that allows you to see people as you speak to them. The participants have to both be in Wi-Fi not just 3G or 4G. With this new upgrade- it will be possible to see people and speak to them just with 3G. I can imagine all sorts of ways this can be used to help individuals with communication challenges! Showing live images of actions, people, and items can often convey messages that words may not be able to.
Options for Answering iPhone Calls -When there is a call on a device with iOS 6, it will ask if you’d like a reminder to call back later, or to reply with a text. There will be preset text options like, “I’ll call you later,” or “What’s Up?” This will be great for individuals who are in a noisy location, a doctor’s office or have writing skills that are better than speaking ability. There will also be a “Do Not Disturb” feature which will block calls, texts, alerts and notifications. The user can designate specific callers who can get thru or the feature will turn off when someone calls twice in a short period of time.
GPS Directions Aloud – The Apple Maps app will be accessible directly from the lock screen and include a 3-D image of the desired location.
App Locks- We will be able to password protect apps that we don’t want others to use. This will be very helpful as part of the “pass back” phenomenon- when parents pass their devices back to kids in the car to help them behave well.
I look forward to giving these new features a try when I feel it is safe for me to download iOS 6. I use my ipad every day and want to give time for the developers to work out any issues that might have arisen from this upgrade. On the flip side- I am a bit hesitant about some of the changes not listed above. Facebook is more closely integrated into the new iOS, I am more of a Facebook lurker than poster. I am inclined to keep much of what I do private and don’t revel in frequent posting and updates. I also use Google quite a bit and know that Google Maps and YouTube will no longer be native applications, pre-loaded on the devices, as the Apple and Google go their separate ways. I know that new apps will be developed and all will be fine- it’s just more to figure out.

I am hosting a number of workshops and webinars on using the iPad and other technologies to help children and adults who have a wide range of communication, cognitive, literacy and learning challenges. To learn more about me and what I do check out  For specific information about upcoming workshops and webinars and to register go to

The Changing World of Augmentative and Alternative Communication (AAC)

September 6, 2012





Each time I prepare to teach a graduate student class, train a group of therapists or provide therapy for a client, I spend time making sure my information is up to date. I recently taught a symposium at George Washington University titled,“AAC Devices and Implementation Strategies to Promote Success: An Update on Cutting-Edge Technologies for Augmentative and Alternative Communication”. Although I have been immersed in this world of AAC for quite a while and use many iPad apps as well as more traditional devices, as I gathered information and prepared for the presentation, I became even more aware of how much the entire world of AAC including its purpose, products and delivery model have changed.

Back in the mid-1980s when I attended Northwestern University, I took an elective AAC class. I remember it well. I learned about devices produced by well-known companies such as Prentke Romich and Dynavox. We learned a formal very lengthy AAC protocol to help us decide which device would be best for individuals with significant communication needs from congenital challenges such as Cerebral Palsy or degenerative diseases such as MS or ALS. We wrote comprehensive reports which included measurable goals to use in therapy. There was a long process to go through to obtain funding of the machines that were many thousands of dollars. I recall spending hours reading manuals so that I could try to customize the vocabulary content to meet the user’s needs.

Fast forward to now. AAC has existed for about 40 years. The types of technologies that provide augmentative and alternative communication functions have grown exponentially. The way our society communicates is changing. Texting, email, video calls, text to speech and speech to text technologies are becoming mainstream. There are now many technology tools available that can help people express themselves. Cell phones, tablets, SmartPhones, Skype, Facebook, and technology devices with vocal output, have worked their way into mainstream society and are readily available to all. Speech-language pathologists are no longer the gatekeepers to the AAC world. It is now more affordable and easy to access AAC solutions.

There are pros and cons to this situation. On the positive side, more individuals who have difficulty expressing themselves now have easier access to potential solutions to improve the quality of their lives. Affordable technologies are finding their way into the lives of individuals who in the past might have spent their lives unable to effectively communicate. There are now more than 200 AAC apps in iTunes alone and more and more are becoming available in the Android marketplace.

The problem is that very often individuals who have complex communication needs (CCN) are frequently not provided with the most appropriate tools and training to develop and maximize their communication skills. It is critical to consider the strengths, communication needs, goals, interests, and characteristics of each person as well as typical language development. There should also be an effort made to appropriately reinforce communication attempts, model the use of the device, and expand newly learned skills into the home and daily routines. I strongly encourage individuals to seek professional guidance from a qualified speech-language pathologist when choosing and using AAC apps. In my practice, families are coming to me with a number of AAC apps that they found already on their iPads- but they don’t know how to go about configuring them or using them to help their loved ones. This often leads to frustration and abandonment.

When I work with individuals who have limited communication abilities, I have found that I often have to work with other apps and toward goals such as first establishing joint attention, promoting the concept of cause/effect and working on ways to motivate individuals to initiate communication and interact with the iPad or other device. I have found the built-in features of the iPad and many free and low cost apps make therapy more engaging and efficient in reaching these initial goals as well as helping people advance to more involved communication tasks.

Tablets with AAC apps are not necessarily the best solutions for individuals with difficulty using their hands to touch pictures and words to be said aloud by a device. Not all consumer products- even those with many accessibility options such as the iPad – meet the needs of every person. When working with adults who have aphasia or individuals with severe autism spectrum disorder the task of learning to use AAC apps to communicate is complex. It is a bit less complex when the lack of communication is due to speech or voice disorder as opposed to a language or cognitive disorder. There are also individuals with significant physical disabilities who may need to use eye gaze or scanning to access the technology. A multidisciplinary team including a physical therapist, occupational therapist, speech-language pathologist and an assistive technology expert is ideal in this situation. It is important that if an iPad is to be used with a person with significant physical limitations, the person selecting the apps and training the individual be familiar with issues relating to seating, positioning, and the apps that are switch accessible as well as recent products using alternate ways to access the iPad..
Many of the products that have been around for a long time have had years of research to support the many features they offer in terms of teaching language and facilitating verbal expression. An increasing number of products are becoming available for tablets- but the products are new. The research on their efficacy has just begun. In addition, if a tablet computer is indeed the product of choice, there is a great deal of planning that needs to go into configuring the device and teaching the individual how to most effectively use it. Careful consideration needs to be given to :
• Language representation- What is the best way to present words and concepts? Photos of people and items in a person’s environment, abstract images, and printed words can be used.
• Visual display- How many images or words should be presented at one time? Should a person have a finite group from which to select or should the person be able to scroll for more choices and produce novel messages?
• Word selection- What needs to be communicated? There is much more to life than just naming objects. Comments, requests and questions are an integral part of communication.
• Communicative Intent- Does the individual need to be externally motivated to communicate? How are the person currently communicating and what further skills need to be developed?
• Communication Abilities- What are the language, speech, cognitive and social skills of the person?
• Implementation Plan- How will the device be configured and what are the strategies for successful implementation of the device into daily routines? How much support is available? Who will continue to update the device as the needs of the individual change?
Even if families do turn to communication professionals for comprehensive assessments- the speech-language pathologists are confronted with a number of dilemmas. How should the availability of these new products change the traditional AAC assessment and intervention process? Should professionals wait for research to take place as new products become available prior to using them in their professional practices?
The following online resources may be helpful for individuals trying to learn more about this exciting but complicated field of AAC during this transformation:
The SETT framework – Joy Zabala’s model to be used in the collaborative decision-making process in all phases of assistive technology and AAC selection and implementation.
AAC TechConnect – A site filled with great suggestions and resources re AAC
Children’s Hospital Boston– An AAC feature matching resource
Spectronics AAC Apps – A wonderful blog by Jane Farrall- a SLP and special educator in Australia who is passionate about literacy, assistive technology and AAC
AAC Institute– A compilation of helpful AAC resources
AAC Language Lab– Great information on language stages and helpful teaching resources provided by Prentke Romich Company
Learning Paths – Many wonderful resources provided by Dynavox

Innovative Speech Therapy– Newsletters, Workshops, Lectures, Webinars,Special Reports, Consultations and Therapy

Webinar with Joan Green: Learn the basics of using your iPad to help individuals with special needs

September 6, 2012

Friday October 5, 2012 1:00-1:30 EST

During this 30 minute webinar, Joan L. Green M.A. CCC-SLP ( The founder of Innovative Speech Therapy) will introduce you to the many features of the iPad which are helpful for individuals with special needs. She will share some of her top app picks and strategies to help you learn to use the iPad to help children and adults who have a wide variety of communication, cognitive, literacy and learning challenges.

Registering now will save you a seat in the live webinar and entitle you to one copy of the “special report” which will be available on the day of the event . “Seating” is limited.

If all goes according to plan, Joan will record the webinar and then offer a “pay per view” option so that the webinar can be viewed online with the accompanying “special report” to be used for future reference of discussed products and ideas.
$25.00 registration fee

Click Here to Reserve Your Space Now

Introductory Interactive iPad Workshop with Joan L. Green, M.A.CCC-SLP

June 6, 2012

 iPad Insights and Implementation Strategies to Improve Communication, Cognition, Literacy and Learning

Thursday October 25, 2012

Rockville, MD 10:30 AM- 2:30 PM ( 45 min.  break for lunch)


Click Here to Reserve a Seat

The morning will begin with an introduction to the many helpful features of the iPad and an overview of how the iPad and iPhone can be used to help children and adults with communication and learning challenges.  During the workshop, Joan  will demonstrate  many helpful features of iDevices and her top app picks for helping others to have fun while maximizing learning and quality of life.  A wide variety of Innovative Technology Treatment Solutions will be presented.

Participants are encouraged to bring their iPads and iPhones and to use them  as Joan presents an overview of her most recent cutting-edge motivating approach for using the iPad to help individuals of all ages with and without special needs including:

  • autism spectrum disorders
  • learning disabilities
  • speech and language delays and disorders
  • twice exceptional learning challenges
  • executive functioning weaknesses
  • aphasia
  • apraxia
  • dyslexia
  • dysgraphia
  • dementia
  • traumatic brain injury

The day will include strategies and suggestions for approaches to improve speaking, understanding, reading, writing, thinking, remembering, socializing, organizing and learning. Participants will be encouraged to actively collaborate throughout the day.

A limited number of professional, graduate student and family scholarships are available. Contact for  for scholarship application information.

MD SLP CEUs approved for 3.25 hours

First Phrases App by Hamaguchi Apps for Speech, Language and Auditory Development

April 12, 2012

First Phrases HD by Hamguchi Apps for Speech, Language and Auditory Development is a wonderful interactive animated app for individuals who need to improve expressive language skills as well as a variety of cognitive skills. I have used it to improve direct selection on an iPad, visual perception, sequencing, speech intelligibility and expansion of utterance length.

The app is essentially the user telling the cute animals what to do either by touching pictures or using speech. There are different options, but typically  the user touches one or more pictures of actions or objects ( or sequences them in the higher levels)  and then views a video of a character doing something such as cutting paper or drinking water. There is then the opportunity to record the individual reciting the command and then the character does what it is told. There is not a voice recognition component- the iPad does not judge the accuracy of the verbal response- it only records what it said.  Humor is embedded throughout the app.

The app is great for working on sentence structure and building sentences. There are 17 simple verbs such as “drink” and 12 verb plus prepositions such as “jump on” . Each verb is paired with nouns  to make logical phrases that can be pictured. Up to 15 users can be added to the app.

I find myself using this app with children as well as adults who have aphasia as well as apraxia and dysarthria and find it quite amusing and helpful. I have also used it with children who present with severe ASD (autism spectrum disorder) who are engaged by the colorful animations and helped by the visual presentation of language and need help with cause and effect as well as comprehension.

When downloading the app, I suggest that you first try the lite version which is $.99 to make sure it is a good fit for your goals. The full version is $9.99. The “HD” version indicates that it is for the iPad. If you find it helpful to view the app in action prior to using it – I recommend clicking here.

There are very few apps such as this which use video to enhance language skills and give true meaning to verbalizations or direct selection of items on the screen. The full app does require a large amount of memory and is best loaded directly from iTunes or WIFI if possible- rather than via 3G.

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.

The World of Apps- They keep on coming!

November 18, 2011

My thoughts on some of the challenges of using apps to help individuals with communication and learning impairments

It’s astounding how much this new world of apps is changing the way I do therapy and run my practice. iPad apps. Droid apps. Google apps. Android apps. Mac apps. They just keep on coming!

I recently gave up my Blackberry for my first iPhone- the iphone 4s just began to explore my KindleFire which arrived a few days ago, ordered a Velocity Micro Cruz Android 7 inch Tablet on Woot two days ago for a deep discount of $70.00, and am about to get a hand-me-down Mac from one of my kids that I will upgrade to run the Lion operating system so I can start to learn about Mac apps rather than just read about them. I strive to use all apps prior to suggesting them to clients or speaking about them in my presentations. In my spare time while I take my son to swimming practice or my daughter to piano lessons, I find myself bringing along my iPad 1 or iPad 2 with headphones to review apps.

My private practice has constantly evolved over the past 19 years, but lately there has been so much to learn I find myself spending more and more time keeping up with the cutting-edge technologies. I feel like I have become an “app consultant.” Calls keep coming in. Everyone wants to know which apps are right for their situations. It’s overwhelming to start from scratch in the iTunes store, Mac Apps store, Amazon store for Kindle Fire apps or Android Marketplace. An increasing number of bloggers feature their favorite apps and offer reviews, but there again, the lists now are quite long. Apps are usually not very expensive except for some of the AAC apps or very robust professionally developed apps, but the cost adds up quickly and it takes time to download and give them a try.

Yesterday I talked to families about apps to help: a woman who had a brain tumor removed, another woman who has memory loss, a man with aphasia and apraxia after a stroke, a 5 year old boy with severe autism, a 3 year old boy with Down syndrome, a 12 year old boy with executive functioning challenges and an 8 year old girl with severe apraxia of speech. I can’t offer concrete guidance on the phone. I have to see each person, learn about their individual strengths and weaknesses as well as goals and interests, explore their environments, speak to others who help them in daily activities and try out what I think may work with the person before sending them on their way with apps that are customized as needed to practice. With each new client I find myself doing research to make sure they have the latest information. I am also preparing for a few presentations and it is incredible how much has changed since the last full day presentation I gave just this past summer. No two presentations are ever alike. Too much changes.

Although I truly believe that the new tablets have quite a bit to offer and may be the most appropriate tool to use in a variety of activities- they aren’t always the most appropriate solution and there are still plenty of challenges to be faced. Some recent publicity has made them appear to be the perfect solution when, in reality, many hurdles still have to be jumped. We can’t forget about the often more robust computer programs which may be more effective for cognitive retraining, reading and studying, communicating or writing essays.

Here are a few of my concerns and thoughts regarding app use and the reasons why I don’t have generic lists of apps to recommend for different diagnoses:

  • It is challenging to select the most appropriate apps as well as online programs and other technology tools to make sure that they are a good fit for the client and their needs and interests.
  • There are some apps that the user is meant to practice with alone, apps that are more appropriate to be used by an education or rehabilitation professional, apps which need to be customized to be effective, and apps which don’t work directly on the skills to be developed but which are great to use for joint attention or to encourage interaction while working on skills in person.
  • Many individuals need to be behaviorally managed while using the apps. These individuals may try to exit the apps, mistakenly touch the wrong locations and need skilled human intervention (with good training from a clinician such as a speech-language pathologist) to maximize the benefit from them.
  • Not everyone has the motor control to interact with apps and may need special accommodations such as switches for input or a different type of device.
  • Insurance companies and schools are now starting to suggest iPads be used as primary dedicated communication devices when children or adults can’t speak, when a more robust dedicated communication device (which is typically much more expensive and takes longer to acquire) with integrated environmental controls, and features to accommodate for poor motor control or learning abilities may be more appropriate. Finding the most effective communication tool is a process and setting it up, teaching the client how to use it and integrating it into daily routines to promote communication skills takes time and expertise. In most cases purchasing an iPad and an app to use is just the beginning and may not always be most appropriate but is often the least expensive and easiest way to provide fast access to a communication tool. In some cases using it as an intermediate step or backup system is more appropriate.
  • Individuals who are “let loose” with a tablet computer to entertain themselves are often difficult to pull back and structure in therapy tasks using apps on the device.
  • If the iPad is going to be an individual’s primary means of communication, these individuals need another device with a different color cover to use as a learning tool or for entertainment. There are now less expensive devices such as the Kindle Fire which makes having two a more affordable option.
  • It is important to keep in mind that if an individual does have a tablet such as an iPad, we should take advantage of the many wonderful integrated tools it has to enhance learning, executive functioning and communication. There is a calendar, address book, still camera, video camera, email, Internet access and many accessibility options such as enlarging print and reading aloud. When used creatively these are also really wonderful supports for individuals with communication, cognitive, learning and literacy challenges.

I’d really like to hear from those of you who are reading this to let me know which apps or computer software/ websites you use and find helpful and whether or not you agree with my concerns. It’s one of my favorite parts about speaking to large groups of people and interacting with you all online. I am always learning from everyone else.

I can be reached at if you would like to discuss the possibility of setting up an individual consultation or  webinar/presentation for your group or organization.