This post is hopefully the start of an open dialog among colleagues about Auditory Processing Disorders.  I have had this post in draft mode for some time and it’s almost the start of a larger post but due to the recent discussion on twitter about Auditory Processing Disorders I thought I would post this. ( I am by no means an expert in the matter and this  post is merely to get people thinking.)

I recently became aware of the controversy over Auditory Processing Disorder. Are you aware of this controversy? It’s apparently very similar to the argument against non-speech oral motor exercises. There are basically two camps on this topic- audiologists/slps that believe that this is a true disorder and SLP’s that insist that APDs simply do not exist and it really all involves a weakness in the individual’s language skills.

This past November at the ASHA convention I sat through two very different talks about Auditory Processing Disorders. The first talk was titled A Speech Pathologist’s Guide for Interpreting the Auditory Processing Evaluation and was given by Velvet Buehler who is a  dual certified Audiologist and Speech-Language Pathologist. She who discussed  how to properly interpret an auditory processing evaluation as well as what the course of treatment looked like. After this talk I felt good that what I was currently doing as far  as assessment and treatment was on par with what this speaker was presenting.  However I then walked into a talk titled What Speech-Language Pathologists Need to Know About Auditory Processing Disorders. The presenters for this session were Alan Kamhi and Geraldine Wallach.  Their stance on APD is essentially that it doesn’t exist and cite their research with the following quote:

“Because there is no evidence that auditory interventions provide any unique therapeutic benefit (Fey et al., 2011), clinicians should treat children who have been diagnosed with APD the same way they treat children who have been diagnosed with language and learning disabilities. The theoretical and clinical problems associated with APD should encourage clinicians to consider viewing auditory deficits as a processing deficit that may occur with common developmental language and reading disabilities rather than as a distinct clinical entity.”

They started their talk off with some real life examples that really made sense at the time. One of the examples was about a woman who who was in a German bar. She was learning the German language and could partake in general conversation however in the bar it was very loud and she was having a very difficult time understanding the other people speaking in German to her. She asked if they spoke English which they did and as they spoke to each other in English she found that she was able to now understand everything that she heard. So what was the difference here? Well the difference was that she had a weak foundation in German and had trouble filling in the parts that she had missed due to the loud environment  This makes lots of sense right? If she was weak in the language she was learning then she couldn’t keep up with the conversation as quickly as she would with her native language of English.  This whole example really started to make me question the earlier session that I had sat through. Was APD really based on some shotty research and questionable auditory intervention techniques?

A few weeks later I was at a  pizza place with a group of friends. This was a Friday night so it was busy and very noisy inside. A friend of mine was in line ordering the pizza for us. We ordered Sausage and Meatball pizza however the cashier taking the order was standing in the kitchen and was having difficulty hearing the order. She asked him to repeat himself a few times and finally questioned his order with “You want a sausage and people pizza?”  Yes you read that right, she asked if he had ordered a pizza with both sausage as well as people on it. Last time I checked  Soylent Green was against the law (Insert funny Charleston Heston joke here —>) So what happened here ? You would think a grown women would have at least the language skills to complete the auditory closure task of I’ll have a  sausage and ________ pizza, right? or does she really have some auditory processing deficits and instead heard people.

I’ll end with this blurb from a study that McArthur and Bishop conducted hinting at the fact that there are components of both language and auditory processing deficits in play.

“McArthur and Bishop (2004b) also found that a subgroup of children with specific language disorder showed difficulty on auditory discrimination (consistent with the view of APD as an impaired skill) and poor reading. Another subset of children inMcArthur and Bishop ’ s study had poor sustained auditory attention and/or auditory memory as well as APD.”

What are your thoughts?

]]> http://the-speechguy.com/2013/04/15/ill-have-a-sausage-and-people-pizza-the-controversy-over-auditory-processing-disorder/feed/ 6 azspeechguy pplpizza http://the-speechguy.com/2013/03/13/fire-fun-with-augmented-reality/ http://the-speechguy.com/2013/03/13/fire-fun-with-augmented-reality/#comments Thu, 14 Mar 2013 06:18:27 +0000 azspeechguy http://the-speechguy.com/?p=976 ]]>

Kids Vehicles 1: Interactive Fire Truck, $1.99, is a 3D interactive App by 22 learn available for iPad and iPhone. It similar to other interactive apps out there as you are able to drive the truck, put out fires, and learn about fire truck vocabulary. The one twist with this app is the augmented reality feature which allows you to virtually drive the fire truck around in your environment. This of course opens lots of doors for use in speech therapy!

This pictures show the fire rescue mini game:

The next thing you want to do is set up your environment to use with the augmented reality. In this example we were driving around and searching for the fire. It was hidden around the room. On chairs, under tables, and in lots of other silly places. (The disclaimer here obviously is to make sure you are working with a client that understands fire safety.) We then worked on his sentence structure as he is one of those kiddos that tends to leave out “the”, “is”, and “a/an” in his sentences. He had to hide the fire and then explain to me over our walkie talkies exactly where it was.

Additional activities can include:

1. Targeting articulation by hiding cards around the room that the child needs to “rescue”
2. Targeting following directions and have the child follow 1-2 step directions i.e., drive to the table then make a left.
3. Targeting narrative skills by having the child tell the story about how the saved the day.

Be creative and have fun!

Please feel free to comment on any other ideas you have for using this app

The use of apps have made the lives of speech-language pathologists and special educators around the world much easier. Well unless you have a parent hand you an iPad and say please program my child’s AAC app, depending on who you are you might run in the other direction! New apps are released daily and it’s almost impossible to keep track of them, heck it’s almost impossible to keep track of the apps I have on my iPad. We really need something better than a “folder” that holds only 20 apps don’t you think ?? Anyway let me get to the point of this post! I have been using a few apps lately that allow me to create on the fly and go with the flow of  some of my moody clients or Appdapt with another app or to a pen and paper type program. Here are 3  great examples:

Puppet Pals HD Directors Pass  $2.99 in the App store available for iPhone and iPad

Puppet Pals as been around a while and there is actually a Puppet Pals 2 that came out recently, however I still prefer the first version because you are able to use your whole body in the scene whereas Puppet Pals 2 you are only capable of using your head.  So with this app you can quickly add a background scene and place virtually any characters in your scene.  You then record your scene by moving your character around as the app records your voice and your character’s movements. You can see by the picture below  that my client is really into dinosaur and enjoyed making the dinosaur eat him.

Director’s Pass allows you to take pictures from your photo roll and narrate a “play” about them.

PicCollage - free for iPhone and iPad

PicCollage is a fabulous app that has lots of applications for therapy. The purpose of this app is to create collages using pictures from your camera roll and the web.  The web search on this app is one of the most useful features you can literally add anything that comes to a client’s mind and instantly crop and add it to the collage.

The picture above is the start screen when opening PicCollage. You can see the options included which are: capturing a picture, adding a photo, photo from web, adding text, and adding stickers. Some stickers like hats or sunglasses are free but most you have to purchase. I quickly started using this app to pair with other apps. For example I have been using Rainbow Sentences by Mobile Education Store to focus on sentence structure with some of my clients. While using the Rainbow Sentences App I take screenshots of some of the sentences my clients were successful with and then use the screenshots in PicCollage. Here is an example:

 As you can see the screen shot is the background image from Rainbow Sentences. I took a picture of my client, cropped her body out and inserted it into the collage. I then searched for roller skates and a helmet having my client request the type that she wanted. These were then cropped and placed on the picture to give the illusion that she is wearing skates and a helmet. Finally I searched for word bubbles and inserted that in as well with the text.  So I was able to seamlessly transition to another activity but still working on the previous goals all while keeping my client motivated by having her personalize the picture.

Another use for PicCollage is with my older clients that I am using Nanci Bell’s  Verbalizing and Visualizing. If you are unfamiliar with the program I recommend that you check it out. It focuses on having children create a whole image or a “gestalt” from auditory information and from printed material to improve their comprehension. I have been using this app at the Word Imaging and Sentence Imaging stages. As we work on images and sentences we are able to use this app to create virtually any sentence on the fly.  For example we were working on the known noun “Christmas tree” and created a sentence “The girl is decorating the Christmas tree.”  Naturally when asked what does this make you picture? my client simply repeated the sentence back to me without being able to actually visualize what the sentence meant to him. So in comes PicCollage to the rescue. Within in a few minutes we had this picture visualized as he explained each portion of the picture to me.

Notability $1.99 on Sale Now!

I originally got this app to use during conferences and workshops because you can upload handouts and write or record voice directly onto them. You are able to integrate handwriting with typing and recording to make taking notes easy. This app can also be used on the fly. I recently started working with a client that had moved out-of-state and only comes to the clinic while she is in town visiting. We were focusing on her /r/ sound and since she would only be seeing me for  a short period I wanted something that she could take with her back home. Using Notability we typed and drew on the screen as we discussed the type of approach we were going to use to work on her /r/ sound.  We then took some pictures of her tongue placement to remind her of what good and not so good placement looks like.   I then printed it out and sent it home with her.

What did Snakey eat?  is one of  my favorite apps right now. The purpose of the game is to figure out what Snakey ate. I love it because its very simple but you can use it to target a variety of areas. It can be used to answer yes/no questions, question formation, problems solving skills, and categories.  For $.99  this is a hands down must buy!

 Yes/No Questions

Have the child answer the questions did Snake eat the sea horse, yes or no?

Question Formulation

1) What did Snakey eat?

2) Snakey did you eat the ______

3) Snakey why did you eat the _____?

4) Snakey where did you eat the ______?

5) Snakey when did you eat the ____?

6) Snakey how did you eat the _______?

Inferencing skills

With this task the child has to evaluate the size and shape of the item in Snakey’s stomach and then compare it the the items in the skunk’s thought bubble. This will offer a variety of opportunities to work on both inferences as well as describing skills. What also is nice about the app is that you are able to pause it before your 3 selections pop up. I am not sure if this is intentional or is a bug in the game but its quite helpful.

Categories 

Snakey eats many different objects throughout the game, all of which fall into the categories of: animals (jungle, zoo, ocean etc..), vehicles, instruments, food, clothes, and tools. So you can see the wonderful opportunity you have to work on sorting and identifying categories!!

What did Snakey eat? The Card Game

I created a simple card game to be used while playing with the app. The cards can be used to make predictions on what Snakey will eat next, to make matches to what Snakey did eat, or to play a game of memory after you finish playing with the app. The cards are pretty open ended so you can work them into whatever you wish. There is also a Bingo board attached just use the cards and place them on the board. Have fun and be creative!  The cards are in a .pdf file you just need to print with your printer’s “print on both sides” option.

 Download the game here –> Snakey Card Game

I have lots to share so keep an eye on this post as I will be updating it regularly. For now start off with these awesome apps that will keep your kids motivated!

Updated 11/27/12

Snow Doodle- $.99  Buy it Now!

Snow Doodle is the latest addition to the Doodle family by Shoe the Goose. This app has tons of potential and was released just in time for the winter season.  You have the ability to not only build “snow people” ( Have to be politically correct here, not all snow beings are men after all) but also build things using your imagination and tools like a pail, castle block, coffee cup, or a tube. Just tap the tool and out pops the snow. You can also use the free form tool and manipulate the snow ball into any design you want. This app has tons of potential and with the ability to import anything from your photo roll you can Appdapt it into any speech or language activity.

Built using the Pail tool

Turn your designs into a puzzle

Why is the Snowman scared??

Toca Hair Salon: Christmas Gift Free Highly Recommended

This is an obvious gem when looking for a Christmas app to target therapy goals. You have the option to cut Santa’s hair! I mean who wouldn’t want to have fun doing that. There is also a Christmas tree option where you can trim and decorate the tree. Target all the goals you would with Toca Hair Salon but throw in some fun Christmas Vocabulary!

Gift-Wrap-App- Free My Favorite!! Download now!

I searched and searched for an App like this hoping it existed and it does it does!! This app has such a simple premise you will be taking every therapy goal and targeting it with this app. You take a picture , pick the gift wrap, and unwrap them! Target articulation, language, or pretty much anything. I would download pictures of popular toys this year and wrap them up. Have your clients describe what the toys do or how you would play with them. In the example below I used an action picture “drinking”.

Santa’s Magice Phone-Deluxe- Free and Fun

PERSONALIZE certain calls by recording your voice, and we will disguise your voice as Milo, Santa’s Elf! Santa will then ask Milo a question during the call, and Milo will bring details into the phone call that your child would never have imagined! “Wow Mommy! How did Santa know I was polite with little Johnny?” Receive the call at your choosing for the ultimate reaction. You can select from numerous Naughty or Nice prerecorded messages, such as Good Job Being Polite, Eating Well, Sharing, You’re Off the Naughty List!, Not Listening, and many more!

Christmas House Decoration- Free iOS

In this app its all in the name. You decorate the exterior of a house for Christmas. This will work great as a motivator, following directions,  or for tasks requiring knowledge of spatial concepts. Decorations include snowmen, trees, Santa, lights, etc..  Endless possibilities for a creative child or therapist!

Chanukah Dreidel- Free 

This is one of the few apps that I found that incorporates Chanukah . It’s  a virtual dreidel so not so exciting but could be a proper motivator for those clients of yours that celebrate Chanukah.

Peekaboo Presents-  $1.99  iOS and Android

Here is a another solid app by Night & Day studios, developers in the ever popular Peekaboo series. I featured there Peekaboo Trick-or-Treat app in my Halloween Post. To play the app you tap on the present that is under the christmas tree  shaking and making noise. The child must make a guess on what is inside the present based on the noise it is making. Lot’s of fun presents to open and noises to guess! Have fun with this one.

Toys “R” Us Toy Finder- Free

I have been using this app to help create my client’s wish list for their holiday presents. You are able to make a profile for a child and then save their list of toys. This app would work well in a group setting to foster some good conversation about what the children have selected and why they made those selections. Also offers a good opportunity to explain what a toy does and what it looks like. Ever have that child that suffers from word retrieval difficulties and is trying to explain a toy that they play with daily but they don’t know the name? Well have them search by  the  toy categories, etc.. to help them narrow it down.

Remember to keep a an eye on this post as there will be new apps being added throughout the next month! Have fun !!

Auditory Rhyming

Auditory Rhyming $29.99

Phonological awareness provides a beginning reader with an important tool for understanding relations between written and spoken language. A deficit in phonological awareness is accepted as a consistent feature of reading disabilities. Poor phonological awareness is linked to poor reading skills independent of IQ.

Children with deficits in one or more areas of phonological processing abilities may have more difficulty learning to read than those who do not. Phonological awareness describes an individual’s awareness of, and access to, the phonological structure of oral language.

The Auditory Rhyming app directly enhances and elevates phonological awareness skills in order for a young child to become a proficient reader and speller.

There are three different rhyme presentation options:

Inclusion:

The child will see and hear three picture cards: two that rhyme and one that does not. The child will identify, by tapping on, the two pictures that rhyme. After the child hears each word, he or she will be prompted to tap on the pictures that rhyme. For example, the child will hear: “big, beach, pig. Which two words rhyme?”

Exclusion:

The child will see and hear three picture cards: two that rhyme and one that does not. The child will identify, by tapping on, the picture that does not belong. After the child hears each word, he or she will be prompted to tap on the picture that does not rhyme with the other two words. For example, the child will hear: “cat, fan, bat. Which one does not rhyme?”

Random:

The random presentation is a mixed of the inclusion and exclusion presentation. This will place more auditory attention demands on the child, as they must listen for the specific directive.

Target Sound Identification

Target Sound Identification  $29.99

Target Sound Identification helps to enhance and elevate phonological awareness skills in order for a young child to become a proficient reader and speller. The Target Sound Identification app includes over 350 colorful and engaging picture cards.

The child is presented with a picture card and a field of three sound (phonogram) cards. The child must identify (by tapping on) a sound in the specific requested position of the word. For example, “Point to the first sound you hear in the word: ship”. In this example the correct response is: sh. “Point to the last sound you hear in the word: dog”. In this example the correct response is: g.

You have the ability to choose if you would like to work on initial (first) sound identification, final (last) sound identification, or initial and final randomized.

• First Sound
• Last Sound
• Random

The randomized presentation will put more auditory attention demands on the child because they have to really attend to whether the target is asking for the first sound or last sound. Selecting “First Sound” will always ask to identify the first sound. Selecting “Last Sound” will always ask for the last sound.

This app is not intended to be self-guided by the child. The parent, teacher or specialist is to provide support and feedback to the child as needed.

Auditory Figure Ground

Auditory Figure Ground $29.99

Do you need an app that will help you determine if your child or client is experiencing a breakdown in their auditory processing of speech when there is background noise or help you  improve auditory processing skills in the presence of background noise?  Auditory Figure Ground-$29.99, by The Speech-EZ Apraxia Program, will help you accomplish this!

This app uses beautiful photographs that are presented to the listener in a field of four. It’s recommended that a good set headphones be used to accurately simulate the speech in the presence of background noise (Over the ear headphones and not ear-buds). You start off by selecting the type of background noise and the signal to noise ratio you want, while the words are presented.

Background Noise

You have the option of: childrens indoor playground, elementary school children in lobby, noisy crowd walking and talking, small cafe ambience, white noise, and quiet (no background noise).

Signal to Noise ratio

You have the option of: SNR 12 dB (Easiest), SNR 8 dB, SNR 4 dB, SNR 0 DB, and SNR -4 dB (Hardest)

Sound Matching

Sound Matching $29.99

The child must identify which word out of a field of two either begins or ends with the same sound as the target card. The child is presented with a target picture card and two other picture cards to sound match. For example, the child is presented with target picture card cub. “Which picture starts with the same sound as cub? leaf or coat.” The child must then tap on the picture of the coat. The following is an example of an ending sound match: “tub, fan, web. Which picture ends with the same sound as tub?”

You have the ability to choose if you would like to work on initial (first) sound matching, or final (last) sound matching, or initial and final in a randomized presentation.

• Starting Sound
• Ending Sound
• Random

The randomized presentation will put more auditory attention demands on the child because they have to really attend to whether the target is asking for the starting sound or ending sound. Selecting “Starting Sound” will always ask to identify the matching first sound. Selecting “Ending Sound” will always ask for the matching last sound.

Enter Here for the Speech-EZ Apps  Rafflecopter Giveaway!!

Click on the image to download the handout

This handout is used during my NSSLHA Day Crash Course on iPad and Apps. Many of the apps I discuss are low cost or free and are used to be Appdapted for speech-language therapy.  Clock or tap on the icon in the handout to download the apps!

These might include checking out the weather. I have never been to Atlanta before so I wanted to know what to expect.  So here is the expected forecast for the week of #ASHA12:

To streamline my organization I am using the Trip It app.  This is a cool app that you allow to access your e-mail’s inbox. It scans your e–mail for important travel info and then places on your Trip It Itinerary so you don’t have to fumble around with printed out info from the airlines, hotels, etc.. you have it all in one place, that is unless your battery dies ( so always bring a backup printed copy just in case).

If you checked out my #ASHA12 infographic you’ll remember that I mentioned last year’s online planner wasn’t much of a planner that included “ease of use”. If you haven’t taken a look at the planner yet here is the link http://www.asha.org/events/convention/program-planner/. What I did is highlighted all the sessions I am thinking about attending in the pocket planner. I am not sure why it’s called the pocket planner as you need some pretty big pockets to put it in. The pocket planner is found in the October 9th edition of The Leader.

After I highlighted all the sessions I want to attend I then went to the online planner. To select the session you want to attend you type in the session code number or do a search. To add it to your itinerary simply select the check box that indicates ” ADD TO MY ITINERARY”. This will save all your sessions to your itinerary where you will have the option to print it out or export it to a calendar app or Outlook.  I suggest exporting it to a Calendar I printed it out and it ended up being 14 pages, so save some trees.

Here are two examples of what my itinerary looks like using Android and iOS. I emailed myself the calendar file that the online planner generated and then opened it up on my Android phone and on my iPad. I suggest double and triple booking yourself just to give yourself some options in case the session sucks or there isn’t any seating available.

#ASHA 12 Itinerary on Android

#ASHA12 Itinerary on iPad

Do you need an app that will help you determine if your child or client is experiencing a breakdown in their auditory processing of speech when there is background noise or help you  improve auditory processing skills in the presence of background noise?  Auditory Figure Ground-$29.99, by The Speech-EZ Apraxia Program, will help you accomplish this!

This app uses beautiful photographs that are presented to the listener in a field of four. It’s recommended that a good set headphones be used to accurately simulate the speech in the presence of background noise (Over the ear headphones and not ear-buds). You start off by selecting the type of background noise and the signal to noise ratio you want, while the words are presented.

Background Noise

You have the option of: childrens indoor playground, elementary school children in lobby, noisy crowd walking and talking, small cafe ambience, white noise, and quiet (no background noise).

Signal to Noise ratio

You have the option of: SNR 12 dB (Easiest), SNR 8 dB, SNR 4 dB, SNR 0 DB, and SNR -4 dB (Hardest)

The narrator will say the target word and the child has to tap on the one that they hear. This activities builds auditory processing and auditory attention skills when there is noise in the background. This skill is important in situations such as a noisy classroom.

Each picture also has the written word on the back of it. Simply hit the little arrow icon that indicates turning the card over. You are able to turn all the cards over if you wanted and hit the narration button as many times as you want. You also have the option to mute the background noise as well.

To win a copy of Auditory Figure Ground I am using a Rafflecopter giveaway.

I haven’t used Rafflecopter before so please let me know if you encounter any difficulty.  There are a few ways to earn points for the giveaway and they   are pretty simple- Click on the above RaffleCopter Link to enter- you will then be asked to:

1) Make  a comment on the blog

2) Follow @SpeechEzApraxia on Twitter

3)  Like The Speech-EZ Apraxia Program on Facebook

Good Luck!