IPad Therapy

Overview

In the last few years, therapy has increasingly included digital elements to account for changing functional needs of adults. In particular, the use of iPads has become an evidence-based practice in therapy due to the multitude of apps available to supplement therapy activities as well as at-home practice. Many studies have concluded that the use of iPad therapy both when used independently or when facilitated by a clinician has shown to be effective for adults with mild to moderate aphasia (Kurland et al., 2018; Stark & Warburton, 2018; Des Roches et al, 2015). It has been shown that aphasia therpay delivered via iPad has a positive effect on both receptive and expressive language domains, in addition to a positive effect on cognitive skills (Des Roches et al., 2015).

How to Implement iPad Therapy

Because iPad therapy varies and does not include a protocol, clinicians must make informed decisions when choosing an app to use with this modality. Clincians can choose to use these apps in-person, via telehealth, or even offer them as options for at-home practice for clients.Considerations can include:

• Choose an app that is evidence-based whenever possible

• Consider your client's skills and abilities (are they comfortable using technology, do they have intact literacy skills?)

• Choose an app that reflects your client's goals

• Practice using the app beforehand so you know what to expect

• If possible, customize the app for your client based on their skill levels and language preference

Materials

There is a wide variety of speech therapy apps available for clinicians. In particular, Tactus Therapy is one of the most widely used and evidence-based options. In particular, the Comprehension Therapy and Advanced Comprehension Therapy apps by Tactus focus on improving spoken and written language abilities for individuals with receptive language deficits. Research has shown that using these apps for 20 minutes a day for at least four weeks can greatly improve chronic aphasic symptoms up to 250% (Stark & Warburton, 2018)! The difficulty rating can be adjusted as the client progresses and the apps can be personalized to include preferred language and functional vocabulary for the client.

Available activities on these apps include:

• Listening to a word and choosing the matching picture

• Listening for a phrase or description and choosing the matching picture

• Reading comprehension

• Following directions

• Assembling sentences

Example Goal

In three months, given a verbal description of an object, Client will independently choose the corresponding object picture with 80% accuracy across three consecutive sessions as measured by clinician data.

References

Des Roches C.A., Balachandran I., Ascenso E.M., Tripodis Y., and Kiran S., (2015) Effectiveness of an impairment-based individualized rehabilitation program using an iPad-based software platform. Frontiers in Human Neuroscience. 8:1015. doi: 10.3389/fnhum.2014.01015

Kurland, J., Liu, A., & Stokes, P. (2018) Effects of a Tablet-Based Home Practice Program With Telepractice on Treatment Outcomes in Chronic Aphasia. Journal of Speech, Language, and Hearing Research. https://doi.org/10.1044/2018_JSLHR-L-17-0277.

Marshall, J. C., Pound, C., White-Thompson, M., Pring, T. (1990). The use of picture matching tasks to assist in word retrieval in aphasic patients. Aphasiology. 4 167–184.

Stark, B. & Warburton, E. (2018) Improved language in chronic aphasia after self-delivered iPad speech therapy, Neuropsychological Rehabilitation, 28:5, 818-831, DOI: 10.1080/09602011.2016.1146150.