June is National Aphasia Awareness Month! To celebrate this, we collaborated with Tactus Therapy Solutions and checked out their first app: Comprehension TherAppy. However, before we start talking about the app, here’s letting everyone know that iSPeak App is giving Tactus Therapy Solutions not two but THREE thumbs up (!) for taking up the task of creating apps specifically designed for individuals with aphasia and brain injury.
Comprehension TherAppy was designed to target auditory and written comprehension of single words. The app fires up fast and straightaway shows the main screen with three modes to choose from: Listen (for auditory comprehension), Read (for written comprehension), and Listen and Read (for both auditory and written comprehension). The Settings button is located on the upper right hand corner of the main screen and provides quick customization options:
- Difficulty: Easy, Medium, Hard
- Field Size: Auto, 2, 3, 4, 6
- Number of Trials: 10, 25, 50, 100, infinity
- Default Email Address for Results: (to be specified by the user)
Picture stimuli are shown in the first two modes (Listen mode, and Read mode). The third mode (Listen and Read mode) offers word stimuli only.
We decided to field-test the app with a client right away. Since the app uses landscape view, using the Smart Cover as a stand would have been a good choice, but not a practical one. We instead used a Belkin Flipblade iPad stand and this suited our client well enough since it gave her an optimal viewing angle of the screen. Our chosen settings were Easy, Auto, and 50 Trials.
What makes this app truly awesome:
- light on memory space, fast on its feet: only 10.3 MB! Fires up fast, no lag when a fresh set of stimulus pictures appears (on the iPad 2)
- a very clean interface: no animations, no complicated patterns nor colors. The pictures and words are set against a white background. On top of the screen is a blue strip containing
- the Home button
- Correct responses indicator
- Incorrect responses indicator
- Progress bar
- pictures are realistic: the stimuli are definitely appropriate for adults, with most of them being clear and sharp.
- sounds are appropriate and low-key: no clapping, music or “good job” voice-ins that are often present in apps for kids. This app’s sounds are presented by a male, North American accented voice in the Listen and Listen and Read modes. The correct and incorrect response feedback sounds are nondistracting dings and beeps.
- adequate spacing between pictures
- appropriately ‘dated’ pictures: several pictures appeared to be carefully chosen with older adults in mind. None of those modernistic or futuristically-designed toasters, ovens or microwave ovens. The toaster was visually recognizable as a toaster. The microwave oven’s door was slightly ajar.
- differentiated pictures: some picture stimuli could have easily looked similar to each other, and this would have been a problem if, say, a pickle occurred in the same set as a cucumber. While this would have been good for working on a client’s attention to details, the app’s developers appeared to be considerate enough to differentiate the picture of a pickle from a cucumber by presenting the latter as sliced and whole (in one picture).
- community workers were presented in context: a nurse is shown working with a patient, a pilot at his cockpit, a secretary in the office
- stimulus words are written in big, bold text: not overwhelmingly huge, but big enough to be read
These are our impressions about the app’s visual aspects. Here is what we found when we went on hyperfocus mode:
What makes this app AWESOMER:
- HUGE selection! over 500 pictured nouns in 10 categories
- expansion packs are available: for a reasonable price, one can purchase add-ons such as
- Verbs: containing over 100 progressive verbs
- Adjectives: over 100 words, includes numbers attributes and colors
- app adjusts field size basing on performance: if your settings are on Auto, the app starts by presenting 3 stimuli pictures/words. Three consecutive correct responses increases the field size to 4, and three more correct responses bumps it up to 6 choices. The reverse happens when three consecutive incorrect responses are made: if the client makes mistakes given 4 choices, the app makes it easier by bringing the selection a notch down to 3.
- level of difficulty is presented in semantic foils (and some phonemic foils): After a few minutes of consistently-correct responses, we observed that semantically-related stimuli occurred in the same set, such as pictures of a set dentures and a toothbrush. In another instance, phonemic foils appeared (a picture of salsa and a picture of pasta in the Listen mode). We needed to clarify this observation with Megan Sutton, Tactus Therapy’s app designer and director. According to Ms. Sutton:
“On Easy Mode, all foils are from different categories. On Medium, there is one foil from the same category and one that begins with the same initial phoneme. On the Hard setting, there is at least one foil from the same subcategory as the target and the rest are from the same category.”
Similarly-shaped pictures also occurred together in some instances (bracelets vs. ball). Ms. Sutton clarified that this consideration fell under the app’s intent to present semantic foils, given that semantic foils (same category) on occasion provides visual foils.
- accurate tallying of responses: each picture gets either 1 correct point or 1 incorrect point. If the client makes an incorrect response in, say, a field of 4 pictures, it counts it as 1 but won’t change the selection until the client selects the correct picture/word. But once the correct response is made, no points are awarded. If the client made more incorrect responses in that same array, these responses are not counted either.
- performance summary is displayed: at the end of the activity, the app provides a summary of the client’s performance by number of correct responses over total items and is categorized by field of 3, 4, and 6.
- option to email performance summary: the email does not just contain a bulleted summary, it even includes a narrative template describing what the client had achieved in what task. Just edit the text, put in the recipient’s email address, sign with your name, and hit Send.
There were some instances when our client slowed down and even squinted at the pictures. We took careful note of these and figured that…
This app could use some tweaking on the following:
- white pictures against a white background: several pictures were hard to distinguish against the app’s white background, such as rice, a white cup and saucer, a pillow, a refrigerator, a map, a notebook. The egg was more distinguishable since this was depicted as cracked open with the yolk showing.
- the REPEAT button (Listen mode) was placed in the same area as the stimulus word (Read mode): this unsettled our client a bit since we used the Read mode first and she had gotten used to seeing the word on the bottom of the screen. When we shifted to the Listen mode, she was confused by the presence of the Repeat button in the same place where the written words had been.
- soft auditory stimulus: the voice that played back for the Listen and Listen and Read modes was soft, considering that we maxed out the iPad 2’s volume settings for this. We have not tried using our X-Mini II Capsule speakers for playback, however, nor have we tried using the app with headphones. We received news that this issue will be addressed on the app’s upcoming free update.
Heads up on other details, such as:
- some pictures required higher processing: it was understood that the app’s pictures varied across levels of difficulty and some of these tasked visual recognition and attention more than the others. A few examples are:
- the sun was depicted as how one would see it with the appropriate filters (sunspots and all)
- the concept of science was represented by test tubes and a microscope
- a policeman was shown to be wearing a uniform, a small badge, no identifying policeman’s hat
- the concept of wedding was shown as two hands holding each other in the foreground, with a blurred celebrant’s image in the background
- target words appear randomly: we also clarified this observation with Ms. Sutton. She specified that the stimulus words and pictures were selected for their frequency, imageability, usefulness, and membership in target categories, not by word length.
Overall, Comprehension TherAppy is a very, VERY useful app, and definitely one that we will be using with our clients on a constant basis. The special introductory price of $19.99 will last only for the month of June, so we highly suggest you purchase the app very soon. The expansion packs are a bargain and we also recommend you to get them in order to maximize the app’s potential.
And just in case we haven’t mentioned it before, we’re showering this one a lot of “likes” =)
- auditory comprehension
- reading comprehension
- auditory processing
- receptive language