Visual Attention TherAppy: More than meets the eye

Tactus Therapy continues to fill the void with their quality therapy apps.  They have recently shifted their apps’ focus from language to cognition–specifically, attention–skills.  Again, while there are apps in the App Store that we can use to target visual attention, a good number of them were made in a gaming context.  Many come with timers, putting temporal stress on a task and making one wish there were ways to toggle the countdown off.  Visual Attention TherAppy puts more options in the clinician (or user’s) hands, enabling one to create specific visual attention tasks and generate information about the user’s performance.

Tap the app’s icon on the iPad and it immediately shows you the main screen. On the upper right corner is the Settings button.  It was a good idea that we checked out Settings first because there were a number of crucial options in it:

  • Number of Trials At Each Level: 1-5, and 10. You want to have 3 trials of Letter in Symbols? Tap 3.
  • Number of Lines: The more lines, the more targets and foils. 
    • Fewest: 4 lines
    • Some: 5 lines
    • More: 6 lines
    • Most: 8 lines (this pretty much fills up the screen)
  • Spacing: Small, Medium, Large.  The number of lines depends on the spacing selected.  If Small is selected, the activity can have as much as 12 lines.  Choose Large spacing however, there will be 6 lines.
  • Signal:  specifically added for clients with neglect issues, this gives the clinician the option to have a Red, Yellow, or Flashing signal at the side of the screen to direct the client’s attention to. The toggle for a Left, Right, or No Signal is found in the main screen.
  • Default Email Address for Results: As with Tactus Therapy’s previous apps, one can enter the receipient’s email address to whom the results will be forwarded.
  • Child-Friendly Mode: toggle this button to turn it off or on.

There are two modes on the app’s main screen: Practice and Test. One can access all of the app’s levels in either mode. The difference between these modes is that in Practice, the client/user cannot move forward and skip targets: he/she must tap and select all targets before moving on to the next line. In Test mode, anything goes, and the user can tap at the targets in any order.  Visual attention skills are measured by how many targets were selected until the Done button is tapped or until all targets have been selected.  One other difference is that the Test mode takes note which quadrant of the screen the user missed targets in.  The Results page includes this information under “Location of Missed Targets.”

There are 10 levels to choose from, and these are arranged by difficulty:

  • Same Symbol
  • Same Letter
  • Symbol in Letters
  • Letter in Symbols
  • Symbol in Symbols and Letters
  • Letter in Letters and Symbols
  • Dissimilar Symbols
  • Similar Symbols
  • Dissimilar Letters
  • Similar Letters

At the bottom of the Level Selection page, one can opt to show 1 or 2 targets.

The task screen is monochromatic, the letter and symbol font in black and is approximately Arial font size 14 or 15. The header bar shows:

  • the Home button
  • the Timer: the clock starts when the user taps the first target
  • the Instructions: centered in the header bar is the target (ex: Touch Every C, Touch Every I and T)
  • the Counters
    • Targets Found / Total Targets
    • Trials / Total Trials
  • the Skip button (Practice Mode) or the Done button (Test Mode)

On Practice Mode, tapping on a correct letter/symbol makes a soft “whooshing” sound. Tap on a wrong letter/symbol, one hears a “thunk” sound. Turn the iPad’s sound off or decrease the volume if you do not wish to hear these sounds.

The Results page is shown in email format, with a brief description on how the client performed (time it took to accomplish tasks, date, spacing, number of targets found, total targets, number of lines). The results are shown in tables with the following information:

  • the Targets
  • the Time it took to finish each trial
  • Number Correct (including percent correct)
  • the Location of Missed Targets (top/bottom left/right)
  • Number of Wrong Targets

What we love about Visual Attention TherAppy:

  • responsive to finger taps, area-specific:  this is worth noting because a good amount of effort in app development goes into programming which areas in every screen should respond to taps (and what happens when that area is tapped). Whether the spacing is large or small, or the lines many or few, the app responds beautifully to touch.
  • font size: consider the app as a tool to help clients manage written word better and pay attention to smaller, finer details. The font size is just right for older children and adults (who may use reading glasses if necessary, of course).
  • provisions for individuals with neglect issues: this one’s a good plus. A colored and/or flashing line at the neglected side of the screen always comes in handy for certain cases.  What’s even more awesome is the app’s ability to report what quadrants were neglected!
  • high customizability: # of trials, # of lines, spacing, levels of difficulty are all within the clinician/user’s control. One needs a thick book full of similar paper-based activities in order to get as customized a visual attention task as possible. And even if one has electronic copies of such activities, printing these out takes time and uses up paper, leading us to our final point…
  • Earth-friendly! some of us undergo a certain amount of guilt (well, we do) when we use up a lot of paper for visual attention tasks only to throw them away afterwards. Small whiteboards solved this problem somewhat, though making the letters and symbols eats up time.  This app saves both natural and time resources.

Did we find anything we didn’t love about the app? Nope.  The app is fast and lightweight (less than 1 MB!), is highly specific in its role in its app-life, and costs only $10.00.  To get a feel of how the app works, get Visual Attention TherAppy Lite from the App Store.  This free version packs a one level activity and lets you try out its Practice and Test modes, put out 1 to 2 targets, and email results.

It is easy to take down an engaging app from the App Store and analyze how it can be used to target specific cognitive skills. Many do address sustained, alternating, even divided attention.  We knew we needed apps like these, but we also wanted highly specialized ones too.  At the back of our heads years ago, we wished for a better way to address visual attention and get measured results without using up so much time.  Seeing how Visual Attention TherAppy was designed to work, the bar is raised even further in therapy app development.  Visual Attention TherAppy is guaranteed to be one of those beautiful apps that, when you see it and try it out, will make you exclaim “Finally!”  We were this close to hugging it, to be honest.  Thanks for yet another amazing release, Tactus Therapy.

Price: $ 9.99 
Weight: 0.9 MB
Updated: 14 September 2012
Version: 1.01
Compatible with: iPad
Seller: Tactus Therapy Solutions, Ltd.
Target Population: children, adults
Awesome if you want to work on:
  • visual attention skills
Customer Ratings (iTunes): 4+ out of 5 stars
iSPeak App says: 4+ out of 5 smileys


Have fun with alternating attention & visual memory with Tiny Pants & X-Memory

Games are excellent cognitive exercises.  All sports require planning ahead and making judgment calls.  Same goes for anybody who’s played with PacMan, Tetris, and the very first Prince of Persia.  Things became more difficult when the developers upped the ante and created 3-D Pacman, Tetris and Prince of Persia.  What did we do?  We kept playing, and we kept getting better at these.

Some games challenged our cognitive skills a bit more than the others.  A goodexample of such game apps are TTGan’s Tiny Pants and X-Memory.  From the makers of Ah Up!, Ah Up! Planet, and PaPaBong,  TTGan‘s suite of games caught our attention because they were so appropriate for our field, helping us work on vocal intensity, cognitive skills and eye-hand coordination the fun way.

The idea behind both apps is simple:  objects pop out from the bottom of the screen.  Pay attention to the underwear patterns and colors (Tiny Pants) or the icon ball’s letters, animals and shapes (X-Memory).  When the selection screen comes out, tap on the underwear / icon balls that you had seen pop out.  That’s the basic rule.  The app makes things a bit more difficult via:

  • distractors that pop out along with the target objects, such as:
    • numbers:  tap on one and you get extra points.  Who doesn’t want extra points?
    • helper objects:  for example, tap on a potion botte and you convert all objects into the same pattern
  • the number of objects that appear:  as you move up in the game, more objects pop out.  The app gives you more helper objects (or objects that you must not tap).
  • the number of choices in the selection page:  at around Level 6-7, you are supposed to pay attention to 3 kinds of underwear patterns / icon balls.  The selection page shows you as many as 15 choices where you select which patterns came out in the game.
  • the pattern size:  Tiny Pants offers 3 difficulty levels basing on the area on which patterns appear:
    • boxer shorts:  biggest area, one can see more of the pattern
    • full underwear:
    • G-strings:  tiny space for patterns to appear on, challenges one’s ability to take note of the tiny details
  • the pattern type:  X-Memory, on the other hand, offers three kinds of graphics basing on ease of recognition and retention
    • letters
    • animals
    • shapes
  • the time limit:  one is allowed a few seconds to make their choices in the selection page.  The clock counts down as one attempts to compare across patterns, match it to one’s memory of which patterns came out, and make the correct decision.  Make three wrong guesses and the game’s over.

Which one to download?  It actually depends on you and your target clientele.  Many kids might find flying underpants amusing, but some may actually prefer letters, shapes and animals instead of patterns.  Tiny Pants and X-Memory seem like simple enough games, until it gets harder and harder.  Try it out for yourself.  One can’t go wrong with $0.99 apps.

Tiny Pants has English and Chinese versions.  Click here for the English iPhone/iPod Touch and iPad versions of Tiny Pants.  Links to Tiny Pants’ Chinese versions for iPhone/iPod Touch and iPad are here.  Click here for the X-Memory’s iPhone/iPod Touch and iPad versions.

Price:  $0.99 
Weight: 12.5 MB (Tiny Pants), 17.0 MB (X-Memory)
Version: both 1.1
Compatible with: the iPhone (and iPod Touch) and iPad
Seller:  Zeyu Luo, copyrights 2011
Target Population: adults and children
Awesome if you want to work on:
  • focused attention
  • alternating attention 
  • visual memory
Customer Ratings (iTunes): 4+ out of 5 smileys
iSPeak App says: 4 out of 5 smileys



Comprehension TherAppy: perfect for working on auditory and written comprehension

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.

Here are our impressions after spending some time using the app during an actual therapy session:

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” =)

Price: $19.99 (special introductory price for June only)
Weight: 10.3 MB
Updated: 16 June 2011
Version: 1
Compatible with: optimized for both the iPhone (and iPod Touch) and iPad
Seller: Tactus Therapy Solutions LLC
Target Population: adults
Awesome if you want to work on:
  • auditory comprehension
  • reading comprehension
  • alexia
  • attention
  • auditory processing
  • receptive language
Customer Ratings (iTunes): no ratings yet as of this article’s date
iSPeak App says: 5 out of 5 smileys




Games with Purpose 2: Smack That Gugl and pin down visual discrimination and focused attention

There are thousands upon thousands of game apps in the App Store and the Android Market.  A lot of these games are so engaging, it’s literally difficult to pry your iDevice out of your little one’s hands.  We all know how crucial it is to sit down and guide our kids in using these gadgets and not make these become replacement babysitters, but we also know that many games can be used at therapy.  Given the right game and the appropriate set of goals, a mediated session with an iPad or iPod Touch can be just as fun as doing free play on the device.  Want to work on prepositions? Your kid will love you for using Angry Birds and you get to work on on, under, in, beside, etc.  Want to work on increasing vocal intensity? The app Ah Up! (now $0.99 in the App Store) just might make little voices go loud without them realizing it.

Smack That Gugl is one game that can be used with a lot of purpose in the therapy room.  These little green blobs rise up from the screen, inviting the player to smash, squish, and smack them flat.  Of course, there are rules:  One can’t squish all the blobs.  Make sure your kid knows that:

  • each Gugl must be squashed before it turns red, or else one loses a life (or a turn, if you’re using the app in a dyad or group session)
  • smash the yellow and red ones twice to really deactivate them
  • don’t whack the chickenpox Gugl! Do it and lose a turn or life
  • blue and yellow Gugls split into two.  If one isn’t fast enough, they can multiply fast and turn red
  • if five red Gugls are unsmashed, they take over the screen and the game is lost

Excitement and the competitive spirit can easily highjack anybody’s visual discrimination skills and attention to detail.  For as long as your kid knows the rules (and learns from his mistakes), this game can help him slow down a bit and process each Gugl visually before he makes an action.

Smack That Gugl is currently FREE at the App Store! Try it out yourself (and go Pro Mode), and enjoy the game’s 3D rendering, cool background music and sound effects, and overall engaging gameplay.