Sunday, December 30, 2012

The Benefits of Using an iPad as a Speech Therapy Tool in Nursing Homes and Rehabilitation Centers

For the past two or three years, I've been using an iPad almost exclusively as my go to tool in speech therapy when I moonlight at nursing homes.  Some people might see the iPad as all fun and games (it is fun and there are a lot of games), but there are so many more benefits of including it in your speech bag--or as I call it "My Speech Bag".

Okay, so I'm a male speech pathologist and most therapists are female.  Usually, you can spot a speech therapist either by their stylish promotional tote bag or by their fancy rolling cart.  Yes, I have a couple of each too.  I admit it.  But...then came the 21st century and this little thing called the iPad.  Technology is really cool--if you know how to use it.  The iPad has been great for me as a PRN speech therapist because I travel to and from different facilities. Because of the iPad, I always have my bag of tricks with me.  It saves me in productivity (something they're always trying to increase) and trying to find the right materials efficiently.

Now, some may argue that an iPad shouldn't take the place of traditional speech therapy materials such as workbooks, paper and pencil tasks, and flashcards.  I'm not saying that those all go to the curbside.  I'm saying that an iPad has the capability to have those and then some included.  Using an iPad brings upon other responsibilities such as protecting HIPPA guidelines and making sure you keep it clean and sanitary to void spreading any communicable diseases by using universal precautions.  Being a professional and being trained yearly on these issues certainly keeps these as priorities.  So let me say this--use common sense and don't put personal information of any patients on your iPad.  And, don't use your iPad to block sneezes or to cover open wounds.  If you do, make sure you go to the nurses' station and get some of those kills all living things wipes to disinfect the iPad.  Did I cover all bases?


Okay, now that I've gotten that out of my system.  Here are some things that I've personally used the iPad in therapy at nursing homes:

  • Therapy Books/Workbooks - Have you ever heard of the WALC books, The Source for Dysphagia, or Just for Adults series?  If you work in a nursing home or a rehab facility, then I'm guessing you have.  If you own the books, then you can use the PDF version (included CD in the back of the book) on your iPad.  Remember that tote bag?  It's now in the back of my car filled with crumpled up paper.
  • YouTube Videos - Try explaining a modified barium swallow study to someone.  Then try showing them an actual demonstration video of an MBS.  Which one do you think is more effective and memorable?  YouTube has everything.  Everything.  Need to show a patient how to properly use a Passy-Muir valve?  YouTube.  I've done it.  It's very resourceful.
  • Functional Communication/AAC Boards - If you're like me, you have exactly one half hour to get patients to communicate and participate in therapy.  I've had several instances of working with people with no expressive verbal skills for various reasons.  Having access to a communication board has made it easier for communication (both ways) between the patient and clinician.  A simple board can be created and printed on the fly.  Seriously.
  • ABA Receptive Identification app by kindergarten.com
  • Flashcards - Word finding?  Naming items? Receptive identification? The iPad has a slew of apps that you can use for this task.  Try typing in "Kindergarten.com" in the App Store and you'll find a whole bunch of free ones.  It saves you from carrying around several decks of cards!
  • Swallowing Guidelines - I use The Source for Dysphagia regularly to review proper positioning, modified diets (what's good and what's not), and compensatory strategies.  I use it to show visual models to the patient and to educate nurse's aides who feed patients.  If you were really fancy, you could email/print the reproducible forms to anyone who needs them on the spot.  Do you monitor PO intake?  How about showing them the FDA's MyPlate diagram to show what is suggested for daily food consumption.  
  • Divergent Naming Apps - One of my favorite games on the iPad to use at nursing homes is Family Feud.  It's great for several reasons.  One, it is a great divergent naming task.  Second, it opens up other areas of discussion.  For instance, one question might be, "Name Someone You Would Call if You Were in an Accident."  Questions like that merge into talking about safety issues.  And, to put it simply, it's fun and engaging.
Tap the Frog by Mentals LLC
  • Following Directions, Sequencing,  and Problem Solving Apps - There are a couple that I like for solving problems including Tap the Frog which is a fun way to have patients follow single, multiple, and complex directions involving spatial concepts, sequential order,  and speed and accuracy.  You can have patients read the directions or you can have them follow the directions orally.  Another random app that I really like is called The Moron Test.  I don't necessarily like the name, but I do like the app a lot.  It's good for following directions, short term memory, identifying pictures/objects, sequencing, language processing, and reading comprehension.
I cannot say enough how valuable of a tool the iPad has been while working in nursing home/rehabilitation center settings.  It allows clinicians on-the-spot access to resources limited only by the user's technology abilities.  There have been several times where I've had unengaged patients who have lit up when I played old time music or classic cars from their generation.  I even had one patient who was rather to himself open up when I showed him the Masonic Lodge that he belonged to after I noticed his picture posted on his bulletin board.  The internet alone can give speech therapists the ability to provide immediate information during a therapy session.  If I had my druthers, all therapists and facilities would have access to this incredible device.  Because of its limitless possibilities, the iPad should be an essential tool in all speech therapists' tote bags!
We got grandma an iPad for passover, she immediately goes to her email to pull up Jewish jokes
photo by miserychick on Flickr
(non-commercial Creative Commons license)

9 comments:

  1. Oh how I love to hear a fellow SLP using the iPad with adults! My patient's families are always so amazed when they join a later session and witness their parent/grandparent "swiping" and having fun. Thanks so much for this post Ryan - great job!

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  2. Great review. Keep up the good work. Its help a lot in nursing homes.
    Nursing homes kent

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  3. Thanks for the nice comments. I'm trying to persuade one of my nursing homes into loosening their "No Personal iPads or Electronic Devices" policy. I'm not sure they fully understand the impact that it's had with my approach to therapy. I love being able to search a topic on the spot to open a discussion. Just today, it would've been great to use with a patient who was trying to discuss/sequence the instructions to two-handed euchre. By the end, she had me confused and wishing I could properly look up the rules. When you're technology minded like me, it's super easy to find use in just about any activity!

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  4. Let me tell you, I had a patient in assessment who HAD to get 45 min. She suffered through 25 min of verbal problem solving with an abcessed tooth. I got her an ice pack, propped her up, pulled out the ipad and had her complete the exclusion and categorization apps for another 20 min. Documented appropriately for medical necessity, it is equally as effective, if not more for the hard of hearing patients.

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  5. I've put together a list of over 100 apps for adult speech-language therapy that you can download here: http://tactustherapy.com/resources/ It's such a wonderful tool! We develop apps for rehab for adults and have lots more coming out!

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  6. Very cool! Thanks Tactus Therapy. Nice list. Pass it on everybody.

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  7. Hi Ryan! Just stumbled upon your blog. Just wondering how you can transfer the CD versions of the Source/WALC books to my iPad? That is such great news!

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  8. The CD version has a PDF file on it. You can email it to yourself as an attachment. Open the PDF on your iPad through your mail browser and it will save to your iBooks. You can also do it through Dropbox or other apps similar. Here's a quick video from YouTube: http://youtu.be/KvxIExj0t5Y

    It saves a lot of paper and back problems!

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  9. YES!! This is what I've been talking about! Check out this video of this nursing home resident reacting to technology: http://tinyurl.com/nursinghometech

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