CD 485 Computer Applications in Communication Disorders and Sciences

Computerized Therapy Programs

Section I

Evaluating a Computer Therapy Program

There are many fine, and some not so fine, computer programs available in the workplace today for the rehabilitation of speech and/or language problems. In the process of selecting (and/or in developing) appropriate software, there are some features to consider which will aid the professional in getting the best programs to meet the needs of their client. These include:

1. The age appropriateness of the topics, language and/or graphics used -- Some programs are developed specifically for very young children and use topics, vocabulary and/or graphics that would be insulting to older children and/or adults.

2. The level of difficulty of the tasks -- In the case of children or adults with learning disorders, complicated tasks beyond their capability to understand or succeed can easily be overwhelming and result in their giving up on the program.

3. The type (or goals) of the program -- Typically software programs are developed to teach a new skill, drill a skill already acquired, or play a game. Games are useful when re-purposed by the clinician for therapy, either as a drill or to teach a new skill. Re-purposing refers to a situation where the clinician uses a program in a manner different than that for which it was designed. For example, a program initially designed for vocabulary development with numerous graphic illustrations may be found to be useful when diverted for such related tasks as articulation drill, fluency practice, counting and/or categorizing development etc. Games, of course, are also often used by clinicians in therapy simply as a form of reinforcement.

4. The skills to be developed -- Whether or not through program design or through clinician based re-purposing, the following skills are frequently focused for development in computer programs:

Spelling	Visual discrimination
Eye/Hand coordination	Visual memory
Reading syllables and words	Math skills
Reading Sentences	Closure
Reading Paragraphs	Sequencing
Syntax	Confrontation naming (vocabulary)
Relational Concepts	Articulation
Logic and Reasoning	Sentence Formulation

5. The format of the program -- The effectiveness of any computer program is determined largely by its format. The following are a number of major organizational considerations:

Multi level -- Some programs are stratified relative to the level of complexity of the material to be learned and/or the tasks that are required by the student. Students can begin at whatever level is appropriate to their needs.

Branches -- Some programs have choices built into the task mechanism so that different paths through the program material will be selected by the program depending upon the student’s responses to each task (e.g. more drill at the same level; or more complicated material and/or new concepts.

Un-timed -- Some programs have a set or variable time-limit on the response time allowed for each task. Others programs have no time limit. Each feature has its strengths and purposes. When working with aphasic patients, for example, the time-limit feature can be useful for developing the initiation process in making a response. In other instances, however, the timing factor can be frustrating and disruptive.

Large type -- Type that is too small is not only often difficult to read on many monitor, but also contributes to a screen that is cluttered. Add to this that many students have various degrees of visual impairment and the need for large print becomes particularly relevant.

Requires few keys -- Many, if not most, students using a computer are not skilled typists. Some, in addition, have motor problems that make typing impractical. Computer programs that require only one to four keys for a response mode are much less likely to overwhelm or frustrate these users.

Uncluttered -- There is a tendency among program developers, particularly new ones, to put as much technology as possible on each page of their program. The result if often a highly cluttered screen environment which is confusing to the users. Programs that are simple and uniform reduce attention distractions and help the user focus on the material.

Gives instructions -- Programs should have instructions that are understandable and accessible. Not only a hard copy manual but also help menus embedded within the computer program itself is a desirable feature that will make the program more user friendly.

User friendly -- This is a global term that actually encompasses the total effect of all the features discussed above. A program that is easily understandable, uniform in its presentation, uncluttered, easily observed, and capable of meeting the needs of the client is user friendly.

6. Clinical Control -- Another major feature that can increase the training effectiveness of a computer program is the degree of control that clinician has over a number of variables in the program. These may include:

Lesson Content -- For programs that have various levels of content it, is more efficient and effective for therapy if the clinician has the option of selecting for the user the particular level of content they feel is most appropriate.

Number of items -- Some programs permit the clinician to set the number of items (pictures and/or words) presented on the screen in either the stimulus and/or the response mode. This gives the clinician the added capability of structuring the tasks from the simple to the more complex.

Timing -- It is very useful to have control over the timing of the presentation and/or the responses. Not only does this permit the tasks to be structures from the simple to the more complex, but also it can serve different goals, such as practicing the initiation of a response, or improving response time.

Starting Point -- Having control of the starting point is particularly important. Some programs are long and are not completed by a student in one sitting. If the student must re-start each time at the beginning of the program, they may never finish the it! Being able to continue from where the student left off, or where ever the clinician feels would be most appropriate is highly desirable. In some cases material that is too simple for the student can be by-passed to the point where the student will be challenged instead of bored.

Number of guesses -- Having control over the number of times a student can answer a question is beneficial for the clinician in terms of using the program to meet the needs of the student. In some cases the goals of therapy may include helping the student be successful, hence several tries at the answer would be desirable; or a goal may be to decreasing the time it takes to complete the program, hence less responses would be beneficial; or the goal may be to get a valid assessment of the students ability, in which one response would be probably most desirable.

7. Feedback -- One of the major strengths of the computer as a teaching tool is its capability for interactivity with the user. Feedback is a major parameter of that feedback. Three elements of feedback are desirable:

Providing the correct answer -- Making the students aware of the correctness of their responses and/or providing the correct answers when all else fails is not only good teaching technique but highly motivating to the users. On the other hand, if the program is being used for assessment purposes, having the answers provided would be counter productive.

Keeping Score -- Programs that automatically keep score are particularly useful for teaching in terms of tracking student progress, report writing and maintaining student motivation. Score may be in terms of numbers of items answered correctly and/or response times.

Providing Reinforcement -- Reinforcements (auditory and/or visual) are always a desirable feature for a teaching program, although care must be taken because some types of reinforcement are in fact insulting, time consuming and/or actually not reinforcing at all. These are judgments that can only be made after examining the program.

8. Access -- As technology advances the means by which student responses can be entered into the computer are proliferating. Different inputs have different strengths as follows:

Keyboard -- The simplest and least expensive means of input, in terms of computer equipment requirements, is data entry through the keyboard. This is standard equipment on all computers. The disadvantage of this method is the complexity that confronts the user in terms of the confusing array of keys. Figure-ground problems and fine motor disabilities in particular mitigate against this form of input.

Joystick -- Some programs that employ game paradigms and those that involve eye-hand motor coordination usually are better suited to the toggle motions of the joystick, a throttle style input mode.

Switch -- An important input means for very young children and for any individual with severe cognitive and/or motor impairments is the switch. Programs that enable this on/off means of input are very useful with these populations.

Touch Window -- This is a popular mode in input in which a window is placed over the computer monitor. Responses by the user are made by touching appropriate areas on the window over the computer screen. It is fun, simple and fast. For very long programs, however, it can be fatiguing; and for individuals with sever motor disabilities, it may be not possible. It requires special equipment (i.e., the touch window) and special programming within the software to match the mode of input.

Mouse -- Like the keyboard, the mouse is now standard equipment on most computers. The mouse has an advantage over other input modes like the touch window, in that it requires a minimum of movement. Hence the factor of fatigue is less prominent. Nevertheless, it does require a substantial amount of eye-hand motor coordination, and is intimidating to some adults. Many programs, like Hyperstudio, have drawing programs that require a mouse to operate.

Voice -- For individuals with visual impairments or severe motor impairments involving the arms, voice input is a major asset. Some speech training programs have used voice input, which has increased not only motivation but also modality involvement. Voice input, however, in the PC computers requires a audio card and speakers. This is standard equipment on Macintosh computers.

Computer Program Analysis Report

GRADUATE STUDENT NAME:
Program Name:
Age Range Appropriate:
Level of Difficulty (1 TO 5):
CRITERIA (X) CRITERIA (X)
Program goals	Clinical Control
Teach a New Skill	Lesson Content
Drill	Number of Items
Game	Timing
Eye/Hand coordination	Starting Point
Reading syllables and words	Number of Guesses
Reading Sentences	Feedback
Reading Paragraphs	Provides Correct Answers
Syntax	Keeps Score
Relational Concepts	Provides Reinforcement
Visual discrimination	Access
Visual memory	Keyboard
Math skills	Joy Stick
Closure	Switch
Sequencing	Touch Window
Confrontation naming	Mouse
Articulation	Voice
Sentence Formulation	Comments:
Program Format
Multi Level
Branching
Un-timed
Large Type
Requires Few Keys
Uncluttered
Gives Instructions
User Friendly

Place an "X" in the shaded column if the program you are evaluating has the Criteria listed. When you are finished, cut and paste the page into a new word processor file and send it to the instructor through the Student Drop Box.