Sunday, November 16, 2014

Blue Tree Publishing Apps Review

App:  Aspiration Disorders

Price:  $4.99

System:  iOS (iPhone, iPod Touch and iPad)

Version:  1.2

App:  Oral Disorders

Price:  $4.99

System:  iOS (iPhone, iPod Touch and iPad)


Version:  1.1

App:  Swallow ID

Price:  $4.99

System:  iOS (iPhone, iPod Touch and iPad)



Version:  1.1

App:  Vocal Folds ID

Price:  $2.99

System:  iOS (iPhone, iPod Touch and iPad)



Version:  1.3

App:  Larynx ID

Price:  $4.99

System:  iOS (iPhone, iPod Touch and iPad)



Version:  1.1

App: Residue Disorders

Price:  $4.99

System:  iOS (iPhone, iPod Touch and iPad)



Version:  1.1

I typically review apps individually.  These apps by Blue Tree Publishing are all very similar, so I decided to review them at once.  

If you've never heard of Blue Tree Publishing, they make incredible educational materials.  They started making educational apps which are great to share with patients, caregivers, physicians, nurses and anyone who may be interested.  The apps can be purchased individually or in a bundle.  


Each app offers a drawing that depicts each structure/function in the title.  The drawing can be viewed still or animated.

There is text that can be used to accompany the drawing or can be removed.  

With the swallowing apps, Aspiration Disorders, Oral Disorders, Swallow ID and Residue Disorders, a video of a modified barium swallow study showing the dysfunction is included on each app.  With the Aspiration Disorders app there is also a FEES video available of aspiration.

The Larynx ID does not have videos, but does have nice animations to show the muscle functions and the structures, including how they move.  Vocal Folds ID does have a video available showing the movement of the vocal cords during phonation.

These apps are definitely worth the money if you need a great educational app.






Dysphagia By Lingraphica App Review

App:  SmallTalk Dysphagia

What it is:  An app that can be used as an AAC device so that the patient can communicate about their swallowing difficulty.

Price:  Free

System:  iOS (iPhone, iPod Touch and iPad)

Version:  3.1


SmallTalk Dysphagia is an app designed for patients to use to communicate about their swallowing disorder.  
 Vertical View

SmallTalk Dysphagia offers a variety of pre-recorded phrases that relate to a patient's swallowing difficulty.  

Horizontal View


The app also offers 4 videos that will first tell the technique required to swallow and then show a video demonstrating the technique.  You find this at the main menu by selecting Videos rather than Icons.  The videos are available for the Mendelsohn, the Supraglottic Swallow, the Super-Supraglottic Swallow and the Effortful Swallow.  The videos can not only be used as a reminder of how to complete each exercise, but can serve as an instructional video for care-givers and other professionals as well.  


It's a nice app and can serve a great purpose, however it cannot be personalized to a specific patient.  The patient would have to scroll through every phrase available to find the phrase they need.

Oral Motor by Lingraphrica App Review

App:  Oral Motor

What it is:  An app full of oral motor exercises with videos to demonstrate each exercise.

Price:  Free

System:  iOS (iPhone, iPod Touch and iPad)

Version:  3.1


SmallTalk Oral Motor Exercises is an app that was created by Lingraphica.  

This app offers an extensive list of exercises with accompanying videos to demonstrate how to complete each exercise.

Horizontal View

 Vertical View


This is an app that can be used for a home exercise program, as there is a video to demonstrate each exercise. 

The downfall with this app is there is no way to personalize it for your patient to make it into a home exercise program.  

This offers a wide variety of exercises and if you are an SLP that likes oral motor exercises, this is a vast array.

Smart Oral Motor App Review

App:  Smart Oral Motor

What it is:  An app that for pediatric oral motor exercises.

Price:  $5.99

System:  iOS (iPad, iPhone and iPod Touch)

Version:  1.0


Smart Oral Motor is an oral motor app by Smarty Ears.  

Smart Oral Motor uses the Smarty Ears mascot "Clever" to demonstrate oral motor exercises.  


There is a list of 12 exercises from which to choose.


Clever will then show the child how to complete the exercise.  For each time the child completes the exercise, they earn a star.

When the child is done, they receive applause for their hard work.

I think Clever is adorable, however, there are times that I would love to skip through the intro.  I'm not much of an oral motor therapist, but do like the app when I need to do an oral motor exam on a child that just does not want to participate.  They love imitating Clever and find the app to be rather engaging.  

This can actually be a very fun app!

Tuesday, November 11, 2014

ASHA Convention.......Here I Come!!

                                              IMG_0173
It's that time of year again.  That time when SLPs all over the country are preparing for the annual trek to the ASHA convention.  For many, it will be their first ASHA convention.  My friend Tara has an amazing blog series right now about the ASHA convention, how to plan and how to pack.  You can find her at SpeechyKeenSLP.
Many of us are veterans of the ASHA convention.  This will be my fifth convention.  I do look forward to the learning, but I mostly look forward to that time that I meet up with my friends.  Through networking on outlets such as Twitter and Facebook, I have a new group of friends with whom I get to spend 4 glorious days a year.
I won't lie, the build-up from ASHA is enormous, but the let-down when it's over is almost the same.  The jam-packed exhibit hall, spending time with people you see once a year ane the rush to get to your next session becomes a part of your day and you miss it.  I spend most of the plane ride home torn between missing my family and just wishing that it was already next November.
Planning is key for the ASHA convention.  I will be taking Tara's advice and planning using Google Docs.  Making a spreadsheet with all the courses I choose is much easier and phone/tablet friendly than trying to use that ridiculous online ASHA planner.  There will be computers set up to look up sessions, but those are usually pretty packed and you will need that time navigating the building.  By having a plan, I can easily run from one session to the next and not have to worry about finding a provided computer.
When I pack my clothes, comfort is key.  I am not presenting at this year's convention.  I present throughout the year and enjoy having a time that I can attend other people's sessions.  I go for a business casual look.  I will be spending time between sessions networking in the exhibit hall, at the Smarty Ears booth and the Yapp Guru booth.  I want to look the part.  I also will not be sporting formal attire nor will a high-heeled shoe be put in my suitcase.  You can dress nicely and be comfy at the same time.  There will be schools and businesses looking to hire at the convention.   You never know when you may score an on-site interview with either and you don't want to interview in old ratty jeans and a sweatshirt.
I pack the bare essentials.  If it's not a beauty routine I would utilize at home, I'm not going to use it at the convention.  I will take my bathroom toiletries, clothes, pajamas and comfy clothes for the evening and plane ride home.  I typically try to jam everything into a carry-on, but this year I'm checking my bag.  That way, I have a much larger suitcase and don't have to skimp on the basics.  I can also pack all my liquids into my suitcase and not have to worry about removing them while being strip-searched to get into the terminal.
Another must have for me is my essential oil collection.  I won't bring them all, but the necessity oils.  The oils I diffuse to help me sleep, perk up, for a headache and my Xanax blend.  Although I was very skeptical about the oils before I started using them, I have realized that I rely heavily on them.  I recently started feeling bad, a mix of oils in a roller bottle for my son and I and a mix of oils taken orally for me in a capsule have helped tremendously!  I didn't even have to sign my life away for medication.
I travel with a backpack.  The backpack will hold all of my essentials.  I don't travel with my purse.  I always make sure to have my iPad with my bluetooth keyboard.  If there is WIFI in the convention center, I can use my iPad to Tweet and to post on Facebook.  Also, working at 2 booths that are app based, it does help to have my iPad to demonstrate the apps.  If there is no WIFI, I can still utilize my Notes app and save information to post later.  I always carry my phone and my portable charger.  I will definitely need the extra battery power.   The other thing that I always have on hand are business cards.  I have a separate set of cards with my address and personal info and one with my blog address so that others can get in touch with me.  I'm hoping to make big changes to this blog and vendors may be an integral part to that.
                                             IMG_0134
To say the exhibit hall is overwhelming may be an understatement.  In the exhibit hall, you will find companies selling products and books, companies giving samples of their product, companies looking to hire new SLPs, app companies, continuing education companies and schools looking to enroll new SLP students.  Make your wish list and map out the exhibit hall.  You could literally spend an entire day just in the exhibit hall.  Companies will be offering discounts on products which makes it even better!!  This is also the time to look at those products you're a little iffy about purchasing or to trial products.   Time in the exhibit hall can be quite valuable.
My days, when not filled with the exhibit hall and sessions, will be filled with an early morning breakfast/meeting on Thursday for BCS-S, bowling with friends, dinner with Yapp Guru and of course, the closing party.
I can barely wait for ASHA to get here!

Sunday, October 5, 2014

Measuring Lingual Range of Motion

For so long, we have focused on lingual strength and range-of-motion.

The Iowa Oral Performance Instrument (IOPI),  the SwallowStrong and the Tongue Press have all been developed to give us visual and numeric strength measurements of the tongue.

We finally have a measurement scale for lingual range of motion.

C.L. Lazarus, H. Husaini, A.S. Jacobson, J.K. Mojica, D. Buchbinder, K. Okay, M.L. Urken.  Development of a New Lingual Range-of-Motion Assessment Scale, Normative Data in Surgically Treated Oral Cancer Patients.  Dysphagia (2014) 29:489-499.

This study compared results in treated surgical patients vs. healthy patients.   36 patients s/p oral tongue surgery with significantly decreased tongue range-of-motion and 31 healthy individuals.

The scale was validated by correlating range-of-motion with performance status, oral outcomes and patient-related Quality of Life.

The scale was made to define lingual deficits.  This is a tool that can be used for baseline and post surgery tongue range-of-motion and to track changes over time with recovery and therapy.

Lingual protrusion was measured using the Therabite jaw range-of-motion measurement discs.

Protrusion Scores:  (100) Normal:  > or = 15 mm past the upper lip margin
                              (50)   Mild-mod:  >1mm but <15mm lip="" margin="" p="" past="" the="" upper="">                              (25)   Severe:  Some movement but unable to reach upper lip margin
                              (0)     Total:  No movement

Lateralization Scores:  based on ability of the tongue to touch the commissures of the mouth.  Measure both right and left side.
                              (100)  Normal:  able to fully touch the corner of the mouth.
                              (50)    Mild-Moderate:  50% reduction of movement to corner of the mouth in either                                               direction.
                              (25)    Severe:  >50% reduction in movement.
                              (0)      Total:  No movement.

Elevation Scores:    (100)  Normal:  complete tongue tip contact with the upper alvoelar ridge.
                              (50)    Moderate:  tongue tip elevation but no contact with the upper alvoelar ridge.
                              (0)      Severe:  No visible tongue tip elevation

Total Scores were assigned by adding the protrusion score+ right lateralization score + left lateralization score + elevation score divided by 4.

Scores were 0-100:        0=severely impaired/totally impaired
                                      25=Severly impaired
                                      50=mild-moderate impairment
                                      100=normal

During this study, tongue strength was measured using the Iowa Oral Performance Instrument.

Jaw range-of-motion was measure using the Therabite jaw range-of-motion measurement discs.

Saliva flow was measured using the Saxon test where the patient was asked to chew a sterile 4x4 piece of gauze for 2 minutes then spit the gauze in a cup.  The gauze was weighed before and after mastication.

The Performance Status Scale was used to determine diet type, speech uderstandability, impact of surgery on ability to eat socially.

Quality of Life was measured using the Eating Assessment Tool-10 (EAT-10), MD Anderson Dysphagia Inventory (MDADI) and Speech Handicap Index (SHI).

The study found that lingual range-of-motion can negatively affect all aspects of a patient's life and correlates with performance and quality of life.


Wednesday, September 10, 2014

Stand Up for Ethical Treatment

This is re-posted with permission from Gray Matter Therapy:



Join us on October 2, 2014 for an event organized by American Association of Rehabilitation Therapists (Janet Mahoney, PT) and Gray Matter Therapy (Rachel Wynn, SLP). Therapists across the country and of all disciplines will stand together to advocate for our patients and our professions. We will politely but firmly put patients first.
This might look different for everyone – educating colleagues and your company, providing care in a patient-centered manner versus profit-centered system, calling your company’s compliance hotline, reporting via the False Claims Act, or calling the Medicare fraud hotline – but for everyone the goal is the same. We need to act together if we are to affect bottom-up change.

Risk of civil resistance

Is there risk in acting together? Yes. But what is the risk if we don’t act?
Civil resistance works for countries. In fact, only 3.5% of people need to act in order to affect change. If it can work for countries, it can work for healthcare.

Request a FREE media kit

Media kits contain the following
  • Poster
  • Lapel buttons
  • Wrist bands
  • T-shirt
  • Supporting documentation
Contact Janet Mahoney with American Association of Rehabilitation Therapists to request media kits. Message her on Facebook or email Janet. This is a grassroots movement, without external funding. Please be conservative with your media kits request. Submit requests prior to September 15th. Digital packets will be available also.