Our chat tonight, February 26, 2001, is being hosted by Terri B. Nichols, Clinical Specialist and
Speech-Language Pathologist.  Terri obtained her M.S. in
Speech/Language Pathology from the University of Washington. She
received her B.S. in Communication Disorders from Northern Illinois
University. Terri is currently a Speech/Language Pathologist at Providence- Portland
Medical Center in Portland, OR, where she provides clinical care to
those with neurological impairments, voice disorders, dysphagia, and
head & neck cancer. Terri started Bungalow Software in 1996 with her
husband, a computer programmer, to provide a way for her patients to
continue therapy practice at home after insurance coverage for
intervention expired. She will chat tonight about using computer software
to assist in speech-language recovery".

Terri> Whenever they are still receiving therapy, we try to get the name of their
    therapist, and send info to them as well.  We always encourage them to get the
    therapist's input
<Terri> Do you contract to home health agencies at all?
<Alison> I gave him your catalog though, and told him to show his new SLP!  He
    wanted to begin driving again and I recommended the software with the street signs
<Alison> I don't contract to home health but I work per diem for many SNFs
<Terri> That's great -  I appreciate you putting in a good word for us.  Direction
    Following is also great for pre-driving, since you can get a good idea of visual
    neglects, and overall attention
<Terri> So, how accessible are computers to patients in the SNFs?
<Alison> Not very, we need to use one in our office when it is free.
<Terri> When I was in the SNFs, they weren't very accessible - I would have loved to
    have been able to set up restorative programs on computer, especially for patients in
    rural facilities...
<Alison> That is an excellent idea!
<Terri> What is your treatment space like in most of your SNFs?
<Terri> I have memories of pulling patients into the bathroom to get a quiet place...
<Alison> Space is limited!  We usually work in the pt.'s room or in small offices off of
    the rehab area, and that is if there isn't a nursing staff meeting
<Terri> Do you work per diem strictly in private practice, or through an agency?
<Alison> I work per diem through an agency, as I just began my practice separate from
<Terri> Do the restorative aides have their own room - or do they share like everyone
<Alison> No we all share!
<Terri> Maybe you could talk your agency into a laptop for you - though that wouldn't
    help the restorative program
<Terri> Do you do any of your charting on computer?
<Alison> I was lucky just to obtain the software...
<Alison> What kind of charting do you mean?  Charting progress?
<Robin> I did a few years ago in an outpatient dept. of a rehab hospital
<Robin> there were never enough computers!
<Terri> Progress, medicare forms, that kind of thing...
<Terri> The hospital I work at is on the "bleeding edge" - we just went to all electronic
    charting, but that did get us a lot of extra computers.
<Alison> No, I have done it all freehand, even in the hospital I used to work in.  Charting
    via computer would be so much more efficient!
<Terri> There are definitely pros and cons to computerized charting - I was just thinking
    that if your rehab agency was into that, you might have more leverage for a laptop.
<Alison> That's definitely something to consider...
<Terri> What kinds of things would you like treatment software to be able to do?
<Alison> One thing I would like is to be able to record responses, thus, as a
    consultant, I can monitor them and provide feedback.
<Terri> Is it most helpful to you to have raw data, or would you like to see graphs?
<Terri> Have you used the patient progress feature of the Bungalow Software?
<Alison> I know some software allows this.  Does Bungalow?  I'm not sure because I've
     never needed that . 
<Alison> I love graphs, then it also gives the pt. visual feedback
<Terri> We don't currently provide graphs, except for a bar graph at the end of each
<Terri> We've been toying with the idea of charting progress, but wanted to get an idea
    of how useful that would be.
<Alison> I always reviewed the printout of raw data with the pt. when I used Bungalow.
<Alison> I think that charting progress would help the SLP revise the program as
<Terri> In the pro versions of the software, you can save all data by the patient's name,
    and print out a file with the history of everything they've done
<Terri> When I have a patient using it at home, I just ask them to print out the raw
    statistics at the end of the session - which at least lets me see what level they were
    working at, and how they were doing
<Terri> So, how have you been using software?
<Terri> New question for everyone out there - how do you all feel about patients going
    out and finding software on their own?
<Anonymous6293> I worry about the cost and if they're finding material suited to their
<Terri> I agree with you there...I can't tell you how many times I've had to explain that
    "Hooked on Phonics" won't necessarily help an aphasic person...
Anonymous6293> I'm looking for some recommendations re:software types and
<Terri> 6293 - what kinds of patients do you work with, and in what setting?
<karla> Acute rehab, inpt, long term care
<Anonymous424> sorry I'm late, but have been to therapy with my wife.
<Terri> Karla - do you encourage patients to bring any product info they find to your
<Alison> Cost is always a problem with software.  I would prefer the family buy
    software with direction of a SLP so they make the right decision.
<Terri> I think it's also really critical that they get to try demos of the program
<karla> yes, that's why I started looking into this because I didn't really have
    suggestions for a family member
<Alison> Exactly, thank god you offer great demos of all your programs!
<Robin> Hi Bob!  Do you have any questions for Terri about software to assist in
    Speech-Language Recovery?
<Terri> Karla - have you received any catalogs or demos from any software
<karla> No. I've looked at Bunglow's website and will try to download some free trials
    when I have enough time-what other products are out there
<Terri> I think it's really important to have a good variety of demos on hand, from a lot of
<Robin> We are chatting with Terri Nichols about software to assist in
    Speech-Language Recovery
<bob f.> hi, just came to listen in
<Alison> Software seems to be so popular now.  It seems everywhere I look another
    company has popped up.
<Terri> For aphasia, besides Bungalow, there's Parrot, Locutour, and one that's Mac
    compatible that I'm blanking on right now...
<Terri> The Mac/PC program is called CHAT - Computerized Home Aphasia Therapy
<Terri> There are also some nice programs out there for TBI/cognition
<Terri> Locutour and a company called "Brain Train"  have some nice cognitive stuff
<karla> Do most offer free trials?
<Terri> Most companies have some type of free trial, though not all of them are "fullyfunctional"
<bob f.> I have speech on cue and janet can say the words but can't recall them 3
    seconds later
<Alison> I realized Locutour's Demo is not very functional.
<karla> do you use software during tx as homework or after tx completed?
<Terri> Bob -Have you tried Sights 'N Sounds?
<bob f.> not yet
<Alison> I have used it both ways.
<Terri> It's common for a person with apraxia to only be able to say words with some
    type of cue at first
<Alison> Software is that flexible!
<sandhya> I am doing my MS in speech path
<Terri> I think it's really important to start introducing software while they're still in
<Robin> hi sandhya...our student chat will start soon, at 9:00pm EST, but please stay
    here and ask questions, if you have any
<sandhya> thanks robin
<Terri> It can give you a lot of freedom to work on a bigger variety of goals face-to-face
<bob m.> We have Sights n sounds and I have been modifying some of the
    lessons to use the vocabulary that my wife's therapists use.
<Terri> Actually, that's one of the best things about software
<Terri> Bob M. - that's great!  Have you added any pictures of your own?
<bob m.> some.  I would like to be able to disable the text on some occasions
    and just use the pix and the sound.  I have put off talking with Clay--been busy.
<Terri> To disable the text, at the start of the lesson, you can select "options" at the top,
    and then take the check off of "Text" as an "automatically display" option 
<Terri> Bob M. - are you still talking about Sights 'N Sounds?
<bob m.> yes
<karla> are most folks computer literate to start with?
<Terri> Karla - Probably the majority of my clients are not computer literate to begin
Alison> I have found that a lot of pts. with aphasia are not computer literate to begin
    with...a challenge.
<Terri> It's a great self-esteem boost for them to be able to do something "high-tech"
    just when they are feeling "stupid" because of aphasia
<Terri> If someone is really computer phobic, I usually start out by having them point to
    the answer on the computer screen
<sandhya> i feel even people who have used computers premorbidly do not feel competent
    enough to use it again as they compare their post morbid computer skills with their
    premorbid computer level
<Terri> Sandhya - definitely an issue - it's hard to confront one more thing you think you
    should be able to do easily...
<karla> have you noticed increased rate of recovery or increased carryover?
<Terri> Has anyone tried using any of the Windows accessibility options to make it
    easier for the person to use the computer?
<Terri> Karla - I have definitely noted both increased rate of recovery, and of carryover
<bob f.> not i
<Terri> I had a globally aphasic patient once - young man who was very motivated.
<karla> bob f.-any products you would recommend?
<Alison> Bob F., what has worked for you?
<Terri> We got to the point where he was working on reading and writing skills almost
    exclusively on his own.  We worked on verbal skills in the clinic
<bob f.> Janet acts as if sounds on cue is childish for her and it seems so easy for
    her to say most words but then she looses interest
<bob f.> actually just starting out
<Terri> Bob, so it sounds like Janet is finding it too easy to repeat words... how does
    she do without a cue?
<Terri> Can she look at a picture or a printed word, and just say or read the word out
<bob f.> she says the word before the voice says it
<Terri> Bob - it sounds like maybe she needs to move onto something a little harder
<bob f.> like?
<karla> how do I search for these products, just www.?
<Terri> Bob - Sights 'N Sounds would be the next place to start for naming - you can
    download a demo off of the Bungalow Website, if you don't already have a CD
<Terri> Sights 'N Sounds would let her say the word, and then hear her own speech
    played back, next to a model
<Terri> In the deluxe or pro version, you could put in your own pictures and words for
    her to practice
<Terri> Vocabulary that's important to her.
<bob f.> i have the demo disk, does that contain the program as well?
<Terri> Yes - it's AT0, or Sights 'N Sounds
<Terri> Karla - getting back to your question on how to search for software - the WWW
    is a great resource.  Also the ASHA buyer's guide.  The National Stroke Association
    and American Stroke Association also
<bob m.> My version of sights n sounds doesn't have an "options" at the top.
    I'll talk with Clay later this week.  Thanks.
<Terri> Bob M. - does it have "automatically..." at the top during a lesson?
<Erika> Terri: What language do you use to write the software?
<karla> thank you for the info. I hope to apply it soon!
<Robin> Terri, our students will be arriving now
<Terri> Well, I can't take credit for the programming - but Clay does it in Visual Basic
<Terri> Welcome students!
<bob m.> yes,  sorry.  Got to tend to Lynne.
<Anonymous8647> Is there a list of preferred software programs somewhere?
<Terri> Thanks for joining in, Bob!
Terri> 8647 - There are some links to resources on the ASHA buyer's guide, and on
    some of the stroke association websites.
<Terri> As far as "preferred," I think the most important thing is to find software that has
    demos, so you can see exactly what it does.
<Terri> It's also important to find interactive demos, so you can try them out with clients.