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
<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
<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
<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
<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
<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
<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.