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 be chatting tonight about
using computer software to assist in speech-language recovery.

<Robin> Terri Nichols is our guest host tonight.  She can answer questions about
    using computer software in speech-language therapy
<Terri> So, how many of you have access to computers in your university clinics?
<Erika> not my program
<Erika> Terri: I have a background in computer science...I am interested in developing
    software for SLPs and patients
<Terri> Erika - that's great - are you in grad school for speech right now?
<Terri> Welcome, everyone!
<Adrienne> Thanks for coming Terri!
<Erika> Terri: I graduate in May from my undergrad program
<Terri> Thanks for having me!
<Erika> but, I have taken several programming classes and am currently learning c++
<Terri> Erika - Sounds like you'll be busy for awhile...
<Suzanne> Terri: what kind of software do you design? (For which types of SLP Tx, I
<Terri> Bungalow primarily specializes in software for stroke recovery - aphasia,
    apraxia, and some cognitive issues
<bob f.> What is "tx"?
<Robin> tx is therapy
<Terri> Erika - you might be able to design your thesis around software development
<Erika> Terri: That is all part of the 'master' plan
<Robin> what a great idea!
<Suzanne> Do the clients have to be at a particular stage of therapy before they use
    these programs? Or is it used to augment therapy throughout the process?
<Terri> It is definitely great to use throughout the process
<Anonymous8647> What kind of program would you suggest for a first grade autistic
    child who can read outloud but spontaneous speech is difficult for him to formulate?
<Suzanne> 8647: computer programs in particular or just Tx ideas?
Terri> OOOh, let me think on that a bit....autism is definitely not my specialty...
<Terri> Anyone else out there with ideas?
<jillspeech> question for Terri
<Terri> As far as Bungalow stuff goes, there is a program called Sights 'N Sounds that
    shows pictures, and has the speaker try to say the name
<Erika> Terri: is there a demo of that somwhere online?
<Terri> It records their speech, and then plays it back for them
<Terri> All the Bungalow stuff can be downloaded from:  www.bungalowsoftware.com
<sandhya> may be start be graphimic cue for conversation initially then fade it out...e.g
    first give full sentences then later on give him only one word as a cue to answer....
<jillspeech> Laurete software=autistic
<Terri> Jill - what programs from Laureate would you recommend?
<sandhya> i have an autistic child in group we use folk's sentence builder with him
<Erika> I am very interested in this!!
<Terri> I've always wondered about software for treating difficulty with initiating - do you
    see good carryover?
<jillspeech> They have a good catalog that groups programs by age and skills...let me
    think on the names here.
<Robin> we are chatting with Terri Nichols about computer software for speech
    language therapy
<Ariela> hi, this is my first time...I'm just listening...
<Terri> Welcome, Ariela - feel free to jump in anytime!
<jillspeech> Terri how do you use your software? On a loan out basis...can you keep
track of how a client is progressing at home?
<Adrienne> Terri, what type of disorders are commonly treated with your software
<Terri> For home basis, most people purchase the software, though my clinic
    outpatients are my "guinea pigs," so they get it for free
<Adrienne> are there different programs for different disorders?
<Terri> All the Bungalow stuff allows them to print out or save statistics on what level
    they are at, and how well they did
<Terri> There are programs for auditory comprehension, reading comprehension,
    written and verbal naming, and memory
<jillspeech> good...I like that "accountability"
<Suzanne> Terri: "auditory comprehension" like for CAPDs?
<Adrienne> that sounds like quite a variety
<jillspeech> Terri it sounds like your programs could also be used for language
    disordered students also...I am assuming there is a more adult theme ?
<Terri> I've used "sights 'n sounds for CAPDs, but honestly I like a program from
    another company even better - let me think of it...
<Terri> Earobics was the program I was trying to think of for CAPD
<Suzanne> Terri: Ah yes! I've heard of Earobics.
<Erika> Terri, where do you think the biggest need is for SLP type software?
<jillspeech> Could you give us an example of how you would go about choosing
    software for a particular client?...say TBI about 22 yrs old?
<Terri> Our stuff is adult-focused mostly in that it doesn't have a lot of really cartoon-ish
<Terri> As far as choosing software, I think the most important thing is to first set your
    treatment goals
<Terri> Then, I would look at the goals, and see what would be best met face to face,
    vs on the computer
<Anonymous142> Do you have any software ideas for non-verbal children with MR, for
    simple concepts (ex. cause & effect)? 
<Terri> For TBI, I think the computer is great for working on auditory memory and
    attention, as well as decreasing impulsivity
<Terri> Software can also be used for reading comprehension activities - I've always
    hated just watching my patients read long passages
<Suzanne> Terri: A BIG question in our ethics class is about the possibility, in the
    future, of therapy being done "over the 'Net" (for those in rural areas, homebound, etc.).
     (more coming)
<Suzanne> Is using a program at home rather than at the office a first step in this?
    How does ASHA feel about it?
<Robin> very good points, Suzanne
Terri> We've always given our patients home activities to do - worksheets, etc.
<Terri> Software actually can give you a little more control over what level they are
    working at
<Brandi> How do you feel about working on a computer program at school and then
    having the family work on it at home?
<Suzanne> Yeah, I'm working at home with a little girl whose SLP sends stuff home,
    too. I mean therapy by computer program.
<Suzanne> Just because I don't know a lot about this area and we've had a lot of
    questions about it in class.
<Adrienne> how common is therapy software use now?
<Erika> that's an interesting concept for rural slps...
<Terri> There's never a guarantee that their spouse isn't correcting everything before
    they bring it to you, so you don't really know how they are doing
<Terri> I think the most important thing to think about ethically is, do they have access
    to something better than software?
<Terri> I certainly don't think software replaces an excellent SLP, face to face
<Terri> But it sure can help them to feel better about themselves, and make progress
<Brandi> I just graduated and started working for a school district.  I have seen the
    range from no use of software to great use, just depending on the therapist comfort
    level I guess.
<Erika> Terri: do you think there's a big need for SLP software?
<Erika> additional software I mean
<Robin> Erika, in the post on our message board about this chat there are references
    compiled by Bungalow software about Computer Treatment Efficacy
<Terri> I think that there's a huge need for software...the technology is going to keep
Terri> Over 5 years ago, my patients and their families were regularly asking for
<Adrienne> how quickly will software become outdated?
<Terri> Adrienne - good question... I think that there will be upgrades to come
<Terri> I think it's our responsibility to stay up to date - our patients are on the Internet,
    getting info on their conditions, the latest research and treatments, etc.
<Ariela> are the software translated to other languages?
<Suzanne> It's exciting to think how software can enhance the SLP experience, esp. for
    those who live in areas where a trip to the SLP is a LOOOOONG distance.
<Terri> I've seen some software translated into other languages - I know Parrot offers
    Spanish and French versions of some of their products
<Terri> I can tell you that a lot of the people that call us are have either been
    discharged from therapy, or are in those rural locations
<Terri> There are also a lot of folks who no longer qualify for home health, but who just
    can't manage to get in to the clinic
<Erika> I don't know about other programs, but I think I am the only computer literate
    person in my dept
<Suzanne> Also very helpful to "stretch out" Tx services when the insurance runs low,
    right?? Neat way to give clients as much benefit as possible.
<Terri> Suzanne - very true!
<Erika> I feel like they are missing out on a lot of resources
<Terri> Erika - good for you!  You've found your niche!
<Suzanne> Erika: maybe your calling is to start locally, get your "legs", branch out! Start
<Erika> Suzanne: I try!!! I am the local tech support to everyone in my dept
<Erika> from designing the NSSLHA website to the dept website
<Terri> One really important thing to remember is that a lot of patients and their
    families are more savvy than we are
<Suzanne> Erika: big corps can be persuaded to donate computer equipment... and
    then it all goes on from there.
<Erika> Suzanne: great thought!
<Suzanne> Erika: MEEEE TOOOO! Tell me your NSSLHA website URL and I'll give you
    mine. Nice to meet another webmistress!
<Suzanne> I want to see your site.
<Terri> Suzanne - good point - you don't generally need the latest greatest computer to
    be able to use treatment software
<Erika> Suzanne: ok, but I'll tell you..I haven't updated it lately because NO ONE WILL
<Terri> A lot of my patients get their grandkids' hand-me downs
<Erika> but it is http://speech-hearing.okstate.edu
<Suzanne> terri: we're using like a 286 or something to run VisiPitch-- and it works
<Erika> no www
<Erika> also, I use raw html, not an editor like frontpage
<Kim> I'm curious about the NESPA.
<Kim> Are we limited on how many times we can take it? or just that it's done by the
    end of the CFY
<Robin> Kim, we will have a speaker on the NESPA exam in a future chat, probably
<Suzanne> ERika: I know, me too. It's tough to get people there! But I did just update it
    this weekend. Do so on a weekly basis (dates, at least-- this last weekend I added
    some javascript and more pics!)
<Terri> Y'know, getting your patients on the web is also a great therapy goal!
<Terri> You can have them find your wonderful websites!
<Erika> Suzanne, what's the url?
<Suzanne> San Jose State chapter of NSSLHA:
    http://www.geocities.com/SJSUNSSLHA -- visit us, e-mail me... :)
<Suzanne> Erika: must admit that I had my hubby show me how to use Frontpage, as I
    lost my script for the marquee.. had to create that on Frontpage. Other than that, I am a
    control freak... must do my HTML!
<Erika> Suzanne: yay!  frontpage generated websites are sooo hard to follow when it
    comes to amending the text
<jillspeech> Terri I might of missed your answer to my question about how you decide
    what programs go with what client...
<Terri> Jill - I basically said that I'd set treatment goals first, then decide which ones
    seem appropriate for software, and then look for software...
<Adrienne> Terri, what type of situation would you NOT recommend software therapy
<Terri> I don't think software is very good if the person's primary issues are
  pragmatics, initiation, or talking in groups.
<Adrienne> that makes sense
<jillspeech> I am in process of organizing a 'software library" for the slp's in our work
    group and also to lend to teachers of special ed students..
<Adrienne> how long does it take a non-computer user to learn to use software?
<Terri> But, again, people usually have difficulty with a lot of things...so it's good to be
    able to work on those face to face goals in the clinic, and then working on something
    else at home
<Anonymous47> hello , I just received the Email about this chat.>:) I am in Maine....I
    work  with school age children>:))
<Terri> How long it takes them to learn to use the computer...depends on the program
<Terri> Most of the Bungalow stuff can be run using just the space bar and enter key,
    so they don't have to know much about the computer
<Adrienne> would you vary software based on computer knowledge, or just spend
    more time teaching to the program for disorder?
<Terri> Adrienne - I would tailor the software to the disorder, rather than the computer
<Adrienne> ok
<Robin> Terri, have you thought about creating software for children?
<Terri> Robin - as far as software for kids - we haven't ventured into that field mostly
    because there are already a lot of excellent programs out there - Laureate, Merit,
<Robin> good point
<Terri> Merit is a great company for school-aged kids.  They have excellent products for
    narrative writing, math word problems, critical thinking, etc.
<jillspeech> Terri..can you use switches with your software?
<Terri> As far as using switches with Bungalow...I guess it would depend what the
    switch interface is.  Theoretically, if you set up one switch to emulate the space bar,
    and one switch to emulate the enter key
<jillspeech> yes..or teach those two keys I guess
<Adrienne> I read something about color coding the keys
Terri> Adrienne - color coding the keys is an excellent idea.  We're in the process of
<Terri> the color of all the on-screen buttons in Bungalow's stuff, and then we'll include
    coordinating stickers
<Adrienne> that sounds like a plan!
<Erika> I can tell this field is wide open...I am so excited
<Erika> what about software for SLPs to help plan a session? what do you think about
<Erika> like software to come up with CVC words that meet a certain criteria
<Adrienne> that's a good idea Erika
<Terri> Re: session planning - there is some great IEP software out there
<Suzanne> Good idea!
<Erika> things that only an SLP would use...not for pt use
<Suzanne> IEP software? I had no idea!
<Terri> Erika - I know that there is a product out there like that - I think it's from Beach
    House Software
<Anonymous3911> Are there any language software programs for Spanish-speaking
<Robin> 3911, perhaps some of the programs mentioned come in a variety of
<Terri> 3911 - I know that Parrot has some stuff in Spanish - not sure if they are
<Anonymous3911> Okay, thanks, sounds like a starting point.
<Terri> Do you all get to ASHA conventions?
<Robin> 3911, maybe Erika can design software in Spanish!
<jillspeech> I do ..every other year or so
<Erika> I would love to do that
<Terri> ASHA's usually a great place to pick up demo CDs
<jillspeech> yes...and great computer labs
<Adrienne> that's good to know
<Robin> Terri presented at a computer lab at ASHA
<Terri> We've been considering translating some of the Bungalow stuff into Spanish -
<jillspeech> I was at Judith Kuster's lab..I'll be sure to attend Terri's next time!
<Robin> that would be a wonderful idea, Terri...it would fill a void
<Terri> Do you think it would be most important to have the vocabulary in Spanish, and
    the instructions in English - or both in Spanish?
<Suzanne> Terri: both in English and SPanish, just like some tests.
<Terri> I wish I could have attended Judith Kuster's lab - I'm always presenting
    opposite someone I would really like to see!
<Adrienne> at least you're presenting! :~)
<Erika> I realllllly  considered applying to her program, just because she seems so
    comptuer savvy
<Robin> Terri, I guess it depends on who is helping the patient with treatment....
<Adrienne> remind me of what Kuster does?
<Erika> she has an awesome website affiliated with her school...all about different
<Erika> I used it plenty when I took fluency disorders
<Adrienne> oh oh oh
<Terri> Judith Kuster writes a column for ASHA on computer resources, and maintains
    a great website.  You can link to her site from the Bungalow site
<Adrienne> yes, her personal webpage is awesome... I remember now
<Robin> Adrienne, her link is on our resource link page
<Adrienne> it sounds like the slp field is really going the technology direction...
<Terri> Adrienne - what field isn't!
<Adrienne> true!!
<Terri> Though, even as a techno-geek myself, I think it's still important that the
    treatment goals come first - software is a means to an end
<Adrienne> it's good to think we are, even though we seem so hands-on involved with
<jillspeech> good point Terri
<Terri> I think it would be a big mistake to get any less hands-on
<Adrienne> that's a good perspective Terri
<Adrienne> do you think software would get that way?
<Robin> we are being forced to be less hands on with limited insurance coverage for
<Terri> I certainly don't think it has to
<Terri> Robin, that's certainly true!
<jillspeech> If computers get more interactive it could expand tx quite a bit..
<jillspeech> either in a good direction or a bad one
<Adrienne> that's a good point... software almost allows us more time to do the
    hands-on stuff when in the clinic
<Terri> But again - I like to think of the more rote or mundane tasks that software can
<Terri> I always hated taking valuable therapy time to go over homework sheets, or
    watching a patient read silently
<jillspeech> yes
<Terri> I love doing therapy with caregivers in the room, in communication triads,
    where I can help them facilitate better functional communication
<Adrienne> my ideal situation Terri!!
<Terri> I also really love doing group therapy, and watching patients interact.  I learned
    some of the most interesting things about some of my patients!
<Adrienne> do you ever have caregivers not liking the software approach?
<Terri> Usually, caregivers love it.  Mostly, they're a little skeptical at first - they think it
    will be too hard
<Suzanne> Group therapy can be SOOO valuable. Have only done it a few times in
<D.> I'm just getting used to this chat room.  Do you use a lap-top computer in you
    practice. Any one?
<Terri> I have on occasion - especially to demo stuff, or for aug comm evals in home
<jillspeech> laptop..yes
<Anonymous41> I use software as a support that I give to the special education
    teachers/parents to use at home :)
<Terri> 41- great idea!
<jillspeech> living books...I like to use them for vocabulary review and
    sequencing...great for verb practice
<D.> What memory and processing power does your laptop have?
<jillspeech> I never remember that stuff...it's about a three yr old think pad so...
<Terri> I'm embarrassed to say, nothing too fancy - it's about 4 years old
<Anonymous41> I have an older laptop....i use it mostly for Report Writing....doesn't
    have enough memory to do many programs...:))
<Terri> I know my husband just added some memory to our laptop..
<jillspeech> Terri, could we use your software with our older..learning disabled students?
Terri> Jill - definitely - I've used just about all the programs with LD students
<Adrienne> do these software programs require very up to date computers?
<D.> Good Question!!
<Terri> Our current software is pretty basic - it will even run on an old Windows 3.1
<jillspeech> It will be nice to see the programs in your catalog when it comes..
<Adrienne> that's good
<Erika> Terri, all your software is written in VB?
<Terri> Erika - At this point, yes
<Terri> As we add more features, though, we may require at least Windows 95
<jillspeech> probably not on the old IIe's we have some of those believe it or not...and
    more iigs's
<Terri> Jill - definitely not on IIes or IIgs - that brings me back to MY grad school days!
<Anonymous41> Terri.....is your software in Super Duper or LinguiSystems catalogs?
<Terri> 41 - Unfortunately, no
<Robin> You can find Bungalow software info on our product page or you can go to
<D.> Can you still download free trials?
<Terri> D. Absolutely!
<Robin> Are there any more questions for Terri?
<Suzanne> Not from here... very informative, Terri. This has been an EXCELLENT topic
    and you are just full of ideas and info! Thank you!
<D.> When's the next session?
<Robin> Terri, this has been a wonderful chat!  Thank you for joining us!
<Adrienne> Thanks for all the info Terri!!
<Erika> yes, thank you!
<Terri> Robin - thanks for having me!
<D.> Thanks!
<Robin> next session chat session we'll talk about the effects of trachs on speech
    and swallowing