What are Phonological Disorders and Processes?

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Mastering Teletherapy for Early Intervention: Portrait of cute girl participating in auditory bombardment with headphones on
school teacher showing a book to the children

In this comprehensive guide, we’ll explore phonological processes, discuss age-related expectations, and outline your role in supporting phonological goals at home. Whether early intervention or the school system has identified your child for services, this post provides valuable insights.

Evaluation, treatment planning, and homework for phonological disorders differ significantly from articulation and childhood apraxia of speech due to their distinct nature. Please note that this post does not take the place of a comprehensive and diagnostic evaluation for your child.  There are many factors that we assess when developing an appropriate treatment plan.  Talk with your pediatrician, child’s teacher, and/ or speech pathologist if you have questions and concerns specific to your child.

PHONOLOGICAL PROCESSES

There are eight, phonological processes that we typically encounter in speech therapy: syllable reduction, syllable structure, cluster reduction, final consonant deletion, stopping, fronting, backing, and gliding.  Below are definitions, examples, and age expectations for suppression of each of these processes.

  1. Syllable reduction: eliminating a syllable in a word should cease by 4 years old. For example, “puter” for “computer”.
  2. Syllable structure: inability to produce part of a syllable.  There are four of these such shapes (CV, VC, CVC, CVCV) with “C” representing “consonants” and “V” meaning “vowels.”  Some examples of these shapes are: (CV) “bee”; (VC) “up”; (CVC) “cat”; and (CVCV) “baby.”  A child with a phonological disorder may have difficulty producing several of these combinations for an undetermined length of time.
  3. Cluster reduction: occurs when a child omits part of a blend, most often /s/ blends /sk, sm, sn, sp, st/.  You may hear him say “kin” or “sin” for the word “skin.”  Children should be able to produce blends together between 4-5 years old.
  4. Final consonant deletion: omitting the last sound in a CVC word (“ca” for “cat”) should suppress by 3 years old.
  5. Stopping: producing a sound that should be stretched like /s/ with a /b, d, p/ (“bun”, “dun”, or “pun” instead of “sun”) should end between 3-5 years old.
  6. Fronting: making sounds that are produced further back in the mouth more towards the front.  For back sounds /k, g, ng/, the tongue lifts in the back while the tongue tip stays down in the front of the mouth.  A child who fronts sounds lifts the tongue tip to touch his palate and substitutes /t, d/ for back sounds.  You may hear “tan” for “can” or “tookie” for “cookie” if your child is fronting.  This process ends at 3.5 years old.
  7. Backing: the reverse of fronting.  Here, your child continues producing sounds made with the tongue towards the front of the mouth, lifting the back of his tongue.  So, you may hear “do” for “goo” or “gog” for “dog.”  This process is often seen in children with severe phonological delays.
  8. Gliding: substituting an /r/ with /w/ (“wun” for “run”) or /l/ sound with /w, y/ (“yeyo” for “yellow”.)  This process may continue through 6 years old.

PHONOLOGICAL

Bowl of pastel colored alphabet letters

Evaluation:

Speech pathologists observe and screen before evaluations, guiding test choices. Analysis and probes help develop treatment plans for phonological delays.

A phonological delay is when your child omits, substitutes, and/or distorts a process. This is something that all children demonstrate at various ages, but eventually suppress as they enter the preschool years. These errors occur at a young age because a child’s speech mechanism (lips, tongue, jaw) is not yet fully, physically developed to move swiftly and precisely. As children grow physically, their speech becomes more intelligible. Those with phonological disorders may need auditory training to improve accuracy.

A phonological delay means multiple sound errors. For instance, using /d/ for /th/ in “thumb” doesn’t signify a delay. This example would likely be an articulation delay. However, if he uses /d/ in addition to one of more of these sounds: /j, sh, ch, th/ (i.e., “padama” for “pajama”, “dells” for “shells”, “lund” for “lunch”, and/or “dum” for “thumb”), then he has not suppressed a phonological process of stopping and needs intervention, especially if he is five years old or older.

One of my most popular, phonological goals is: Reduce cluster reduction for /s/ blends (sk, sm, sn, sp, st) in initial positions of words with 80% accuracy given supports as needed.

Therapy:

In phonological therapy, we work towards helping the child learn to suppress the process. The speech pathologist prioritizes processes occurring over 40% in a speech sample. Unlike articulation issues, phonological delays vary contextually. Two options for treating phonological processes are the cycles and complexity approaches.

Auditory Bombardment:

Portrait of cute girl participating in auditory bombardment with headphones on

Auditory bombardment involves repeatedly exposing your child to correct target sounds in different contexts. By hearing these sounds frequently, your child’s ears get used to them, helping them understand and recognize the correct sounds better. Hearing the correct sounds over and over helps your child learn and imitate these sounds, making it easier for them to produce the target sounds correctly.

This technique strengthens your child’s ability to hear and produce correct speech sounds, enhancing their overall speech clarity and phonological awareness. Auditory bombardment provides essential auditory input, supporting your child’s speech sound development and helping them improve more effectively in therapy.

Homework:

mother and son
Photo by cottonbro studio on Pexels.com

It is nearly impossible to skip homework practice and make progress in phonological therapy. Again, your child’s speech pathologist will want a certain level of mastery in the therapy room before assigning homework practice. Once targets are identified, clients with phonological delays can benefit from engaging in listening training at home. Ask for appropriate book suggestions. The sooner you start, the better.

Conclusion

In conclusion, grasping the nuances of phonological processes is vital for effective intervention strategies. With thorough evaluation and targeted treatment plans, accompanied by diligent home programming, children can overcome phonological challenges more effectively. Encouraging parental involvement in home practice reinforces therapy gains and fosters lasting progress in speech development.

Tongue Tie: Impacts on Speech, Dentition, Feeding, and More

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Young Child Sticking Tongue out with Noticeable Tongue Tie
multiethnic family spending time together at home

Unlock the mysteries of tongue tie with our comprehensive, helpful guide tailored specifically for caregivers of children facing this challenge. We will define this condition, review identification, discuss the impacts, outline laser surgeries, and provide more reading material about tongue tie.

Tongue Tie Defined

Tongue tie, formally known as, ankyloglossia, restricts the tongue’s range of movement, making it challenging to reach the top palate or sides of the mouth. This movement is not only important for producing speech sounds, but also for manipulating foods to the sides of the mouth for chewing and clearing mouth pockets of leftover foods.  The tongue is connected to the bottom of the mouth by a band of tissues called lingual frenulum.  Tongue tie occurs when this collection of tissues is unusually short, thick, or tight. Children are born with tongue ties with some needing laser surgery to release the restriction.

How is Tongue Tie Identified?

Most often, a tongue tie is first identified by lactation consultants when nursing mothers have difficulty feeding their infants.  Otherwise, your child’s speech pathologist may refer you to specialists for suspected tongue tie.  Some behaviors observed in a child with tongue tie include:

  • Inability to point tongue straight out of the mouth
  • Difficulty lifting the tongue up inside the mouth and reaching the palate
  • Reduced ability to move the tongue from side to side
  • Small indentation at the tongue tip that makes the tongue look like a heart when the person sticks his tongue out
  • Unable to stick the tongue out past the lower teeth
  • Trouble with moving the tongue up when licking ice cream or lollipops

Speaking from personal experience, I have referred five clients over the last eight years to a local periodontist for suspected tongue tie.  Two of those clients needed a tongue tie release surgery and soon after demonstrated immediate, notable improvements in both speech sound productions and feeding.

Young Child Sticking Tongue out with Noticeable Tongue Tie

What Else can a Tongue Tie Impact?

In addition to a tongue tie, some clients also have lip ties.  Beyond having implications on speech production, tongue and lip ties can also impact the following:

  • tooth decay
  • pain while brushing teeth
  • dental issues such as teeth crowding
  • food and texture aversions
  • chewing and swallowing difficulties
  • TMJ
  • facial tension
  • chronic sinus/ congestion issues
  • ear infections
  • migraines

Why are Laser Surgeries a Better Option than Clipping Tongue Ties?

Laser procedures completely disintegrate the restricted lingual frenulum with no reattachment of the muscles observed with children undergoing this procedure.  According to a local periodontist, Dr. Robert Pick, who pioneered the using a carbon dioxide Laser Frenectomy technique with his team at Northwestern in 1983,

“The laser is fabulous for tongue tie release because there is no bleeding during and/or after the procedure, no suturing needed, minimal to absent swelling and scarring, almost no chance for recurrence and a decreased to complete absence of pain post-surgically! In addition to use of the laser surgical time is dramatically reduced.”

Observations during Tongue Tie Release

Dr Pick has been using his innovative laser procedure with pediatrics for over 30 years at his office.  I called the office as soon as I finished exploring his website. A month later, I found myself observing a tongue tie release in Dr. Pick’s office.

The frenectomy, lasting 30 minutes, ensured numbing, keeping the patient informed and calm. Dr. Pick’s jovial manner and skilled surgery left a lasting impact. Within seconds of the laser surgery, the patient exclaimed, “I can finally stick my tongue out of my mouth!”  The muscle vanished before my eyes and the tongue found freedom. Five minutes later, the procedure was complete, and the patient was heading out the door to a lunch date with mom.

Recommendations and Resources

For tongue tie surgery, seek a specialized surgeon. Dr. Pick’s expertise ensures successful releases. According to Dr Pick, he has not had to perform a second release on any patient that he has seen over the last few decades; however, he does refer post-operative patients to their speech pathologists and/or myofunctional therapists to teach the tongue new placements at rest and during speech productions.  Below are some links and resources that you may find helpful in identifying red flags and performing post-operative exercises.

List of Published Articles Concerning Tongue and Lip Tie

Tongue Tie Babies

FREE Love Idioms Game for Valentine’s Day

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Valentine's Day Reinforcement Boxes and Tokens
Valentine's Day

Add love and fun to your Valentine’s Day plans with my free updated resource for engaging students in meaningful lessons! Engage upper elementary students with this FREE love idiom game for Valentine’s Day, teaching 20 idioms through meaningful conversations and context clues. I also enhanced the graphics with adorable Valentine’s heart emotions.

Don’t worry about finding materials – a quick trip to the Dollar Tree for small gift boxes and heart decor should do the trick. Alternatively, you can use Hershey’s Kisses if supplies are scarce. As for gameplay, students collect heart tokens in their boxes as they answer questions correctly. But here’s the twist – instead of counting tokens to determine the winner, students rely on their senses to make the call. So, get ready to shake things up and spread some Valentine’s Day cheer in your classroom!

FREEBIE

Why wait? Go grab your FREE love idiom game for Valentine’s Day for upper elementary students that encourages conversations.  Now, you can teach your students to use context clues in interpreting 20 idioms. This resource includes idioms and sayings related to “heart,” “love,” and “red,” ideal for Valentine’s Day lesson plans! I even updated the graphics with this sweet, Valentines heart emotions listed for FREE by Creating4 the Classroom Clipart.  

Simple Game Play

The Dollar Tree usually has small, Valentine gift boxes and plastic heart table decor, but if the shelves are cleared, then you could use Hersey’s Kisses. To play the game, students collect a heart token in their box as they answer questions correctly. Instead of counting tokens, players used other senses, like weighing boxes or listening for noise when shaken, to determine winners.

With this updated love idiom game for Valentine’s Day, you have a fantastic resource to engage upper elementary students in meaningful conversations. Incorporating idioms related to “heart,” “love,” and “red,” it’s perfect for any Valentine’s Day lesson. The simple gameplay, utilizing Dollar Tree finds or Hershey’s Kisses, adds a tactile and sensory dimension to the activity. Whether students collect heart tokens or listen for the noisiest box, they’re in for a memorable, enjoyable learning experience!

Why Straw & Cup Drinking are Better Options than Sippy Cups

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Honey Bear with Supportive Accessories for Teaching Straw Drinking

Just Say No to the Sippy

Sippy cups, prolonged bottle drinking, and excessive pacifier use can hinder oral development. As a speech pathologist, I advise families to switch to straw and cup drinking. This post aims to discuss why opting for straw and cup drinking over sippy cups can significantly benefit your child’s oral development and overall health.

Sippy cups

A sippy cup mimics bottle feeding, promoting an immature sucking pattern. By age one, children should transition to straw or open cup. A suckle pattern means that your child needs to stick his or her tongue out of the mouth to drink.  There is little to no tongue retraction involved in this movement.  Most of the time, the liquid will drip out of a sippy if you turn it upside down. 

Extended use of a bottle or sippy cup may promote poor tongue posture.  As a result, you will notice your child’s tongue rest outside of the mouth and you may observe articulation difficulty, especially with production of sounds made inside the mouth along the palate (t, d, k, g, n). As toddlers grow, we want to support transitioning them from a suckle pattern to a more mature movement. Toddlers, particularly those with speech delays, often protrude their tongues slightly while speaking or eating. This tongue position mirrors the placement for suckle drinking. 

Nuby Cup

Now that you know the pitfalls of using a sippy cup, let me offer two other options that not only secure liquids in a cup but also promote good oral motor development: a Nuby cup and straws.  First, the Nuby cup looks like a sippy, but has a flexible top that encourages sucking rather than suckling to drink.  The flow of liquid cannot drip out as easy as the sippy cup; rather it requires some effort, or sucking on the child’s part.  Similar to straw drinking, this sucking pattern pulls the tongue back into the mouth thereby supporting good oral motor development.

Straw Drinking Supports

A built-in straw cup is another great option but can be a little challenging for beginners, so it may be easier to start with a regular straw.  If your child is not sure how to use a straw, then trap some liquid in one end and slowly release that liquid into your child’s mouth once he puts his lips around the straw.  In the event that your one-year old or child with special needs needs more supports in learning how to drink from a straw, then I would highly recommend the Bear Bottle Collection from Ark Therapeutics.

Bear Bottle, lip blocker, and one-way valve:

This adorable, bear-shaped bottle is a great way to transition your child from bottle to straw drinking with several supports for quick success.  We attach a lip blocker to the straw to prevent excessive insertion into the mouth and encourage tongue retraction. This durable tool stays put after washing. There are three types of blockers sold by Ark Therapeutic which allow for graduation as your child improves his ability to position musculature for drinking without tactile feedback. The one-way valve traps fluid in the straw, preventing it from dropping back when suction is released. This makes learning to drink from the straw less effortful and sets the child on a quick path for success.

The Benefits of Straw Drinking

Straw drinking promotes tongue retraction into the mouth while drinking. To draw liquid from the cup, the tongue must retract into the mouth, a crucial movement for speech sounds like (t, d, k, g, n). You can also mix things up a little by varying the intensity of the straw. Shorter straws with thin liquids suit beginners, while longer or twisty straws with thicker liquids demand more effort. The latter version challenges older children to improve oral motor awareness. Drinking thick beverages with a straw improves lip and tongue awareness, aiding sound placements. Speech therapy alongside this change shows success.

I’ve long advocated for the straw’s benefits, even using seasonal ones as speech practice prizes. A small change can impact development significantly. While eliminating sippy cup usage is a great start, it will not be the only change that you need to make.  Please continue working with your speech pathologist and practicing sound targets at home to develop muscle memory for improved articulation development.

Seated Drinking

Children don’t need a cup in hand all the time. Overconsumption of liquids from sippy cups can hinder eating. Many children fill up on these liquids, making it difficult for them to eat because their bellies have an excess. Plus, it is far more challenging for children to drink while walking around, than it is when they are seated. Toddlers focus on moving around, making drinking from a cup challenging. They might spill or choke as they navigate and drink. Seated postures for drinking are just more optional all around. Let’s make sure children are seated safely before offering drinks, though they can still have water throughout the day.

In conclusion, by eliminating sippy cups and opting for better drinking choices, you’re not just improving oral motor development but overall health.

How Many Words Should my Toddler Say?

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Mother sitting outside holding a child in her lap with a basket of fruit on the table in front of them

Prerequisites

Communication is an amazing and complicated ability that literally explodes in the early years leading many to ask how many words a toddler should say. For some toddlers, this explosion happens early while others are “late talkers.” This range makes it tricky to predict the right time to seek out an evaluation.

Monitoring a child’s language development is a critical aspect of understanding their overall growth. As children grow, they reach various developmental milestones that signal their progress. Speech development is one important area where caregivers and professionals look for specific advancements. Two-word phrases, for example, are a significant hallmark that typically emerge when a child is between 18 to 24 months old. Recognizing the number of words a child should know or use at different stages can be a useful gauge of their language acquisition.

A child pointing at objects while saying simple two-word phrases. By 15 months, they can say around 10-50 words

By 15 months old, it is expected for a child to say eight to ten words. This early vocabulary will usually include names for parents, common objects, and possibly a few action words. By 16 months, the expected range can increase to around 15 words as the child starts to experiment with sounds and the meaning associated with them. A 17-month-old might be expected to say a similar number of words, but individual progress can vary. Moving forward, an 18-month-old child may have a vocabulary of 20 to 50 words. By the age of two, a child’s vocabulary typically explodes to around 200 words, a significant increase that underscores the rapid development in this stage.

Key Takeaways

  • Speech milestones act as indicators of a child’s language development.
  • Vocabulary size typically expands rapidly between 15 months to 2 years of age.
  • The emergence of two-word phrases marks an important progression in speech acquisition.

Developmental Milestones Overview

A young child is pointing to objects and using two-word phrases to communicate. They are actively engaging in speech development, reaching the milestone of using around 15 words by 15 months

Understanding developmental milestones helps you monitor your child’s growth and developmental progress, particularly in speech and communication.

Speech Development Fundamentals

Speech development is a critical aspect of your child’s overall development. By 15 months, a typical toddler might have a vocabulary of 8 to 10 words, although it’s not unusual for the number to vary among individual children. By 16 months, your child should use at least 15 words, increasing to nearly 20 words consistently by 17 months.

At 18 months, a child’s vocabulary undergoes significant expansion, and they can often learn new words rapidly, with some children reaching over 50 word. Simple phrases like “more milk” and “mommy go” may emerge alongside this single word vocabulary development.

By 24 months, a child should comprehend at least 300 words, with some capable of understanding and using more. Variability is normal, and these figures serve as a general guideline. Speech development relies on both genetics and environmental factors, like interaction with parents and caregivers.

Early Communication Milestones

AgeExpected Vocabulary
15 Months8-10 words: mama, dada, familiar objects
16 MonthsAt least 15 words
17 MonthsMinimum of 20 words
18 MonthsRapid word learning, >100 words likely
24 Months50 recognizable words, phrases emerging

Your child’s early communication includes gestures, babbling, and responsiveness to auditory stimuli even before the first word is spoken. You should observe increased intentionality in communication at around 18 months, with notable improvements in the complexity and clarity of expressed ideas. Early interactions greatly influence these milestones; engaging with your child through reading, talking, and playing supports their learning process.

Speech Milestones By Age

Mother sitting outside holding a child in her lap with a basket of fruit on the table in front of them

Understanding speech milestones helps you monitor your child’s language development effectively. Here are some highlights from the American Speech-Hearing Association (ASHA), when it comes to speech expectations:

  • By one year old, a toddler should say 2-3 words (such as hi, dog, dada, mama, uh-oh) and make attempts to imitate sounds.
  • Between 13 to 18 months, a toddler should say names of common objects, some actions, and important people. You will likely also hear long strings of sounds, syllables, and real words that appear conversational.
  • By two years, most toddlers should say over 50 words, which in turn gives them a large enough selection to combine single words into phrases like: “more apple”, “no bed”, “mommy book.”
  • Somewhere between 2-3 years, a toddler should be able to say sounds: p, b, m, h, w, d, n and most vowels in words. At 3 years old, toddlers are typically combining three words into a phrase to talk about things.

More Resources

As a speech pathologist, I often send families this Google Document with alphabet labeling and ask caregivers to fill in a word count. This information aids in documentation of the Rossetti Infant-Toddler Language Scale when it is time for an initial assessment. The Rossetti measures communication from birth through three years. While there are a number of factors in measuring communication development, for purposes of this post, these are the number of words a toddler should say by range:

  • 15-18 months: says 15 meaningful words
  • 18-21 months: uses single words regularly and imitates phrases
  • 21-24 months: uses 50 different words
  • 24-27 months: *MLU 1.50-2.00
  • 27-30 months: *MLU 2.00-2.50
  • 33-36 months: *MLU 2.50-3.00

*MLU: Mean Length of Utterance

Constructing Two-Word Phrases

A child pointing and naming objects, using two-word phrases, reaching developmental milestones in speech by 15 months

When you observe speech development in toddlers, constructing two-word phrases is a significant milestone. Around the age of 24 months, you will likely notice your child beginning to pair words together. This step is crucial as it represents the start of combinatorial speech, allowing your child to express more complex thoughts and needs.

Key Aspects:

  • Expression: Two-word phrases enable your child to convey relationships between concepts, like possession (e.g., “my toy”) or actions (e.g., “go home”).
  • Understanding: This stage reflects an increasing understanding of grammar and syntax, even in its most basic form.

Expected Progression:

AgeMilestone
18 monthsImitates two- and three-word phrases
20 monthsUses two-word phrases occasionally
24 monthsRoutinely constructs two-word phrases

Vocabulary Growth: Your child’s word bank typically includes 50-100 words by the time they are 2 years old. This richness in vocabulary supports the construction of meaningful two-word combinations.

Examples of Two-Word Phrases:

  • Requests: “More milk,” “Hold you,” “Help please”
  • Comments: “Doggie big,” “Truck loud,” “Shoe off”
  • Identification: “Mommy coat,” “Daddy car,” “Baby sleep”

You can encourage your child to form two-word phrases by reading to them, speaking in simple sentences, and naming objects during your daily routines. It is important to acknowledge and reinforce their attempts at speech. Each child develops at their own pace, but if you have concerns about your child’s speech development, consulting with a pediatrician or a speech-language pathologist might be beneficial.

Frequently Asked Questions

A child pointing at objects, babbling, and using two-word phrases while reaching for a bookshelf

This section addresses common inquiries regarding the progression of early language development in children.

By what age do babies typically start using two-word phrases?

You can expect babies to typically begin forming two-word phrases between 18 and 24 months. This is a natural progression as their vocabulary expands.

How many words should an 18-month-old typically be able to say?

At 18 months, a child may typically say between 20 and 50 words. The range is wide as individual growth varies.

What are the expected language milestones for an 18-month-old child?

An 18-month-old child usually recognizes names of familiar people, objects, body parts, and actions. They also begin to follow simple instructions, imitate two- and three-word phrases, and spontaneously say a two-word phrase on occasion.

At 2 years old, about how many words should a child know?

By the age of 2, children often comprehend about 300 words, express 50 recognizable, and combine words into short phrases.

Teaching Present, Past, & Future Verbs with a Dynamic app

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Teaching present, past, and future verb tenses has never been easier with the Tense Builder app by the Mobile Education Store! With two levels of play, short video clips, and a variety of settings, this app will surely please any crowd.  This app has been on my iPad since its release in 2012 and I still use it for teaching verb tenses twelve years later!  For those who have not seen it before, let me show you the settings and two levels of play.

Over a decade ago, I was given this app so I could put it to the test and offer a first person, hands on review of the product.

PROS:

  • Ability to record answers to foster expressive language and articulation practice.
  • Engaging video clips that hold attention
  • Leveled game play
  • Built-in teaching tool

Settings Screen:

The following features can be switched on or off:

  • Audio Instructions: select to play the same direction on each screen.
  • Answer Reinforcement: a naturally sounding voice repeats the correct sentence.
  • Record Correct Answer: clients work on their own expressive skills and gain auditory feedback by recording their voice reading the accurate sentence. Also a great option to work on articulation of sounds at the sentence level. My young examiners LOVED this feature!

Levels of Play

Level 1: clients match a sentence to the correct picture in a field of three. First, you hit the “Play Video” button and then watch a short clip. The clips are really fun and they contain sound effects that delighted my clients! Next, you will see one of the scenes from the movie. Last, you tap the correct picture answer.

Level 2: clients must drag the correct verb tense to complete the sentence. You can select future, present, past, or all verb tenses for either level. Again, you must first watch an animated video. While the videos only use sound effects, you may see some word bubbles above characters.

In this level, the word choice you select is said aloud as you begin to drag the word or word phrase to the top of the page to complete the sentence. I especially like this feature because it allows clients self correct errors. You can also set how many choices you want to display. This way, you can start at an easy level with three choices and increase the challenge gradually to as many as seven choices.

Tense: select future/ present/ past/ all

Regular/ Irregular Verbs/ All: select one or both for a mixed play

Lesson Style: chose between a “long” or “short” lesson. Should you hit the “Play lesson” on a picture screen, you will get a lesson about the verb target. Regardless of which type of lesson you chose, short or long, you will see a visual demonstration with verbal instructions. Yet another, great feature!

I hope that you get a chance to try this app at home!  At $9.99, it’s an affordable and interactive option for teaching verb tenses. This gem made it to my top 10 list of favorite apps.

Expressive by Smarty Ears Apps- An Affordable AAC app

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What do you think is a reasonable price for an AAC app compatible with the iPhone/ iPad that includes over 14,000 images and acts as a voice output communication system? An AAC app of this magnitude typically costs over a hundred dollars. What if I told you that you could get this app for under sixty dollars? Crazy, right? Well, the cost for the Expressive app by Smarty Ears is an affordable $59.99! 

I was given this app so I could put it to the test and offer a first person, hands on review of the product.

PROS:

  • This AAC app with 14,000 images is a steal for the price.
  • The ability to customize it with settings controls and links to add your own photos!
  • The main menu page is very organized and user friendly.

CONS:

  • It would be even better if the developers could eliminate moving to a new screen to view category members.

Main Page

Now, let’s take a closer look at this affordable AAC app and its customization features. We begin at the opening menu page. Here you will find color coded folders for the following groups: basics, categories, expressions, descriptive, food, people, places, questions, verbs, and time. After you tap the icon, you are navigated to another screen with category member images.

The main page also includes the following, core icons: not, yes, go, be, like, have, want, do, bad, and more.

Settings

The settings allow you to select either “on” or “off” modes for the ‘iCloud’, ‘lock’, ‘capital/lowercase’, ‘speak folder’, ‘automatically erases messages’, and ‘go to home after selection’ features.

Locking the app will prevent users from seeing the bottom tabs that bring you to the settings; allow you to delete or add images and folders; and give you access to other links for Smarty Ears, which includes a tutorial of this app. It is a good idea to lock the app if you want to avoid accidental deletion of images and folders.

The capital/lowercase selection displays the written word for the pictures you select to appear in either all lowercase or capital/lowercase. The Speak folder allows you to hear the name of the selected folder. Finally, the automatically erase feature removes images in the top bar after you play the sentence strip.

You can also change the speaker’s voice by choosing from four different male/female voices. If desired, you can slow down the rate of voicing or speed it up faster.

Another handy feature is the delete key. Simply tap the red “x” icon at the bottom of the screen to enter edit mode for delete, replace, or hide options.

If you need some specific pictures from your own photo library or if you want to add more smarty symbols, you can create new folders and add new images by tapping the green “+” button. In the screenshot below, you will notice a color wheel, which allows you to select a tab color for the folders and images you create. Once you add the picture and text, the app automatically sets an audio recording of the word! This by far is my favorite feature because you can really customize the app to suit any client, regardless of age!

The Engaging and Reinforcing Syntax City App

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Over a decade ago, the developers at Smarty Ears apps released their Syntax City App.  They were kind enough to gift me this $19.99 app so I could provide a first person, hands on review for caregivers and colleagues.  Nearly 12 years later and Syntax City still ranks in my top 10 list of apps for speech therapy. Let’s take an even closer look at this engaging and reinforcing app: Syntax City.

PROS:

  • You can customize this app for game play with several students at one time.
  • Ability to select easy to more challenging levels.
  • Fun layout and pictures that make learning engaging
  • Reinforcing, virtual prizes

CONS:

  • Sentences are read aloud and users must tap the correct word choice to fill in the blank. Unfortunately, the audio stops as soon as the user makes a selection. I would like to see the audio play the entire sentence.

Getting Started

Before you dive into the app, I highly recommend that you take a tour through a tutorial that lasts just under 10 minutes via the ‘Support’ tab. Next, you will need to set up some profiles. Type in the user name and chose either an avatar or photo image for a visitor badge. Up to five users can ‘visit the city’ at one time. You could also opt for a ‘quick play’ with one player, which will give you a chance to play and collect data, but the information will not save in ‘quick play’ mode.  At any time, you can remove badges too by deleting users.

While in settings mode, you can also chose the following:

  • Play Audio on/off
  • Remove error choices or allow users to hear a buzzer when incorrect
  • Recorder on/off

Before playing, you need to select the players that will visit, and then the next screen will show you selected users on the bottom. Simply drag and click users to any area you desire. Even better, you can bring one user to multiple locations. This is my favorite feature because you can target each individuals goal all during one game!! First, you move your player ID to a location, then you select a level. Some locations have more options for levels than others.

Syntax city is primarily a receptive language app with 2-3 word choices to fill in the blanks for sentences. However, you can also work on expressive language skills by having users record correct sentences, thereby giving users a chance to hear auditory feedback of syntactically correct sentences. By recording, you can also address any articulation concerns by having clients self-rate their utterances.

Playtime

Initially, the first thing that caught my eye about this app, was the clever, categorical layout of the city. You have the option of visiting any or all of the following locations:

  • Plurals Zoo
  • Was-Were Bakery
  • Do-Does Gym
  • Irregular Past Tense Farm
  • Is-Are Park
  • Have-Has Grocery
  • 3rd Person Singular Beach
  • He-She Ski Resort

After dragging players to locations, you are prompted to select a level of play.

When you first enter a location, you will see a scene related to that destination and hear a cute passage that talks about the importance of using that particular syntax appropriately.

Play commences with users shown his or her visitor badge in the upper left hand corner of the screen. A picture scene that matches the location appears with a sentence and 2-4 word choices (depending on the level of play selected.) Sentences are read aloud and users must tap the correct word choice to fill in the blank. Unfortunately, the audio stops as soon as the user makes a selection. I would like to see the audio play the entire sentence even if answer choices are selected quickly.

Rewards

The absolute highlight for all my trial users was earning prizes for correct answer choices. Each location has a shelf load of items that relate to the destination. For example, accurate answers on the beach earn you prizes like a beach towel, chair, and container of sea salt. I REALLY like the categorization design for prizes too! We have been reviewing the prize shelf, and then removing pictures and talking about the items we can recall from that category.

Also included in this app is a data collection screen. This page tracks each users performance in each location when you play in the ‘visit the city’ mode. You can opt to email, print or copy this page for fast and efficient data collection!

Creating Sentences with the Vibrant Rainbow Sentences app

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Embark on a colorful journey of language development as we delve into the efficacy of using the Rainbow Sentences app in therapy. You might have noticed a brief mention of Rainbow Sentences in my post, 10 Apps that Stand the Test of Time. I’d like to delve into creating grammatically correct sentences in more detail with the vibrant features of this app.
Rainbow Sentences, developed by Mobile Education Store, is accessible for $9.99 on the iPad platform.

I was given this app over a decade ago so I could put it to the test and offer a first person, hands on review of the product.

PROS:

  • You can toggle to allow sentence recordings to build expressive language skills and practice articulation of speech at the sentence level.
  • Reinforcing puzzle completion after accurately word ordering several sentences. The app stores the puzzles for you so when you return to your profile, you can pick up where you left off.
  • You get a nice break down of how many items clients answered correctly on their first, second, and third attempts for each complexity level. Plus, you can email this information!
  • Shown a scrambled sentence, you select “show,” then “play lesson.” This tool teaches sentence formation by answering questions, color-coding parts.
  • This tool guides clients in formulating sentences, answering questions, and color-coding sentence parts like “who,” “what,” “when,” “where,” “why.”

First, you set the stage at the settings screen. Select the on or off mode for the following:

  • Audio instructions
  • Correct answer reinforcement
  • Record correct answer
  • Line color coding: Subjective parts of the sentence are coded in blue, while the predicate portions are red.
  • Word color coding: For more support, you can allow clients to match words to designated line colors.
  • Word grouping: Challenge your clients a bit by selecting this option and just a few lines are shown. Users must group words together into an accurate sentence with minimal cueing.

Levels of Play

There are three complexity levels in Rainbow Sentences for constructing short to longer grammatically correct sentences. The first level is simple: sequence a few blocks or 4-5 words into a grammatically correct sentence order.

The second level is slightly harder as it requires sequencing three blocks or seven words into a grammatically correct sentence.

The last level is the most difficult and can contain four blocks or as many as fourteen scrambled words.

As stated in the PROs section, you receive a breakdown of correct answers for each complexity level on first, second, and third attempts. Plus, you can email this information!

I couldn’t find any cons to owning this app, especially if your child needs help with constructing grammatically correct sentences.

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