Monday, July 15, 2013

App Review: Comprehension Aphasia

I had the pleasure of trying out Comprehension Aphasia by the Virtual Speech Center.  Despite its name, this app is not just for adults, but can be used with children who have comprehension issues as well!


You can see the home screen of Comprehension Aphasia above. If you tap the info button, you will see a description of the app as well as how it is used:


According to the description, Comprehension Aphasia "focuses on auditory comprehension of increasingly longer and complex yes-no questions and directions with the ability to turn on background noise."  The app can be used with clients who exhibit aphasia, cognitive deficits, decreased attention, Central Auditory Processing Disorder (CAPD), receptive language impairments, and autism.  In my opinion, this app can be used with any client who needs to strengthen their ability to listen to and comprehend spoken language (specifically questions and directions).

You can tap More Apps to see a list of apps by Virtual Speech Center, along with a description of each app.  You can also modify the Settings for the app from the home screen:


Settings include:  Turning on/off audio, automatically moving to the next item when a response is given, randomization of items, turning on/off background noise (and adjusting both the type of noise and the volume), and modifying the sounds heard for correct and incorrect responses.

Using the App:

When you tap Start from the home screen, you will be prompted to add/select students.  You can use this app with individual clients or in groups.


Once you have your student(s) selected, you will be prompted to select activities.  You may select multiple activities for each student playing, then tap Next to begin.


 The activities in this app include:

1.  Yes/No Questions:

  • Yes-No Questions with pictures (Nouns, Function of Objects, Verbs, or Adjectives)
  • Concrete Yes-No Questions without pictures
  • Abstract Yes-No Questions without pictures

While targeting yes/no questions with pictures, the client is given a verbal question (written cues for stimulus items are not utilized in this app) and shown an image.  A question is posed regarding the image.  Examples include:  "Is this an apple?" (Nouns), "Do we use a garden hose to water?" (Function of Objects), "Is she reading a book?" (Verbs), and "Is this rose long?" (Adjectives).

"Is this an apple?"

Examples of Concrete yes/no questions without pictures include, "Do we wear sunglasses on our feet?" and "Do people sleep at night?"  Examples of abstract yes/no questions include "Do we wash our hair after we go to bed?" and "Is a dime more than a quarter?"  For these items, the client will be shown only the words "Yes" and "No" and will select their response by tapping the appropriate word.

"Do people sleep at night?"


2.  Basic Directions with 1 Element:

  • Follow 1-step Directions with 1 Item - Nouns (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with 1 Item - Verbs (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with 1 Item - Adjectives (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with 1 Item - Function of Objects (field of 3, 4, or 6 pictures)

For these activities, clients will be prompted to touch one picture from a field that best fits the description. Examples include:  "Show me the trumpet" (Nouns), "Show me the girl blowing bubbles" (Verbs), "Show me the angry man" (Adjectives), and "Show me the object used to mix" (Function of Objects).

"Show me the stapler"

"Show me the man shaving"


3.  Basic Directions with 2 Elements:

  • Follow 1-step Directions with 2 Items - Nouns (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with 2 Items - Verbs (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with 2 Items - Adjectives (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with 2 Items - Function of Objects (field of 3, 4, or 6 pictures)
For these activities, the client is asked to point to two objects instead of one (as above).  Because you are selecting more than one object, you must press "Go" when you are finished.  Examples include, "Show me the cap and the chair" (Nouns), "Show me the  girl sleeping and the child taking a bath" (Verbs), "Show me the empty basket and the full basket (Adjectives), and "Show me the animal that lives in the jungle and the object used for blending" (Function of Objects).


"Show me the broccoli and the bicycle."

"Show me the sweet food and the pink food."


4.  Temporal Directions:

  • Follow 1-step Directions with Concept "Before" - Nouns (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with Concept "Before" - Verbs (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with Concept "Before" - Adjectives (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with Concept "After" - Nouns (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with Concept "After" - Verbs (field of 3, 4, or 6 pictures)
  • Follow 1-step Directions with Concept "After" - Adjectives (field of 3, 4, or 6 pictures)


The directions in this set are increased in complexity.  Again, you must select two pictures and press "Go" when finished.  Examples of "Before" items include:  "Show me the office before you show me the fox" (Before - Nouns), "Before you show me the man pouring water, show me the boy eating" (Before - Verbs), "Show me the open can before you show me the open mailbox" (Before - Adjectives).  Examples of "After" items include:  "Show me the hand after you show me the chicken" (After - Nouns), "After you show me the child crawling, show me the child taking a bath" (After - Verbs), "Show me the long hair after you show me the short measuring tape" (After - Adjectives).

"Show me the child drawing, before you show me the child crying."

"After you show me the belt, show me the eggs."


5.  Conditional Directions:

  • Follow Conditional Directions - Nouns (field of 3, 4, or 6 pictures)
  • Follow Conditional Directions - Verbs (field of 3, 4, or 6 pictures)
  • Follow Conditional Directions - Adjectives (field of 3, 4, or 6 pictures)

These activities are the most complex and include the most linguistically complex directions.  Examples of conditional directions include:  "If kangaroos live in Australia, tap the chicken.  If not, tap the 'Go' button" (Nouns), "If raisins are made from grapes, tap the woman watering.  If not, tap the 'Go' button" (Verbs), "If not, tap the 'Go' button" (Adjectives).

"If we pay full price with a coupon, tap the man yawning.  If not, tap the 'Go' button."


What I like about this app:
  • The variety within the levels.  This app really does allow you to challenge clients/students by increasing complexity.  You can target yes/no questions with and without visual cues in addition to following basic directions and complex directions. 
  • The ability to add background noise makes each level more challenging.  An adult with aphasia may have difficulty distinguishing figure/ground and, with this app, you can target that skill easily.  
  • The ability to target vocabulary and concepts using real life photographs. 
  • If a client/student is working on repeating directions, you can record them as they are repeating in addition to replaying the original direction.  Using these features, a client can compare what they heard/perceived vs. what was initially said.
Changes I would like to see in an update:
  • I've been trying to think of something I would like to see changed and I really couldn't come up with much.  My first thought was to add an option to have written cues for directions, but that would undermine the focus of auditory comprehension.  So, I guess there isn't anything I would change about this app!
The Bottom Line:
Comprehension Aphasia is a great app for anyone working on improving their auditory processing/receptive language abilities.  It's a comprehensive app that allows you to work on so much, while increasing cognitive and linguistic complexity.  I have to admit, I wasn't sure about this app upon hearing the name of it as I typically work with younger children.  However, I was VERY pleased with the app and I think I will be able to use it with some of my younger students as well!  I think "Comprehension Aphasia" may be a bit of a misnomer for this app because it really can be used for so much more than just aphasia!  If you do have students on your caseload with auditory processing/listening comprehension difficulties, you will not be disappointed with this app!  Comprehension Aphasia sells for $19.99 in the App Store.

Have you tried this app?  If so, what do you think of it?


Disclaimer:  Virtual Speech Center provided a copy of Comprehension Aphasia for the purpose of this review, but the opinions expressed (as always) are mine alone.

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