April 5, 2011 Features

The Future at Hand: Mobile Devices and Apps in Clinical Practice

As of early 2011, more than 65 million Americans own a smartphone, according to a recent comScore report. This should come as no surprise to speech-language pathologists; at least one of every five peers and patients with whom an SLP interacts daily is using a handheld mini-computer. Their types vary but the capabilities of smartphones and tablets, the versatility of their software applications (apps), and their popularity as a preferred mode of communicating and accessing information continues to grow.

SLPs see the clinical value of this fast-growing technology. Sean Sweeney, an SLP and instructional technology specialist working in a public school and private practice in Newton, Mass., noted that "as a whole, SLPs are just beginning to explore mobile devices, but they are likely to become pretty prevalent in clinical practice."

Jeremy Legaspi, a pediatric SLP at the non-profit Upward Foundation in Phoenix, Ariz., agreed that apps for mobile devices are "the future of the profession and some clinicians are already there."  It's a "really exciting platform," said Jessica Gosnell, an SLP at Children's Hospital Boston, where apps have been used in augmentative communication assessment.

Some SLPs are developing specialized apps themselves and sharing their experiences with colleagues. Witness the well-attended apps sessions at the 2010 ASHA Convention as well as the energized online listings, discussions, and reviews of the latest mobile devices and speech-language pathology applications through Facebook, Twitter, and websites (e.g., SpeechTechie, GeekSLP, Technology in Practice SLP (TiPS), PocketSLP, and  Speech-Language Pathology Sharing). Apple has established a Special Education section of its iTunes App Store, where SLPs will find a number of apps of interest.

Mobile devices may be new, but they don't represent a radical departure from past clinical practice. Apps are the latest version of the useful contextual tools, Sweeney said. "We use engaging tools as contexts all the time, such as books, toys, games, stimulus cards, and worksheets. Apps can serve the same purpose." Gosnell also sees current apps as part of a technology continuum. In 2007, Children's Hospital Boston capitalized on the iPod Touch to develop a photo library for scene cues, visual schedules, and activity sequences, among other uses. "It's become clear that part of our job is to be aware of what apps are out there," she said.

SLPs familiar with mobile devices and their apps can strengthen ties with patients and families and extend treatment more thoroughly into daily lives. "Using apps in treatment is a win-win," Sweeney noted. "The client engages with an exciting device, and the clinician is able to model and elicit the targeted skills more easily." For Gosnell, too, apps enhance engagement and facilitate parents' "buy-in" to augementative and alternative communication as an option for their child. Some patients directly assert their technology preference. "For a majority of my clients, the iPad is the first thing they ask for in treatment," Legaspi said.

"I have found that the families I work with that have iPads are more likely to follow through with carryover activities at home," he said. "However, I caution them not to make their child's speech practice on the iPad at home a passive activity. Parents must interact with and engage the child."

Versatility is another advantage of mobile apps. Even those not specifically designed for SLPs' practice can often be repurposed. Gosnell uses a "whiteboard" app for mobile devices. She writes and draws on it and uses the app to record the session schedule, allowing the patient to check off each completed item as the session unfolds.

SLPs most conversant with clinical apps do not hesitate to point out their potential pitfalls and the need for responsible, informed use by clinicians. Sweeney observed that the tools easily could become the focus of a session but added, "with the proper structure, this can be avoided and the app becomes simply a helpful context." Legaspi noted that the cost of mobile devices, although dropping, is prohibitive for some patients and families. Another problem, Gosnell said, is a patient bringing a device to treatment and asking the SLP to adapt treatment to the device.

The potential of mobile devices and apps continues to excite SLPs despite these cautions. Gosnell envisions the time—soon—when they are a "low-cost, mainstream tool that's integrated into our toolkit." One of this technology's greatest advantages also may be the most practical—replacing physical tools such as stimulus cards with a hand-held device will lighten the load for SLPs who must carry heavy bags of materials between treatment sites.

Gary Dunham, PhD, director of publications, can be reached at gdunham@asha.org.

cite as: Dunham, G. (2011, April 05). The Future at Hand: Mobile Devices and Apps in Clinical Practice. The ASHA Leader.


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