Speech-EZ® Apraxia Picture Sound Cards – Review

The Speech-EZ® Apraxia Program uses multi-sensory strategies to teach the child the correct movement sequences for speech. This addresses various levels of speech motor control, in particular: motor preparation and execution processes. Teaching the child how to form the correct movement gestures equips the child’s motor planning system to better predict and prepare the articulators to execute the correct target positions for speech intelligibility. There are SLPs trained in this method, there are paper versions of the APSC available and there are the Speech-EZ® apps. The APSC app comes in two versions – a parent version and a professional version. They are identical except the professional version can record data on multiple students and can email data, the parent version can only track data on one child and can not email data. There are also a series of supplemental apps available.
The APSC app has 3 main components:

Hand Cue Cards: for each sound there is a video showing the Hand Cue (sign) and saying the sound at the same time. If you tap the card it turns over to show the letter (or combination of letters). You can use these videos to learn the signs yourself and your child can learn them by watching the videos and by copying you. Once you have taught a sign you can reinforce it by showing the videos with the sound off and asking your child to identify which sound is being signed. You can also say a sound and ask them to sign it to you.
Sound and Number Cards: these contain cards representing each sound, and numbers from one to ten. When you turn the sound cards over there is a word containing that sound. There is also a chart containing all the long and short vowel sounds with words demonstrating each sound.
Picture Cards: there are over 775 Picture cards; each has a high quality photograph on one side and the written word on the other side. You can choose which cards to work on in one of several ways. You can choose to work on CVC, CVCV words, compound words, or one, two, three or four syllable words. Within the CVC words you can choose them by initial sound, final sound or place of articulation (e.g. Bilabial (p, b, m)_ Alveolar (t, d, n, s, d, l)). You can also hand choose which cards to work on. With each card you can press a button to hear the word spoken, and you can turn the card over to see the written word.
You can grade each response – but the grading isn’t obvious to the child as it is represented by straight or curved lines and accompanied by a musical note. After the session ends you save the data from the session. You can see the results of previous sessions in both table form and as a graph.

The app also contains detailed information sections for each card set that have a lot of extra information and tips for using the program. The help section also includes an IEP goal bank with suggestions for IEP goals for a child with CAS – something I found very useful for our recent IEP meeting.

I first found out about this program last summer and I thought it sounded like a great program for a child recently diagnosed with Apraxia, but I wasn’t sure how helpful it would be for a child like my daughter. She has CAS but had already been in speech therapy for several years and is now verbal but still having articulation issues. I read reviews from parents of pre-verbal children using this app who had found it really helpful, but I couldn’t find reviews from parents of older children. I was lucky enough to hear the developer Lynn Carahaly speak at the national Apraxia conference (CASANA), and learned about the theory of why the hand cues can be so helpful for children with CAS. I asked Lynn if the app would still be helpful for a child like mine, and she said yes, so I decided to buy it.

I started off by teaching her five signs – four for sounds she knew well, and one that we were working on. She liked watching the videos and was quickly able to recognize the signs and sign back to me when we practiced the signs. Her SLP was encouraging and willing to use the signs in her speech therapy sessions, so I taught them to her also. Her SLP and I used the signs during speech therapy and home practice, but my daughter wouldn’t sign back except when we were specifically practicing the signs. One day in a ST session I just started moving her hand through the motion of doing the sign whilst she was working on her articulation practice, something just clicked and she started signing back. Once she was signing back, we gradually started introducing new signs, and now she has a large repertoire. She doesn’t use the signs all the time, but if she is struggling with a target word I remind her to sign, and she is definitely able to produce the sound easier when she signs. Since we have started using the APSC her articulation has definitely improved faster, and by watching how much easier it is for her to say a difficult sound when she signs, I can really see how it is helping her. Her SLP has been so impressed by how well the program is working for her that she has started using it with another child too.

I would like the ability to add my own picture cards (with audio), for when she is working on words not found in the app. I would like to see the addition of a record and play back feature in this app, as I find that hearing herself practice is a big motivator for my daughter. More detailed data tracking would also be nice. The developer is currently working on updating the app, so we may see some of these features added in future updates.

The big drawback with this app is the price tag, $180 is a lot of money. However, to put this in perspective the paper version of the APSC costs $900, and the paper Kaufman Apraxia cards (with 225 cards and only covering some of these sounds) cost $200 per set. Children with CAS require A LOT of speech therapy and anything that can speed up their progress, and mean they need less Speech Therapy is a good thing. I really believe this system is doing that for my daughter, and with private speech therapy in my area costing $120+ an hour, the cost of the app is only the equivalent of 1 1/2 hours of therapy. You can watch a video of this app in action here.

In conclusion if you have a child with CAS, or another speech disorder that has a motor planning component, and who is still struggling with articulation I would strongly recommend you consider purchasing this app. I have seen how much my daughter’s speech has improved whilst using the Speech-EZ system and really think the hand cues have made a major contribution to that progress.

Requirements: Compatible with iPad only. Requires iOS 4.3 or later.