Does Technology Inhibit Our Engagement With Children?

toddler apps

Photo by jenny downing

I had an interesting online discussion with a colleague as to whether or not technology detracts from or enhances communication. She wrote, “…communication is a relational activity, it’s all about relationships. Should we be investing so much energy on encouraging children to engage maybe more with technology than they do with people? … Do we really need all of the apps in order to engage children with spoken communication or do we need to get back to the real function of speech and language which is to connect people with people?”

As a speech path, I fully agree, to a point. But does technology disengage children from human interaction? Does our enthusiasm for the iPad, and using it in therapy, have the potential for reducing the child’s interpersonal relationship with us and others? I believe the answer is that it depends on how we use technology.

Technology is a tool like any other, but with expanded possibilities. There are apps available that can be used as a starting point for conversation. New app innovation holds the possibility of animating the standard pictures we have been using in therapy for years. I find it hard to understand why that is a negative. As with all materials available to us, it all depends on how we put them to use. Letters replaced human messengers, books replaced human storytellers, radio and television took their place alongside live entertainment. Today’s technology is another medium of interaction on this continuum.

Another colleague offered this anecdote. “At the end of school last year, I grouped two preschoolers who I had been seeing separately and at the end, we used the iPad for some free time. Boy, was I surprised at the amount of spontaneous conversation between the two boys! They shared their favorite app, described how to play it, asked questions about the other boy’s app, and made helpful suggestions. I hadn’t gotten such spontaneous language from the one student for over a year of therapy!!”

(This post originally appeared on Apps for Speech Therapy)


Mirla Raz, CCC-SLP, is a speech pathologist in private practice (Communication Skills Center) and the author of the Help Me Talk Book: How to Teach a Child to Say the “R” Sound in 15 Easy Lessons, How to Teach a Child to Say the “S” Sound in 15 Easy Lessons, and How to Teach a Child to Say the “L” Sound in 15 Easy Lessons (also available in Kindle). Her latest endeavor is her blog Apps for Speech Therapy.

ASHAsphere One Year Later


Photo by melalouise

Ok, technically it’s been over a year (the first ASHAsphere post was published August 31, 2010), but I wanted to mark the belated one-year anniversary of ASHAsphere by saying thank you.

Thank you, faithful readers, who comment on and share and tweet the posts we publish here each week. We appreciate your support and hope you continue to find this blog engaging and useful.

Thank you, talented ASHAsphere bloggers, who are generous enough to share your insights here. You are the reason this blog has been such a success, and I personally am deeply grateful to you all and hope you’ll continue to contribute to ASHAsphere.

If you’ve thought about blogging for ASHAsphere but haven’t applied to become a blogger yet, please do.

Here’s to another year of shared insights and ideas!

FaceTime calls on iPad are HIPAA compliant


You heard it right! FaceTime calls are HIPAA compliant. In an age in which privacy laws often become burdensome to healthcare providers, it is so refreshing to be able to share this exciting news. While I have never done telepractice myself, I am an iPad user and recently used FaceTime to discuss a new app development project with another SLP up in Canada. I loved it!  As an SLP and an iPad geek, I could not help but to want to share this with you guys.

FaceTime is a video calling service that runs on Apple devices such as the iPad and iPhone that allow video conferencing. Just like any other function on the iPad, it opens the door  to a host of new possibilities. The front camera make it the perfect way to communicate  with others who also use Apple devices. When the iPad 2 camera was announced I remember thinking about all the possibilities for therapy. The fact that video conferences are encrypted using HIPAA standards just reinforces the iPad’s status as  my favorite toy of all time.

Now why should SLPs care?

The  Health Insurance Portability and Accountability Act (HIPPA) requires that electronic health care transactions are designed to keep patient records secure to protect patient privacy. Speech-Language Pathologists who deliver services at a distance can now use FaceTime to deliver their services if the patient owns an iPad and/or iPhone. The delivery of services at a distance is also known as telepractice. ASHA defines telepractice as “the application of telecommunications technology to delivery of professional services at a distance by linking clinician to client, or clinician to clinician, for assessment, intervention, and/or consultation.” So in order to follow HIPAA guidelines for telepractice, SLPs have to use a service that has been encrypted (which is the case with FaceTime)

Besides using FaceTime for service delivery, SLPs can also now be sure that they can “face call” their co-workers to consult on a case. The uses are immense!

Now, in order to be fully HIPAA compliant, SLPs must make sure that their wireless connection utilizes WPA2 Enterprise security with 128-bit AES.  WPA2 is a security protocol that was develop to protect the information that goes in and out of your computer using your wireless signal. Here is a well-written article on how to WPA2 Enterprise your Home.

This is definitely great news, and just one more reason why the iPad is transforming service delivery in speech therapy.

For additional information on Telepractice you can visit the ASHA website.


(This post originally appeared on GeekSLP)


Barbara Fernandes is a trilingual Speech- Language pathologist, a geek  and an app developer. She is the founder and CEO of Smarty Ears Apps , a company that creates apps for speech therapy. Barbara is also the face behind GeekSLP TV, a blog and video podcast focusing on the use of technology in speech therapy. Barbara has also been a practicing speech therapist both in Brazil and in the United States. Barbara has created over 21 applications for the mobile devices for speech therapists.

Top 5 Foods I Wish My Speech Therapy Students Would Stop Eating

Pizza Face

Photo by ayesamson

Speech-language pathologists are no strangers when it comes to the human oral and facial anatomy. We are always (consciously or subconsciously) analyzing our students’ teeth, tongue range and motion, and lips to ensure that they are able to produce adequate speech articulation. So here is my silly little question to you: have you ever looked inside of a child’s mouth and then all of a sudden screamed out, “Eww! OMG! What did you eat?!” Trust me, we have ALL been there before (oh the joys of being a speech therapist). Never a dull moment, indeed!

The following is a list of the top 5 things I wish my students would stop eating right before they come to speech therapy.

5. Ice cream

  • They say that you should wash your face twice a day with warm water and soap if you want to keep your skin nice and clean. For some reason though, I feel like my younger clients wash their face with ice cream and chocolate syrup every time they eat that sweet treat! “My friend, please walk to the bathroom and wash the ice cream off your face, then we can start speech therapy.”

4. Oreo cookies

  • Don’t get me wrong, I love Oreos just as much as the next guy, but when students come into the speech therapy room with those chocolate crumbs all over their mouth and in their teeth, I can’t help but think that they ate a handful of dirt. “Guys, did you go outside during recess and take a bite out of the ground? How did it taste? Should I try eating the ground, too?”

3. Blue lollipops/blue gum

  • In speech therapy, I typically see red and pink colored tongues, so you can imagine my shock when a child comes to speech therapy with a full blown BLUE tongue. “We can’t do speech therapy today because we have to get you to the nurse! You are turning into a Smurf!”

2. Fruit punch

  • Imagine seeing a child with a mustache. Pretty wacky thought, right? Now imagine seeing a child with a RED mustache. Super distracting when we are trying to work on the /TH/ sound, don’t cha thing? “I like the red mustache you are sporting. Not only is it stylish, but you can also taste it when you get a bit hungry. Convenient!”

1. Doritos chips

  • Wow. Ok. I don’t think there is a worse smell on this planet than a child’s breath after they have devoured a bag of Doritos. “Please, keep your shoes on during speech therapy because your socks are kinda stinky. Wait, your shoes ARE on?! Oh, that is the Dorito breath I am smelling.”

In closing . . .

Agree? Disagree? Did I miss any foods? Writing this post sure has made me a bit hungry for a snack. Lucky for me, I packed some S’mores Pop-Tarts in my book bag. Haha! Have a great day and I look forward to writing a new blog post soon! Oh, and please feel free to share this post with all of your SLP friends :-)

(This post originally appeared on the ArticBrain blog)


Erik X. Raj, M.S., CCC-SLP ( is a speech-language pathologist who has provided direct care to pediatric, adolescent, and adult clients who exhibit a broad spectrum of communication difficulties. He is presently pursuing his Doctor of Philosophy degree in Communication Sciences & Disorders as a Thomas C. Rumble University Graduate Fellowship recipient at Wayne State University. Erik is also the founder of ArticBrain, LLC, a speech therapy product development company.

Dear Patient

365: 31 -  31.01.09

Photo by Foxtongue

Dear patient,

When you were admitted to my facility I was literally heading out of the door to go home and relax for the evening. I probably planned to have some dinner, read and maybe if I was lucky I’d have a good beer to round out the night. But on my way out I was flagged down by a nurse saying that you wanted to drink regular, thin water.  Actually, the nurse said that you were demanding and yelling about it. At this point, I had no idea who you were; I had no idea we even had any new admissions.  So, I put down my bag and made my day a little longer to see what the buzz was about. I know this isn’t your fault; you probably had little control over what time your transfer took place, and even if you did, I was probably the last person on your mind, but probably not even that. There’s a good chance it didn’t register with you that you’d be seeing someone like me. I don’t mind, and since I like my job and I care about your well-being I came straight to your room without even looking at your chart, something I almost never do, to have a little chat.

As I came into your room I noticed right away that you had a trach. I introduced myself and explained my role as the person who works with swallowing and diet modifications, among other things. Without an acknowledgement of who I was, you began to curse and yell at me that you wanted water and that your previous speech pathologist at the other facility let you have ice chips and water. Not that I expected anything less; you’ve been through a lot, I’m sure, and you’re just trying to advocate for yourself. I get it. And I actually believe everything you told me, but being diligent with my duties and to ultimately look out for your well-being I needed to look through your medical chart to get a better sense of your history and to see if there was any information to clear up this misunderstanding.

After you made your needs known to me, I checked your chart. Your transfer order stated that you should have honey thickened liquids. I found no notes from your previous speech pathologist and no other indication that you were allowed water and ice chips. I also learned you had a PEG and some other conditions that put you at risk for swallowing difficulties. Not to mention you have a trach which adds another level of potential problems. Believe it or not, I still believed what you said about about drinking water and having ice chips but that doesn’t mean I can just change your diet.

I came back to your room to tell you what I learned, but before I could explain what this information meant, you flipped out at me, continued to curse at me and demanded that you be allowed to have thin liquids. Obviously you knew where I was going with this conversation. Between your outbursts, I did my best to explain that even though you may have had thin liquids at your last hospital, you came here with a honey thick liquid restriction and that I couldn’t find anything in your chart that indicated you were able to drink thin liquids safely, that is, drinking thin liquids without it entering your lungs. I couldn’t even find a single note about thin liquid trials with your previous speech pathologist. I don’t blame you for how you felt, nor did I get upset about it. Even though I work with dysphagic patients every day, I still can not fathom what it would be like to not drink what I like, on top of that, having a stranger tell me what I can and can not drink. That would totally suck. I once even tried to drink the stuff we give you. Its gross, and I couldn’t imagine drinking that stuff with every meal. That would also totally suck. I could see you were upset because you kept swearing at me. You really do have some foul language! I still don’t blame you, because your situation is awful and I can imagine myself acting very much in the same way. So, as a last ditch effort I called your last hospital but could not get a hold of anybody in the speech department or anyone in nursing who could clarify what your diet was. So honey thickened liquid remained your diet for at least that night.

You see, I did everything I could to determine if thin liquids were safe for you. I do care; I empathize with you, because I do not envy what are going through. But I have to make my decisions not based on entirely what you want, but based on the data I have about you. I believe you when you say you had water and ice at the last hospital, but I have no way to verify that. I don’t have the tools at my immediate disposal to determine if you can drink water without it going into your lungs. You came to my building with a honey thick liquid restriction and that will remain until I can verify that you are safe for thin liquids, whether it be a report from your previous speech pathologist or passing a video swallow eval. This isn’t because I’m a jerk, even though you might think I am-its because I actually do care and I don’t want to make a careless decision that could land you back in the hospital with pneumonia. Pneumonia will undoubtably prolong your course of hospitalization and it will add quite a bit of money to your bill. Not to mention that aspiration pneumonia is life-threatening. You could die if I mindlessly changed you to thin liquids. That is simply a risk I won’t make. Not just for you, but for any of my patients.

You seem like a good person and I do look forward to working with you. I look forward to hopefully getting rid of that nasty honey thick restriction and seeing the happiness and relief on your face when you hear the good news. I want you to avoid getting sucked into the blackhole of health care, bouncing between hospitals and skilled nursing facilities for preventable issues. Instead, I want to see you go home healthy and fit so you can live a happy life. I hope that you realize I’m not some dolt, but someone that does genuinely care about your health.

Your Speech Pathologist,

(This post originally appeared on slowdog)


Adam Slota M.A., CCC-SLP is a speech pathologist working in long term care and long term acute care settings, primarily with tracheostomy and ventilator dependent patients. He is also the author of the blog slowdog where he writes about various topics in speech pathology and beer, among other frisky and/or mundane missives.