â˘Â Reach out, then touch something: a review of Tactusâ âAdvanced Comprehension Therapyâ
[Editorâs Note: In honor of #BHSM, and since #DysphagiaAwareness happens in a couple weeks anyhow, we are foregoing our regularly scheduled programming in favor of a dive into one of our favorite tech-based therapy tools for language, auditory processing, and cognitive-communication, in lieu of our usual swallowing-only MO. Again, we promise not to make a habit of it. If you want a dysphagia-centric app review, thereâs one here.]
Tactus Therapyâs Advanced Comprehension Therapy has a deceptive name. Ostensibly, itâs exercises in sentence-level auditory comprehension. In the right hands, this tool addresses not only auditory and reading comprehension, but also syntax skills, visual discrimination, sequencing, immediate recall, and cognitive flexibility.
The app is broken down into three main subheads: Identify, which provides field choices for concept identification at sentence level; Build, a sentence construction task; and Follow, for following directions.
Identify provides sentences of customizable complexity, anywhere from âThe woman reads,â to âShe is being told a secret by him,â and, âThe man is sprayed by the woman.â As Iâve said before, Tactus has always been truly adept at choosing distinct, appropriate, engaging (and sometime eminently memeable) visual stimuli, and the images here are no exception. I personally love to use the pronoun-centric stimuli for my patients who keep keep calling me âmaâam.â Stimuli can be presented written, via built-in text-to-speech generation, or both.
Build is intended as a âcopy what you hearâ exercise, but I prefer to hit the mute switch and use it as a generative syntax and constraint-based cognitive flexibility task. âYouâve got 5 blanks here, and 8 words. Make a caption for this picture that makes sense.â The complexity of stimulus can be configured here just as it can in âIdentify,â and the images come from the same bank. Targets can be dragged to their intended location, or simply tapped in sequential order.
Follow is where I get the most mileage. One-, two-, and three-step directives. Conditional directives. Directives with adjectives. Directives with multiple adjectives. Semantic and syntactical variation in the directives. Auditory stimuli. Written stimuli. Iâm not going to say the possibilities are endless, but the possibilities are endless.
This is great for immediate recall and sequencing skills, andâunlike some other rehab-centric app subtasks Iâve usedâit provides enough flexibility to use with patients that have a variety of functional barriers. Have trouble with touch-drag skills? Have unaided hearing loss? Have low educational status or limited semantic memory? Bad with spatial concepts? Honey badger Follow donât care, you can still exercise those sequencing skills.
From an app design perspective, Tactus has really settled on an aesthetic that is modern but not flashy, and they clearly strive to strike a balance between complexity/customizability and simplicity/ease of use.
Animations are snappy and provide a sense of place when navigating through task setup, and then within the tasks, dynamic motion is replaced by subtle fades between stimuli, which are generally appropriately paced for the target patient population. As with all their patient-focused apps, data keeping is straightforward and easily exportable as a PDF via email, orâif you have a relatively modern iPadâvia drag and drop/copy-paste from the email screen.
Iâve used this tool extensively since I purchased it, and find it to be tremendously powerful. Still, there are a few things I would love to see in a 2.0:
The option of which order âbefore/afterâ directives are presented for 3-step directions in addition to 2-step.Â
Use of the system default voice for spoken stimuli. Maybe this isnât possible with the APIs available (Iâm not a programmer, so I donât know), but I would love to hear Siri reading those sentences rather than Samantha.
Some slightly more semantically complex targets for âFollow,â like the images youâd see in Naming or Comprehension Therapy. Iâve had a number of patients comment âthis would be great for kidsâ or something similar for that task in a way that never occurs with any other Tactus stimuli set, and I suspect itâs the restriction of the directives to the objects that can be displayed effectively in multiple bright colors to accommodate the â+ adjectivesâ complexity levels. âBefore you touch the jumping girl, touch the open envelopeâ as an option might help to mitigate that.
An option for Build to only play the auditory stimulus when you hit the ârepeatâ button to allow it to more naturally be partially generative syntax task.
If, like me, you are always looking for ways to replace paper in your cognitive exercise sessions, Advanced Comprehension Therapy is a solid choice. At time of publishing, thisâand all of the Tactus appsâare on sale for Better Hearing and Speech Month. They seem to do that every year, but their pricing is usually a pretty good deal even when itâs not on sale, especially when you think about what a WALC book costs. The Tactus library keeps expanding, and Advanced Comprehension Therapy is an excellent addition to any clinical toolbox.
[Finally, a couple disclosures. Disclosure the First: Tactus gave me a copy of âConversation Therapyâ gratis a few years agoâback when they still called their software âTherAppyââto review. Since then, Iâve had to pay for everything, and the software reviewed here is no exception. Disclosure the Second: Even though Iâve had this review in mind as long as Iâve been using the app (a few months at least), itâs being published at this particular moment in time as a thank you to Megan for laughing at one of my stupid memes. She didnât solicit the review; one good turn deserves another. Disclosure the third: In the title of this review, I am consciously using Anglo-style possessive construction for collective nouns. Donât @ me. Or do @ me.]
Probably shouldâve posted this here first to keep the dysphagia brand unsullied. BUT I AM MY OWN PERSON.
