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Fast ForWord: Does it Really Work?

September 24, 2014 By

Fast Forward Does It Work I have been exposed to the Fast ForWord® program for several years. I was introduced to the program during my Clinical Fellowship (first year of work after grad school). I worked at a private practice in Pasadena, CA. The owner of the private practice was a veteran in implementing the program and used it with a wide variety of students with disabilities ranging from mild auditory processing to severe autism. My first reaction on viewing the program was skepticism. How can any computer program take the place of a real, live clinician? How can sitting in front of a computer for an hour a day fix all the language and learning problems? Now, 12 years later, as an owner of a private practice and a Fast ForWord provider, my perspective hasn’t really changed. Fast ForWord cannot (and wasn’t designed to) take the place of a therapist, nor can it truly “fix” all language and learning challenges. So perhaps, it is more productive to look at what it was really meant to do, and then decide if it truly does work.

According to Dr. Martha Burns, language processing can be broadly divided into three hierarchical levels: Low Level (Perceptual Skills or Listening skills), Mid Level (Grammar and Vocabulary), and High Level (Complex Problem Solving). If the three levels are viewed as a pyramid, the Perceptual skills would form the base, Grammar and Vocabulary skills would form the middle portion, and Problem Solving skills would form the tip of the pyramid. As you can imagine a shaky foundation or base could potentially cause the entire pyramid to fall. Our ability to quickly perceive (listen to) sounds, tell if two sounds are same or different, put sounds together to form words, and also manipulate sounds to change words and their meanings is truly the foundation of language. Several conditions in young children can lead to impairments in these Low Level processing skills. Autism, ADD, ADHD, middle ear infections, and seizures are only a few conditions that lead to these impairments. The goal of the Fast ForWord programs, therefore, is not repair high-level problem solving skills, or even to teach grammar and vocabulary. The primary focus of Fast ForWord is to enable a child to perceive miniscule changes in speech sounds that occur at a rapid rate during spontaneous conversation or classroom lessons. Of course, this may result in changes in mid- and high-level processing, but these changes are a product of the progress seen in low-level processing. However, this does not eliminate the need for more traditional individual therapy to work on grammar, expanding vocabulary, and problem solving. In fact, Fast ForWord may make traditional behavioral approaches more effective and productive.

One of the criticisms of Fast ForWord has been that a clinician can target the areas addressed by Fast ForWord. Traditional auditory processing therapy focuses on skills such as following directions, phonological awareness, and auditory recall. While Fast ForWord targets the same areas, traditional approaches are merely asking the child to do things that are already challenging for him without making any modifications to the stimulus. Clinicians attempt to change the stimulus by saying it slower, or louder, or by using headphones to eliminate noise. While these are beneficial to some extent, they do not take into account the core deficit that many students face in terms of auditory processing: the speed with which sounds change within words. It is impossible for humans to stretch the speech sounds to reduce the rate. At present, the only software that can achieve this is Fast ForWord. Thus the traditional approaches provide compensatory strategies without really addressing the core area of deficit.

In my experience, it is rare to find sudden dramatic changes that encompass all language areas after a few weeks, or even a few months of Fast ForWord. It appears that although Fast ForWord drives neurological changes in the white matter tracts of the brain, these changes are not evident in a vacuum. They must be supported by behavioral intervention that targets higher-level language processing. In a crux, it just seems like Fast ForWord works best when it is done in conjunction with language therapy that targets mid- and high-level skills.

Filed Under: Attention Deficit Disorder, Auditory Processing Disorder, Language Delay Tagged With: ,

Superflex Superdecks: Product Review

September 11, 2014 By

Superflex SuperdecksAre you having trouble squeezing in time to develop novel therapy materials for your social thinking groups? You’re not alone. With a crazy schedule of both private and public school speech therapists, this new pack of cards is an incredible time-saver.

The Superflex Superdecks are card decks to help your students practice and promote the skills they learned in the Superflex Curriculum. It is important to note that the card decks do not replace the curriculum, but in fact supplement it. I used them after my students were at least familiar with the Unthinkables and the Superflex strategies. So if you’re looking at this set, consider purchasing the Superflex Curriculum and comic books first. The card decks are meant for kids between ages 8-11 years.

The game includes:

  • Unthinkable Card deck which includes 14 Unthinkables (2 each), 6 Superflex Cards, 18 Brain Sensory Cards.
  • Situation Card deck which includes 5 Power Pat cards, 47 situation cards.
  • Strategy Card deck which includes 52 Strategy cards.
  • Thinkables Card deck which includes 14 Thinkables (2 each), 6 Superflex cards, 18 Brain Sensory cards.
  • 5 Step Power Plan Cards (4 copies)
  • Thinkables/ Unthinkables Reference Card (4 copies)
  • An Informational and General Instruction booklet.

Even though I’ve been using the Superflex curriculum for a while now, it was really helpful to look through the Informational and General Instruction booklet. There was a lot of useful information about what’s included and general instructions about using the game.

The reference cards are an excellent visual to review all the Unthinkable and Thinkable characters. I spent a lot of time with these cards before using the card games. A good understanding of these characters is crucial to this program.

The 5 Step Power Plan includes the 5 Power Pals who will help the students review the steps to take in a socially tricky situation. I like the clean visual. I made several copies of this card and will sometimes have the students write or draw what the 5 Power Pals would do in each situation.

The Thinkable cards can be used as a game such as “Put ‘em to Rest.” The object of the game is to identify which Unthinkable is put to rest by the Thinkable. (The answers are on the back of the instruction card). You can build on this by asking your student to come up with a “Thinkable” moment and describe the Thinkable’s superpower.

The Unthinkable cards are used to play the “On the Scene!” game. The object of this game is to describe a time and situation when the Unthinkable character may make an appearance.

The Situation card deck contains various social situations where the Unthinkables appear. The object of the game is to identify which Unthinkable may be at work in that situation. (It might be useful to keep the reference cards for the characters handy for this game.) The situations are realistic and easy to relate to for most school-age students. You can also go on the Social Thinking website (www.socialthinking.com) for a blank template to make up more social situations.

The Strategy card deck contains possible Social Thinking strategies to use when the Unthinkables usually make their appearance. The object of the game is for the student to identify, which Unthinkable can be defeated by the strategy on the card. Since our focus is almost always on thinking of strategies when a situation is presented, I think it is really useful to work in reverse sometimes. It helps solidify the concept.

*Even though you can play the card games by themselves, some of my students prefer to use them with their favorite game (just like you would any flashcard set).

Overall: The Superflex Superdecks is a fun, engaging and motivating game to review and practice the Superflex Curriculum. I love the idea of creating your own Unthinkable characters and situations using the templates on the website. Even though the instructions for the card sets are provided, it is easy to create your own games to make it more exciting for your students. On days when the kids seem particularly lethargic and slow, we used the Unthinkables card set to play treasure hunt. I hide the character cards and the students take turns to find them. They then describe what the Unthinkables do in a social situation and come up with a strategy to cope with them. Really, the possibilities are endless! I definitely think this game is an excellent buy for around $40. You can purchase your set here.

Disclaimer: This item was provided to complete this review. No other forms of compensation were provided. The thoughts and opinions expressed in the review are the author’s.

Filed Under: Social Thinking Tagged With:

A Voice for Amelie Part 2: Ready to Choose

September 7, 2014 By

Amelie began using Speak for Yourself (SfY) independently as long as a single button was open on the screen. She was using it consistently for about two weeks in the therapy room, at home and at school. Despite the enormous success, we knew it was too early to pat ourselves on the back. Having just one button open on the screen while she uses it to make requests wasn’t functional. It was critical that we started opening up the buttons that were familiar so she could discriminate and choose the one she wanted. So during one of her sessions, I tried opening up two buttons (banana and peach). She was familiar with both words. However, the only snack we had was a banana. We didn’t have a peach. We started the session by displaying her snack (banana), and then placing her iPad (now referred to as her “talker”) in front of her. By now, she knew the drill. Like a pro, she hit “eat” which lead her to the secondary page. Now, instead of just one option, there were two. The couple of times she hit “banana” there were no problems. But, when she hit “peach” and I said “Oh, sorry, we don’t have peach today,” there was a meltdown. If she could talk, I know she would be saying, “But I hit the button! What more do you want?!!” After a few episodes, I found myself thinking, “Gosh I wish there was an easier way to do this.” It made me think of an old PECS® training I had attended many years ago. They work on discrimination by pairing a highly desired object with something the child did not care about.

So for the next session, I asked mom to send a food item that Amelie doesn’t like (pickles) along with her favorite snack. So this session I displayed the two snacks and placed her talker in front of her. Once again, hitting “eat” was easy. Again, two options were open on the secondary page: a desired item (banana) and a non-preferred item (pickles). This time, when Amelie hit “pickles” and was presented with pickles, we didn’t have a meltdown. She looked confused. She even tried putting it in her mouth. She spat it out after a few seconds and instead of crying, she reached for her talker again. While this may not seem like a huge deal, to her nanny and I who waited for her outburst with our breaths held, it was an enormous achievement. For the next few trials, every time she hit “pickles,” she shook her head as if to say “no, no, that’s not it,” and then went ahead and hit “banana” instead. Suddenly it seemed that she realized that different buttons meant different words. She understood that because I gave her the pickle when she asked for it. Having her press a button and then say “Oh, I don’t have that,” was too much to process through her frustration. Now that she understands the concept of different buttons for different words, we are seeing a dramatic decrease in tantrums and meltdowns. I can now say, “I’m sorry, there’s no more banana. Would you like grapes instead?” There are no more tantrums. She reaches for her talker and tries again.

Hindsight is always 20/20. I think I should have worked on discrimination earlier than I did. I don’t think Amelie needed the two weeks I gave her to familiarize herself to her talker. Instead of closing all the buttons except the one she was requesting may not have been necessary. In the long run, I don’t think that two weeks is a lot of time lost, but I know that in the future I will push a little harder and move a little faster. While there is the occasional drama when she hits the wrong button sometimes (truthfully, it wouldn’t be Amelie without the drama), the big picture is that she has almost a dozen words on her talker that she can use to make a choice.

Filed Under: Augmentative and Alternative Communication, Expressive Language Disorders Tagged With: , , , ,