Friday, March 27, 2020

Corona Virus Resources

Hey Tek-ninjas, the folks at Tobii Dynavox are providing various communication resources and supports during this unprecedented time. Here are a few places to check for the most up-to-date offerings:

What you can expect to find on the links above: 

Home Learning for Educators, Parents and Students

Tons of FREE resources are available to promote learning at home including Boardmaker Activities-to-Go, 10 units of ready-made activities that include books, games, communication boards, behavior supports, and more. If you are an educator, and find yourself all of a sudden providing remote education, this site here, might be helpful.

Hospital Intensive Care Unit Communication Resources

Printable communication pages to support caregiver to patient communications in a hospital environment. Available in English (US,UK), Finnish, French, German, Italian, Norwegian, Spanish, Swedish, and more. Printable is ideal, because after use, throwing them out costs little.

Coronavirus Teaching and Communication Resources

A set of activities and resources to support students in learning and communicating about the Coronavirus. Available in English (US,UK), German, Spanish, Swedish, and more.

How to Import the Coronavirus Page Topic into Snap Core First

Learn how you can import the new Coronavirus Topic Page into the Snap Core First app.
Watch now.  Don’t have Snap Core First? Not a problem – download it today for a 60-day FREE trial.

Pathways for Clinicians and Families

Not familiar with Pathways? It is your FREE companion app to Snap Core First and is ideal for those looking for expert guidance and best practices for engaging users.

Clinicians: Watch how to use the Goals Grid to remain focused and organized while supporting your AAC clients.

Families: Watch how to use the Top Tips section in Pathways to effectively implement Snap Core First with your family.

Wash those hands!!

Wednesday, March 25, 2020

Snap Core First and SAPI Voices

Hey Tek-ninjas! Did you know Snap Core First has the capacity to import banked voice files? This is pretty exciting for individuals who’ve taken the time to store their voice prior to it’s loss.

Most, if not all voice banking services provide the user with an install file. The video below demonstrates the loading and installation of a CereVoice file. It’s quick, and easy.

And now, users can choose between Communicator 5 or the newer Text-Based Pageset in Snap Core First, which I blogged about in January.

Clean those hands!!

Remote services, FAPE, and free resources

Hey Tek-ninjas! Monday, in North Carolina, Governor Cooper announced that schools are officially closed for "in-person" education.

Cooper did not specify when or how students will resume "not-in-person" education, but the notion of remote education raises a number of questions for me. If FAPE is now manifesting as remote, homebound instruction:

  1. will NCDPI provide a computer for families who don't have one? 
  2. will NCDPI provide internet for families who don't have access?

Some school districts have long been working towards some type of 1:1 computer/student ratio. I imagine laptop sales may spike in the next few weeks.

The question of wifi still exists. A clinician emailed me some helpful links this morning, which may be beneficial for folks you serve, both for education purposes, as well as delivering tele-health. For qualifying families, Spectrum is offering free access to high-speed Internet service.

  • 30 Mbps Internet speed (wireless speeds may vary) 
  • Free Internet Modem 
  • Free Security Suite 
  • No Data Caps 
  • Parental Controls 
  • No Contracts

In addition, even if you don't qualify for the program above, citing COVID-19, Spectrum is offering special discounts to households affected by this virus. Beginning Monday, March 16, they will offer two free months of internet and WiFi services to new customers in households with Pre-K to 12 or college students who need remote education. This discount will be applied as a credit for your first two months of internet services. They state that they will waive any installation or pre-payment fees to help get you started. 

Spectrum is not national, but certainly covers a lot of states. These may be solid resources for your clients. I cannot speak to how long these programs will be available, or what happens when the program ends, so investigate wisely. They do note in the fine grey print:  "Equipment, activation and installation fees may apply. Services not available in all areas. Restrictions apply."  Still. Might be a boon to some families. 

If you live somewhere that a internet provider is offering similar access please let me know in the comments. 

Clean your hands! 

Tuesday, March 24, 2020

FAQ on Telehealth

Hey Tek-ninjas, this information comes from the source... hopefully it will be useful to some of you navigating the world of Telehealth. 


Medicare has not extended telepractice to audiologists, SLPs, or physical and occupational therapists, despite the publicity regarding alleviation of penalties regarding noncompliance with telepractice requirements. However, Medicare has expanded use of e-visit G-codes—which are not considered telepractice—to more providers in an effort to ease access issues.

The e-visit codes describe specific online communications that require a clinical decision and must meet specific criteria for appropriate billing.
The Medicare G-codes for e-visits are G2061-G2063 and include very specific parameters to determine whether an e-visit can be included on a Medicare Part B (outpatient) claim for payment.
  • G2061: Qualified non-physician healthcare professional online assessment and management, for an established patient, for up to seven days, cumulative time during the 7 days; 5–10 minutes
  • G2062: Qualified non-physician healthcare professional online assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 11–20 minutes 
  • G2063: Qualified non-physician qualified healthcare professional assessment and management service, for an established patient, for up to seven days, cumulative time during the 7 days; 21 or more minutes 

To correctly report G2061-G2063, the online assessment and management services must be:
  • initiated by an established/existing patient,
  • conducted through a patient portal
  • medically necessary (requires clinical decision-making and is not for administrative or scheduling purposes), and 
  • documented and stored to reflect the clinical decision-making and amount of cumulative time spent providing e-visit services to each patient. 
Clinicians may report an e-visit code only once per seven consecutive days.


Each State Medicaid program is issuing guidance on their decision to allow telehealth. For example, Ohio Medicaid recently release an update to their Administrative rule that allows telehealth to SLPs. If a state allows this, the following billing codes are applicable –

Commercial Insurance

Commercial Insurance Plans typically follow suit with Medicare (CMS). We continue to monitor each commercial insurance plan as they publish guidance and will keep you updated when the information is applicable.

HIPAA Guidance for Telehealth

The Office for Civil Rights (OCR) at the Department of Health and Human Services (HHS) is responsible for enforcing certain regulations issued under the Health Insurance Portability and Accountability Act of 1996 (HIPAA), as amended by the Health Information Technology for Economic and Clinical Health (HITECH) Act, to protect the privacy and security of protected health information, namely the HIPAA Privacy, Security and Breach Notification Rules (the HIPAA Rules).
  • During the COVID-19 national emergency, which also constitutes a nationwide public health emergency, covered health care providers subject to the HIPAA Rules may seek to communicate with patients, and provide telehealth services, through remote communications technologies. Some of these technologies, and the manner in which they are used by HIPAA covered health care providers, may not fully comply with the requirements of the HIPAA Rules.
  • OCR will exercise its enforcement discretion and will not impose penalties for noncompliance with the regulatory requirements under the HIPAA Rules against covered health care providers in connection with the good faith provision of telehealth during the COVID-19 nationwide public health emergency. This notification is effective immediately. 
  • A covered health care provider that wants to use audio or video communication technology to provide telehealth to patients during the COVID-19 nationwide public health emergency can use any non-public facing remote communication product that is available to communicate with patients. 
  • OCR is exercising its enforcement discretion to not impose penalties for noncompliance with the HIPAA Rules in connection with the good faith provision of telehealth using such non-public facing audio or video communication products during the COVID-19 nationwide public health emergency. 
  • This exercise of discretion applies to telehealth provided for any reason, regardless of whether the telehealth service is related to the diagnosis and treatment of health conditions related to COVID-19. 
  • For example, a covered health care provider in the exercise of their professional judgement may request to examine a patient exhibiting COVID- 19 symptoms, using a video chat application connecting the provider’s or patient’s phone or desktop computer in order to assess a greater number of patients while limiting the risk of infection of other persons who would be exposed from an in-person consultation. Likewise, a covered health care provider may provide similar telehealth services in the exercise of their professional judgment to assess or treat any other medical condition, even if not related to COVID-19, such as a sprained ankle, dental consultation or psychological evaluation, or other conditions. Under this Notice, covered health care providers may use popular applications that allow for video chats, including Apple FaceTime, Facebook Messenger video chat, Google Hangouts video, or Skype, to provide telehealth without risk that OCR might seek to impose a penalty for noncompliance with the HIPAA Rules related to the good faith provision of telehealth during the COVID-19 nationwide public health emergency. Providers are encouraged to notify patients that these third-party applications potentially introduce privacy risks, and providers should enable all available encryption and privacy modes when using such applications. 
  • Under this Notice, however, Facebook Live, Twitch, TikTok, and similar video communication applications are public facing, and should not be used in the provision of telehealth by covered health care providers. 
  • Covered health care providers that seek additional privacy protections for telehealth while using video communication products should provide such services through technology vendors that are HIPAA compliant and will enter into HIPAA business associate agreements (BAAs) in connection with the provision of their video communication products. The list below includes some vendors that represent that they provide HIPAA-compliant video communication products and that they will enter into a HIPAA BAA. 
    • Skype for Business / Microsoft Teams 
    • Updox 
    • VSee 
    • Zoom for Healthcare 
    • Google G Suite Hangouts Meet
Clean those hands!! 

Monday, March 23, 2020

Printing Pagesets made easy!

Hey Tek-ninjas, so here's some good news... if you use Snap Core First, you can now print directly from within the app. And, it's super easy. 

In order for this new function to work, be sure to run the update today. Take a look at the video below.

Happy therapy!!

Sunday, March 22, 2020

Blog referral...

Hey Tek-ninjas, good morning! I was planning on writing a “how-to” for the pragmatics of tele-Therapy... 

Then I read this brilliant blog post at, and thought, why try to write this again. This post is really solid, discussing “how to” and “what to” do.

So, if you are interested in learning about tele-Therapy, check out this excellent and thorough article by Holly Rosensweig of Spiffy Speech and SLP, Lucy Stone of The Speech Express.

Happy therapy!

Thursday, March 19, 2020

Eating of crow...

Hey Tek-ninjas... it looks like I jumped the gun, based on early information.  I’m sorry to report the following clarification on Telehealth for SLP.

Therapy cannot be provided within the e-visit structure and SLPs aren’t allowed telehealth yet.

The billing codes G2061-G2063 are for check ins, quick portal chats, etc. They can bill for an entire week’s worth of time in one code.

I apologize for sharing inaccurate information. My source (who is generally spot-on accurate) indicates there was a mis-read that it was applicable to SLP for full therapy services.

As I receive more information, I will pass it along!

Wednesday, March 18, 2020

Tobii-Dynavox Commitment

Hey Tek-ninjas! So this came in my email today, and I thought I’d pass it forward. The following came from Tobii Dynavox:

Our commitment to you

Along with the rest of the world, we have been monitoring the spread of the Coronavirus (COVID-19). To do our part in stopping the spread of COVID-19, many of our employees are working remotely from home. However, we want to assure you that Tobii Dynavox remains fully operational.

As our customers are our #1 priority, know that we are here and available to you. Below are a few different ways to reach us:

Customer Service

Phone:1-800-344-1778 ext. 3

Tech Support
1-800-344-1778 ext. 1

E-Funding: Complete funding packets online

Additionally, our Tobii Dynavox Solutions Consultants are available. To contact your local consultant, please click here.

As the Coronavirus situation continues to unfold, we will keep you updated with important information from Tobii Dynavox.

Coronavirus Communication Support Materials

To help educators, parents, and learners during this time of need, the Tobii Dynavox team has created and gathered free Coronavirus support materials.

Snap Core First
A symbol-based communication app custom designed for AAC.
60-day free trial - Download for iOS
Download for Windows

Coronavirus Topic Pages - Download now

A free Snap Core First® companion app that provides communication partners with guidance and resources for engaging AAC users.
Download now

Boardmaker Online
Access PCS® for over 40,000 words, including Coronavirus, and behavior support templates, such as daily schedules and behavior supports.
30-day free trial - Download now

Boardmaker Activities-to-Go
Free, ready-made activities - includes games, communication boards, behavior supports, and more.
Download now

So, anyway... I hope you are all staying healthy and engaged in meaningful occupations! 

Saturday, March 14, 2020

Virtual Learning for students with significant disabilities

Hey Tek-ninjas! If you live in Virginia and you are interested in assistive technology or education, likely you've heard of Old Dominion University's Training & Technical Assistance Center, aka: T-TAC.

If not, let's correct this now!

T-TAC "is part of a statewide network of assistance centers that are designed to improve educational opportunities and contribute to the success of children and youth with disabilities (birth-22 years)". T-TAC provides training and technical assistance to educators and therapists to generate improved educational opportunities for children with developmental delays in Virginia. They do good work!

Yesterday I received an email with some really great resources to facilitate Virtual Learning for students with significant disabilities. Virginia, like many states has closed schools state wide for several weeks. 

I thought it might be useful to share these resources here. If you read this, and have other suggestions, please don't hesitate to add them to the comments section below. 

· Looking for leveled reading? Try these free resources for teachers:
· Epic!
· Newsela

· Are you using Tar Heel Reader? Need a tip for how to share selected books with your students? Create a favorites list of the books you want your students to read. Open the favorites page. Copy the link and share with students and families.

· For switch access training (students can use a switch, space bar, and/or mouse click), try these free resources:
· Priory Woods
· Helpkidzlearn (free games)
· Shiny Learning

· Online Academic Activities

· ​Sheppard Software
· CK12
· Freckle
· Brain Pop
· Mystery Science
· ABCya

· Digital Books:
· Storyline Online
· Special Bites for YouTube Videos (gives switch access)

· Remember, learning can come in many forms. Take advantage of everyday activities and opportunities:
· Read to kids
· Take a walk and talk about nature, shapes, count items, sounds, etc.
· Work on social skills during play
· Let children help write grocery lists, to do list for the day, etc.

For additional resources and information, please check out the Focus Areas pages on the T-TAC ODU website. You can also access their previous newsletter articles and other publications.

Wash your hands, and happy therapy!!

Friday, March 13, 2020

Maybe it's just sinusitis, and useful tools

Hey Tek-ninjas! These are disconcerting times in the face of Covid-19. I hope you are all staying well.

Today my wife went to the physician after a week of feeling poorly. She had been reluctant, concerned she had the Corona Virus, and might be hauled off to some undisclosed quarantine location. She was diagnosed with a severe case of Sinusitis (and I did NOT take the opportunity to say 'told you so'). So, take care of yourselves, and don't assume the worst. 

In the meantime, I received an email from Tobii Dynavox with some excellent resources for some of your end-users.

PCS – Coronavirus symbols have been created and released in Boardmaker Online. The English
version is being integrated into Snap Core First today and localized versions for our standard languages will be completed soon. 

Snap Core First - The US English Coronavirus Topic Pages for Snap Core First are posted on myTobiiDynavox Pageset Central and titled “Coronavirus Topic Pages for Snap Core First.”  If someone does not currently have Snap Core First, they can trial the lite version by downloading it at no cost here. Localized versions are being created for our standard languages with Spanish, German, Norwegian and Swedish coming very soon.

Boardmaker Behavior Support Templates – Since schedules and routines are unusual, these tools and PCS can be used to create a more personalized approach to managing an individual’s behavior. These  boards can be found here, and shared within the Boardmaker Community, other channels and localized.

Boardmaker Activites-to-Go – Anyone is able to download these free, ready-made activities and supports for students who need to be homeschooled. They are available in US and UK English here.

Wash your hands, and happy therapy!! 

Thursday, March 12, 2020

Upcoming Workshop in Fayetteville, NC

Hey Tek-ninjas! I've got another North Carolina learning opportunity for you! The folks at Therapy Innovations are hosting Lisa Geary and myself for a workshop titled "Communicating Beyond Requesting", Thursday, April 30, 2020. 

Where do you typically start when introducing augmentative and alternative communication (AAC)? If you are like most people, you probably start with activities that involve an individual requesting a motivating object or action. But what happens next? What happens when we run out of things to request? This session, will explore key areas to go beyond requesting including vocabulary selection, goal writing, intervention strategies and communication partner tips.

This course will be offered for 0.5 ASHA CEUs (Introductory level, Professional Area).

Date & Time: Thursday, April 30, 2020 09:00 AM - 03:30 PM ET

Location: Therapy Innovations 4140 Ramsey Street Suite 111, Fayetteville, North Carolina 28311, United States

Cost: Free of Charge

Currently, there are 10 open seats. These seats will fill up quickly!!

Our presenter Lisa M. Geary, M.S., CCC-SLP has over 25 years’ experience in speech-language therapy, teaching, and supervision. She previously served as Clinical Assistant Professor in a university setting where she taught clinical and didactic courses including the graduate augmentative and alternative communication (AAC) class. Lisa also worked for many years in the public school, private practice, and outpatient rehabilitation settings. Lisa is currently a member of the Tobii Dynavox Learning Team where she develops and conducts trainings for professionals and customers.

Basically, she's a rock star. 

If you are interested, you can learn more here


Monday, March 9, 2020

Last call...

Hey Tek-Ninja’s! This is just a quick update, my buddy Todd’s Core Tour in the Maryland area is filling up rapidly! As of this morning, there are only seven seats left.

If you are in the area I cannot emphasize what a great learning event this will be covering AAC and Literacy. Clinicians who attended our event in Chapel Hill are still raving about what they learned and how it has positively impacted there therapy!

If you are interested, get registered ASAP!

Wednesday, March 4, 2020

Switch Scanning Made Easier!

Hey Tek-ninjas, today I want to share a new resource that I am excited about. Many folks struggle with the variables of, and teaching of Switch Scanning as an access mode. Recently Tobii Dynavox rolled out a Core First Scanning Page Set Implementation Guide which is available for free. By design it focuses on scanning in Snap Core First, but as usual, many aspects generalize to other tools.

This is timely, as the company also recently rolled out significant upgrades to the scanning options for the software. If you've not taken a look, I suggest you do so.

If you don't have a copy of Snap Core First, a free "editing" version can be downloaded here. There is also a Professional version available for speech therapists, occupational therapists, and other professionals working with AAC users, which you can read about here. The software by itself retails for only $49.95.

The guide is a digital file, which you can save on any computer or print out. The contents include a thorough introduction to scanning, scan types and patterns, and switch positions. There is also a review of switches and accessories. The guide covers teaching scanning, both within a page and between pages. A section covers auditory scanning, and another looks at modeling and training. Snap Core First allows users to edit a scan group, modify scan settings, and both functions are clearly covered in the guide. Finally, the guide offers troubleshooting, resources, and even references.

Clear, articulate, free, and evidence based. What more could you ask for.

If you have further questions about the software, reach out to your Tobii Dynavox Solution Consultant.

Happy therapy!

Tuesday, March 3, 2020

Attaching the AAC Device to a Wheelchair

Hey Tek-ninjas! In this post I want to talk about wheelchair mounting. This is often the bane of many speech therapists. A colleague from a large mounting company made the observation in regards to slps and mounts, that "those drawn to language, may not necessarily be drawn to building". Essentially, assembling a chair mount to a chair is like building with an Erector Set from my childhood.

So not everyone is drawn towards building, and your friendly neighborhood Physical Therapist or Occupational Therapist may be out of the picture, or have limited mounting experience themselves. None-the-less, wheelchair mounting is also a key factor supporting your end-users being able to consistently access their equipment, no matter their access modality. Unfortunately, there really is not an "industry standard" among wheelchair manufacturers for attaching AAC devices.

Often I sell the same chair mount, but there is an attachment piece necessary to join the mount to the chair. And those parts vary significantly. 

Regardless of which AAC vendor you are working with, your Sales Rep should be able to help you, but will be better able to do so with some specific information.

If the Rep has not been involved in choosing/selecting the appropriate device (because you are such a comfortable veteran AAC therapist) you will need to tell them what device your client wants, and what the access methods are.

Some wheelchair manufacturers are pretty cut and dry when it comes to recommending attachment parts. For example Permobil and Quickie Power Chairs have a version of channel nuts. Once I hear we are mounting to those chairs, I really don't need much other information or photos. Other manufacturers might require a 1 inch tube (side clamp, or tube clamp) and other manufacturers require different dimensions.

Photo Angles
The Rep may need pictures of the chair. I cannot tell you how many times I've asked for a picture, and received a lovely picture of a smiling child or adult suitable for a holiday card, but offering no insight regarding the chair! So, take a look at the "Photo Angles" picture to see what your Rep is likely looking for. Smiling pictures of your clients are always welcome, but not always helpful in this situation.

Other considerations may include: does the end-user have a lap tray? Is there a preference for which side the mount is on? This can be dictated by pre-existing equipment on the chair (ie: joy-stick). Or maybe a caregiver needs to do chair transfers to one side due to their own health/medical issues.

I hope this post facilitates acquiring the correct mount for your clients.

Happy therapy!

Monday, March 2, 2020

Bragging rights...

Hey Tek-ninjas!

So, last Thursday I hosted a Tobii Dynavox Core Tour event in my home town, Chapel Hill. I have to say, it exceeded my expectations. And I know... I'm a Tobii Dynavox "fan-boy", but the feed back on-site was wonderful, and then, several clinicians emailed me the following day to say the following...

"I am an SLP who attended the seminar in Chapel Hill yesterday. I learned so much - thank you!"

"Thank you for bringing the Core Tour to Chapel Hill. The course was very helpful and I’m excited about “playing” with the system and the app to become more familiar with it."

"I learned so much and thoroughly enjoyed the experience... and really appreciate the opportunity yesterday."

"I loved the workshop!"

I'm sharing this, well, partly to say, we rock... but also to suggest that you to find a Core Tour or an Implementation Workshop in your neighborhood. If it's a few hours away, get some colleagues you like and drive there.

Follow this link for a listing of current on location training sites all over the world.

If you still can't find a seminar, reach out to your Solution Consultant and ask them to help. Chances are, they have one in the works!

You will not regret it.