We’re back again today with more app reviews! This is post two of three, so be on the look out for one more great review.

The second review is for the app LetterReflex. LetterReflex is available in the iTunes store for Apple devices and sells for $1.99 (at time of posting). 

Today’s reviewer is Christie Kiley, MA, OTR/L, but you probably know her as MamaOT. Her very popular blog is devoted to sharing tips and tricks for those who care for children. Christie is a USC grad and currently works in clinic and school-based settings. She’s also the mom of a toddler boy (and another boy on the way!). Keep up with Christie at www.MamaOT.com or on Facebook, Pinterest, and Twitter.

Christie tested out the LetterReflex app for a few weeks with her clients and here’s what she thinks of it!

AOTA: Briefly describe the LetterReflex app.
Christie: LetterReflex is an app that uses kinesthetic learning to address visual perceptual issues related to commonly reversed letters, numbers, and words. LetterReflex consists of two programs: Tilt It and Flip It. Tilt It contains ten levels and is easier to experience than it is to explain. Basically, it's like a digital version of "Labyrinth", except the focus is on learning and understanding letter orientation. In level one, the user is shown a screen that is divided into four quadrants which correspond to four commonly reversed letters: q, p, d, and b. Letter quadrants relate to which side of  the line each letter's circle is located (left or right), and which part of the line it connects to (top or bottom). Voice prompts encourage users to tilt the device in order to roll the ball toward a particular letter. This teaches them to discriminate between left and right as it relates to the orientation of these commonly reversed letters.

Flip It contains ten levels and is much easier to explain. In level one, the user is shown a target letter and then the screen is filled with variations of that letter (i.e., backward, upside down, or some combination of the two). The goal is to swipe all the letters on the screen up/down/left/right until they match the correct orientation of the target letter. More complex targets are presented as the levels progress.
AOTA: How would you use this app in the clinic?
Christie: I would use LetterReflex as part of a more comprehensive warm-up prior to working on handwriting (specifically letter orientation). 
AOTA: What age group would this app be best for?
Christie: LetterReflex is appropriate for students who have already learned how to form all of their lowercase letters, such as first graders and above. In order to benefit from this app a student must be able to: 1) Cognitively understand how the game works;, 2) Possess the proprioceptive awareness and grading of force necessary to control the movements of the ball when playing Tilt It; 3) Possess the attention span and impulse control necessary to correctly play each game; and 4) Possess the basic ability to read or identify the letters, numbers, and words presented.
AOTA: In what ways would you improve the app?
Christie: I would improve this app in two ways: 1) By allowing users to select a level to start on, rather than forcing more advanced students to always start at level one and 2) By providing a means of repeating instructions in the levels where the voice prompt provides a 2-step instruction. (Sometimes it takes so long to get the ball into the first letter that the student then forgets the second one, or they simply weren't paying attention when the initial instructions were presented.)
AOTA: Would you recommend that occupational therapy practitioners spend the $1.99 to buy the app?
Christie: If you want to have a quick tool in your "back pocket" for practicing visual perceptual skills then, yes, I'd recommend it. If you purchase the app for $1.99 and then decide you like it and want to use it with more students, I'd recommend purchasing the additional $3.99 upgrade in order to be able to save each user's data. This will allow you to better track their progress and save their work so they do not have to always start on level one if you don't want them to.
AOTA: Did you test the app with any clients or children? If so, how did they react to the app?
Christie: Yes, I tested this app with children in both the clinic- and school-based settings over the course of several sessions,with diagnoses ranging from Autism to Specific Learning Disability to Visual Motor Impairment. As mentioned previously, this app is very difficult to explain, especially the Tilt It game. I found that most students became confused when I tried to explain Tilt It to them and they were the least confused when I first demonstrated it to them and then handed it over for them to try. The majority of students who tried this game enjoyed playing it at first but then became bored or frustrated and asked if they could be finished with it after a few levels.
AOTA: Will you continue using the app? Why or why not?
Christie: I will continue to keep this app in my "back pocket" so I can use it as the need arises. Though it is not my go-to resource for working on visual perceptual skills and letter orientation, I do feel it is useful as part of a comprehensive, big picture approach to OT treatment.   
AOTA: If you are currently using apps in the clinic, what is your favorite app?
Christie: I enjoy using many apps in the clinic- and school-based settings but my favorite one is currently a pre-writing app called "Ready to Print." It takes users through the developmental progression of pre-writing skills from pointing to matching shapes to following mazes to forming pre-writing strokes and more. I love it!

Get more information about Dexteria here. Also, look for one more great reviews from your colleaguecoming soon!

Disclaimer: AOTA was provided with a promotional code to download this app. AOTA is not endorsing the app.