Missing Letters

The third exercise in our Writing category is Fill in Letters by Hand. If this looks familiar, you are not seeing double. This task is an extension of Copy Words by Hand where patients copy complete words they see on screen.

This exercise supports writing and reading skills on multiple levels. Alongside the motor skills needed for writing and sound–letter correspondence, patients strengthen visual word recognition, technical reading, and language-based reasoning, all in one engaging and simple task.

When you launch Fill in Letters by Hand, you see a word that is missing a letter. Below the word, there is an empty box. Instruct your patient to write either the missing letter or the whole word into the box using their finger or a stylus pen. I often encourage patients to write the whole word and read it aloud to me as well. The more work and opportunities to interact, the better, right!?

As you move through the words, you will notice that some are trickier than others. Patients may need more support for certain words (P_LARBEA_) compared to others (_IGER). Get creative with your cues to find a style that works best:

• Show the whole word on paper, identify the missing letters together (then hide the word)

• Say the word aloud or sound it out so they can match the sounds to letters

• Offer a visual cue with three letters to choose from

The flexibility of SanapsisPro makes it easy to mix and match these ideas. You can even skip or redo tasks with a simple swipe. You are in control.

The difficulty level of the task can be fine-tuned with categories. Selecting words from just one category adds a semantic priming effect that makes the task easier. For example, figuring out that (P_LARBEA_) needs an O and an R is much easier if you know you are looking for an animal, especially if you have just worked on GIRAF_E, Z_BRA, and BEA_. These categories align with many other exercises, giving you fresh ways to use the same material across different tasks.

You can also experiment with different colors to write with. Switching to blue or bright yellow can sometimes make a big difference, especially if the patient is working with visual limitations or deficits.

As in the other writing exercises, I am quite sure nobody minds if you decide to invite patients to write the word on paper with a traditional pen as well! After all, the end goal is to be work outside the app, right?

We hope you enjoy working with Fill in Letters by Hand, and would love to hear your thoughts on the task.

Fun fact of the day: Sometimes I like to reward my patients by drawing a picture of the animal or object in question while they work on their writing, so we can compare who did better. They usually win.

The Logical Next Step in Writing

In our last post about SanapsisPro Writing category updates, we looked at Copy Letters by Hand. Today’s exercise provides a logical next step and a natural progression once the patient feels comfortable tracing individual letters. Let's take a look at Copy Words by Hand.

On screen, a word is shown above an empty box. The patient uses their finger or a stylus pen to copy the entire word into the box. The eraser tool makes it easy to start over, so multiple attempts are always possible.

This task combines visual recognition with motor execution. It can be used to retrain the physical movements required for handwriting while also reinforcing spelling patterns. For some patients, it is additionally a useful tool to address perseveration tendencies, since the word to be copied remains visible at all times for easy checking and self-correction.

In addition to writing, SanapsisPro gives you the flexibility to turn this task into a simple drawing activity. You can even make it interactive by taking turns drawing the objects that appear on screen. This can be a great addition for word retrieval and semantic processing.

The settings open up a range of categories. These categories are filled with a wide variety of everyday words: Animals, Tools, Food, Home, Garden, and Transport. Switch these categories on or off to control the topic of the task. Selecting just one category restricts words to that topic, while combining two or more categories mixes them together. It’s an easy way to tailor the exercise from focused to varied.

Beyond variety, categories add therapeutic depth. Keeping one category active reinforces semantic priming. Using two categories invites a sorting task (for example: does this word belong to Home or Transport?). For an extra challenge, turn on all categories and ask the patient to sort the words into categories as they copy the word (e.g., “dog → animal”).

You may recognize these categories from other SanapsisPro exercises such as Fill in Letters by Hand, Copy Words Using the Keyboard, Naming (Nouns), Word and Picture, and Repetitive Naming (Pictures). This shared structure helps build connections across tasks and keeps therapy both engaging and effective.

The Importance of User Feedback

Let’s turn our attention to Sanapsis+ for a moment. This is the app designed for patients to practice their language skills independently.

The Breaking News: Sanapsis+ has been improved, thanks to our wonderful users!

The latest updates are now live in both the App Store and Google Play. This release includes general stability improvements, and more importantly: no more overlapping audio if you tap the image rapidly multiple times, and no more freezing for the recording function on the Naming exercise!

Spotlight on the Naming Exercise

I will take a quick moment to walk you through the Naming exercise here, as many of you might have experienced some frustration using it lately.

Today I selected Verbs as my category. It is a hot day today, so showcasing the verb DRINK felt appropriate. That water looks mighty refreshing!

The goal is straightforward: Name the word the image represents and say it out loud. In my example, I would aim to say “drink.”

1. Record your response.

- Tap the red microphone button to start recording (it will display “recording”).

- Speak at your own pace; the feature is intentionally slow to give you plenty of time.

- The recording stops automatically and the Play button turns white

2. Listen to your voice

- Tap the Play button to listen to the recording of your voice.

You can record the word and listen to the recording as many times as you like.

Need a little support?

If you need a little boost, you have several options:

- Tap the big image to hear the word.

- The green button with letters spells out the word letter by letter.

- The green speaker button plays a phonetic clue (like “dr...”) to get you started.

Note that there is no feedback on how you did. Sanapsis+ is a tool for you to evaluate and improve your spontaneous speech – not just talk to get a “green light” from a device. This is a good tool to take a moment and reflect. What did that sound like? How can I improve? And if that was perfect, how will I celebrate the success?

Thank You, Users!

We are so grateful for everyone who reports bugs, shares feedback, or simply lets us know they are using the app. We love to reach out and ask: How can we improve your experience?

We are here for you and because of you. Every update is designed to support your rehabilitation journey. Thank you for supporting us in this mission!

Update for the Writing category is live

Head over to the App Store to explore new content and enjoy an improved user experience in exercises:

• Copy Letters by Hand

• Copy Words by Hand

• Copy Words Using the Keyboard

• Fill in Letters by Hand

• Fill in the Blank

• Write a Sentence

• Synopsis

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We’re sharing a series of short spotlights on each exercise in this category over the coming weeks, practical tips and clinical applications included. Let’s go!

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Spotlight on Copy Letters by Hand

To kick things off, let’s take a closer look at Copy Letters by Hand. In this exercise, the patient uses either their finger or a stylus pen to copy a letter displayed on the screen into a box shown next to it.
The settings allow for multiple adjustments. 👉

For this task, a key option is Show background image. When you select  Show  the white box contains a dark gray outline of the target letter for tracing (see image with letter A). When you select  Hide, the box stays completely empty, inviting the patient to complete the letter independently (see image with letter B).

When you choose  Fading, (see video with letter N) the outline is gradually faded with each task, helping the patient build confidence and progress toward independent writing.

This exercise is a gentle way to work up to using pen and paper when a familiar task has become a new skill to learn.

It’s especially helpful for patients who need to strengthen motor skills in their dominant hand or adapt to using their non-dominant hand after a stroke.

NB. An occupational therapist can be a valuable partner in developing motor skills needed for writing, and many skills practiced in occupational therapy can also be reinforced in speech therapy. Collaboration is key!

This exercise also benefits patients with cognitive challenges, offering a clear, simple way to practice goal-directed work and cooperation. You can also add an element of interaction by taking turns to complete the tasks. Since SanapsisPro does not provide automatic feedback, the goals and success criteria can be set individually to suit every patient.

Thank you stopping by my blog and stay tuned! We will soon walk you through the next updated exercise in SanapsisPro Writing category.