Nicole’s Nook: Read, Markup & Share PDFs with iAnnotate

sc552x414iAnnotate is one of my long-standing favorite apps used for reading, annotating and sharing PDFs. Recently Apple has made some fantastic upgrades and changes, which are definitely worth blogging about.

One new streamlining feature to note, is the option to take and import pictures. This feature now allows you to take a picture and import documents directly with the iAnnotate app. This eliminates the need for a second scanning app, which was previously a two-step, often confusing, process.

Other great features include:

  • Annotate and comment on PDFs: using pen, highlighter, typewriter, or pop-up comments
  • Works with many file types: DOC, XLS, PPT, images and web
  • Access and convert files to PDF
  • Several ways to share: share the annotated file, a flattened file, or just send a summary of your annotations.
  • Works on all apple devices
  • Customize your own toolbars

iAnnotate can be a very overwhelminsc552x414-2g app as it offers so many options and features.  However, this can be a very powerful tool, especially for the older student with NF.  Completing worksheets with this app can drastically minimize fine motor demands.  Students can also use the app with study guides or presentations, marking them up and adding their own notes.  The possibilities are endless!

For detailed information on specific functions, and features, please click on the titles below:

Importing Pictures:

  • Select the LIBRARY TAB
  • Select ADD, then IMPORT IMAGE
    • You can choose to take a picture using the camera or select an image from your Camera Roll. (Hint: The app does not allow you to crop the image.  You may want to take the picture in your camera app vs. iAnnotate, so you can use the editing/cropping tools in the photos app.)
  • Once imported, you will need to name the image and then select it. You can now modify the document using a variety of annotation tools.

Creating a Custom Toolbar:

  • Click the + sign at the top right corner
  • Then select ADD TOOLBAR/+ at the top right corner
  • Press the icon you want to use and drag to right side of screen
  • Repeat this for each icon, up to 11 icons per toolbar
  • Toolbars can include multiple colors of same tool (i.e. many colored pencils, colored highlighters)
  • Press DONE when finished
  • Multiple custom toolbars can be created
  • To edit a toolbar (adding or removing tools):
    • Click the box at the right bottom corner
    • Once it expands, select the toolbar you want to edit
    • To remove tools, press icon and drag to left
    • To add tools, select icon and drag to right
  • To remove a toolbar:
    • Click the box at the right bottom corner
    • Once it expands, select the toolbar you want to remove
    • Then press the + sign at the top right corner
    • Select the trashcan icon at the lower right corner
  • Choose from a variety of toolbars
    • Click the box at the right bottom corner to display all toolbars available

Annotation tools available:

  • Caption: creates notes on page
  • Pen/Marker: use finger to write, color editing available
  • Highlighter, underline, & strikeout: works only with text in a document, not a PDF
  • Stamp: choose from a variety of graphics, including your own photos
  • Custom Stamp: create a custom stamp(s) to save time, especially if stamp is used repeatedly
    • Add the icon STAMP WITH A SPECIFIC IMAGE to your toolbar
    • Select graphic or image you would like to designate to that stamp
    • Press DONE
  • Custom Stamp with Signature/Name:
    • For signature, add the Feather icon to your toolbar, press DONE
    • For text name, add the Typewriter icon to your toolbar, press DONE
    • Select Feather, tap on area and sign name, press DONE, OR
    • Select Typewriter, tap on area and type name, press DONE
    • Tap on signature/name until it blinks, in the upper right, press STAMP
    • Enter a Stamp Name and press CHECKMARK
    • Press DONE
    • Now go back and edit toolbar and add a new icon (STAMP WITH A SPECIFIC IMAGE)
    • Find your signature/text and SELECT
    • Press DONE
  • Typewriter: creates text boxes, change font/color
    • Dictate answers, if built-in dictation is available
  • Wrist guard: available for pencil/straight-line, highlight, underline and strikeout annotations
    • Provides an annotation ribbon that allows wrist stability when using select tools and prevents touch screen registration
  • Camera: insert photo or take photo
  • Microphone: record a sound annotation
    • If sharing the annotated version, the recipient will get sound/audio, but only if opened in iAnnotate (sound will not play in any other app)
  • Print or email
    • Send original or flattened version (viewable, but not editable) or annotated version (viewable and editable)
  • Additional sharing options: export to other apps such as Dropbox or Google Drive
    • Must add OPEN IN EXTERNAL APPLICATION icon on toolbar
    • Send “flattened” version so mark ups can be viewed, when exporting to other apps
  • Create folders to help with organization


– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist


Nicole’s Nook: Taking Notes & Recording With AudioNote

Taking notes in class can be challenging and frustrating for many students, especially those with NF1 who may have diminished fine motor skills and struggle with learning and attention deficits. Often times, they are more focused on the motor of writing and typing, versus listening to the content of the material being presented. For some students, they may even rely on another peer, or adult, to take notes for them.

AudioNote (by Luminant Software, Inc.), an app available in both the App Store and Google Play Store, can be used to record lectures, while also taking notes. The lite version is free, but limits each note to 10 minutes and only allows 2 hours of total recorded time. Upgrading to the full version (App Store: $9.99/Google Play Store: $5.99), will allow unlimited recording and sharing options.


During lectures, students can take notes, draw pictures, or insert photos all within the AudioNote app. Each note entry is time stamped for easy locating and playback of specific portions of the lecture. One helpful tip to prevent taking lengthy notes and missing important parts of a lecture is to simply mark an “X”  with a keyword to create a time stamp for future repeat listening and note taking. During playback of the lecture, the notes and drawings associated with each section of the recording are highlighted.

Students can also import PDF notes or outlines into AudioNote, and take notes directly on the PDF while listening to the lecture. This helps students keep all of their notes organized, while also enabling them to keep up during class lectures. Additionally, AudioNote features an audio amplifier for larger conference rooms, so students can utilize the app in all types of classroom environments.

Try the lite version today, and help your child increase his/her productivity and academic independence!

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist

Nicole’s Nook: Apple iPad Accessibility Features


I have long been a champion of using an Apple iPad to facilitate learning.  Apple has some great built-in accessibility features to make reading, typing and navigating the iPad easier and faster. Some of my favorite features are highlighted below:

SPEAK SELECTION: Text to speech; words can be highlighted as they are spoken aloud. This works with built-in apps and also some third party apps.

  • Turn ON
  • Options include selecting dialect, speaking rate and highlighting of words
  • Get out of that screen; open Safari, Notes or Email app
  • Highlight text, select SPEAK and it will read aloud

SPEAK SCREEN: Text to speech; words can be highlighted as they are spoken aloud. This works with built-in apps and some third party apps.

  • Turn Speak Screen ON
  • Now you are able to swipe down with two fingers from the top of the screen to hear the contents of the screen
  • This allows reading of text, names of buttons and other interface elements
  • This is different from SPEAK SELECTION

Speak Selection and Speak Screen are both useful tools, even for those students who are functional readers. Having the option to have both auditory and visual feedback while reading is very powerful and can help with processing, comprehension and learning retention.


  • To EXTRACT JUST THE TEXT of an article, click on the left end of browser (you will see 4 horizontal lines). This is extremely helpful in eliminating extraneous information and other distractions such as advertisements, links to other sites, graphics, etc. It helps to zero in on just the article needed. From here, you can swipe down with two fingers from the top of the screen to utilize the Speak Screen feature.


  • Photos or sketches can be inserted into the NOTES app
  •  Photos or attachments from another source or app can be inserted into the MAIL app
  • When in note or email, double click where you want photo to go.
  • Select INSERT PHOTO and then choose from PHOTO app.


  • When on a desired web page, select (arrow in box) icon on the bottom of the screen. Select ADD TO HOME SCREEN. Name/title the “app” and select ADD. This creates a shortcut to frequently visited websites.

Have some fun and try out these helpful and unique built-in features. To learn more about these and other accessibility features built into iOS, visit

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist

Nicole’s Nook: Chromebooks as a Learning Tool


School has started, and I hope you all are enjoying the start of another school year! Beyond the usual piles of notebooks, binders, pencils and markers, many paperless options are also being recommended to help your child complete school assignments. A lot of schools have opted for Chromebooks and access to Google Docs and Google Classroom for their students and staff.

I will be the first to admit that exploring the Chromebook has been uncharted territory for me. However, this technology is becoming prevalent in so many schools that taking a closer look at its features and options are a necessity.

If you have access to a Chromebook, let me walk you through some of the accessibility features:

Go to the lower right corner and click on the hand icon, Select Accessibility. This can enable:

  • ChromeVox (screen reader, spoken feedback of screen)
  • High contrast mode
  • Screen Magnifier
  • Automatic Clicks (click without using your mouse; clicks when the mouse pointer stops)
  • On­screen keyboard (can be used with a mouse or tapped with touch screen)

To add any of these Accessibility Options, simply click on that option. You can also go to Settings and enable the features you’d like as well as the following:

  • Showing Accessibility options in the system menu
  • Having a large mouse cursor
  • Enabling Sticky keys (this includes holding down the ChromeVox keys)
  • Enabling Tap Dragging (to move objects, tap and drag your finger)

When using Google Docs, there are also some Accessibility options available:


  • Go to TOOLS, select VOICE TYPING (or CTRL/SHIFT/S)

Screen Reader:

  •  CTRL/ALT/Z (reads entire screen)
  • CTRL/ALT/X (reads selection)

This has been a quick introduction to what Chromebooks can offer.  More to come on this new-to-me piece of technology. I wish you all a happy and smooth transition into the new school year!

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist

Nicole’s Nook: GoWorksheet to Enhance Learning

GoWorksheet-Main[1]It’s back to school time and I want to introduce a new productivity app that can benefit many students. Some children with fine motor challenges have trouble with conventional pencil and paper worksheets.  These children can use GoWorksheet to do their schoolwork on an iPad.  This app allows them to focus on the content presented and therefore complete their assignments with less difficulty.

Now, let’s take a look at some of the accessibility features included in the app:

  • Adding word banks – A keyboard pops up when selected and a student can pick from the teacher-created options.  This allows a student to focus on the vocabulary presented.
  • Further, the program allows tapping to fill multiple choice answers rather than filling in bubbles with pencil.  Therefore, this is a major benefit for children who struggle with fine motor challenges.
  • Teachers have the ability to create drag and drop answers which narrows the range of choices and allows students to focus better on the material presented.
  • The program provides audio output that includes more detailed instructions and additional prompting.  This feature is a benefit to students who may do better with audio learning or those who may need extra prompting to stay on task.
  • OCR (optical character recognition) allows text to be read aloud. Parents or teachers can add the text or text can be identified with the built-in OCR feature.  This is another feature that can benefit audio learners allowing them to both see and hear the task at hand allowing them to increase understanding of the material.
  • Some support tips and tricks:
    • This app will likely be most useful to students working in a small group setting or those that have a 1-1 paraprofessional working with them, most likely because of the time and effort it will take to create the worksheets.
    • Once the worksheet is completed, it can be shared via email, AirDrop, Google Drive, Dropbox or other cloud based storage sites.  The worksheet can also be printed or saved to your Camera Roll.

GoWorksheet is available in the iTunes store.  Two versions are available and both are necessary to fully implement this app.  Teachers or parents can use GoWorksheet Maker, which costs $19.99, to create customized worksheets. Students can use the free app, GoWorksheet, to complete the customized worksheet.

For more iPad information, check out my website at

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist

Nicole’s Nook: Journaling with myMemoir

MyMemoirIn this month’s blog, I want to take a look at another one of my favorite apps, myMemoir. Many children start their school day by journaling as part of their morning routine. This very simple journaling app allows them to complete that task on the iPad, thus eliminating some of the fine motor demands.

Let’s take a closer look at what this app can do:

  • Create your own journal. Select “Add Journal” in the upper left-hand corner. You are able to customize the colors and background experience within the app, as well as back your journal up to Dropbox or another file sharing source.
  • When you are ready to make an entry, click on the journal. Then in the upper right-hand corner, click the calendar icon to select the date of your entry and select “Create New Entry”.
  • You will then be prompted to add a photo, which can be anything from your camera roll. Many children want to journal about a photo they took, an experience they had, or even something they have created in another app, such as a doodle or drawing. There are a variety of creative and art apps which allow you to save your finished masterpieces and drop pictures of them in your camera roll. Once you select your photo, you will have the option to move and scale it. Click “Use” once you are finished.
  • You are then ready to start journaling! You can type using the onscreen keyboard or use a Bluetooth wireless keyboard. If you are connected to Wi-Fi, you will also have the option to use dictation via the microphone icon on the bottom left-hand corner of the onscreen keyboard.
  • Once you are finished, you can “Save” your entry by selecting the Arrow in Box icon in the upper left corner. You will also have the option to “Share” as a PDF. Simply scroll to the bottom, and you can either “Email”, “Export” or move to “DropBox”.  If you select “Export”, then select “Open In”.  This will allow you to export to any of your other apps such as Google Drive. For school purposes, this is a great and easy way to submit work!
  • Some support tips and tricks:
    • Utilize the word prediction on the keyboard to speed up typing.
    • To edit your journal entry, highlight the entire entry and select “Speak”. As long as you have Speak Selection” enabled in your settings, this text to speech option will be available. This gives valuable auditory feedback for children trying to proofread and edit.

myMemoir is available at the iTunes Store for $1.99.  For more app recommendations, check out our apps section or view my app page on the St. Louis Children’s Hospital website.

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist


Nicole’s Nook: App Spotlight

In this month’s blog, I am going to continue showcasing my favorite apps and talk about Co:Writer, a great app for word processing and document creation. It has a long history of being utilized as a PC-based program in the schools, but more recently developers have created a Co:Writer app.

Co:Writer has many accessibility features that make this an easy-to-use, productive app for children with NF1. Some of these features include:

  • WordPredictionWord Prediction: this feature increases typing speed and provides spelling support. The amount of words in your “word bank” can be altered in the app settings, and you can select the type of dictionary you want to use. This can vary from a core vocabulary to an advanced one.
  • Text to Speech: this feature allows you to select whether they want every letter, word or sentence spoken. You can also adjust the rate of speech in which it is read. This option is incredibly useful as it provides auditory feedback on what you have written.
  • Text Features: you can adjust the font style or size to meet your visual needs, and provide contrast with white on a black background, if needed.
  • Topic Dictionaries: these dictionaries enable you to put words related to a specific topic in your “word bank.” There are six example topics to choose from, however, when connected online, you also have the option to use a web-scraped topic dictionary, which searches the web for any topic you choose and moves common words associated with that topic into your “word bank.”

To share work completed in Co:Writer, you can:

  • Email the information, however, it does not attach as a document or PDF but appears in the content of the email.
  • Move it to cloud-based sites such as Google Drive or Dropbox.
  • Post it to Twitter.
  • Print the content.

Co:Writer is available within the iTunes Store for $19.99. For more app recommendations, check out our apps section or view my app page on the St. Louis Children’s Hospital website.

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist

Nicole’s Nook: Doing Math on the iPad

The ModMath app enables children to easily do math problems on the iPad.

The ModMath app enables children to easily do math problems on the iPad.

One of the most frequently asked questions I get from parents and teachers is how to do math worksheets on the iPad. While there are some great apps for annotating PDFs and worksheets such as SnapType Pro and iAnnotate, math is a little tricky as it may move right to left versus reading, which is always left to right.

The free app, ModMath, can be very helpful in completing math work on the iPad. While it does not offer every function I would like to see available for completing math worksheets, it can be a useful tool in helping with organization, legibility and sequencing. The app functions much like a virtual graph pad, which is useful in that it allows children to plot out their work in a much more legible and visual platform.

To get started with this app, just follow these steps:

  1. Add a new document. You can name it by the date or other title to make it easy to find and reference.
  2. In your new document, type your equation using the keypad. You will notice the cursor moves left to right, but you can override that by tapping on any cell on the screen.
  3. Many of symbols have additional options so if you tap and hold, contextual menus with options will display.
  4. The flexible line tool draws horizontal lines, but if you tap and drag, it can cover multiple cells for more complex equations.
  5. To share, you can export as a PDF via email or to other apps such as Dropbox, Google Drive. You also have the option to print your work.

For more app recommendations, check out our apps section or view my app page on the St. Louis Children’s Hospital website.

– Nicole Weckherlin, OTR/L, St. Louis Children’s Hospital Occupational Therapist

Nicole’s Nook: Visual Scheduling with Choiceworks

Choiceworks Visual Scheduling App

Choiceworks Visual Scheduling App

Visual scheduling provides some predictability in what can sometimes be an overwhelming and unpredictable world. This is what makes it such an effective tool to help manage behavior and excessive anxiety in children with NF1. Often better processed than auditory input, visual learning utilizes one of the most powerful senses and channels. For many children with NF1, a visual schedule provides necessary structure and a feeling of control over their environment, ultimately increasing compliance with daily tasks and transitions.

As adults, we often make to-do lists and keep a detailed calendar to help us manage our busy lives. A visual schedule for your child is based on that same concept. It can be very specific and break down a task into its individual components, or it can be a simple, broad list of tasks, covering an entire day.

The Choiceworks app ($6.99, iTunes store) provides these customizable schedules, as well as a visual timer and tools for effective management of feelings and emotions. The app features symbols, which most children are familiar with, but if a symbol is not available or appropriate for your child, you can default to your camera or camera roll. You can also record your own voice to be utilized within the app.

One of my favorite features of this app is the ability to create a timer to go along with the tasks on your schedule. For example, a visual timer can be set for each task, giving your child three minutes to brush his/her teeth or eight minutes to get dressed.

Check out the Choiceworks app and see if it might be right for your family!  For more iPad information and app recommendations, check the Family Resources section or St. Louis Children’s Hospital App site.

Written by Nicole Weckherlin, OTR/L

Nicole’s Nook: SnapType Eases Handwriting Struggles

SnapTypeOne of my favorite, easy-to-use, kid friendly apps is SnapType, an app developed by an occupational therapy student. SnapType is free ($3.99 for the Pro version), and it allows you to easily type in answers to complete worksheets on the iPad. You can then print or share the worksheet as a PDF.

To use SnapType:

  • Download and open the app, select NEW DOCUMENT, select CAMERA
  • Take a picture of the worksheet
  • You can crop the photo by selecting the icon mid-center on the bottom of screen
  • Once done, select the CHECKMARK in lower right hand corner
  • It will prompt you to add/name the document (my suggestion is to use name/subject/date to help quickly identify documents)
  • Select ADD
  • Select the document you just named
  • Complete the worksheet by tapping on the screen where you want your answer to be. This will prompt the keyboard to come up. You can then type your answers in. At the top, you can move the guide left or right to adjust the size. You can also change colors by selecting the artist palette icon in the upper left corner. When you are done typing your answer, hit the keyboard icon on the keyboard in the lower right corner and the keyboard will disappear. To continue working on the worksheet, repeat the process and tap the screen where you want to put your next answer. Continue until the worksheet is complete.
  • Once done, you can SAVE it (upper left corner) or you can share it (icon in the upper right corner).
  • Select PDF. Here you have multiple options to print it, email it (it will attach as a PDF) or move it to Google Drive or Dropbox.

A few more tips for using SnapType:

  • When working on the worksheet, you can zoom in to work on just a portion of the page at a time, which will improve attention and is less visually overwhelming.
  • If you want to prepare ahead of time, you can take pictures of multiple worksheets and just save them in your “home” area.
    • You can also organize by folders:
      • Select NEW FOLDER and name
      • Select CREATE
      • To move a document to a folder, select EDIT in upper right corner
      • Select the RED CIRCLE on the left of the document name
      • From here, select MOVE (you can also select RENAME, EDIT or DELETE)
      • Select FOLDER you want to move it to
      • Select MOVE

I highly recommend at least downloading the free version and giving it a try. This app has made quite the difference for many students who struggle with handwriting and productivity in the classroom.

Visit the App Recommendations page for additional information about great classroom and productivity apps for your children, or view additional resources on the St. Louis Children’s Hospital iPad Resource webpage.

Nicole Weckherlin, OTR/L, Occupational Therapist