Click the initial letter sound in the middle of the page. Click the bubbles to make them disappear and reveal an image. Click the image to hear it's word said out loud. Then decide if the image's initial sound matches the letter on the page. If so, cut & paste the image onto the worksheet.
This can be used either via PowerPoint on an interactive whiteboard as a whole class activity, or, as an individual activity using a QR code app, with iPads or other portable devices.
26 iPad activities for each letter of the alphabet!