Speech and language therapy service delivery: overcoming limited provision for children

Automated phonological analysis and treatment target selection using AutoPATT

Automated analyses of speech samples can offer improved accuracy and timesaving advantages that streamline clinical assessment for children with a suspected speech sound disorder. In this paper, we introduce AutoPATT, an automated tool for clinical analysis of speech samples. This free, open-source tool was developed as a plug-in for Phon and follows the procedures of the Phonological Analysis and Treatment Target Selection protocol, including extraction of a phonetic inventory, phonemic inventory with corresponding minimal pairs, and initial consonant cluster inventory. AutoPATT also provides suggestions for complex treatment targets using evidence-based guidelines. Automated analyses and target suggestions were compared to manual analyses of 25 speech samples from children with phonological disorder. Results indicate that AutoPATT inventory analyses are more accurate than manual analyses. However, treatment targets generated by AutoPATT should be viewed as suggestions and not used to substitute necessary clinical judgement in the target selection process.

Treating Children With Speech Sound Disorders: Development of a Tangible Artefact Prototype

BACKGROUND

A prototype of a tangible user interface (TUI) for a fishing game, which is intended to be used by children with speech sound disorders (SSD), speech and language therapists (SLTs), and kindergarten teachers and assistants (KTAs) and parents alike, has been developed and tested.

OBJECTIVE

The aim of this study was to answer the following question: How can TUIs be used as a tool to help in interventions for children with SSD?

METHODS

To obtain feedback and to ensure that the prototype was being developed according to the needs of the identified target users, an exploratory test was prepared and carried out. During this test using an ethnographic approach, an observation grid, a semistructured questionnaire, and interviews were used to gather data. A total of 4 different types of stakeholders (sample size of 10) tested the prototype: 2 SLTs, 2 KTAs, and 6 children.

RESULTS

The analysis of quantitative and qualitative data revealed that the prototype addresses the existing needs of SLTs and KTAs, and it revealed that 5 out of 6 (83%) children enjoyed the activity. Results also revealed a high replay value, with all children saying they would play more.

CONCLUSIONS

Serious games and tangible interaction for learning and problem solving serve both teachers and children, as children enjoy playing, and, through a playful approach, learning is facilitated. A clear pattern was observed: Children enjoyed playing, and numerous valid indicators showed the transposition of the traditional game into the TUI artefact was successful. The game is varied and rich enough to be attractive and fun. There is a clear need and interest in similar objects from SLTs and educators. However, the process should be even more iterative, with a multidisciplinary team, and all end users should be able to participate as co-designers.

Comparing Traditional and Tablet-Based Intervention for Children With Speech Sound Disorders: A Randomized Controlled Trial

Purpose This article reports on the effectiveness of a novel tablet-based approach to phonological intervention and compares it to a traditional tabletop approach, targeting children with phonologically based speech sound disorders (SSD). Method Twenty-two Portuguese children with phonologically based SSD were randomly assigned to 1 of 2 interventions, tabletop or tablet (11 children in each group), and received intervention based on the same activities, with the only difference being the delivery. All children were treated by the same speech-language pathologist over 2 blocks of 6 weekly sessions, for 12 sessions of intervention. Participants were assessed at 3 time points: baseline; pre-intervention, after a 3-month waiting period; and post-intervention. Outcome measures included percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct. A generalization of target sounds was also explored. Results Both tabletop and tablet-based interventions were effective in improving percentage of consonants correct and percentage of phonemes correct scores, with an intervention effect only evident for percentage of vowels correct in the tablet group. Change scores across both interventions were significantly greater after the intervention, compared to baseline, indicating that the change was due to the intervention. High levels of generalization (60% and above for the majority of participants) were obtained across both tabletop and tablet groups. Conclusions The software proved to be as effective as a traditional tabletop approach in treating children with phonologically based SSD. These findings provide new evidence regarding the use of digital materials in improving speech in children with SSD. Supplemental Material https://doi.org/10.23641/asha.9989816.

The Table to Tablet (T2T) Speech and Language Therapy Software Development Roadmap

Background

Few studies have analyzed gains in using computers in speech and language therapy interventions for children with speech and/or language disorders when compared to a control group, but virtual tutors and computer-based visual feedback have been gaining interest in the literature. Previous systematic reviews mainly focused on development technological details of computer-based speech training systems or the potential of integrating mobile technology into education and rehabilitation, but recent systematic reviews have also evaluated the efficacy of computer-based speech and language therapy for children and how digital technology can support different activities, at school or elsewhere.

Objective

This study aimed to analyze a continuous communication and joint team approach to develop solutions focused on the real needs of end users, which digitally emulate reliable and validated physical intervention materials for children with speech sound disorders (SSD).

Methods

The Table to Tablet (T2T) software was developed using a design-based research methodology, which included four phases: activities development; ethnographic pretesting with a sample from the target population; software development; and beta-testing. The technology used to develop the software, the method used to ensure satisfaction and replay ability of the intervention materials, and results from the ethnographic and beta-testing phases are presented.

Results

Nineteen activities were developed during the first phase, which were then tested, with 7 service users, using a physical prototype. The beta-test approach included extensive testing and reformulation, supported by direct, nonparticipant observation and data collection using a questionnaire designed for children. Feedback was used to improve the software and interaction with users.

Conclusions

The use of T2T-based intervention programmes by speech and language therapists (SLTs) will allow these professionals to make a better and more effective communication intervention, based on proven methodologies, that coexists in a structured physical and a digital version. These versions provide a full, 6-week intervention program, with minimal effort in preparing the session by the SLTs while delivering a very consistent intervention, with high replay value. A continuous communication and joint team approach was beneficial to the project and to the development of a solution focused on the real needs of SLTs and children with SSD. All problems were approached as a team with different skills and expertise, which minimized errors (eg, the developer making choices that would save him from spending time doing something that would not be used) and time spent. To add to this, the importance of integrating the end users as testers and collecting their opinions and actions per session allowed the production of better-targeted activities.

Trial Registration

ClinicalTrials.gov NCT02490826; https://clinicaltrials.gov/ct2/show/NCT02490826