Children with speech impairment need the help of speech therapists to teach them how to correct their speech sound errors. During speech practice, children are given specific feedback on their performance (e.g. how the lips/tongue should be moving). The feedback can be (i) verbal prompts – “Put your tongue behind” (ii) visual prompts – using mouth puppets to model the movement (iii) touch prompts – using tools like tongue depressors to highlight the correct position. Prompts that work for the child are then taught to the caregivers for them to use during home practice. For therapy success, the child has to be given multiple practice opportunities and accurate feedback on their practice beyond clinic settings. However, it is often hard to achieve regular, consistent, and accurate home practice.
Parents are the child’s main partners for home practice. However, working parents often report difficulty in finding time to practise with their child. Hence, there is a need to tap on the other available stakeholders of the child (e.g. school teachers, allied educators, student care teachers, tutors) to help with the practice beyond clinic settings. There is a lack of suitable home practice resources that are motivating and tailored to our local context. Traditional speech practice materials take the form of worksheets or photo cards and these are often not engaging enough. These materials, and other online speech therapy apps, often contain targets (e.g. words, sentences, pictures) that are unfamiliar to our local speakers as they are developed by overseas publishers. Very often, we face great limitations in how we teach the prompts to both the child and their caregivers. Some families find it difficult to remember/understand the prompts taught in the speech therapy sessions while replicating some of the prompts at home is not possible (e.g. unable to give out mouth puppets to each child to bring home). Without accurate feedback on the child’s practice, consistently wrong practice beyond clinic setting will ensue. This in turn generates unnecessary cost for both the speech therapist and the patient as additional therapy sessions are needed to correct these unintended mis-learnt pronunciation errors.
Our solution is an interactive app that will involve all the child’s stakeholders to share in the home practice responsibility as: (1) it will be readily downloadable, and (2) it will serve as a common platform where the speech therapist, parents, and other stakeholders can communicate and update each other on the child’s difficulties, therapy progress, and the focus of home practice. The app will increase motivation for home practice as it will be in the format of fun and interactive competitive games with multiple levels of difficulty. The app will also be adapted to our local context through our carefully selected targets. The app can bridge this gap with the multi-modal feedback features built in: e.g. verbal and written reminders for correct positions/movements as well as an interactive 3D mouth model to allow visualisation of the lips/tongue movements during sound production. Tapping on available technology, the app can also rate the accuracy of the child’s pronunciation – for example, by exploring the use of acoustic analysis or visual tracking functions, to record and compare the practice performance for subsequent review – and if the child’s weekly average performance falls below a stipulated level, the speech therapist is notified so that appropriate intervention can be done in a timelier manner. In the long run, this would allow maximisation of limited resources to achieve effective clinical outcomes.