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

Luis Mt Jesus, Joaquim Santos, Joana Martinez, Luis Mt Jesus, Joaquim Santos, Joana Martinez

Abstract

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://ichgcp.net/clinical-trials-registry/NCT02490826.

Keywords: children; design-based research; software; speech sound disorders; tablets.

Conflict of interest statement

Conflicts of Interest: None declared.

©Luis MT Jesus, Joaquim Santos, Joana Martinez. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 30.01.2019.

Figures

Figure 1
Figure 1
The Table to Table to Tablet (T2T) development roadmap. CSS: cascading style sheets.
Figure 2
Figure 2
Sprite sheet sub for the Munching Monsters activity.
Figure 3
Figure 3
The “smileyometers”: Left (question 1 and question 2); right (question 3).
Figure 4
Figure 4
Simplified flowchart. SLT: speech and language therapist.
Figure 5
Figure 5
The evolution of the Match activity from the end of second development phase to beta testing. From less buttons and more dependent on the speech and language therapist (left) to less clutter on screen, bigger buttons to accommodate users with less touch screen capacities (middle), and more interactivity in terms of sound production and audiovisual feedback when the user completes an action (right).
Figure 6
Figure 6
The main menu (left) and the Munching Monsters activity (right): area: hearing and discrimination; name: Munching Monsters; description: The child is presented with 2 open-mouth monsters each associated with an illustration of a minimal pair. At the bottom of the screen, there is a hand with a ball moving sideways. When “Play” is pressed, 1 of 2 possible words is heard. The child has to identify the corresponding image and release the ball with the right timing (into the mouth of the monsters). Digital audio feedback is given.

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