Use of an AI-powered Mobile Health App in Assessing and Training Oral Motor Functions (ORAR SG)

For the normative study: 150 individuals of Malay descent (e.g., Boyanese, Javanese, Banjarese, Bugis, and Indonesian extract) and 150 bilingual Chinese individuals. Another 35 speech-language therapists and carers of dysarthric pateints will be recruited.

Inclusion criteria for healthy adults in the normative study, as well as SLTs and caregivers of individuals with dysarthria in the implementation study are as follows: (1) Adults aged 21-79 years who are Singapore citizens, (2)absence of severe systemic conditions, including uncontrolled diabetes, cerebrovascular disease, head and neck tumours, or neurological disorders, (3) not currently undergoing radiation therapy or chemotherapy, (4) normal or corrected-to-normal vision and hearing, (5) fluent in Malay/ English respectively, (6) no history of speech difficulties/disorders. Additional inclusion criteria for SLTs are: (1) AHPC licensed and (2) have been practising in Singapore for at least one year.

35 individuals with neurogenic dysarthria will be recruited. For the implementation study, inclusion criteria for participants with dysarthria include (1) to (5) above, with the exception of a history of stroke, and being diagnosed with an acquired speech sound disorder by an SLT. Exclusion criteria include (1) individuals who are dependent on non-oral feeding, (2) individuals unable to provide informed consent due to cognitive impairment. Written or digital consent will be obtained from all participants prior to participation.

Feasibility Study:

Participants wi l first complete a demographic form that collects information such as age, occupation, gender, housing type, and dental history.

This study will be conducted in a controlled environment, such as a quiet room at SIT, clinics, and participants' homes, under the guidance of SLT students. Participants wi l complete three 4-item measures of implementation outcomes - Acceptability of Intervention Measure (AIM), Intervention Appropriateness Measure (IAM), and Feasibility of Intervention Measure (FIM; Weiner et al., 2017). Subsequently, they will be given 30 minutes to explore and experiment with the app's different features. Following this, participants will complete the AIM, IAM, and FIM again, as well as participate in a semi-structured interview with the SLT student on their experience using the app and feedback about the app. The app wil be available in Mandarin (Simplified) and English.

The range of movement of lips, tongue, and jaw of the participants will be analyzed by the computer vision model of ORAR to give range-of-motion scores.

Each participant will be asked to take a deep breathe and say 'ah' as long as they can. This will repeat for 3 times.

The number of repeated syllables, trisyllabic non-word, trisyllabic Malay real word (only for Malay participants), trisyllabic English real word produced in 8 seconds will be measured.

Participants will be asked to read aloud a word list covering phonetic inventory of the language and multisyllabic words (English: 38 words from Robertson Dysarthria Profile; Malay: 30 words selected from Malay Lexicon Project).

Participants will be asked to recall a personal event.

Participants will be asked to produce as many items in a given category (e.g., fruits, vehicles) within a minute.

A semi-structured interview will be conducted. Questions regarding the acceptability, apropriateness and feasibility of ORAR app will be asked.

The questionnaire consists of 10 questions, and participants will be asked to evaluate their swallowing functions based on a 5-point Likert scale (0=not at all; 4=very much). Lower scores reflect better swallowing performance. Maximum and minimal scores are 40 and 0, respectively.

Participants will be asked to give ratings on the questionnaire based on a 5-point Likert scale. Lower scores represent better oral condition-related quality of life. The maximum and minimum scores are 56 and 0, respectively.