Equitable access to speech practice for rural Australian children using the SayBananas! mobile game

Abstract

Purpose

To evaluate the effect, usage, and user-experience for SayBananas!, a Mario-style mobile game providing Australian children access to high-dose individualised speech therapy practice.

Method

Participants were 45 rural Australian children with speech sound disorders (SSD; 4;4–10;5 years) with internet access. This mixed-methods study involved: (a) recruitment, (b) eligibility screening, (c) questionnaire, (d) online pre-assessment, (e) SayBananas! intervention using motor learning principles (4 weeks, 10–15 target words), and (f) online post-assessment and interview. Usage and performance were automatically monitored.

Result

Most participants were highly engaged with SayBananas! completing a median of 44.71 trials/session (∼45% of the 100 trial/session target, range 7–194). After intervention, participants made significant gains on treated words and on formal assessment of percentage of consonants, vowels, and phonemes correct. There was no reliable change for parent-rated intelligibility or children’s feelings about talking. The number of practice sessions was significantly correlated with percent change on treated words. On average, children rated the app as “happy/good/fun” providing detailed drawings of playing SayBananas!. Families provided high ratings of engagement, functionality, aesthetics, and quality.

Conclusion

SayBananas! is a viable and engaging solution for rural Australian children with SSD to gain access to equitable, cost-effective speech practice. The amount of app use was associated with amount of speech production improvement over a 4-week period.

Keywords:

• Speech sound disorder
• intervention
• rural
• technology
• telehealth
• telepractice

Acknowledgments

The authors thank Christine Porter, the children, and children's families.

Disclosure statement

Beena Ahmed and Kirrie Ballard are co-founders of UCanSay66, trading as Say66 Pty Ltd, designing speech therapy video game solutions that incorporate automated speech recognition. They created the SayBananas! game (previously called Apraxia World). The research leading to the development of SayBananas! received the Speech Pathology Australia Research Innovation Award in 2020. Sharynne McLeod is co-author of the Intelligibility in Context Scale and the International Speech Screener.

Additional information

Funding

This research was supported by an AMP Tomorrow Maker award to Kirrie Ballard.