Self-Supervised App-Based Speech Training for Children With Speech Sound Disorder-A Single-Case Experimental Design Study.

backgroundFor children with speech sound disorder (SSD), speech intervention often involves a considerable amount of home-training, to achieve high-enough training frequency to promote speech change. A digital speech-training app has been developed that could serve as a cost-effective means of providing accessible intervention to children with SSD.

aimsTo evaluate whether self-supervised home-training with the app Pop2TalkNordic can expedite more target-like speech for children with SSD and to explore children's experiences of using the app. METHODS AND PROCEDURES: Four 4-6-year-old Swedish children with SSD participated in a single-case experimental design study, with a multiple-baseline across-subjects design. The children's production of target error patterns was monitored during baseline and intervention phases, for trained and untrained stimulus words. Three weeks of self-supervised training with the app, with an aspired frequency of 5 days a week, in 15-min training sessions, served as the intervention. The children's app usage was tracked, and their production of target word stimuli was recorded via the app. OUTCOMES AND

resultsNone of the children reached more target-like production of targeted consonants as a result of the intervention. For two participants, slight improvement was observed on trained, but not untrained, word stimuli. In terms of user experiences, the children varied from liking the game a lot and finding it easy, to not liking the game much at all and finding it difficult. CONCLUSIONS AND IMPLICATIONS: In its current form, and when delivered as a self-supervised training-activity over three weeks, training with Pop2TalkNordic is not sufficient to expedite more target-like speech in children with SSD. More parental engagement in the children's training with the app, and changes in game design (e.g., highlighting phonological contrast and allowing playback of multiple exemplars of target word items), are suggested routes to achieve better outcomes. WHAT THIS PAPER ADDS: What is already known on this subject To achieve high-enough intervention dose, home-training is often an important part of intervention for speech sound disorder (SSD). This is not always easy for families to attain, however, and digital speech training games may offer an attractive alternative or complement. What this paper adds to existing knowledge By tracking four children's usage and speech production over three weeks of playing a speech training game at home, the paper shows that the current version of the game and the implemented intervention delivery are not sufficient to promote more accurate production of targeted speech sounds. What are the potential or actual clinical implications of this work? Before recommending the speech training game for children with SSD, changes are recommended both with regard to the design of the game itself (e.g., refining the feedback provided in the game) and to the intervention delivery (e.g., increasing parental involvement).