Terapia fonológica com uso de computador: relato de caso

Efficacy in the use of gamification strategy in phonological therapy

PURPOSE

to compare the efficacies of traditional phonological therapy and phonology associated with the gamification strategy in children with Phonological Disorder (PD).

METHODS

ten individuals with PD participated who showed the process of replacing liquids. They were randomized into two groups: traditional phonological therapy (control group - CG) and phonological therapy associated with a gamification strategy mediated by computer (gamification group - GG). The phonological intervention comprised, for both groups, stages of speech perception and production. Interventions differed in the perception stage, in which the GG was submitted to the game with gamification strategies. At the end of each session, individuals speech production (% of correct answers) were registered for each therapeutic stage, based on target words and sounding words. For analysis the following were considered: The individuals mean of correct answers for each therapeutic stage; PCC-R value (percentage of correct consonants) pre and post therapy; beyond of the number of sessions used to reach 85% of correct production.

RESULTS

there was no statistical difference between the types of intervention considering the average of correct answers of the productions and the number of sessions. There was a significant effect for pre- and post-therapy conditions in the comparison PCC-R values ​​for both models. The individuals in the GC had the PCC-R values higher than those of GG.

CONCLUSION

both models of intervention present similar results, providing an improvement in the individuals phonological performance from the first session.

Phonological awareness digital program: a randomized controlled study

The purpose of this study is to analyze the efficacy of the Phonological Awareness Digital Program (PADP) in typically developing preschool children aged 4 to 6 years. A randomized controlled trial was conducted with a total of 49 children assigned to two groups: the experimental group, EG (n=25) and the delayed control group, CG (n=24). Both groups were assessed before and after the implementation of the PADP. A follow-up study for the experimental group was also performed after two months. Outcome measures of phonological awareness skills (task 1: Syllable segmentation task; task 2: Syllable identification task; task3: Syllable omission task; task 4: Onset-rime units segmentation task; task 5: Phoneme segmentation task; task 6: Phoneme blending task) were evaluated at three separate moments. The results showed significant improvement in phonological awareness skills for the EG between the first and the second assessments for all the tasks considered. Between the second and third assessment, the results showed a significant improvement for the CG. The follow-up study also demonstrated the PADP’s efficacy. The PADP has shown to be an effective program in promoting the development of phonological awareness in children. These findings provide evidence for different professionals to use PADP with preschool children.   

Comparing Traditional and Tablet-Based Intervention for Children With Speech Sound Disorders: A Randomized Controlled Trial

Purpose This article reports on the effectiveness of a novel tablet-based approach to phonological intervention and compares it to a traditional tabletop approach, targeting children with phonologically based speech sound disorders (SSD). Method Twenty-two Portuguese children with phonologically based SSD were randomly assigned to 1 of 2 interventions, tabletop or tablet (11 children in each group), and received intervention based on the same activities, with the only difference being the delivery. All children were treated by the same speech-language pathologist over 2 blocks of 6 weekly sessions, for 12 sessions of intervention. Participants were assessed at 3 time points: baseline; pre-intervention, after a 3-month waiting period; and post-intervention. Outcome measures included percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct. A generalization of target sounds was also explored. Results Both tabletop and tablet-based interventions were effective in improving percentage of consonants correct and percentage of phonemes correct scores, with an intervention effect only evident for percentage of vowels correct in the tablet group. Change scores across both interventions were significantly greater after the intervention, compared to baseline, indicating that the change was due to the intervention. High levels of generalization (60% and above for the majority of participants) were obtained across both tabletop and tablet groups. Conclusions The software proved to be as effective as a traditional tabletop approach in treating children with phonologically based SSD. These findings provide new evidence regarding the use of digital materials in improving speech in children with SSD. Supplemental Material https://doi.org/10.23641/asha.9989816.

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

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://clinicaltrials.gov/ct2/show/NCT02490826

Efeito do tratamento do desvio fonológico pelo modelo de estratos por estimulabilidade e complexidade dos segmentos com software de intervenção para fala (SIFALA)

RESUMO O tema desse artigo aborda o efeito que o Modelo de Estrato por Estimulabilidade e Complexidade e o uso do Software de Intervenção para Fala resulta no tratamento do desvio fonológico. Realizou-se estudo de caso de quatro sujeitos com idade entre 4:10 a 6:7, de ambos os gêneros, com desvio fonológico. Todos os sujeitos foram submetidos a avaliação da fonologia, estimulabilidade, sistema estomatognático e triagem auditiva. O Modelo terapêutico baseou-se em uma abordagem eclética, na qual diferentes modelos, procedimentos e estratégias foram unidos, adaptados e criados. Cada sujeito foi tratado por um dos quatro estratos propostos no Modelo. O uso do Software de Intervenção para Fala teve como finalidade despertar a motivação da criança a partir de um código interativo, animado e lúdico. Analisaram-se os dados da avaliação fonológica e o número de consoantes produzidas corretamente, pré e após período de terapia. Utilizou-se o teste Qui-Quadrado, ao nível de significância de 5% (p<0,05). Verificou-se mudança no sistema de sons para todos os sujeitos tratados, na qual segmentos foram estabelecidos no inventário fonético e adquiridos no sistema fonológico. Os sujeitos tratados por estratos direcionados para maior complexidade do Modelo Implicacional de Complexidade de Traços apresentaram melhor avanço terapêutico. Entretanto, devido ao número reduzido de sujeitos não é possível fazer afirmações quanto ao estrato de maior eficácia. Conclui-se que o Modelo e o uso do Software de Intervenção para Fala resultam efeito positivo, contribuindo com o planejamento e o tratamento do desvio fonológico. Contudo, há necessidade de realização de outros estudos com ampliação casuística para confirmação dos achados.