Du Yao, Lubniewski Kathryn, Price Lori, Breslin Grace, Thomson Paula, Jinadasa Natashka, Soni Nikita
Caruso Department of Otolaryngology, Head and Neck Surgery (OHNS), Keck School of Medicine, University of Southern California, Los Angeles, California, USA.
Department of Special Education, School of Education, Monmouth University, West Long Branch, New Jersey, USA.
Int J Lang Commun Disord. 2023 Sep-Oct;58(5):1717-1737. doi: 10.1111/1460-6984.12898. Epub 2023 May 23.
Children with communication disorders experience difficulty in one or more areas of articulation and speech, language, fluency, voice and social communication, and they work with speech-language pathologists (SLPs) to improve their communication. With the rise of adoption and use for mobile applications among special education and healthcare service providers, SLPs also have implemented, and for some, contributed to the design of, mobile applications (apps) during clinical practice. However, how these mobile apps are designed and implemented for clinicians to facilitate their clients' communication and learning experiences during therapy remains underinvestigated.
This qualitative research study investigated how mobile apps were designed for clinicians to target assessment and intervention goals. Additionally, it focused on how clinicians adopted these apps while integrating therapy techniques to facilitate their clients' learning.
Informed by the Research, Practice, and Design for iPad Apps (iRPD) framework and the Consolidated Framework for Implementation Research (CFIR), semi-structured interviews were conducted with 37 licensed pediatric SLPs, including 23 SLPs who have used apps and 14 SLPs who have contributed to the design of their own mobile apps. Two rounds of qualitative coding via template analysis and thematic analysis were then used to analyse client and clinician characteristics, clinical practice, therapy tools, app characteristics, influential factors and app design and use recommendations.
Results showed SLPs utilise different genres of assistive, educational and recreational game apps to support children's communication development when working with children who have diverse disorders and therapy needs across different age groups. SLPs who have designed their own apps emphasised the importance of following evidence-based practice, well-researched teaching methods and learning theories. Additionally, multiple financial, sociocultural, political and ethical factors contributed to the design, adoption and implementation of mobile apps during services.
By understanding the clinician's app use practices situated in various therapy activities and techniques, we specified a list of design recommendations for app designers who are interested in creating mobile apps for supporting children's speech and language development. By bringing insights from both clinical practitioners as well as those with additional technical design backgrounds, this study contributes to the understanding of clinical practice needs and strategies and will lead to the most optimal app design and adoption practice to support the well-being of children with communication disorders.
What is already known on the subject Speech language pathologist (SLPs) implement mobile apps for clients with diverse therapy needs, and their app adoption and use are influenced by multifaceted factors. Although prior studies have reported SLPs' mobile app use, additional information is still needed. For example, the research literature does not include how specific technology is used during therapy practice, or specific details about challenges and needs in implementing and utilising the technology. Additional research also needs to include influential factors (e.g., financial, sociocultural, political, ethical) that are considered when selecting, implementing, assessing and designing an app. The lack of research in these areas directly affects the understanding of clinical mobile technology practices and further hinders clinicians' abilities to advocate for better clinical and design decisions towards identifying and implementing effective mobile apps that facilitate children's communication. What this study adds to existing knowledge This qualitative study is the first known empirical research that interviewed pediatric speech-language pathologists who have used and designed mobile apps for children who receive speech-language therapy across different clinical settings. By investigating experiences from clinician stakeholders to illustrate a holistic overview of app design and development to deployment, this study reported finding on (1) how clinicians use mobile apps to help children to participate in different therapy activities, and (2) a list of recommended design and development guidelines that informs the design and use of mobile apps that best support and motivate children to engage in therapy. What are the potential or actual clinical implications of this work? This study disseminates clinician-reported practices of app design and use with pediatric clients across different speech-language disorders, and identifies gaps and needs for clinicians and researchers who are interested in understanding the role of mobile technology in relationship to human communication and interaction. Additionally, the paper demonstrates that SLPs have instrumental roles rather than passive users in influencing the design and implementation of different genres of mobile apps through evidence-based clinical practice, and call for partnerships across clinicians, special educators and technologists to support children's communication development.
患有沟通障碍的儿童在发音与言语、语言、流畅性、嗓音及社交沟通等一个或多个领域存在困难，他们与言语语言病理学家（SLP）合作以改善沟通能力。随着特殊教育和医疗服务提供者对移动应用的采用和使用增加，SLP在临床实践中也实施了移动应用，并且一些人还参与了移动应用（应用程序）的设计。然而，这些移动应用如何为临床医生设计和实施，以在治疗期间促进其客户的沟通和学习体验，仍有待深入研究。
这项定性研究调查了移动应用如何为临床医生设计以实现评估和干预目标。此外，研究聚焦于临床医生如何在整合治疗技术的同时采用这些应用来促进其客户的学习。
以iPad应用的研究、实践与设计（iRPD）框架和实施研究整合框架（CFIR）为指导，对37名有执照的儿科SLP进行了半结构化访谈，其中包括23名使用过应用程序的SLP和14名参与过自己移动应用设计的SLP。然后通过模板分析和主题分析进行两轮定性编码，以分析客户和临床医生特征、临床实践、治疗工具、应用程序特征、影响因素以及应用程序设计和使用建议。
结果显示，当与不同年龄组有各种障碍和治疗需求的儿童合作时，SLP会使用不同类型的辅助、教育和娱乐游戏应用来支持儿童的沟通发展。设计过自己应用程序的SLP强调遵循循证实践、经过充分研究的教学方法和学习理论的重要性。此外，在服务期间，多种财务文化、社会文化、政治和伦理因素对移动应用的设计、采用和实施产生了影响。
通过了解临床医生在各种治疗活动和技术中使用应用程序的实践，我们为有兴趣创建支持儿童言语和语言发展的移动应用的应用程序设计师列出了一系列设计建议。通过引入临床从业者以及具有额外技术设计背景的人员的见解，本研究有助于理解临床实践需求和策略，并将带来最佳的应用程序设计和采用实践，以支持患有沟通障碍儿童的福祉。
关于该主题已知的信息 言语语言病理学家（SLP）为有不同治疗需求的客户实施移动应用，他们对应用的采用和使用受到多方面因素的影响。尽管先前的研究报告了SLP对移动应用的使用情况，但仍需要更多信息。例如，研究文献未包括在治疗实践中如何使用特定技术，或实施和利用该技术时挑战和需求的具体细节。额外的研究还需要包括在选择、实施、评估和设计应用程序时考虑的影响因素（如财务、社会文化、政治、伦理）。这些领域研究的缺乏直接影响对临床移动技术实践的理解，并进一步阻碍临床医生倡导做出更好的临床和设计决策，以识别和实施促进儿童沟通的有效移动应用。本研究对现有知识的补充 这项定性研究是第一项已知的实证研究，采访了在不同临床环境中为接受言语语言治疗的儿童使用和设计移动应用的儿科言语语言病理学家。通过调查临床医生利益相关者的经验，以全面概述应用程序从设计开发到部署的过程，本研究报告了以下发现：（1）临床医生如何使用移动应用帮助儿童参与不同的治疗活动；（2）一系列推荐的设计和开发指南，为最能支持和激励儿童参与治疗的移动应用的设计和使用提供参考。这项工作的潜在或实际临床意义是什么？本研究传播了临床医生报告使用移动应用治疗不同言语语言障碍儿科患者的实践经验，并为有兴趣了解移动技术在人类沟通和互动中作用的临床医生和研究人员确定了差距和需求。此外，本文表明SLP在通过循证临床实践影响不同类型移动应用的设计和实施方面具有重要作用，而非被动使用者，并呼吁临床医生、特殊教育工作者和技术专家建立合作关系，以支持儿童的沟通发展。
