Addressing Challenges in Speech Therapy and Augmentative and Alternative Communication: The potential of gamification and e-textiles

Speech and language therapy is often intensive and long-term. The daily lives of children in speech therapy and their families can include the use of augmentative and alternative communication (AAC). However, previous studies have identified several challenges in both speech therapy interventions and the use of AAC tools, with one significant challenge being the maintenance of motivation for the client and those around them. This study aimed to identify factors that influence speech therapy interventions either by motivating or hindering and explore how electronic textiles (e-textiles)—traditional textiles integrated with electronics—can be utilized in general, and more specifically, in speech therapy and AAC.

Factors affecting speech therapy interventions were studied from the perspective of speech-language pathologists (SLP) (n=26). The use of e-textiles was explored more broadly from the perspective of experts in the fields of education, social and healthcare and health technology (n=50). The potential of e-textiles specifically as a means of AAC was explored from the perspective of parents of a child with cerebral palsy (CP) (n=9). Qualitative research methods, including online questionnaires and workshops, were used to collect and analyze data, with multiple researchers involved in all stages.

According to the results of the study, barriers to speech therapy home practice are related to family life, parents, working with the child or the speech-language pathologist providing the rehabilitation. SLPs highlighted the use of games and gamification as effective motivators, alongside other factors such as the SLP’s expertise, external incentives, playfulness, making progress tangible, and aligning with the child’s interests and environment. Three types of games were identified from the SLPs’ responses: self-made games targeted for speech therapy, commercial board games, and commercial digital games. The SLPs explained that these games were used during training to make the exercises more playful and motivating, and as a reward, allowing the child to play a game after completing speech therapy treatment.

The results suggest that the potential for using e-textiles appears to be wide. Experts participating in the multidisciplinary workshops pointed out that people of all ages and different levels of functionality could benefit from e-textiles. E-textiles could be used in a variety of environments and fields, such as everyday life, rehabilitation, healthcare and work environments. From a speech and language therapy perspective, participants thought that e-textiles could, for example, assist in communication, be used to remotely connect with somebody, and provide guidance in controlling emotions. Parents of children with CP believed that e-textiles could aid in everyday communication, underscoring the importance of providing children with more opportunities to express themselves and influence matters concerning them. They envisioned e-textiles being attached to mobility aids, home environments, clothing, or cars to be used with their hand.

This study provided new insights into the factors influencing speech therapy rehabilitation and the potential of e-textiles in general, and more specifically from the perspective of speech therapy and AAC. Additionally, it explored the potential of games and gamification in speech therapy rehabilitation.