An mHealth App (Speech Banana) for Auditory Training: App Design and Development Study

Abstract

Background With the growing adult population using electronic hearing devices such as cochlear implants or hearing aids, there is an increasing worldwide need for auditory training (AT) to promote optimal device use. However, financial resources and scheduling conflicts make clinical AT infeasible. Objective To address this gap between need and accessibility, we primarily aimed to develop a mobile health (mHealth) app called Speech Banana for AT. The app would be substantially more affordable and portable than clinical AT; would deliver a validated training model that is reflective of modern techniques; and would track users’ progress in speech comprehension, providing greater continuity between periodic in-person visits. To improve international availability, our secondary aim was to implement the English language training model into Korean as a proof of concept for worldwide usability. Methods A problem- and objective-centered Design Science Research Methodology approach was adopted to develop the Speech Banana app. A review of previous literature and computer-based learning programs outlined current AT gaps, whereas interviews with speech pathologists and users clarified the features that were addressed in the app. Past and present users were invited to evaluate the app via community forums and the System Usability Scale. Results Speech Banana has been implemented in English and Korean languages for iPad and web use. The app comprises 38 lessons, which include analytic exercises pairing visual and auditory stimuli, and synthetic quizzes presenting auditory stimuli only. During quizzes, users type the sentence heard, and the app provides visual feedback on performance. Users may select a male or female speaker and the volume of background noise, allowing for training with a range of frequencies and signal-to-noise ratios. There were more than 3200 downloads of the English iPad app and almost 100 downloads of the Korean app; more than 100 users registered for the web apps. The English app received a System Usability Scale rating of “good” from 6 users, and the Korean app received a rating of “OK” from 16 users. Conclusions Speech Banana offers AT accessibility with a validated curriculum, allowing users to develop speech comprehension skills with the aid of a mobile device. This mHealth app holds potential as a supplement to clinical AT, particularly in this era of global telemedicine.

Visualization of Speech Perception Analysis via Phoneme Alignment: A Pilot Study

“…It is important to provide enough repetitions for each phoneme, otherwise the transmitted information estimate becomes highly erratic and overestimates the stimulus information on average ( 43 , 61 ). Accumulating responses over time is one way to overcome bias and error which might be useful in mobile apps for auditory training ( 10 ). In this case, it may be necessary to use bootstrapping to generate confidence intervals ( 62 ).…”

“…Future work includes feasibility for clinical usage, user-friendly implementation for mobile auditory training apps such as Speech Banana ( 10 ), and exploring alternative approaches such as multidimensional scaling for features ( 29 , 30 ) as opposed to prescribed ones, other features ( 69 ) and other metrics ( 6 , 16 , 73 ).…”

“…For the sentences, six volunteers with hearing loss recorded their responses to stimuli. In 2017, four people with various degrees of hearing loss tested the alpha version of the Speech Banana iPad app for auditory training ( 10 ); testing was approved by JHU Homewood Institutional Research Board Protocol HIRB00001670. Specifically, the volunteers provided their responses to different sets of 30 sentences recorded in Clear Speech ( 44 ) by male and female American English speakers, extracted as WAV audio files from the app which is based on an auditory training book ( 45 ).…”

“…At the same time, many people learning to hear with a new hearing aid or a cochlear implant use auditory training apps such as the Speech Banana app which is freely available ( 10 ). Progress tracking provides the user a record of correct sentences, correct words, and number of repetitions in the quizzes.…”

Guidance on Providing Patient-Centered Care

“…59 Apps come and go, but at the time of this writing, an app called “Speech Banana for Auditory Training” is an example of innovative ways to provide mHealth support based on a validated curriculum. 60…”