Listening to Stakeholders Involved in Speech-Language Therapy for Children With Communication Disorders: Content Analysis of Apple App Store Reviews

Abstract

Background With the plethora of mobile apps available on the Apple App Store, more speech-language pathologists (SLPs) have adopted apps for speech-language therapy services, especially for pediatric clients. App Store reviews are publicly available data sources that can not only create avenues for communication between technology developers and consumers but also enable stakeholders such as parents and clinicians to share their opinions and view opinions about the app content and quality based on user experiences. Objective This study examines the Apple App Store reviews from multiple key stakeholders (eg, parents, educators, and SLPs) to identify and understand user needs and challenges of using speech-language therapy apps (including augmentative and alternative communication [AAC] apps) for pediatric clients who receive speech-language therapy services. Methods We selected 16 apps from a prior interview study with SLPs that covered multiple American Speech-Language-Hearing Association Big Nine competencies, including articulation, receptive and expressive language, fluency, voice, social communication, and communication modalities. Using an automatic Python (Python Software Foundation) crawler developed by our research team and a Really Simple Syndication feed generator provided by Apple, we extracted a total of 721 app reviews from 2009 to 2020. Using qualitative coding to identify emerging themes, we conducted a content analysis of 57.9% (418/721) reviews and synthesized user feedback related to app features and content, usability issues, recommendations for improvement, and multiple influential factors related to app design and use. Results Our analyses revealed that key stakeholders such as family members, educators, and individuals with communication disorders have used App Store reviews as a platform to share their experiences with AAC and speech-language apps. User reviews for AAC apps were primarily written by parents who indicated that AAC apps consistently exhibited more usability issues owing to violations of design guidelines in areas of aesthetics, user errors, controls, and customization. Reviews for speech-language apps were primarily written by SLPs and educators who requested and recommended specific app features (eg, customization of visuals, recorded feedback within the app, and culturally diverse character roles) based on their experiences working with a diverse group of pediatric clients with a variety of communication disorders. Conclusions To our knowledge, this is the first study to compile and analyze publicly available App Store reviews to identify areas for improvement within mobile apps for pediatric speech-language therapy apps from children with communication disorders and different stakeholders (eg, clinicians, parents, and educators). The findings contribute to the understanding of apps for children with communication disorders regarding content and features, app usability and accessibility issues, and influential factors that impact both AAC apps and speech-language apps for children with communication disorders who need speech therapy.

Augmentative and Alternative Communication and digital participation

“…In addition, there is a focus on the usability of applications. The design of applications applied to devices is sometimes very creative and thus violates recommendations for the design of online applications, such as the current Web Accessibility Guidelines (https://www.w3.org/ WAI/standards-guidelines/wcag/), and is therefore very often not optimally implemented in terms of design, adaptability and control (Du et al, 2022). It is essential that manufacturers work closely with research and development, but also with users, to best understand the needs of the people who will later use the devices (McNaughton and Light, 2013).…”

“They Can't Believe They're a Tiger”: Insights from pediatric speech‐language pathologist mobile app users and app designers

“…To date, limited empirical research has examined SLPs’ clinical practices of using different genres of mobile apps, including augmentative alternative communication (AAC) apps, speech therapy apps, and games across multiple settings (Benedon, 2018; Fichten et al., 2021; Thompson & Zimmerman, 2019). Furthermore, to make it more complex, some SLPs have gone a step further to design their own apps that they can use in therapy sessions (Du & Tekinbas, 2020; Du et al., 2022b). This study seeks to understand how clinicians deploy various mobile apps while also designing their own apps to facilitate their clients’ communication for pediatric speech‐language therapy services.…”