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

Abstract

BACKGROUND With the plethora of mobile applications (apps) available in the App Store, more speech-language pathologists (SLPs) have adopted apps for speech-language therapy services, especially for pediatric clients who may benefit from various interactive apps. App Store reviews are publically available data sources that can not only create avenues for communication between technology developers and consumers to understand user needs and challenges but also inform and educate clinicians about the app content and quality based on clinical user experience with their clients. OBJECTIVE This study examines the iOS App Store reviews from multiple key stakeholders (e.g., parents, educators, SLPs, and individuals with communication disorders) to better understand user needs and challenges of using speech-language therapy apps (including augmentative and alternative communication, or AAC apps) for pediatric clients who receive speech-language therapy services. METHODS We selected a total of 16 apps from a prior interview study with SLPs which covered multiple American Speech-Language-Hearing Association (ASHA) Big Nine competencies, including articulation, receptive and expressive language, fluency, voice, social communication, and communication modalities. Using an automatic Python Crawler developed by our research team, we extracted a total of 1107 app reviews from 2009 to 2020. Using a qualitative coding scheme and usability guidelines, we conducted a content analysis of a total of 484 reviews and synthesized user feedback related to app features and content, usability issues, and multiple influential factors related to app use. RESULTS Our analysis revealed that multiple key stakeholders, such as family members, educators, as well as individuals with communication disorders have utilized app store reviews as a platform to share their experiences with AAC and speech-language apps. User reviews suggested that AAC apps consistently demonstrated more usability issues due to violations of design guidelines in areas of aesthetics, user errors, controls, and customization. Reviews for speech-language apps reviews were mostly written by SLPs who requested and recommended specific app features (e.g., customization of visuals, recorded feedback within the app, culturally diverse character roles) based on their clinical service delivery working with a diverse age group of pediatric clients with a variety of communication disorders. CONCLUSIONS To our knowledge, this is the first study that analyzes publicly available app store reviews to examine mobile apps for pediatric speech-language therapy apps from children with communication disorders (CwCDs) and different stakeholders, including clinicians, educators, and parents. The findings contributed to the understanding of CwCDs’ app content and features as well as usability and accessibility issues with both AAC apps and speech-language apps. App reviews also revealed influential factors that highlight ongoing financial, sociocultural, ethical and moral considerations for app design and development for CwCDs who need speech therapy.

Perspectives on Mental Health Digital Platforms: A Usability Study with Ergonomics Design Students

“…Usability studies provide valuable insights into how mental health apps can better meet the needs of diverse users. Studies have found that aspects like user engagement, partic-ipatory design, user-centred design, and the inclusion of end-users in the evaluation process are critical for mental health app effectiveness [37][38][39][40] . The usability of mental health apps has also been linked to their impact on specific mental health conditions 41,42 .…”

Perspectives on Mental Health Digital Platforms: A Usability Study with Ergonomics Design Students

“…Usability studies provide valuable insights into how mental health apps can better meet the needs of diverse users. Studies have found that aspects like user engagement, participatory design, user-centred design, and the inclusion of end-users in the evaluation process are critical for mental health app effectiveness [38][39][40][41] . The usability of mental health apps has also been linked to their impact on specific mental health conditions 42,43 .…”