Sept 2020 The Hearing Journal
Children with hearing impairment face challenges in developing their spoken language and literacy—a challenge that is compounded by limited access to pediatric speech-language pathologists (SLP). In recent years, mobile apps have emerged to help develop certain parts of speech, but few of these apps are designed for children, and none specifically deal with listening and spoken language among children with hearing loss. A new app called Hear Me Read hopes to change this. According to a study published in JMIR Human Factors, focus group feedback on the app was “promising for the use of educational apps designed specifically for those with hearing loss who are pursuing listening and spoken language as a communication outcome.”
EXPANDING THE GOLD STANDARD
“The current gold standard for children with hearing loss to develop spoken language and literacy is through in-person one-on-one therapy sessions with a pediatric hearing loss expert (a speech and language or auditory-verbal therapist),” the study authors noted. However, this has often been difficult to access—and more so now with restrictions due to the COVID-19 pandemic. “Access to an SLP with expertise in pediatric hearing loss (such as an auditory-verbal therapist) is limited. They are not always close by,” said Prashant S. Malhotra, MD, FAAP, the principal investigator of the study. “This imposes a tremendous barrier to access and burdens on families who need to take time off work, arrange transportation, and travel distances. Prior to COVID-19, families have been seeking digital resources and therapeutic products to help fill this void. The current pandemic highlights the need for distance learning options.”
Finding no expert-guided digital options for children who are deaf or hard of hearing (D/HH), Malhotra's team created the Hear Me Read prototype. The app allows parents and caregivers to work with therapists in developing lesson plans for digital storybook reading aimed at their child's reading, speech, and language goals. It has both an interactive digital reading environment for caregivers and children to use together, and a recording feature for caregivers to prerecord reading sessions which children can then use on their own. It also has a tracking functionality, allowing caregivers and therapists to monitor reading progress with in-app metrics. Hear Me Read emphasizes the role of caregivers and parents as primary language facilitators of children's language and literacy skills. It is meant to enable “caregivers and their children to complete therapy activities outside of therapy sessions.”
EVALUATING USER EXPERIENCE
The Hear Me Read app is currently preclinical. Malhotra's study wanted to assess the user experience of caregivers and children using the app. Eight children with and without hearing loss and eight caregivers participated in separate focus groups: one for 2- to 5-year-olds and their caregivers, and another for 7- to 12-year-olds and their caregivers. In one-hour sessions, they interacted with the app and discussed their experiences.
The focus groups yielded generally positive feedback. “Participants found the app to be esthetically pleasing and easy to use,” the study concluded. “Caregivers and children appreciated the enhancements, such as highlighting of parts of speech and caregiver reading of video playback, which were made possible by the digital format. Participants expressed that the app could be used to enhance family reading sessions and family interaction.”
Prior to the test, the researchers also conducted initial surveys of SLPs and parents of DHH children. “Our initial feedback indicated that both groups had high interest in this kind of technology, which was encouraging,” Malhotra told The Hearing Journal.When asked about any challenges regarding app use, Malhotra enumerated several refinements being made to the app, including improvements to the page-turning and audio/video capture, additional books for better leveling of stories, and a new “Me and My Ears” profile to encourage the child's familiarity with his or her hearing impairment and technology.
Malhotra also new revealed enhancements. “We have recently been awarded funding for phase two of development that will allow the SLP to input more targets (phonemes, word categories) and comprehension questions and target knowledge about print conventions. After phase two, the goal is to have the app deliver the above through an error-free, easily navigable, and desirable interface,” he said. “This would make it ready for a clinical trial of efficacy, and distinguish this technology from other therapy apps that exist in the marketplace.”
The researchers are hopeful that technologies like Hear Me Read will soon be ready to aid children and caregivers, especially at a time of quarantines and travel restrictions. “The COVID-19 pandemic is likely a long-term phenomenon. Insurance, state, and institutional regulations on the use of teletherapy have undergone vast changes,” said Malhotra. “A platform such as Hear Me Read, once proven beneficial, has the potential to play a huge role in extending therapy to children who are deaf or hard of hearing in the future.”