Design and Evaluation of Interactive, Customizable and Extensible Speech Enabled Games as Speech Therapy for Kids with Autism

Background: Approximately one third to one half of individuals diagnosed with an ASD have significant difficulty using speech and language as an effective means of communication. While conventional speech-language therapy can help address these issues, it can be tedious, time consuming, and minimally engaging. Objectives: We aimed to create and evaluate a suite of engaging, customized, interactive computer games to help children improve speech difficulties relating to loudness and speech rate (both of which have direct impact on intelligibility). The games were easily customizable to suit the needs and interests of individuals with diverse levels of ability and free and open-source, making them accessible to all with an Internet connection. Our objective was to supplement regular speech therapy with entertaining and customizable tools that a speech-language therapist can use when working with individuals on the autism spectrum. Methods: Eight children (two females, six males) on the autism spectrum (ranging in age from 7‐20yr) who had difficulties with loudness and/or speech rate participated in this study. Participants were matched and assigned to two groups of four (A and B) based on their speech difficulties, age, and gender. After an initial baseline assessment of loudness and speech rate, Group A engaged in two weeks of computerized speech therapy while Group B engaged in two weeks of conventional speech therapy. In the following two weeks interventions were switched and Group A received conventional speech therapy while Group B received computerized speech therapy. Speech was recorded during all sessions and loudness and speech rate were calculated and summarized at the end of each intervention period. Results: Out of our eight participants, six had “speaking louder” as a target. Five of the six showed a statistically significant increase in loudness at the end of the study compared to baseline. Three of those five showed either comparable or significantly greater improvement following the computerized speech therapy compared to conventional speech therapy. Only one participant showed a significant decrease in loudness following the computerized sessions compared to conventional therapy. Five participants had “speaking slower” and two had “speaking faster” as targets. Two participants showed a statistically significant desirable change in speech rate after intervention compared to baseline. One spoke more slowly after conventional therapy and the other spoke more slowly after the computerized therapy. Conclusions: Our computerized intervention appeared engaging and effective for the majority of our participants. Some participants demonstrated statistically significant changes in speech following the computerized therapy relative to conventional therapy, suggesting that a subset of individuals on the autism spectrum may especially benefit from our intervention. The finding that some participants had statistically significant gains in both the computer as well as the conventional therapy sessions is also promising since computer therapy may be a useful option for individuals who cannot afford, or do not otherwise have regular access to or interest in, speech‐language therapy.