Development and Clinical Efficacy of the Application for Articulation Therapy-Thai (AAT-T) for Thai Children With Cleft Lip and Palate

泰国唇腭裂儿童发音治疗应用软件(AAT-T)的开发及临床疗效

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Abstract

OBJECTIVES: Mobile applications are becoming essential for speech therapy, especially in areas with limited access to professional speech therapists. This technological intervention is especially pertinent during pandemics, which further restrict access to traditional therapeutic modalities. The objective of this study was to develop and evaluate a mobile application for articulation therapy, specifically designed for pediatric patients with articulation disorders associated with cleft palate. MATERIAL AND METHODS: The articulation exercises incorporated in the application encompassed 27 Thai initial and final consonant sounds, presented through video demonstrations and tabular reading materials. These materials included nonsense syllables, words, phrases, and sentences. The content validity was assessed using the Item-Objective Congruence (IOC) index. Face validity and functional satisfaction were evaluated by a panel comprising four speech-language pathologists (SLPs), five children with cleft palate with or without cleft lip (CP ± L) and their respective caregivers, and an expert in application design. The clinical efficacy of the application for speech correction was subsequently assessed in a cohort of 19 children diagnosed with CP ± L. RESULTS: The Application for Articulation Therapy-Thai (AAT-T) was finalized after four iterative revisions. The IOC index for the application ranged from 0.80 to 1.00, indicating strong content validity. Functional satisfaction scores ranged from 76% to 100%, suggesting high user acceptability. Nineteen children participated in the clinical efficacy assessment; however, one child was withdrawn due to the inability to complete 6-month follow-up. The results demonstrated that AAT-T significantly reduced articulation errors in connected speech (mean difference = 2.33, SD = 2.40, 95% CI = 1.14-3.53, p < 0.001). CONCLUSIONS: The AAT-T application emerged as an accessible, engaging, and motivational tool for articulation practice. Its efficacy in speech correction was demonstrated.

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