Co-Designing Child-Centered Digital Speech Sound Disorder Assessment Tools with Speech Language Pathologists

Abstract

Speech Sound Disorders (SSD) affect approximately one in twelve children and require early assessment to support language development. In Sweden, SSD assessment remains largely paper-based, time-consuming, and poorly adapted to the linguistic characteristics of Swedish and the practical workflows of Speech Language Pathologists (SLPs). This paper presents the co-design and evaluation of a digital assessment platform for Swedish-speaking children, developed collaboratively with SLPs at an Oral Motor Center in Stockholm. Through iterative workshops, four clinicians shaped the platform’s assessment workflows, interaction design, privacy handling, and child engagement strategies. The platform supports adaptive phonological awareness and speech perception assessments using minimal pairs tailored to individual children. Thematic analysis revealed clinician-informed design principles that may support the development of child-centered healthcare assessment technologies, including clinician-controlled adaptability, low-distraction interaction design, non-performance-based gamification, and privacy-conscious data handling. In particular, the findings highlight how assessment-oriented gamification differs from therapy-oriented reward systems by prioritizing participation, emotional comfort, and attention regulation over performance reinforcement. Initial usability evaluations with four SLPs suggested positive perceptions regarding usefulness, workflow clarity, and suitability for clinical practice. Beyond presenting a clinically grounded prototype, this work contributes empirical insights and design implications for future healthcare technologies targeting children with communication difficulties.