Development of a Child Articulation Screening Test Within Digital Therapeutics: Delphi Study

Area of Science:

• Speech-language pathology
• Digital therapeutics
• Pediatric audiology

Background:

• Speech sound disorders are prevalent in children, often leading to reading difficulties.
• Existing assessment tools in South Korea have limitations, including face-to-face requirements and lack of automated scoring.
• The COVID-19 pandemic emphasized the need for remote and digitalized assessment solutions.

Purpose of the Study:

• To develop a novel articulation assessment tool.
• To establish the content validity of this tool.
• To ensure the tool's integration into digital therapeutics (DTx) and overcome limitations of current methods.

Main Methods:

• A 3-round modified Delphi survey was conducted with 23 experts (physiatrists and speech-language pathologists).
• Experts evaluated word lists, phonological environments, and scoring criteria using quantitative analyses (CVR, CVI, median, IQR).
• Consensus thresholds were established, and items were retained only if all criteria were met.

Main Results:

• The study refined word stimuli, expanded phonological coverage, and improved scoring criteria for clarity.
• In round 2, 20 out of 25 items (80%) met consensus criteria, with CVRs from 0.57 to 0.91 and CVI s from 0.78 to 0.96.
• All remaining items achieved consensus in round 3, indicating robust content validity.

Conclusions:

• A novel articulation assessment tool with strong content validity was developed.
• The tool features updated stimuli, analysis indexes, and visualization for enhanced clinical utility.
• This standardized, digital tool supports personalized interventions for children with speech sound disorders and is suitable for AI-based DTx.