With the emergence of online learning, a need for supportive distance learning is made paramount. People across the globe were forced to adjust within the text-byte walls of the internet. To adapt to this change, speech-language pathologists worldwide are now shifting their materials from actual toys to interactive online activities - it’s as if the world of therapy made no difference in the year 2020.  Here in the Philippines, a life-changing software was developed to aid and encourage carrying over speech therapy goals at home for the cleft community. With this purpose, Smile Train initiated the speech application project in May 2020. A team of Filipino SLPs, headed by Veronica “Veve” Yu, together with Dazelyn Ku and Georgia Danga, worked on the content of the speech app which was customized for children with cleft-related speech concerns together with the Nifty Hero Multimedia, a web and application development company.

Initiating the Project

Smile Train is an international charitable organization that aims to ensure that every child born with a cleft can have a productive and meaningful life. Smile Train has made it its mission to provide sustainable and empowering opportunities to support children and families with Cleft-related concerns. With these, they have adopted a sustainable and local model of multiple support and essential care for this community. Worldwide, many establishments and units of all forms were affected due to the restrictions caused by the pandemic. The therapeutic world was no different. Services that implored face-to-face and contact settings were halted, thus impeding groups from receiving the necessary care and interventions which were primarily received in this setting. With the initiative of Smile Train Philippines, a team of Speech-Language Pathologists and developers were invited to help put this solution into place, with the aim of providing continuous speech intervention, and carry home practice at home.

Meet the Team

Ms. Veronica Yu or known by her colleagues as “Veve Yu” started teaching at the University of Santo Tomas in 2018 and handled classes for craniofacial studies. Veve was inspired by a workshop conducted by Dr. Catherine Crowley in 2017, wherein she learned the principles in selecting the target words for drills. As a practicing SLP and collegiate instructor in the study of speech and communication for more than 5 years, she has come to realize that there are very few locally-made Speech therapy materials. The challenge here was how she can make one in our language, the Filipino language. Being the dedicated SLP that she is, she was willing to take extra steps to make sure that she could better serve cleft patients. 

To make the goal into fruition, a comprehensive tool that can target different linguistic contexts of target sounds as well as consider the accessibility of this tool even at home was visualized. The creation of this tool was made significant with the vision of providing home-care speech and language-rich activities amidst the problem of distance brought about by the pandemic. Considering the load of the project, there was a need to collaborate with different developers specializing in areas from content to application. 

And so the project started with the coming together of a team of SLPs dedicated to the creation of locally-made, language-rich, speech therapy materials as well as family-friendly activities within reach of a hand even with the distance of a Speech Specialist.  Beginning in May 2020, Ms. Veve Yu came together with fellow Smile Train SLP volunteers, Ms. Dazelyn Faith Ku and Ms. Giorgia Denise Danga.

In the development of the application, roles were assigned for each team member. Veronica Yu, along with Giorgia Danga, worked on the sentence content to be programmed on the app and stimuli to be presented in the storybooks. Much emphasis was placed on the sensitivity of the sounds and the mechanics of the game. Target sounds for practice were divided for each game, each sound contained in a story of its own. In the selection of stimuli, the team made sure that each storybook would only target a specific high-pressure sound, making sure that these materials not only provided a fun-learning activity but also evidenced-based activity in the improvement brought about by concerns in speech.

One of the few and unique features of the app is the development of video tutorials for the use of families. Dazelyn Ku, another team member, provided the visuals and tutorials for the app.

Dazelyn Ku giving a video tutorial on the production of /p/ and /b/ (courtesy Smile Train Speech App)

The content would not be complete without the creation of a sustainable platform to access these contents. Nifty Hero Multimedia was the web and application developer that collaborated with Speech Therapists in the development of a mobile speech therapy app. The SLP team made rigorous collaborations with the app developer, aiming to bring the app and workbooks to realization through the review of each frame, given the intricacy of the app's activities, and the coding needed to set the activities in motion. 

The First Filipino Speech Therapy app

Each member, having their own roles, worked together in the creation of a locally-sourced and accessible speech therapy material: The Smile Train Speech App and its accompanying storybook. Together with Nifty Hero, the genius app developers who worked hand in hand with the SLPs, they developed an application that contains Filipino speech targets that can be used in and out of the therapy providing continuous speech practice at home.

The Smile Train speech application contains 4 modules targeting the high pressure sounds: /p/ and /b/, /t/ and /d/, /k/ and /g/, /s/ and sh. A separate folder was allotted for other high-pressure sounds that are less common in the Filipino Language such as the sounds ch, dz (j), f, v, m, n, ng, and th.

Imploring a gamified approach, students produce each sound ten times while moving up the game story and completing the other 4 levels with different interactive games per module to motivate users. These 5 levels contain the linguistic levels of isolation, syllable, word, sentence, and stories or conversation production. Before starting production, a video recording that parents can watch to review the speech sound production will appear on the screen. The app features a record button for auditory feedback.

From the app, the stories were later on published as books. These books were also made available as digital copies to increase provision of easy access for those who need to train at connected speech level.

The Smile Train story books

Filipino Roots 

When asked what made these materials essential for the community, Veronica Yu stated that these materials provide a way for continuous therapy and learning at home for the CLAP community and its roots in the Filipino language; A Filipino app for Filipino children.

Aside from the careful creation of evidence-based stimuli for the app, the themes of the storybooks and the app were given careful consideration, giving more significance to the Filipino Culture. For example, Module 1, targeting the phonemes /p/ and /b/ is centered on the theme of being thrifty or Masinop - a known Filipino trait in addition to the celebration of Filipino characteristics. Modules 2, 3 and 4, on the other hand are centered on themes of respectfulness, helpfulness, and Filipino festivities, respectively. 

/p/ and /b/ game from the Smile Train App (courtesy Smile Train Speech App)

The Future of Filipino Speech Therapy materials

What's next?

According to Veve Yu, there are continuing developments for more localized speech therapy materials. She says that she wants to keep the fire burning in terms of the development of local therapy materials. In fact, some therapy materials are in the process of brainstorming as these projects take a bit of time and focus to make. Amidst the busy schedules, Smile Train has been very supportive of all the works and efforts of Filipino Speech-Language Pathologists such as the current development for a Filipino word list. 

Just recently, with the collaboration of LeadersProject.org, a Filipino Cleft Screener was developed. Future projects are currently in development such as the creation of Filipino Word games

In hopes to provide more localized and accessible materials, Ms. Veronica Yu envisions the creation of Smile Train’s Youtube channel with the aim of teaching the families techniques and strategies in providing for their child’s communication needs even at home. What sets this channel apart from existing content is that the videos are personalized for the Filipino people with the use of the Filipino language. In addition to future video content projects, She says it would be great to have a workbook for the parents and the patients to work on. She also added that a more realistic idea would be making Filipino Boom cards specifically for cleft lip and palate patients since most of the Boom cards available today are in English as well as the growing need for technological platforms nowadays.

Be it the creation of storybooks, new applications and materials, the creation of therapy materials customized in the Filipino language serves as one big step in the continuing service of providing for children’s access to care and improvement for their communicative needs.

The Smile Train Speech App is now available for download for free at the App store and Google Play.

Written by: Racela Jian M. Asuncion, Charles Sean O. Cheung, Michelle C. Dungca,