Towards Automated Game-Based Early Screening for Language Disorder (2024)

Abstract: This paper examines the potential of gamifying early childhood language disorder screening to make the process more accessible and scalable. We provide an overview of current practices in screening and assessment, and a description of our on-going work towards automation of early screening. By integrating developmental milestones into a video game format and employing automatic speech recognition and natural language processing, this approach aims to enhance the efficiency and reach of early screening in order to identify children who need further professional assessment.

## introduction language development is a crucial aspect of early childhood development, significantly impacting future academic success and social integration (sunderajan and kanhere, 2019). traditional screening methods for developmental language disorders involve one-on-one sessions that, while effective, are resource-intensive, lengthy and not easily scalable @xcite . this process, combined with the global shortage of experienced speech-language pathologists (slps) @xcite , presents a challenge in efficiently identifying children who could benefit from early intervention on a wide scale. gamification, the application of game-design elements in non-game contexts, is a powerful tool that can engage and motivate children, potentially transforming the screening process into an enjoyable, playful activity. additionally, recent advancements in technology, particularly in automatic speech recognition (asr) and natural language processing (nlp), offer new potential for automating the language screening process. we propose the development of a game that integrates these technological advancements with established developmental milestones to create a screening tool for early childhood language disorders. the proposed game aims to target children aged 3 to 4 years, a critical developmental window for identifying potential disorders @xcite . by embedding screening parameters into a game environment, we aim to gather comprehensive data on a child's language capabilities in a setting that is both natural and engaging. this approach aims to address the challenges posed by the shortage of slps and increase the probability of early screening by extending the reach and efficiency of screening processes from the outset. in this paper, we describe work in progress exploring related projects at the intersection between speech-language pathology and computer science, identifying screening methodologies that are amenable to automation, and proposing game activities that have the potential to probe the target developmental milestones. ## communication disorders communication disorders encompass a range of impairments in the ability to receive, send, process, and comprehend concepts through verbal, nonverbal, and graphic symbol systems @xcite . a communication disorder may be evident in the processes of hearing, language, and/or speech. these disorders vary significantly in severity from mild to profound, and can be either developmental or acquired @xcite . for the purposes of this paper, the focus will be specifically on language disorders @xcite . language disorders may affect different aspects of language, including phonology (the sound system of a language), morphology (the structure of words), and syntax (the arrangement of words to form sentences). they may also involve the content of language, which pertains to semantics, or the meanings of words and sentences. furthermore, language disorders can influence the function of language in communication, known as pragmatics, which involves the social uses of language (asha, 1993). individuals with communication disorders often face difficulties in various aspects of life @xcite . studies involving large groups of children with communication disorders have shown that they tend to have lower academic achievement, struggle more with reading, experience increased bullying, have weaker peer relationships, and encounter more psychosocial challenges than their typically developing peers @xcite . ## proposed method: an interactive game for early language screening our proposed approach aims to synthesize these technological advancements, particularly gamification, speech processing, nlp, and ml, into a comprehensive tool for early detection of language disorders. screening for language disorders is a broad topic, encompassing various sub-categories of screening, such as semantics, morphosyntax, pragmatics, and phonology. while earlier detection and intervention is effective 2 , we focus on the age group between three and four years old, as screen use is not recommended for children younger than 24 months (american academy of pediatrics, 2024). through the game, we aim to collect data that allow us to analyze the child's language performance. to do so, we base our measurement on @xcite , which indicates that evaluating a child's language abilities can be done by assessing utterance length and complexity, as well as lexical diversity. the assessment of lexical diversity focus on the total number of different words used by the child 3 , and the type-token ratio, which measures the ratio of different word types (types) to the total number of words (tokens) used, providing insight into the child's vocabulary richness and variety. more specifically, as reflected by @xcite and akmeşe and kanmaz 2 ward (1999) followed up with 122 children aged between 8 to 21 months diagnosed with early language delay, and concluded that early intervention is effective at preventing language delay at 3 years old. ## conclusion the proposed game-based screening tool utilizes established developmental milestones to guide its design. by embedding these milestones into a game's mechanics, we ensure that each interaction within the game serves a dual purpose: to engage the child and to evaluate their language development. the use of nlp and ml methods for analyzing the data collected from these interactions aims to provide a preliminary screening that can help identify children who may require further evaluation by a specialist. this ensures that no child in need of further screening is overlooked, while maximizing the utilization of slp time for the most likely cases of language delay. early detection and intervention in language disorders are critical for the educational and social development of children. by providing a more accessible and appealing method for screening, we hope to increase the number of children who receive timely intervention, thereby improving long-term outcomes in their learning and communication abilities.