Design | HelpYourCELF

CELF-5 is a frequently used assessment tool for Speech and Language Pathologists (SLPs). The goal of the mHealth product, HelpYourCELF, is to simplify the procedure hence decrease the workload and errors. It got overall score 8.83 out of 10 from usability testing.

AWARD:

Finalist of 2023 Student mHealth App Competition

Introduction

Problem

The need for pediatric speech and Language support is increasing. Nowadays, each speech therapist needs to take care of 25 patients at a time.
CELF-5 is commonly used but rated complicated to use.
Therapist needs to spend at least an hour on each patient implementing CELF-5 assessment.

Tools

Figma
Miro
Survey
Interview
Usability Testing

My role

Recruitment
Survey Design
Interview
Design Ideation
Final Design
Usability Testing

Solution

Digitalization simplified the process of data recording and historical data tracing.
Speech recognition not only shortened the recording time but also saved the full articulatory performance in audio form.
Replacing the table of final result, data visualization provides more intuitive demonstration of the assessment result.

Teammates

Angel Yim
Alyssa Mickelson

Duration

3 months

Background

"The number of five and six year olds who need speech and language support at school has risen by 10% in England over the past year" -- BBC (2022)

Research Question: How might we help Speech and Language Pathologists (SLPs) cope with the increasing demand?

Research

Process of Speech and Language Therapy

Takeaway:

Clinical assessment tool is selected for optimization due to its standardized features, high use rate and diverse uses in both assessment and treatment outcome evaluation in the process of speech and language therapy.

Survey (n=8): to determine which assessment tool can create most benefits to SLPs with optimization

Takeaway:

CELF-5 (Clinical Evaluation of Language Fundamentals - 5th Edition) is rated the most frequently used but most disliked. Hence, CELF-5 is targeted for improvement.

Product Evaluation

CELF-5 is consisted of 6 materials:

Record forms (1 for age 5-8 and 2 for age 9-21)
Stimulus books (1 for age 5-8 and 2 for age 9-21)
Reading and Writing Supplement (1 for 8-10 and 2 for 11-21)
Observational Rating Scale
Examiner's manual
Technical manual

Takeaways:

Low mobility due to miscellaneous and heavy materials.
Different age groups require different materials.

4

3

1

2

5

6 Task Flow

Assessment Scene - with patient

Takeaways:

SLPs' tasks include reading assessment questions, observing patient's performance and recording patient's answers. -- Multitasking
SLPs have to intermittently and repeatedly shift their attention between patient and 3 different materials during the assessment.

Record Form Operation

To calculate the final score of the assessment, SLPs need to go through a series of calculation and score conversion.

1

2

4

5

6

7

3

Fill out patient information and calculate the age through their date of birth.
Decide which indexes to assess.
Implement designated tests and calculate the Raw Scores.
Convert the Raw Scores into Scaled Scores, Confidence Interval, Percentile rank, etc.
Sum up the Scaled Scores and convert the summed value into Percentile Rank and Confidence Interval.
Calculate Discrepancy Comparison.
Sum up the checked items on the Pragmatic Activities Checklist.

Operation rules: (varies on tests)

Takeaways:

Each test has different operation rules to follow, increasing the mental workload of SLPs.
Heavy math increase the operation time of CELF-5.
Potential risk of miscalculation behind heavy math and fatigue.

Interview (n=3)

3 SLPs with CELF-5 experience were individually interviewed and the users' pain points were summarized as below:

"I wish someone could do the math for me."

"It is more complex than other tools but I still use it a lot because it can fit wider age range than others."

"For some students with special conditions such as ADHD, having them sitting there for more than an hour is challenging to both therapists and patients."

Takeaways:

Complexity: Due to complicated navigation in different materials and different age groups.
Inconvenience: Due to paper-based data storage and retrieval.
Time-consuming: Due to the comprehensiveness, high amount of computations and conditionally student's focus situations.

Problems

High Mental Workload: The wide range of applicable age from 5 to 21 is one of the reasons for CELF-5 being popular. However, different ages also require different assessment content and different start points in each test which increases the workload and risk of incorrect operation.
Long Operation Time (Fatigue): SLPs need to spend about an hour on executing CELF-5 assessment with each student. For students with attention issue, it may take longer. Plus the extra time for counting, calculating and converting scores, it can be very fatigued.
Risk of error: Errors of miscalculation and misuse the rules. High mental workload x fatigue = higher risk of error.
Low Legibility: The final results are presented in a table full of numbers. It is not intuitive while interpreting results, especially to non-professional stakeholders such as teachers and parents.

Solutions

Patient List Page:

Patient data integration: Include medical history / assessment history / consultant results into patient's profile for comprehensive assessment and tracking.

Assessment Page:

Task flow re-organization: firstly enable SLPs to select the indices for testing. Afterwards, based on the selection and patient age, corresponding tests and questions will be shown on the tablet automatically.
Question and Answer Integration: By consolidating questions and their corresponding answers onto the same page, SLPs can optimize efficiency by eliminating the need for repetitive shifts in visual attention between different areas. This streamlines the process, saving valuable time and cognitive effort.
Auto alert for rule violation: instead of requesting SLP guard against rule violation, the auto alert feature allows SLPs focus more on the patients and their performance.

Result Page:

Free of math: The results are automatically generated.
Data visualization: result is more intuitively for both users and stakeholders to understand.
Criteria of state: for student receiving school treatment, the criteria varies on states. SLPs can now quickly aware weather the patient is qualified for governmental funded treatment or not.

Prototyping

Mid Fidelity

High Fidelity

Result

Usability Test

Participants were asked to accomplish designated tasks through the prototype and rate the app. The overall scoring was 8.83 out of 10. (n = 3)

Limitation

Limited access to CELF-5: Since don't have full access to CELF-5, we couldn't build the app with all the questions. Hence, the assumption of shorter operation time needs to be further tested after thorough development.
Limited sample size: Due to restrict network and resources, we were not able to recruit more SLPs. In the future, sample size needs to be enlarged to reach statistical significance.

Reflection

Working with healthcare industry experts is a precious experience. Collecting and digesting vocational knowledge was challenging but helpful. Patient's ages, diagnoses and healthcare providers can all impact the decision of an assessment tool. So interviewing multiple interviewers helped with clarifying the situation.
The ideal prospect of the product is to integrate all kinds of assessment tools relating to speech and language therapy. Due to limited resources, we took CELF-5 as the precursor. Even though there are many assessment products being commercially competitive to one another, I hope eventually all these tools can be contained into one platform so that SLPs don't need to struggle between different patients and different tools.

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