Speech training for neurological patients using a serious game.

The majority of patients with neurological impairment like Parkinson's Disease (PD) or stroke are affected by dysarthria. Dysarthria is a motor speech impairment which negatively affects speech dimensions such as articulation and loudness. This leads to reduced intelligibility, often hindering daily life communication. Intensive and prolonged speech training can increase patients' speech intelligibility. Unfortunately, interventions by speech therapists are generally provided only for a short period of time, while continuing practice is needed to maintain or improve intelligibility. eHealth applications might provide a solution. In our research, we explored whether it is possible to develop a game that is suitable for providing speech training in elderly patients with dysarthria due to PD or stroke. In the game, we developed, called Treasure Hunters, two players interact verbally to find the way to the treasure, while receiving automatic feedback on voice loudness and pitch. Participants played with our game in several sessions and generally appreciated it, hinting at our game's potential for speech training in elderly patients. In a within-subjects experiment with five dysarthric patients, our game was compared to a non-game computer-based speech training system: e-learning-based Speech Therapy (EST). We focussed on three variables: speech intelligibility, user satisfaction and user preference. Substantial variability between participants was observed, in the outcomes of these three variables and their relations. We conclude that one size that fits all does not apply to computer-based speech training, but a personalised approach is needed.