JMIR Publications

ABSTRACT

Background:

While smart speakers are emerging as a novel healthcare technology, people with Parkinson’s (PwPD) and speech and language therapists (SaLTs) have reported difficulties using a smart speaker with speech and voice difficulties in research. PwPD identified frustration with having to repeat themselves to be understood, with devices timing out before they had finished speaking, and being unable to have a conversation with smart speakers. SLTs reported technical and practical challenges with implementing VAT tools. Both PwPD and SLTs indicated that they had a lack of knowledge about what smart speakers could do, and concerns about privacy and the listening nature of devices. Therefore, to identify optimal solutions, co-design is needed.

Objective:

To co-design solutions that support the use of smart speakers for speech and voice difficulties experienced by PwPD.

Methods:

Based on design thinking a multi-stage design process was conducted, involving a lay steering group, and two online co-design workshops. Twenty participants, including PwPD, carers, speech and language therapists, design and technology experts, and third-sector staff collaborated during co-design workshops. The ideate phase included brainstorming and ranking: conventional content analysis was used to specify prototypes.

Results:

Two main prototypes were created: 1) Education and Guidance, including privacy, therapeutic usage guides for PwPD and SLTs, to address troubleshooting and delivery considerations, and 2) New speech and language therapy specific features for smart speakers. Participants provided feedback on their experiences of co-design highlighting feeling valued, the balance of perspectives and making improvement suggestions. Feedback aligned with the UK standards for public involvement.

Conclusions:

Smart speakers could enhance accessibility, therapy engagement, and long-term speech outcomes, offering a scalable, cost-effective solution to support SLT services and patient independence and could reduce service demand. Smart speaker solutions with an SLT focus enable PwPD to self-manage speech and voice difficulties at home and reinforce therapy gains between clinic visits. Co-designed with users, these prototypes are intended to address health disparities and relieve pressure on SLT services, offering a scalable, sustainable solution that enhances efficiency and supports ongoing rehabilitation within healthcare systems. Clinical Trial: Open Science Framework