Engaging Language therapy game

In every primary school class there are on average 1 to 2 children with a developmental language disorder (DLD). DLD is a neurobiological developmental disorder, the cause of which is still unknown. Children with DLD process language less efficiently, making it harder for them to understand and use language. This can lead to misunderstanding from those around them and a misestimate of their cognitive abilities, despite the fact that they usually have a normal IQ. Also, in children from migrant backgrounds, their developmental language disorder is sometimes wrongly attributed to a lack of exposure to Dutch. Because of their language difficulties, children with DLD are less able to participate in their social environment and at school. Rob Zwitserlood, researcher at the HU University of Applied Sciences Utrecht: "Children actually learn their mother tongue naturally. In children with DLD, this is not the case. Difficulty learning the grammatical rules of their language is a core problem." Together with partners, Rob has developed a serious game to be used in speech and language treatment of these children.

Rob has worked as a speech and language therapist (SLT) for many years, working with children with developmental language disorders. "When I started as an SLT, most available treatment material was developed for young children; for older children - aged 10 years and above – the general idea was that these children  could not benefit that much from language therapy anymore. With these children, we mainly worked on compensation strategies and learning them to cope with their limitations. These older children usually had received language therapy for several years and often were no longer motivated for therapy. I therefore got the question: "What can we do for these older children?" I searched the international literature and discovered a therapy approach that perfectly suits  this target group. What these older children are able to do - and young children cannot – is to think about language form, which can be used to learn to understand the structure of language." Rob developed the metalinguistic and multimodal therapy programme MetaTaal for children aged 10 and above. With this  therapy approach, children literally learn to build sentences, using LEGO® blocks. Each type of block represents a different word class.

After MetaTaal, Rob developed Bouke Bouwt (Billie Builds). This online game is based on the idea behind MetaTaal. Bouke Bouwt is aimed at children with DLD aged 7 to 10. The sentences are simpler than MetaTaal's sentences. Some language therapy materials already existed for this group, however, among children of this age, enthusiasm for language therapy often decreases. So we pulled out all the stops to make Bouke Bouwt a game that kids really like, toensure that children continue to enjoy going to the SLT. In Bouke Bouwt, aliens visit planet Earth, and they think our world is just a dirty mess. The aliens are willing to help clean up our polluted earth, but in return the children have to teach them knowledge of the world and our language. Bouke Bouwt contains many gaming principles. It is an interactive story, all kinds of things happen in different game scenes, to which the children learn to make sentences. The children can earn rewards and make choices themselves, the game has built-in surprises, and the progress of the game is visualised. The story, characters and visual style were developed in consultation with children with DLD so that Bouke Bouwt suits their interests as well as possible. The game also includes a home assigment module so that the child can also practise at home with peers or parents. Children love to game, and this way sentence structure is practised intensely, which is necessary to make real progress."

Rob: "We studied the effect of Bouke Bouwt and compared it with usual language therapy. Children, parents and SLTs really enjoy working with the game, and the children start making more correct sentences. We do see a lot of individual differences. Some children progress well, but others make less progress. It would be good to investigate further what characterises the children who really benefit from the game. And what characterises children who do not make much progress with Bouke Bouwt. Then we can look for an appropriate therapy approach or adaptation of Bouke Bouwt for that group."

"I did not develop Bouke Bouwt on my own. This could not have been possible. Game designers Game Tailors have been indispensable. In our project, they developed the game together with researchers, SLTs and children with DLD. Game Tailors adopted the game when the project - funded by Taskforce for Applied Research SIA - was finalised, and launched it on the market. In total 10 SLTpractices co-developed the game, together with HU lecturers and bachelor students speech and language therapy, ICT, and Communication and Multimedia Design (CMD). CMD student Quincy was instrumental in designing the game's visuals. In addition, the professional SLT association NVLF, Royal Dutch Auris and researchers in language development and disorders from University of Utrecht collaborated in the project. Applied research - research into solutions that work in real life - is only possible with enthusiastic partners, who go full steam ahead."

• Bouke Bouwt (Billie Builds, NL)
• Research group speech and language therapy: participation through communication
• Research Group Meaningful Digital Innovation (NL)
• Speech and language therapy programme (NL)
• Communication and multimedia design programme (NL)
• Game Tailors (NL)
• Speech therapy practice Sprekend Spijkenisse (NL)