# The involvement of individuals with speech and language impairments in research: insights from a co-creation process

## TL;DR

This paper explores how people with speech and language impairments can be meaningfully involved in developing new technologies, using a co-creation process in a teletherapy app project.

## Contribution

The study provides insights into the opportunities and challenges of co-creating technology with people with speech and language impairments.

## Key findings

- Four key themes were identified: communicative limitations, researcher skills, interprofessional collaboration, and organization of participation.
- People with speech and language impairments can contribute meaningfully to technology development when the process is methodologically designed.
- Early and case-specific decisions about user involvement are crucial for successful co-creation.

## Abstract

Involvement of end users in development processes is increasing, but there are still relatively few examples of the involvement of people with speech and language impairment (PWSLI). One reason for this is that these impairments are sometimes seen as a criterion for exclusion. The aim of this article is to identify both opportunities and challenges in a co-created technology development process with PWSLI. The project HiSSS (Hybrid and interactive speech and language therapy after stroke) has the objective of developing a hybrid teletherapy application for the treatment of speech and language impairments following a stroke. It includes a co-creation development process, engaging people with speech and language impairments and speech and language therapists. A comprehensive evaluation of the co-creation process in the HiSSS project will highlight opportunities and challenges in a co-created technology development process with PWSLI.All affiliations are captured correctly

The data sources (workshop transcripts, process adaptations, team meeting protocols, researchers' reflective notes) from the co-creation process were analysed using Braun and Clarke's reflexive thematic analysis (2021). Both challenges and opportunities were identified deductively through the analysis. In a further step, the authors inductively generated themes to which they assigned the opportunities and challenges.

Six workshops with a total of 11 speech and language therapists and four workshops with a total of 7 people with speech and/or language impairments took place. Through thematic analysis four themes were generated: (1) Communicative limitations, (2) Researcher skills, (3) Interprofessional collaboration, (4) Organisation of participation.

The generated themes represent dimensions of co-creation that should be considered in future technology developments. This study demonstrates the complexity of technology co-creation with PWSLI and confirms that they can be effectively involved in research and contribute meaningfully to technology development. Whether and to what extent users should be involved in research projects must be clarified as early as possible and on a case-by-case basis according to the specific objectives of the respective project. In order to take these four dimensions into account in future co-creation projects, the funding conditions must provide the necessary framework.

The study is registered in the German Register of Clinical Trials (DRKS00030430).

The online version contains supplementary material available at 10.1186/s40900-025-00762-8.

There are still relatively few examples of the involvement of people with speech and language impairments (PWSLI) in the development process of new technologies. Some other research groups described the lack of involvement of people with communication impairments. This article shows why and how people with speech and language impairments can be involved in development processes. The HiSSS (Hybrid and interactive speech and language therapy after stroke) project aims to develop a hybrid teletherapy app for treating speech and language impairments after a stroke. The project involves people with speech and/or language impairments as well as speech and language therapists to create the new platform. Looking at how this was done will help us understand how to make new technology work well in speech and language therapy.

The data sources (workshop transcripts, process adaptations, team meeting protocols, researchers' reflective notes) from the co-creation process were analysed using Braun and Clarke's reflexive thematic analysis (2021). Both challenges and opportunities were identified deductively through the analysis. In a further step, the authors inductively generated themes to which they assigned the opportunities and challenges. Six workshops with a total of 11 speech and language therapists and four workshops with a total of 7 people with speech and/or language impairments took place. Through thematic analysis four themes were generated: (1) Communicative limitations, (2) Researcher skills, (3) Interprofessional collaboration, (4) Organisation of participation. People with speech and/or language impairment can be successfully integrated into development processes, but a methodologically designed and target group-oriented approach is necessary. It is important to decide early on how users will be involved in a research project and on a case-by-case basis. The implementation of co-creation based on these dimensions depends on the funding conditions for research.

The online version contains supplementary material available at 10.1186/s40900-025-00762-8.