To ensure the validity of the original data-collection tools used in this study, namely self-administered questionnaires, smile-o-metre scales, and observation forms, a face-validity study was carried out. Face validity evaluates whether posed questions effectively measure their intended objectives, enhancing overall reliability and clarity (Leon et al., 2022).

In this phase, five SLPs reviewed the tools, providing feedback about them through quantitative and qualitative methods. This process was conducted in January 2024, and it allowed for the refinement of the tools before their use in the subsequent phases of data collection. The feedback received revealed the need for minor adjustments to the presentation of the questions in the self-administered questionnaires. Amendments were consequently carried out where necessary. It should be noted that only the revised versions of the self-administered questionnaires were used for data analysis. The initial versions were discarded following feedback and amendment.

To develop the initial BETA-Prototype of “Olly’s Adventures,” expert feedback from SLPs was sought through a remote focus group discussion. This aimed to align the tool’s evidence-based knowledge with practise-based insights, thus further improving the tool before its evaluation sessions.

Initially, participants completed a pre-interview questionnaire to share their experiences and beliefs (Haukås and Tishakov, 2024). The group’s discussion was then moderated through open-ended questions, providing a platform for the SLPs to critically assess the game’s ALPHA prototype (Figure 1; Moser and Korstjens, 2018). Ultimately, post-discussion, the participants completed another questionnaire to complement the group discussion’s insights with subjective feedback (Harris and Brown, 2019). This holistic approach allowed for comprehensive feedback, enabling the formulation of design recommendations for the BETA prototype (Figure 2).

The iterative, user-centred approach adopted in this study was exemplified in Phase two of data collection, which focused on observing interactions between typically developing children and their caregivers while using the BETA-Prototype of the “Olly’s Adventures” board game and companion app. The BETA-Prototype of the “Olly’s Adventures” board game (Figure 2) was designed following the opinion gathered from Phase 1, hence leading to a variety of changes meant to enhance its overall design.

In Phase 2, a total of 115 participants including children, caregivers, and educators who were also parents, were involved. They were required to interact with the prototypes of the board game and companion app under observation, to then provide subjective feedback after gameplay. Observations took place in public child-friendly spaces, such as the public library to capture naturalistic interactions between the adults and children. As stated, this phase of data collection incorporated observations from the first author’s perspective, to ensure robust data collection and achieve triangulation of data. Drawing on ethnographic methods as described by Cotton et al. (2010), the first author participated in gameplay sessions, making neutral observations and taking notes during these interactions. Observing gameplay was integral to the study, given that the tool’s novel nature required the first author’s involvement for effective use by the participants. To minimise potential biases brought forth by the first author’s agendas (as one of the creators of “Olly’s Adventures”) and preserve the authenticity of the data, the real-time observations were documented using previously validated observation forms. This provided the first author with the opportunity to annotate events in a structured manner as they occurred naturally and organically amongst participants.

The participants recruited in this phase of data collection formed part of two distinct sample populations. The first group of participants was comprised of typically developing children aged 5–8 years old. The second group, on the other hand, was made up of the respective caregivers of the children.

These two overarching groups of participants were further divided into five subdivisions of participant pools. The child participants were categorised into three sub-groups, whereas the adult participants were categorised into two.

The child participants were classed as either active viable child participants, active non-viable child participants or spectating child participants. On the other hand, the adult participants were categorised as either active adult participants or spectating adult participants. The following table outlines the defining criteria for participant categorisation. It should be noted that the participant groupings in Table 1 were used for descriptive purposes only and were not subjected to statistical comparison.

For each group (i.e., adult and child participants), once the adult participant read through the provided information letter and signed the attached consent form, the participants were guided towards the physical versions of the BETA Prototype of the “Olly’s Adventures” (Figure 2). They then interacted with the prototype for periods ranging between 30 and 45 min.

As Hess (2012) defines it, a prototype is an approximation of a product along one or more of its dimensions. Therefore, the prototype would be an assimilation of the envisaged final product but may not be functional. However, opposing what Hess (2012) stated, the “Olly’s Adventures” BETA prototype was fully functional to prove its concept, but it simply did not look like the final tool (i.e., the images used were stock images and the design was still not finalised).

Throughout the participants’ interactions with the prototype, the observing first author completed an observation form of her design. The observation form was aimed at eliciting feedback about:

As aforementioned, this observation form encouraged the first author to stick to a standard protocol of observation. It thus encouraged the gathering of higher quality feedback, as opposed to the input which could have been gathered in an unstructured fashion (Beck Dallaghan et al., 2018). Consequently, after the participants’ interactions with the tool and the completion of the observation forms by the first author, the adult participants were asked to complete a self-report questionnaire regarding each child’s participation. To reduce observer influence, the researcher stepped out during questionnaire completion and reflection activities.

This questionnaire aimed to elicit information about:

Thus, these tools gathered comprehensive data about the use of the game with typically developing children aged 5–8 years and their active interacting caregivers, a substantial 20% per cent of whom reported themselves as educators. This percentage of experienced early-years, primary, and secondary educators were able to provide insight into how the “Olly’s Adventures” board game and companion app could be introduced in classroom settings; this will be further delved into in this study’s discussion of results.

Based on the user-centred design methodology used throughout this study, it was necessary to take into consideration the possible end-user requirements throughout every phase of product development. To meet the tool’s innovation goals as extensively as possible, as much end-user input as feasible needed to be obtained (Liem and Sanders, 2011).

An end goal for the “Olly’s Adventures” tool would be implementation into local speech and language sessions. As Hysong et al. (2013) discuss, in the context of implementation, professionals serve not only as a source of data but also as stakeholders and resources that ensure the success of any new technique’s implementation. In the present study, this was made possible by holding gameplay workshops for SLPs. Nudel et al. (2023) found DLD to be critically underdiagnosed in Danish hospital registers, prompting this study’s first author to gauge that accessibility to this research population would be somewhat limited (Newington and Metcalfe, 2014). Therefore, the decision to separate the evaluations made by SLPs and children with DLD was made. Seeing as the input elicited from these SLPs would still be considered vital for the study’s progression, even though gathered in the absence of children with DLD.

It was encouraging that 12 speech and language pathologists were recruited to evaluate the BETA prototype of the “Olly’s Adventures” tool (Figure 2) during this phase of data collection, particularly given rising work demands and the time of clinicians becoming increasingly valuable. However, only 10 attended the workshops on the scheduled day. Despite this, the interest from clinicians was a positive sign for the future of the “Olly’s Adventures” tool. Indeed, Hysong et al. (2013) assert that clinician engagement with novel concepts will support the future implementation of the tool in clinical settings.

The focus group held with the 10 participating SLPs encouraged structured discussion about the BETA prototype which was further bolstered using individual mini-surveys to gain further insight into their subjective thoughts and opinions regarding the “Olly’s Adventures” tool. The surveys focused on the exploration of domain-related cases to fulfil both the first author’s and participants’ expectations and achieve a pre-defined interest (Ørngreen and Levinsen, 2017). For the research team, which is made up of Speech and Language Pathologists, Engineers and App Developers, the aim was to produce reliable and valid data regarding clinicians’ perspectives on the following:

Continually, attending clinicians had the opportunity to gain exposure to innovative tools and gain more knowledge about the potential implications that connected technologies could have within their profession. In doing so, they also contributed to its user-experience-based design since the input received from those 10 SLPs then served as a channel through which further design recommendations were formulated for the creation of the Pre-Production version of the “Olly’s Adventures” tools.

In Phase 4, a case study-based approach was employed to observe a child diagnosed with DLD’s interaction with the BETA Prototype of the tool (Figure 2) alongside his main caregiver (a self-reported primary education learning support educator) and SLP. Similar to Phase 2’s research design, caregiver-report questionnaires along with observations were taken on in Phase 4. However, Phase 4 employed a smaller scale of participants when compared to Phase 2. Therefore, a mixed methods-based design was used in this data collection phase. Quantitative input was gathered using caregiver-report questionnaires and clinician observation forms. Qualitative input was gathered through the annotations gathered during the session observation when the “Olly’s Adventures” tool was used in the clinical setting.

Given the limitations in recruitment, only one child diagnosed with DLD could trial the tool in therapy. Hence, limiting the generalizability of findings, and larger-scale validation studies will be required to assess the tool’s clinical effectiveness more robustly. To maximise efforts, a case study-based approach was adopted in this phase’s design. As Huby et al. (2011) describe it, the case-study approach is beneficial when a study requires an in-depth analysis of a phenomenon of interest as it occurs in its natural, real-life context. Furthermore, Stake (1995) work is particularly influential when defining the case-study approach, characterising three main types of case studies: intrinsic, instrumental and collective. In this study’s case, an intrinsic case study was undertaken, as we attempted to learn about a unique phenomenon. The distinguishing factor of this case lies in the fact that the child, diagnosed with DLD, utilised the “Olly’s Adventures” tool in therapy. Documentation of language as elicited using the “Olly’s Adventures” tool was unprecedented, as no other child with a similar developmental profile had ever used this tool before.

In addition to the scarcity of children diagnosed with DLD who wished to participate in the study, the case-study approach was also chosen to explore the implementation of the “Olly’s Adventures” tool in the clinical setting in depth. Thus, as Crowe and Sarma (2022) highlight, in contrast to experimental designs, which aim to test a specific hypothesis by deliberately manipulating the environment, the case study approach is well-suited for exploring explanatory questions like “how,” “what,” and “why.” For example, it can address questions such as, “How is the intervention being implemented and received by the client?”

To once again achieve data triangulation, observations from the first author’s perspective were undertaken to better understand the presented situation. To maintain a standard operation protocol regarding observations, notes were taken using an observation form purposefully designed for this study. To further ensure the reliability of results, the participating clinician was also tasked with completing the same observation form as the first author.

Continually, feedback from both the SLP and the caregiver was required given the study’s user-experience-based design. Therefore, post-experience questionnaires were still handed out to both participants.

Given that the child’s literacy skills were still in the process of developing, they could not be presented with a questionnaire such as the ones disseminated to the adult participants. In light of this, a smile-o-metre was presented to the child after each activity.

Ultimately, the clinical evaluation held in phase 4 highlighted the tool’s potential as an engaging and effective tool to support language development in children diagnosed with DLD. Regardless of the limited sample size, the feedback gathered from the caregiver and SLP, along with the observational data, emphasised its usability and adaptable nature in the clinical setting. Hence, this suggests that the tool’s gamified and customizable design is scalable to broader therapeutic and educational contexts, making it a promising resource for bilingual and diverse learning environments.

Following the gathering and analysis of the above-mentioned data from Phases 1–4, a new prototype (pre-production prototype) was created. Consequently, a preliminary round of feedback (Phase 5) was conducted with 20 board game designers at the SPIEL 2024 convention in Essen; this phase aimed to gather impressions on the game’s design, playability and perceived educational value.

The designers were given some time to interact with the pre-production prototype of the game, and after engaging with the game, they were asked to complete an opinion-based questionnaire exploring themes such as:

While these early insights contributed meaningfully towards game mechanic improvements, this phase is not included in the formal statistical analysis due to its limited scope. The aim was to inform design refinement from a playability standpoint before broader validation studies were carried out.

Moving onwards, upcoming data collection phases will involve more structured evaluations of the pre-production prototype. Including further clinician evaluation with the same clinicians involved in Phase 3 to allow for a direct comparison of their experiences with the BETA and Pre-Production versions. Additionally, further testing with educators and in-classroom evaluations may be carried out to gather broader feedback about the game’s integration in educational contexts. In parallel, further evaluations with the clinical population through in-situ observations will need to be carried out, given the initial limited sample elicited in Phase 4. These steps will be critical to ensure that the final version of the game is both effective and appropriate for its diverse user groups (Figure 3).

The theme of “Elevating Play” outlined the emphasis placed on the role that engaging and well-thought-out designs play in attracting and maintaining children’s interest in educational materials. The data gathered revealed that through the combination of attractive visual aesthetics and apt gameplay mechanics, immersive learning experiences tailored to the target audience’s needs can be created. Participants also noted the impact of the tool’s use of thematic elements and appealing characters, which innately enhance the “fun” aspect of the tool and further contribute to sustained engagement.

A recurring insight from the data was the value of prioritising UXs through continuous feedback loops, hence, underscoring the importance of designers being responsive towards users’ evolving needs and preferences. Additionally, effective pricing and marketing strategies were identified as influential factors towards improving accessibility and the promotion of the tool’s widespread adoption. Together, these elements formed a comprehensive approach towards elevating play in a way which would maximise the potential impact of such an educational tool.

Theme 1 elicited the following sub-themes:

The theme of “Navigating the Uncommon” explores the unique opportunities and challenges associated with the introduction of an innovative tool within the local context (in this study’s case that is the Maltese context), where similar design and the use of gamification as an educational and therapeutic channel is relatively unfamiliar. The data outlined mixed responses from local caregivers, educators and SLPs toward the tool’s use of connected technologies. While some participants displayed enthusiastic and open-minded responses, others highlighted scepticism and/or a lack of understanding towards its applications and benefits.

This section sheds light on the novelty of the study, highlighting the tool’s potential to transform therapeutic practises by offering uncommon ways to support therapeutic goal targeting. However, the data also underscored the importance of providing education and support to SLPs, to address their gaps in knowledge and foster confidence towards the adoption of such techniques. These steps would be crucial towards the tool’s successful integration within the local context.

Theme 2 elicited the following sub-themes:

The third theme “Revealing Future Possibilities” explores the scalable potential of the tool, emphasising its versatility beyond its primary application in speech and language pathology. Despite being designed for therapy, the collected data suggested that the tool also holds major promise as an educational resource for the mainstream classroom. This potential, particularly regarding its data-handling capabilities, supports effective use across diverse contexts.

Consequently, findings also highlighted the tool’s capacity to facilitate the carry-over and follow-up of language practise in the home environment. Thus, bridging the gap between formal instruction and daily life, the tool offers a seamless way through which educators may ensure continued progress in practise. Overall, this dual functionality, between therapeutic and educational contexts, placed the tool as a valuable innovation with wide-reaching implications.

Theme 3 elicited the following sub-themes:

The tool’s adaptability to fit children’s particular needs establishes its value in delivering personalised language instruction. The gathered data highlighted the tool’s unique features, which actively support language acquisition by accommodating varied learning styles and abilities. A key point of importance for the participants was the tool’s bilingual functionality, enabling its use in both Maltese and English, either independently or simultaneously. This flexibility broadens its applicability across diverse linguistic contexts. Furthermore, the gameplay evaluations revealed varied interaction and instruction techniques, highlighting the tool’s dynamic and engaging approach to bolstering language development. The data affirmed the game’s potential as an innovative resource for language learning both in therapy, in the classroom, and at home.

Theme 4 elicited the following sub-themes:

The final theme elicited from the data examines the concerns and criticisms towards the integration of connected technologies and gamification in therapy/educational materials. Certain individuals across the data collection phases revealed scepticism regarding the effectiveness and appropriateness of gamification in the therapeutic and educational contexts, hence, reflecting a broader hesitation towards such innovations.

The prototype evaluations further emphasised these challenges, since the presented difficulty levels were inadequate for certain children, showing the need for continued refinement to ensure the tool meets its diverse users’ needs. Another critical finding was that a few participants found that the BETA prototype (Figure 2) had an absence of cultural elements, which could lead to limited relevance and acceptance within the local community. By bringing these concerns to light, thoughtful design adjustments can be made before production and community engagement with the tool can be maximised.

Theme 5 elicited the following sub-themes:

Overall, these themes encapsulate the key findings and provide a structured framework for readers to better understand the gathered data.

The statistical analysis of Phases 2 and 3 of data collection complements the preceding qualitative insights by highlighting empirical evidence that detects patterns and relationships not captured through qualitative means, thereby strengthening the overall findings (Guetterman et al., 2015). While qualitative data captures detailed user experiences (UXs), quantitative analysis provides objectivity, particularly when comparing user groups such as caregivers (CG) and speech-language pathologists (SLPs), as is done in the subsequent analysis (Law et al., 2014). This mixed-methods approach not only reinforces the qualitative findings but also enhances the rigour and generalizability of the research, leading to richer, replicable insights (Johnson et al., 2020).

Statistical measures of distribution and central tendency were first used to summarise key characteristics of the dataset. Variables such as age, gender, language exposure, and developmental status were reported for descriptive purposes only, in order to contextualise the participant sample; no inferential testing was conducted on these demographic variables.

Although Likert-scale responses are often summarised using means and standard deviations, these data are ordinal in nature, and this was taken into account when selecting appropriate analytical techniques (Bishop and Herron, 2015). To compare responses from CGs and SLPs regarding tool usability and engagement, non-parametric tests, specifically, Mann–Whitney U and Chi-square tests, were employed, given the ordinal scale of the data and the small, non-normally distributed sample. While no formal null hypotheses were stated, each test was used to evaluate whether statistically meaningful differences existed between the two participant groups.

In Table 2, the descriptive statistics presented, focus on the age of the typically developing (TD) child participants from the BETA-Prototype Evaluation held during Phase 2 of data collection. The sample consists of 48 children, with a mean age of 6.57 years (SD = 11.16), ranging from a minimum of 5.01 years to a maximum of 8.11 years.

Table 3 further elaborates on the distribution of TD children across several demographic variables. In terms of gender, 56.3% of the children were female (n = 27), while 43.8% were male (n = 21). The sample is also divided by school type, with 47.9% attending church schools (n = 23), 14.6% in private schools (n = 7), and 37.5% in public schools (n = 18). Geographically, 50% of the children were from Malta Centre (n = 24), while 14.6 and 35.4% came from Malta North (n = 7) and Malta South (n = 17), respectively.

Regarding language background, 39.6% of the children (n = 19) had an approximately balanced use of both English and Maltese, 25% (n = 12) predominantly spoke English, and 35.4% (n = 17) predominantly spoke Maltese. In terms of language exposure, 54.2% of the children (n = 26) were exposed primarily to Maltese, while 27.1% (n = 13) experienced balanced exposure and 18.8% (n = 9) were exposed predominantly to English. The distribution by game language reveals that 56.3% of the children (n = 27) played the game in English, and 43.8% (n = 21) played it in Maltese. Finally, the children were distributed evenly across difficulty levels, with each level being chosen by approximately 20–30% of the sample.

Table 4 provides central tendency measures for two variables, scored according to the opinions of the TD children’s caregivers. The mean score for the effectiveness of games in making language learning enjoyable is M = 4.52 (SD = 0.618), with a median and mode of 5. The efficiency of activities in gaining children’s attention had a mean score of M = 5.00 (SD = 0.512), and both the median and mode were also 5.

Table 5 outlines the game duration and activity replay frequencies for TD children as noted by the observing first author during the evaluation sessions. Most children (44%, n = 22) played the game for 45 min, followed by 40 min (28%, n = 14), 35 min (14%, n = 7), and 30 min (14%, n = 7). Game completion was achieved by 96% of the children (n = 48), with only two children (4%) not completing the game.

The replay frequencies for various activities are also detailed. For “Activity 1: Categories,” 80% of the children (n = 40) did not replay the activity, while 14% (n = 7) replayed it once and 6% (n = 3) replayed it between 2 and 5 times. Similar patterns are observed for “Activity 2: Odd One Out,” with 80% of children not replaying it, 16% replaying it once, and 4% replaying it more than five times. For “Activity 3: Matching Pairs,” 88% did not replay, while 10% replayed once, and 2% replayed 2–5 times.

Parametric tests rely on assumptions like normal data distribution and homogeneity of variances, but with small and unequal sample sizes, these assumptions are often violated, risking invalid statistical inferences (Yu, 2012). Due to the characteristics of this dataset, non-parametric testing was chosen instead. To ensure comparability, the caregiver sample was equalised by dividing the original sample by age range and randomly selecting participants using randomisation software (Xiang, 2016).

Non-parametric tests, which rank data rather than rely on distribution assumptions, offer greater flexibility for small, unequal samples, reducing the risk of Type I and II errors (Nahm, 2016). Non-parametric methods were used due to the small sample size (n < 30) and as Ghasemi and Zahediasl (2012) note, such methods are appropriate when normality cannot be assumed. These tests were applied to compare UXs between caregivers and speech-language pathologists (SLPs) and evaluate performance scores provided by both caregivers and the first author through observation forms. This test provides a more reliable and holistic understanding of UXs, enhancing the validity of the analysis.

Aesthetics are crucial in the effectiveness of pedagogical tools, as highlighted by Page and Thorsteinsson (2017), who state that toys similar to “Olly’s Adventures” need to balance visual appeal and educational value. The findings align with this, as caregivers consistently praised the design during evaluation sessions. For example, one caregiver described it as “very stimulating and fun,” while another commented, “It’s very attractive in terms of the design and all of that, it’s very appealing.” Heljakka (2019) advocates for “wow factors” to enhance the long-term play value of toys, a sentiment reflected in feedback from an SLP during the clinical evaluation: “Children tend to love and be motivated to use board games, which is very appealing.” Feng (2024), however, emphasises the importance of incorporating innovative play modes and materials to foster healthy cognitive development.

From the gathered data, “Olly’s Adventures” was deemed highly attractive, with one caregiver noting, “The board and the pieces are very appealing.” Another caregiver, whose child was diagnosed with DLD, highlighted its relatable design: “The board game is very colourful, and children can relate to the background of the game as it shows places that they would normally visit.” These findings suggest that the game successfully integrates visual appeal with engaging and relatable elements, creating an attention-grabbing and motivating environment.

The delivery of language instruction stands to be enhanced through the use of game-based elements that provide well-designed and interactive gameplay. Olly’s Adventures benefits from intuitive and captivating mechanics that balance developmental goals with an enjoyable experience. As outlined by Qiu (2024), the combination of digital and traditional play promotes parent–child interactions, which when paired with effective language exercises, as Saeedi et al. (2022) suggest, could lead to streamlined and supportive learning. One SLP emphasised the importance of purposeful game design, stating, “Exactly, but it’s specifically a language game so no matter what language goals are being targeted.”

However, Piculo dos Santos et al. (2019) emphasise the need for designing inclusive games that accommodate diverse needs, ensuring equity in terms of accessibility. This is crucial for ensuring that children with varying abilities benefit equally from the game. Additionally, Jiang et al. (2018) suggest that aligning designs with children’s preferences encourages greater use and sustained interest. One caregiver noted during the evaluation session, “Since we are in a world of using technology, it’s nice to have something to learn from it as well.”

The integration of both physical and digital elements also received praise from an SLP, who said, “It would be very useful in our clinics because children need that digital aspect these days, and the included physical aspect would help for better explanations from the SLP.” This feedback highlights the value of combining traditional play with digital elements, fostering a comprehensive and engaging approach to language therapy.

Effective engagement, whether in a clinic, classroom, or home setting, requires a deep understanding of how to capture and maintain attention. Educators must tailor their approach to diverse learning styles and employ strategies to grab and sustain focus (Arifadah et al., 2020). Similarly, toy designers must create products that are appealing and engaging for different children. One caregiver highlighted the immediate appeal of Olly’s Adventures, noting, “The fact that it has an app, it grabs the child’s attention immediately.” However, as with any tool, maintaining attention over time remains a challenge. As another caregiver pointed out, “If the game takes too long, young users start losing interest.”

Family-centred approaches emphasise the importance of involving parents in children’s learning and play (Law et al., 2019). Olly’s Adventures fosters this inclusion by offering an interactive environment that engages both children and adults. One caregiver appreciated this aspect, stating, “I liked that the children could play together, but also the adults.”

When designing board games for language therapy, a balance between complexity and simplicity is essential. Observations from the evaluation workshops highlight this need for balance: “It should be noted that the child’s attention was fleeting at times, and she had to be redirected to the game on multiple occasions.” This emphasises the importance of designing games that are not only engaging but also adaptable to various attention spans and developmental stages. Customizable gameplay, including tiered rules and adaptable components (as is found in the pre-production version of “Olly’s Adventures”), can cater to different skill levels and developmental needs.

The Olly’s Adventures tool utilises animated penguin characters in its design to appeal to its younger potential users. Character design, particularly for younger audiences, plays a crucial role in capturing attention and enhancing learning experiences. Features like larger eyes and rounder faces can make characters more appealing (Carter et al., 2016). Feedback from caregivers and observations during the evaluation sessions support this, with one caregiver noting, “My son really liked the penguins!” and another observing that, “Both girls were mostly attracted to the game because of the penguins, they are their favourite animals.”

Thematic choices, such as using animal protagonists and prosocial themes, can significantly impact children’s engagement and development (Hejazi, 2023; Larsen et al., 2018). This aligns with insights from board game designers, who emphasise the importance of blending popular themes with humour and relatability: “To make board games truly relevant to children, blend trending themes, like Paw Patrol or Disney, with seasonal or cheeky humour that resonates with their everyday experiences, making play both fun and impactful.” This was reflected in the evaluation, where one caregiver remarked, “Love the colours and penguins.”

Such design choices not only captivate children but also support their cognitive and emotional growth. However, some caregivers suggested that integrating the penguin’s environment into the gameplay could further enhance engagement: “It would be nicer to match the games to the ambient where the penguin of the respective player is.” This feedback suggests that creating more contextually immersive environments for the characters could deepen the connection children feel with the game.

User feedback is crucial in designing effective and engaging toys. By gathering input from users throughout the design process, developers can ensure that the final product meets the needs and preferences of the target audience (Pagano and Bruegge, 2013; Fotrousi et al., 2014). Iterative design, involving prototyping, testing, and refinement, allows for continuous improvement of the UX (Bernhaupt, 2015). This approach is particularly important in game development, where creating fun and engaging experiences is a primary goal. Feedback from the evaluation sessions highlighted the need for refinement. For example, one speech-language pathologist (SLP) suggested, “To add the points onto the app, to have one path instead of 4 in order to be less time consuming, it’s a very fun game and very stimulating.” Another SLP recommended, “To combine the areas on the board to make it one complete path,” aiming to streamline gameplay and reduce complexity. In accordance, this was incorporated into the pre-production design.

Understanding the dual requirements of functionality and enjoyment is key to designing toys that resonate with users (Roto et al., 2009). By considering factors such as the Quality of Experience (QoE), designers can identify areas for improvement and create products that delight users (Le Callet et al., 2013; Fotrousi et al., 2018). This balance is especially critical in therapeutic games. One SLP, emphasised the need to reduce playtime, stating, “Decrease playing time. A 40-min game is too long for most 5-8-year-olds (especially those with additional challenges).”

Effective pricing and marketing strategies are crucial for the successful implementation of “Olly’s Adventures” in healthcare clinics and classrooms. Pricing strategies must be carefully considered to appeal to both professionals and at-home users. Transparent, relevant, and engaging pricing, coupled with effective marketing, can significantly influence product acceptance (Ali and Anwar, 2021). Understanding buyer behaviour and incorporating customer feedback into the product development process is essential, particularly in healthcare, where products directly impact patient outcomes (Ballanger, 1996).

For tools like Olly’s Adventures, additional factors such as content quality, perceived value, and innovation influence pricing decisions. Offering high-quality components, expansion packs, and adaptable gameplay can enhance product appeal and long-term engagement. As noted by a board game designer who participated in Phase 5 of data collection “When determining a pricing strategy for therapeutic board games, consider the value you are offering—are users getting what they expect for the price, while ensuring innovation, high-quality content, and a truly exceptional product?” Expansion packs, in particular, can enhance playability and replayability by introducing variance, increasing difficulty, and addressing gameplay issues in the core game: “Expansion packs may not be essential, but they enhance playability and replayability by introducing variance, increasing difficulty, and fixing gameplay issues in the core game.”

However, caregivers emphasise the need for a balanced pricing approach. One caregiver noted, “It requires a lot of money to be able to ‘publish’ this and put it on the market, so it cannot be put at a high price, but at the same time if it is very expensive people will not buy it even though it is fun to play.” Therefore, the importance of finding a pricing strategy that reflects both the value of the product and the financial limitations of potential users.

The integration of new technologies in speech and language therapy has the potential to transform clinical practise, enhancing data collection, assessment, and treatment (Pierrakeas et al., 2006; Garrett, 2013; Chen et al., 2016). However, many free-to-download apps lack empirical support or may not align with evidence-based principles, which raises concerns about their adoption (Furlong et al., 2018). The success of technology adoption in speech and language therapy is heavily influenced by the perceived usefulness and ease of use, as highlighted by early technology acceptance models (Davis, 1989). Clinicians must see the technology as beneficial and easy to integrate into their workflows (Albudoor and Peña, 2021).

Challenges to adoption include technical issues, such as network reliability, and individual barriers, like clinician familiarity with the technology (Zakerabasali et al., 2021). SLPs in the evaluation workshops emphasised the importance of flexibility in design to address these barriers. One therapist noted, “I wish we could have the ability to use it without the app (due to potential connectivity issues in district clinics).” Another expressed concern over the complexity of the design, suggesting, “I would simplify the process by removing the app and having the instructions on flashcards.”

Despite these challenges, many clinicians recognised the tool’s potential to enhance therapy. One therapist stated, “I do believe it could augment therapy in terms of variety and interest.” The visuals and customizable features of the game, such as different levels of difficulty, also contributed to its appeal, with one therapist remarking, “The colours, the characters, they are really interesting and I liked that it wasn’t like the normal sorting or labelling.”

The potential for collaboration between education and speech-language therapy is promising. Both fields share the common goal of improving language skills, albeit with distinct focuses. Gamification, as explored by Zhang and Hasim (2023), offers a potential avenue for shared resources. By adapting educational materials, such as game-based learning, for therapeutic use, more engaging and motivating interventions can be developed for children with SLCN (Speech, Language and Communication Needs). For instance, feedback from caregivers, who were also educators, highlighted the versatility of such tools. One participant noted that “it could be introduced in literacy classes where students are practising without noticing; it could also be used in complementary classes, CCP, Prince Trust, and also as a means to assess speaking.” Another participant suggested extending the use of these resources to “other subject areas across the curriculum.” This feedback underscores the potential for integrating game-based tools into various educational contexts. However, as highlighted by Mathers et al. (2024), clear guidelines and frameworks are needed to facilitate collaboration and optimise resource sharing. Involving learning support educators (LSEs) in this process is crucial to ensure effective implementation. By building on the strengths of both fields and addressing the identified challenges, a more efficient and effective system of language support for children regardless of language abilities can be created.

The companion app has the potential to revolutionise healthcare by generating valuable patient-generated health data (PGHD) (Pulimamidi, 2024). For example, as one SLP suggested, “having data collected would help for progress notes and to track progress.” Personalised experiences can further enhance user engagement and adherence to therapy (Omaghomi et al., 2024). Feedback from SLPs emphasised the importance of customization, such as the ability to create individual client profiles to track performance and facilitate carryover at home. One SLP proposed, “including profiles for clients which can be accessed by carers at home. SLPs can set goals for the client on the app to facilitate carryover at home. Data related to performance (at home and during the session) could be stored on profiles on the app.”

However, some concerns were raised about the potential complexity and impact on workflow. As another SLP reflected, “I personally would not like that because it really takes away from the. fun of it. It becomes much more complicated. If it’s integrated as something that you have to do, it’s like you cannot get away from it.” These contrasting perspectives highlight the need to balance functionality with usability to ensure the app remains a helpful tool rather than an added burden.

Additionally, rigorous attention to data privacy, security, and quality is essential (Omaghomi et al., 2024; Ohalete et al., 2024). Addressing the digital divide is also crucial to ensure equitable access and outcomes for all users (Ohalete et al., 2024; Adebisi and Lucero-Prisno, 2022). By addressing these challenges and incorporating user feedback, the app can become a powerful tool for both therapy and data-driven decision-making.

The board game and companion app can significantly enhance language therapy outcomes by fostering therapeutic carryover and supporting follow-up practise at home. By supplementing in-person therapy and lessons with structured exercises, immediate feedback, and additional practise opportunities, the app can help address the common challenge of maintaining consistent practise outside the professional setting (Okolo et al., 2024; Orehovački et al., 2017). As one SLP noted, “It would augment therapy, rather than solve, I think. It would make it more interesting and varied. It would also help carryover if parents purchase it too.”

The inclusion of app features like user profiles, which caregivers can access at home, was highlighted during the evaluation. These profiles could enable professionals to set goals and monitor performance both in class or clinic and at home, supporting a more integrated approach to learning. One caregiver reflected on her experience, saying, “It used to be very difficult for me to try and get my son to sit and work on the carryover activities the SLP provided. If I had had something like this, I could have potentially instructed my child in a better way.”

While the tool holds great potential, addressing user privacy, data security, and sustained engagement remains critical to its success (Okolo et al., 2024). By integrating these considerations, the tool can serve as an engaging and effective extension of therapy, bridging the gap between clinic and home.

Person-centred care (PCC) is a cornerstone of speech and language therapy, emphasising personalised interventions that address individual needs and preferences (DiLollo and Favreau, 2010; Forsgren et al., 2022; Bellon-Harn et al., 2017; Mahomed-Asmail et al., 2023). While balancing individualisation with caseload demands is challenging (Binns et al., 2022), adaptable tools offer solutions, particularly for diverse clinical populations (Mahomed-Asmail et al., 2023).

The tool’s multiple difficulty levels and customization options exemplify this adaptability. As one board game designer noted, “Customising a board game for different cognitive abilities is all about adjusting the rules.to match each child’s language and cognitive skills, making the game more engaging and tailored to their level.” This flexibility was also appreciated during evaluation sessions, where a caregiver remarked, “I liked the fact that she was able to play the same game as an older child but the questions were tailored for their ages, respectively.” These features ensure that children of varying developmental abilities can meaningfully engage, enhancing inclusivity.

Incorporating physical and tangible elements, collaborative tasks, and adaptable visuals enhances accessibility and engagement. A board game designer emphasised that “board games should enhance UX by combining team engagement with customisation.ensuring motivation and inclusivity for all users.” Balancing difficulty is also crucial, with designers noting the importance of games being “challenging enough to motivate, but not so hard, complex, or lengthy that the child loses interest.”

By combining flexibility, personalization, and thoughtful design, the tool supports PCC principles, fostering engagement and accessibility across therapeutic and clinical contexts.

Bilingual materials, as highlighted by Li (2023), can enhance language understanding and use by reflecting the child’s linguistic reality, fostering cultural identity, and identifying strengths and weaknesses across both languages (Dam and Pham, 2023; Nair et al., 2023). One caregiver noted the value of the tool, stating that children “can use it in both Maltese and English and also that they will learn something from the game.”

The tool’s potential applicability was further demonstrated during evaluation workshops. For instance, Austrian children fluent in English, German, and Russian played the game in English, with one child translating instructions into German for his younger sister. Their Maltese-speaking nanny noted that the game could also serve as a base for learning French, which the children were studying. Similarly, a Hungarian mother commented on its utility in contexts where English is not widely taught. Another session highlighted flexibility in language preferences: a child initially played in Maltese to accommodate his grandmother but later switched to English, requiring the moderator to translate for the grandmother to continue participating. A feature which at the time of writing has been included in the pre-production version of the companion app, thus no longer requiring spontaneous translation as the app offers the ability to change the game’s language during play. These examples underscore the potential of bilingual materials not only for therapeutic use but also for broader educational applications, particularly in diverse linguistic settings. While individual needs and clinician expertise remain critical, tools like “Olly’s Adventures” can bridge gaps in multilingual education and therapy.

It should be noted that this study was intentionally limited to Maltese and English-speaking children, as it served as an initial exploration of the tool’s potential within a bilingual context. Malta is officially bilingual, and both Maltese and English are used widely in education and everyday communication (Mifsud and Vella, 2018). While the tool is designed to be adaptable, future research will be necessary to assess its application in other linguistic settings.

While digital gamification shows promise in language therapy and education, its adoption faces several challenges, including therapist/educator concerns and user apprehensions. The comfort levels users have with technology is a significant barrier; less tech-savvy professionals may hesitate to adopt new tools without proper training (Gustafsson and Edberg, 2017). Additionally, concerns about effectiveness persist, as evidence supporting gamification outcomes continues to emerge (Gentry et al., 2019; Melcarne et al., 2023).

Therapists also express concerns about accessibility and usability for diverse populations. As one therapist noted, “Could prove difficult to use with those with limited fine motors and clients with aggressive behaviour,” which could be due to the smaller physical pieces included in the board game and also the possibility that the child may not win the game in the end, whereas another highlighted the need for practical solutions: “Accessibility for children with access issues could be managed with advice + a communication board to navigate using partner-assisted scanning, for example.” Simplification was also suggested to address cognitive and usability barriers: “I would simplify the process by, for instance, removing the app and having the instructions on flashcards and presenting fewer items at any given time.”

For users, privacy concerns related to data sharing and the complexity of learning new systems can also hinder adoption (De Cremer et al., 2017; Gustafsson and Edberg, 2017). Older adults or individuals with limited tech literacy may find the tools intimidating, and some professionals remain sceptical about their reliability compared to traditional methods.

Addressing these barriers requires comprehensive training for SLPs, evidence-based demonstrations of effectiveness, and robust privacy measures. By building trust and providing tailored support, digital gamification can better realise its potential to enhance language therapy outcomes.

Using culturally appropriate therapy materials is essential for effective intervention with diverse populations. Culturally relevant content enhances client engagement, builds rapport, and improves outcomes by respecting clients’ values and beliefs, which significantly influence their perceptions of therapy (McLeod et al., 2017). Ignoring these factors risks miscommunication and undermines care quality.

Culturally tailored materials also help reduce power imbalances by showing respect for clients’ backgrounds, fostering trust, and promoting collaboration, particularly with marginalised populations (Stubbe, 2020). As one SLP remarked during the evaluation, “It would be a shame to lose the Maltese element as it is something that makes the game unique, and since it is a bilingual game that includes Maltese as one of the main languages, I think it would make it stand out.”

Feedback from caregivers echoed this sentiment, suggesting that the tool could be “more Maltese-centric” or include culturally iconic features, such as “the luzzu” (a known Maltese icon) or activities linked to popular locations like “Ta′ Qali National Park” (a location in Malta). Suggestions also included replacing the penguins with “another animal typical of Malta.”

While some professionals may resist shifting from traditional methods (O’Connor and Pettigrew, 2009), professional development and exposure to culturally responsive tools can ease this transition. As Verdon et al. (2015) note, a “one-size-fits-all” approach is inadequate. By embracing cultural awareness, SLPs can create stronger connections and foster improved outcomes, making tools like “Olly’s Adventures” both impactful and inclusive.

While this study provides promising insights into the potential of “Olly’s Adventures” as a therapeutic and educational language intervention tool for children, several limitations need to be acknowledged.

One of the limitations encountered was that of the study’s small sample size, which limits the generalsability and statistical power of its findings, particularly in terms of recruiting children diagnosed with DLD and SLPs. This limitation restricted the broader representation of the population and the variability in needs across different demographics. Additionally, the single-session clinical evaluation prevented the assessment of long-term impact when using “Olly’s Adventures” in its intended way. Therefore, despite the tool being designed with DLD in mind, this phase focused on initial development and testing. The DLD-related findings are exploratory and should not be interpreted as clinical validation. Further targeted research needs to occur prior to clinical implementation.

Continually, subjective interpretation was another key limitation, as the study relied heavily on feedback from caregivers, clinicians, and other stakeholders, which stood to introduce elements of observer bias and personal interpretation. These differing responses highlight the importance of context when evaluating educational tools. SLPs and caregivers/educators reported different levels of usability and satisfaction. SLPs tended to assess the tool in terms of therapeutic alignment, structure, and language intervention potential. In contrast, CGs appeared to focus more on practical aspects such as engagement, ease of use, and integration into daily routines. These divergent perspectives likely reflect the users’ distinct roles, expectations, and experiences with language support tools.

The BETA prototype of the tool (Figure 2) also revealed functional limitations within the tool’s concept. Seeing as, the randomised prompts included in the app led to inconsistent practise of certain language structures, when repetition is essential towards acquisition. Furthermore, despite proving effectively engaging, the reward system included in the game allowed for rapid game completion, which detracted from children’s sustained focus on the linguistic targets. Hence, a balance in the mechanics needed to be struck to not shift the child’s focus from educational objectives to gameplay completion, potentially diminishing the effectiveness of the therapeutic/educational intervention provided.

Challenges in terms of ease of use were also reported by caregivers (from the non-educator pool) when it came to using the companion app, contrasting the clinicians and educators who found it effective for data collection. This discrepancy suggests that improved accessibility and intuitive design are necessary to support all types of users, ensuring that anyone can confidently engage in language reinforcement outside professional settings.

Despite the significant amount of progress that was made in these phases, further data collection remains ongoing at the time of this article’s writing, underscoring the iterative and detailed design nature of this research study.

“Olly’s Adventures” shows strong potential as a bilingual educational and therapeutic tool. Its adaptable design supports language development in classroom and clinical settings, benefitting both bilingual children who have language difficulties, as a result of impaired language processing or of limited exposure to a second language, and those with typically developing language.

The tool’s dual-language format encourages cross-linguistic transfer, whereby improvements made in one language may positively influence the other, fostering holistic bilingual development. Furthermore, the integration of gamification with physical and digital components encourages engagement with the tool in a playful, evidence-based approach towards language learning. Its customizable features such as the language tasks, adjustable difficulty levels and QR-code-based interactivity ensure that the tool is inclusive towards diverse learning needs, extending its applicability beyond its Maltese English origins to other contexts.

Continually, another sector that stands to benefit from the creation of such tools is design engineering. Given the cyclical adaptive approach adopted to designing “Olly’s Adventures” the design engineering aspect was able to showcase how gamification principles can address complex educational and therapeutic challenges. Which, in turn, created an opportunity for the potential development of a Knowledge Discovery in Data (KDD) model. Based on collected data, a Knowledge Discovery in Data (KDD) model could be developed to support board game designers in the specialised fields of speech and language therapy and second-language education, with a focus on bilingual applications. Building on principles originally used for therapeutic toy design, this adapted model would address the specific requirements of board game design for children acquiring their second language and those diagnosed with language and communication difficulties. When providing the KDD model with predictive insights into the potential effects of game elements, such as language complexity, types of interaction and gameplay mechanics, designers can anticipate engagement levels, emotional responses and learning outcomes. Thus, allowing for acute, data-driven adjustments that better align gameplay with individual learning goals. A simplified user interface could further aid designers by focusing on key parameters such as age, language background, and emotional engagement, with flexibility for both toy and board game design contexts. Additionally, by using demographic-driven inputs and predictive analytics, the model’s applicability could extend beyond itself as a valuable resource in therapy, and educational settings and as a recreational game design. In doing so, this framework has the potential to bridge the gap between therapeutic/educational requirements and practical design, supporting the development of games that effectively enhance cognitive, emotional, and linguistic growth in children. Ultimately, the modular framework allows for its possible global scalability, through its adaptability towards different language pairs and other cultural settings.

Future research should explore the tool’s long-term use in both clinical and educational settings to gauge its effectiveness across diverse contexts. Additionally, the incorporation of emerging technologies such as AI could further enhance the tool’s personalization abilities.

These innovations, combined with the tool’s scalability, demonstrate how connected technology can bridge gaps in resources and foster inclusivity, positioning the tool as a model for advancing bilingual education.