BACKGROUND

Mary Joe Osberger stated that “the devastating effect of a profound congenital hearing loss on the development of language and communication skills has been of concern to parents, physicians, educators, and clinicians for decades.1” And this “concern” still persists today.

Today’s numbers show that a better solution is very much needed. The chances of being born deaf is relatively high as “about 2 to 3 out of every 1,000 children in the United States are born with a detectable level of hearing loss in one or both ears.2” This disorder is one that is difficult to predict as “more than 90 percent of deaf children are born to hearing parents.3” So parents with deaf children easily find themselves at a loss as to how to help their kids develop various abilities, especially linguistic skills. “One of the main impacts of hearing loss is on the individual’s ability to communicate with others. Spoken language development is often delayed in children with deafness.4”

Unfortunately, the problem is worse in developing countries as access to clinicians and speech therapists is difficult, and “children with hearing loss and deafness rarely receive any schooling.4”

PROBLEM STATEMENT

In addition to secondary research, we also spoke with and observed our target users, including teachers and therapists. Through our interactions we found:

Young hearing impaired patients often face speech and language problems as they grow up.

Hearing impairment is not an illness that can be cured. It needs constant therapy through which the patient can grasp language at a young age. The earlier therapy starts, the quicker the patient is able to grasp speech.

Therapy comes at a cost and it takes place few times a week in a clinic.

RESEARCH QUESTIONS

Our insights helped raise major questions:

Why should the young patients learning be restricted to the few hours spent at the clinic?
How can the time spent by the patient outside the clinic also be turned into a learning experience?
The biggest opportunity we saw was to create a therapy product, which the patient could use at home with their family and friends. The product would accelerate the process of grasping language, in the younger years when the learning of language is most crucial.

DESIGN CRITERIA

We set the following elements as the criteria to judge our ideas against. We thought the solution should be:

1. Fun
   The children should be naturally attracted to the game. They must want to play with it without much external push.
2. Intuitive
   The game must be easy to use by either the therapist, parents or teachers with little to no instructions. Children should be able to explain the rules of the game to new players themselves too.
3. Creative
   The game should be simple enough that it encourages the kids to modify and try various ways of playing. It should let facilitate language learning, along with various other things like, build, sentence formation, order, sequencing etc.

4. 

   Inclusive
   The solution should be such that it can be played amongst able and children with disabilities. Playing together helps the children with disabilities socialise and the able children learn to empathize with the children with disabilities.

METHODS (DESIGN AND DEVELOPMENT)

Prototype – Version 1

After prototyping different shapes, sizes, and words we decided to go ahead with a rhombus shape and an ergonomic size.

We designed the game with the goal of collecting as many rhombus pieces as possible.

1. The following were the instruction regarding how to play the game:
2. Split into two groups (or get into pairs) and decide which group/who is going to go first.
3. Start with the rhombus pieces picture side up and cards upside down.
4. Pick a card and keep it to yourself.

5. 

   Mouth the word to your teammates (no sounds allowed!). You could start with saying ‘The word is (then mouth it)’. Your teammates have to guess the word you’re mouthing by lip-reading in 3 minutes (multiple times possible).
6. If your teammates guess the word right, then your team gets the rhombus piece; if not, the turn goes over to the opposing team.
7. The opposing team repeats steps 3 to 5.
8. Repeat step 6 until all the rhombus pieces are gone.
9. Count how many rhombus pieces each team has.
   

Testing Prototype Version 1 – Zina Jawadi

We spoke to Stanford student Zina Jawadi. She discovered she had hearing impairment at the age of 3 and underwent speech therapy until she was 10 years of age. She did 10 hours of therapy every week and recalled it as a torturous time. She also told us how lip-reading is different from speech-reading (reading the entire face) and that everyone lip-reads, even people without hearing impairment.

She was delighted with our game and give us the following feedback:

• Could have a light flashing, to give visual feedback.
• Allow the therapist to track the number of times the game is played.
• Size could be bigger.
• Kids get distracted; it needs to capture their attention.

Testing Prototype Version 1 – Teachers at Bing Nursery

The teachers told us how the children like to build and showed us examples of existing toys.

Their feedback on the game was as follows:

• The tiles could be bigger and colorful.
• Children don’t need motivation like winning the game; they are intrinsically motivated.
• Liked the wood and the tactility.
• The game can be used during snack time, when children are requested to be quiet.

Prototype – Version 2

Based on the feedback we got on our first prototype we redesigned the game and also made a deck of cards.

Testing Prototype Version 2 – Children at Bing

From the prototyping session at the Bing Nursery School, we were able to observe how the children interacted with our game.

Firstly, some children were confused as to what the images represented. Since the children were between two and five years old, they couldn’t read words yet, and a word we had labeled as “doll” was mistaken for “teddy bear.” From this we realized that we should be more selective when choosing images for the nouns.

Secondly, there was a preference toward yellow pieces. We used various colors to represent different places of articulation of the word in the mouth, reflective of levels of difficulty in the guessing the words. However, the children naturally gravitated towards the yellow cards. To remove the bias towards one color, we need to think about what colors we use to indicate the difficulty levels.

We observed that the kids liked to twist the cards in their hands in an attempt to hide it from the guessers. With the current thickness, the cards easily got mangled and weren’t durable in the long run.

It also wasn’t clear as to what to do with the cards after someone guessed the word right, so already-played cards went back into the pile and they were replayed. In order to address this, we would need to keep already-drawn cards separate from the words that haven’t been drawn.

Lastly, some kids just guessed every word possible in one pile, in effect defying the main purpose of the game, which was to practice lip-reading. Seeing this, we realized we would need to limit the number of guesses.

Our game particularly excited one of the shyest, quietest kid in class and we realized that this was a game that helped anyone join in. It is the inclusive game that we were envisioning, and we hope that it will also help children with hearing disabilities to play with other friends easily.

RESULTS

1. Features
   The rhombus shape is easy to tesselate. The size and thickness were chosen for ease of grip and for safety. Colorful images support the text below them and the various colors represent the various levels in the point of articulation.
2. Benefits
   The game allows children with hearing disabilities to practice lip-reading within a fun context. It’s a game that can be played by children with and without hearing disabilities, so it’s an inclusive game that everyone can play together.
3. Aesthetics
   The pieces have vibrant colors on them. Also, for an intuitive understanding of the corresponding pieces, we’ve used the negative vinyl cuts for the rhombus cards. The streamlined and minimalistic design conveys that this game is intuitive and easy.
4. Safety
   The size of the rhombus discourages children from putting it into their mouths. The rounded corners of our rhombus pieces prevent children from getting themselves hurt.
5. Reliability
   Duron is a hardy material that won’t break easily and is reliable.
6. Usability
   There are only two components to this game and they are all of the same shape, hence easy to use. We have also shaped and sized the pieces to optimize usability.

DISCUSSION/OUTCOMES/PERFORMANCE

We will make the following changes to the current prototype that we have:

1. Thicker word cards
   The cards would get less mangled and allow for better grasp (the cards were sometimes difficult to pick up because they were so flat).
2. Revised instructions
   Specify that there are a maximum number of guesses allowed, because otherwise the children would keep guessing every word in the stack instead of making the effort to lip-read.
3. Better graphics that refer to only one word
   We will be more selective when choosing the images for the corresponding nouns to avoid confusions.
4. Choose brighter colors
   We will choose brighter colors that stand out against the darker duron.
5. More ways for kids to play with the tiles
   Cover the perimeter of the tiles with magnetic tape so that the children can arrange them into shapes they want. This will also allow kids to expand their rearrangement into 3D structures.

COST

Provided that only one of the entire set of Rhombus Rumbles is manufactured, we would expect the total to come to an approximate $300 as per the breakdown below.

Cost Breakdown

Material	Duron & Vinyl	$10
Technology	Laser engraving	$60
	Laser cutting	$80
	Vinyl cutting	$50
Labor	Transfer vinyl	$100
TOTAL		$300