Abstract Background: Speech intelligibility is a critical milestone in child development, shaping communication, social integration, and academic success. Children with speech sound disorders, particularly those with hearing impairments, often struggle with speech intelligibility due to impairments in perceiving and producing specific phonemes. Traditional speech therapy methods commonly rely on repetitive word-level drills, limiting generalization to natural speech contexts. There is a lack of culturally and linguistically relevant therapeutic material to elicit sentence-or narration-level speech samples in many regional languages, especially in Malayalam. Aim: This study aimed to develop and evaluate phoneme-loaded articulation stories in Malayalam, illustrated using two methods: a web-based application and artificial intelligence (AI) to facilitate speech sound correction. Materials and Methods: Target phonemes /k/ and/ɾ/ were selected due to their high frequency and articulatory challenges. Three developmentally appropriate storylines per phoneme were developed, embedding the target sounds with a minimum 20% occurrence. Each story was illustrated using both web-based applications and AI image generation tools. A total of twelve stories were content validated by nine experts: three speech–language pathologists, three parents of children with hearing impairment, and three children with hearing impairment. The experts rated the illustrations on iconicity, color and appearance, relevance, attractiveness, and stimulability using a 5-point Likert scale. Analysis: Quantitative analysis included Item-level Content Validity Index (I-CVI) and Modified Kappa Coefficient ( K ). Results revealed that AI-generated illustrations achieved excellent content validity across all parameters (I-CVI = 1; K = 1.0), whereas web-based illustrations consistently failed validation (I-CVI = 0; K = −0.143), particularly in accurately depicting target words. Conclusion: The findings highlight AI’s superior capability in generating culturally relevant, engaging, and stimulating illustrations for speech therapy materials, suggesting its potential to enhance speech sound correction in children with hearing impairments.
Chandran et al. (Tue,) studied this question.