Reframing Speech Therapy Through Design: Gamification, Emotion, and Embodied Interaction

Gamification and conversational technologies are increasingly explored as design strategies to enhance engagement and adherence in paediatric rehabilitation contexts. Within speech therapy, however, the integration of Embodied Conversational Agents (ECAs) remains underexplored from a design perspective, particularly with regard to children’s emotional experience, motivation, and interaction dynamics. This paper presents a gamification approach featuring an embodied conversational agent for paediatric speech therapy. Adopting a humancentred approach, the research combines a review of existing gamified therapeutic systems with field research conducted through non-participant observation of clinical speech therapy sessions and interviews with therapists. The findings highlight the central role of emotional responses to errors, the importance of relational sensitivity in therapeutic interactions, and the limitations of existing tools in supporting home-based practice. These insights informed the development of Ziza’s Words, a narrative-based game including an embodied agent designed as a playful companion rather than an authoritative coach. The paper discusses key design decisions related to embodiment, narrative structure, feedback strategies, and emotional modulation, and reports preliminary observations from a pilot study. The contribution lies in framing ECAs as mediating design artefacts that humanise care, support therapeutic relationships, and open new trajectories for design research in health, rehabilitation, and child–computer interaction.