Building Tools for Where We Work: Why Local Context Matters in Speech Therapy

If you look at the assistive technology market for speech-language pathology, you'll find dozens of excellent apps. Most were developed in North America or Europe, where they make perfect sense: they cost $100-$500 per license, they assume reliable internet, they're designed for English (or maybe French, Spanish), and they're priced for that market's economy.

The problem isn't that these apps are poorly made. It's that their design reflects the contexts where they were built. In Kenya, almost every assumption shifts. We sat down with three SLPs working across Kenya to understand the gap between what exists globally and what's actually needed locally. Their stories reveal why we're building SoinsAvec — a tool designed from the ground up for Eastern African contexts.

Joan: The Context Gap

Joan works in a small clinic in Nairobi serving about 200 active clients. She has two degrees, fifteen years of experience, and sees 15-20 children per week. She also has a problem that most AAC app developers never think about.

"I tried one of the major US apps for iPad," she says. "The cost was $400. I managed to get the clinic to buy it. But here's the issue: the vocabulary is American. It has words kids in Nairobi don't use. The cultural references don't make sense. And when I tried to customize it for my kids and their families, the system made it nearly impossible."

Joan is describing a real gap. A child learning AAC in Boston benefits from interfaces optimized for English syntax and cultural contexts they recognize. Those same tools, when used in Nairobi, aren't optimized for how kids actually communicate here — the code-switching between Kiswahili and English, the different cultural references, the language mixing that happens in most households.

"Then there's the affordability problem," she continues. "Yes, $400 is expensive for me. But even if my clinic could afford it, most of my families can't. A parent hears there's an app that could help their kid communicate, but it costs 50,000 shillings? That's not happening for 90% of my clients."

This creates a painful dynamic: Joan becomes a tool for the wealthy. She can help families with resources access global apps. Everyone else keeps manually making paper picture cards, improvising communication strategies, and hoping the child's speech improves.

"What would help is tools designed with our context in mind from the start," Joan says. "Apps built for Kenyan markets, supporting local languages, and priced for what families here can actually afford. Not global apps trying to adapt after the fact."

David: When Support Infrastructure Doesn't Align

David is the only SLP at a private school in Kiambu with a special education program. He's screening, running therapy, consulting with teachers, and training parents — all alone.

Three years ago, he got a student with severe apraxia of speech who was completely non-verbal. "Everything I tried wasn't working," he remembers. "He was 8 years old and frustrated to the point of isolation."

David found a popular US-designed AAC app. Within a week, the student was communicating. "I watched him transform," David says. "He went from withdrawing to participating."

Then the app stopped working.

"There was an update that broke compatibility with the school's tablets," David explains. "I emailed support. They responded promptly — from California. But for follow-up troubleshooting, time zones matter. There's a delay built in. By the time we resolved it several weeks later, the student had lost some momentum."

This is a structural challenge. When apps are supported from another continent, time zone differences create friction. Developer teams naturally optimize for their local markets where they can respond quickly. But for schools in Kenya, that built-in delay affects children's progress.

"What would help," David says, "is support and infrastructure designed for our context. Teams in our time zone. Training that accounts for our bandwidth and device constraints. That's hard to do if you're supporting a global market from one office."

Most international apps also assume internet reliability. Many freeze or crash if connectivity drops. In rural Kiambu, that's nearly every session.

Rose: Language and Connectivity Design Decisions

Rose is the only SLP within 50 kilometers of her semi-rural area near Embu. She does home visits, works at the local health center, and runs a group program for children with hearing impairments.

"My biggest challenge is isolation," she says. "How do you stay current when you don't have colleagues to learn from?"

Rose found an online AAC app that looked promising. But she ran into a wall immediately: it only supported English and Spanish. Most of her clients speak Kiembu or Kikuyu, and code-switch with Kiswahili and English. The app was useless for her population.

"I spent two hours trying to figure out if I could add local languages. You can't," she says. "It's hard-coded for English and Spanish. The company that built it is in London. To them, that's the whole world."

This is a natural consequence of how global software gets built. Most international apps prioritize the languages with the largest user bases and strongest markets. That means English, Spanish, maybe French. The languages most commonly used in Kenya — Kiswahili, Kikuyu, Luhya, Samburu — are rarely priorities for global development.

But there's another gap Rose experiences that's even more fundamental: connectivity.

"I did a home visit with a family in the foothills last month. No internet. So the app I brought — which requires a constant connection — was dead weight. The family couldn't use it at home even if they wanted to."

Most global AAC apps are built on cloud infrastructure. They sync to servers and update frequently. This makes sense for urban markets with reliable internet, but it shapes what's possible elsewhere.

"The tools are good," Rose says. "But they're built for a reality that doesn't include us. We need apps designed to work offline. In our languages. By people who understand that connectivity isn't guaranteed everywhere."

The Market Gap Nobody's Filling

When we asked Joan, David, and Rose what would actually help them do their jobs, the answer wasn't "better versions of what exists." It was: "Tools designed for us."

They identified specific gaps that international apps simply don't address:

Language and cultural fit. Apps supporting local languages (Kiswahili, Kikuyu, Luhya, Samburu, etc.) with vocabulary and contexts that fit how families in East Africa actually communicate — not translations, but genuine local design.
Offline-first design. Tools that work without internet, because connectivity isn't guaranteed. Apps that can sync when connected and function fully without it.
Local support and training. Support teams in the same time zone. Training in languages clinicians speak. Troubleshooting from people who understand Kenyan school budgets and clinic realities.
Pricing for local economies. Tools priced for what families, schools, and clinics in Kenya can realistically afford. Not $400 per license. This reflects East African economies from day one, not as a discount, but as the primary market.
Built WITH, not FOR. SLPs and families in Kenya shaping these tools. East African clinicians understand what works here. That knowledge should drive design from the beginning.

"The global apps are really well-built," Joan says. "But they're built for global markets. That means they naturally center the contexts where the biggest user bases and profits are. There's nothing wrong with that — it's how markets work. But it also means there's a real gap for places like Kenya that nobody's filling."

Why SoinsAvec Exists

This gap is why we're building SoinsAvec. Not as another app competing in the global market. But as a tool designed from the ground up for speech-language pathology in Kenya and East Africa.

The global AAC market assumes:

Reliable internet -> We're building offline-first
English + Spanish → We're supporting Swahili, Kikuyu, & other local languages
High budgets → We're pricing for realistic family incomes
Western clinical context → We're consulting with SLPs IN this context

Joan, David, and Rose aren't asking for charity pricing or lower-quality versions of existing tools. They're pointing to a gap: there's actually a different design space needed here. Different priorities. Different constraints. Different possibilities.

"If someone had asked me to help design an app from the start," Joan says, "I could tell them exactly what would work here. Which vocabulary matters. What families can afford. How connectivity actually works. I could help build something that fits this context. Not the same tool adapted for us. Something built for us."

SoinsAvec is in early development, and we're actively working with SLPs across Kenya and East Africa to shape what it becomes. If you're a clinician, educator, or family member and want to share your needs, we'd like to hear from you. Reach out to hello@umbilabs.com.