Hugues Pellerin

[This corrects the article DOI: 10.2196/76435.].

Background: Specific learning disorder in reading (SLD reading), commonly named dyslexia, is a neurodevelopmental condition affecting reading. Current best practice recommendations for SLD reading emphasize the necessity of including graphophonological interventions. The serious game Mila-Learn, which is based on rhythm training, showed promising results in a prior randomized trial. However, it lacked a component of graphophonological training. Objective: This study aimed to evaluate the effectiveness of Poppins, a new digital medical device that combines rhythm-based and graphophonological training for improving reading and phonological skills in children with SLD reading. We also explored its performance against Mila-Learn, the earlier version based on rhythm training only. Methods: A single-arm study without an active control group was conducted with 38 children (aged 7-11 years) diagnosed with SLD reading. The participants completed an 8-week training program with Poppins (five 20-minute sessions per week). Pre- and posttraining assessments measured reading accuracy and speed, phoneme deletion, and phonological discrimination. Statistical analysis included pre- and postcomparisons (primary analysis) and comparisons with children's improvement from a previous randomized controlled trial of Mila-Learn, an earlier version of the device (exploratory analysis). Results: The participants demonstrated significant improvements in reading accuracy (+11.46 words correctly read; P<.001), reading speed (+10.26 words read; P<.001), and phoneme deletion (+2.87 points; P<.001). No significant change was observed in reading comprehension for younger participants (grades 2-3; P=.09), although improvements were noted in older children (grades 4-5, P=.03). Exploratory analysis comparing children’s improvements with Mila-Learn and Poppins revealed similar gains in reading accuracy and speed but revealed superior improvement in phonological skills for the Poppins group, with a moderate effect size according to the benchmarks by Cohen (Cohen d=0.48, P=.02). Conclusions: Poppins is an effective and safe tool for enhancing reading and phonological skills in children with SLD reading. By integrating rhythm-based and graphophonological exercises, the device aligns with best practice recommendations for curative intervention. Future research should explore its long-term effects and medicoeconomic impact and compare outcomes with those of conventional therapy, as serious games provide an engaging, scalable method for delivering such interventions. Trial Registration: ClinicalTrials.gov NCT06596980; https://clinicaltrials.gov/study/NCT06596980

BACKGROUND Specific learning disorder in reading (SLD reading), commonly named dyslexia, is a neurodevelopmental condition affecting reading. Current best practice recommendations for SLD reading emphasize the necessity of including graphophonological interventions. The serious game Mila-Learn, which is based on rhythm training, showed promising results in a prior randomized trial. However, it lacked a component of graphophonological training. OBJECTIVE This study aimed to evaluate the effectiveness of Poppins, a new digital medical device that combines rhythm-based and graphophonological training for improving reading and phonological skills in children with SLD reading. We also explored its performance against Mila-Learn, the earlier version based on rhythm training only. METHODS A single-arm study without an active control group was conducted with 38 children (aged 7-11 years) diagnosed with SLD reading. The participants completed an 8-week training program with Poppins (five 20-minute sessions per week). Pre- and posttraining assessments measured reading accuracy and speed, phoneme deletion, and phonological discrimination. Statistical analysis included pre- and postcomparisons (primary analysis) and comparisons with children's improvement from a previous randomized controlled trial of Mila-Learn, an earlier version of the device (exploratory analysis). RESULTS The participants demonstrated significant improvements in reading accuracy (+11.46 words correctly read; P<.001), reading speed (+10.26 words read; P<.001), and phoneme deletion (+2.87 points; P<.001). No significant change was observed in reading comprehension for younger participants (grades 2-3; P=.09), although improvements were noted in older children (grades 4-5, P=.03). Exploratory analysis comparing children’s improvements with Mila-Learn and Poppins revealed similar gains in reading accuracy and speed but revealed superior improvement in phonological skills for the Poppins group, with a moderate effect size according to the benchmarks by Cohen (Cohen d=0.48, P=.02). CONCLUSIONS Poppins is an effective and safe tool for enhancing reading and phonological skills in children with SLD reading. By integrating rhythm-based and graphophonological exercises, the device aligns with best practice recommendations for curative intervention. Future research should explore its long-term effects and medicoeconomic impact and compare outcomes with those of conventional therapy, as serious games provide an engaging, scalable method for delivering such interventions. CLINICALTRIAL ClinicalTrials.gov NCT06596980; https://clinicaltrials.gov/study/NCT06596980

Background: Specific learning disorder (SLD) of reading skills impacts approximately 7% of children. Speech and reading therapy is currently the gold-standard intervention for improving children’s reading abilities. However, intensive interventions are difficult to implement. Recently, numerous studies have investigated the interest of game- and home-based training approaches to enhance children’s motivation and facilitate intensive learning activities in home settings. The serious game Poppins Clinical integrates rhythm and specific written language exercises to improve reading skills in children with SLD. Objective: This study aimed to assess the noninferiority of Poppins Clinical combined with a reading specialist session once every 2 weeks versus a reading specialist session every week, on the reading skills of children with SLD. Methods: A total of 306 children with dyslexia will be recruited for this study and randomly assigned to either the experimental or control group. Children in the experimental group will use the serious game Poppins Clinical at home for 20 minutes, 5 days a week, and attend 1 reading therapy session every 2 weeks. The control group will participate in one reading therapy session per week. Poppins Clinical combines rhythm and language exercises integrated into an engaging game designed to maintain user motivation. We will use a noninferiority paradigm to assess the clinical impact of both interventions in terms of reading accuracy, reading speed, and reading comprehension. We will also investigate the evolution of phonological and visual-attentional skills. However, we will explore the impact of the protocol on parental stress and children’s perception of their difficulties. Finally, we will also assess the cost of medical care and the impact of introducing the serious game Poppins Clinical on reading therapy. To facilitate recruitment and ensure the representativeness of our sample, the evaluation of the children will be conducted via videoconference using standardized tests that have been adapted for videoconference administration. Results: Patient recruitment is expected to start in December 2024, with study completion by the end of August 2025. Conclusions: This study should allow us to assess the interest in using the serious game Poppins Clinical in addition to reading therapy to improve reading abilities in children with SLD. Trial Registration: ClinicalTrials.gov NCT06592911; https://clinicaltrials.gov/study/NCT06592911 International Registered Report Identifier (IRRID): DERR1-10.2196/71326

BACKGROUND Specific learning disorder (SLD) of reading skills impacts approximately 7% of children. Speech and reading therapy is currently the gold-standard intervention for improving children’s reading abilities. However, intensive interventions are difficult to implement. Recently, numerous studies have investigated the interest of game- and home-based training approaches to enhance children’s motivation and facilitate intensive learning activities in home settings. The serious game Poppins Clinical integrates rhythm and specific written language exercises to improve reading skills in children with SLD. OBJECTIVE This study aimed to assess the noninferiority of Poppins Clinical combined with a reading specialist session once every 2 weeks versus a reading specialist session every week, on the reading skills of children with SLD. METHODS A total of 306 children with dyslexia will be recruited for this study and randomly assigned to either the experimental or control group. Children in the experimental group will use the serious game Poppins Clinical at home for 20 minutes, 5 days a week, and attend 1 reading therapy session every 2 weeks. The control group will participate in one reading therapy session per week. Poppins Clinical combines rhythm and language exercises integrated into an engaging game designed to maintain user motivation. We will use a noninferiority paradigm to assess the clinical impact of both interventions in terms of reading accuracy, reading speed, and reading comprehension. We will also investigate the evolution of phonological and visual-attentional skills. However, we will explore the impact of the protocol on parental stress and children’s perception of their difficulties. Finally, we will also assess the cost of medical care and the impact of introducing the serious game Poppins Clinical on reading therapy. To facilitate recruitment and ensure the representativeness of our sample, the evaluation of the children will be conducted via videoconference using standardized tests that have been adapted for videoconference administration. RESULTS Patient recruitment is expected to start in December 2024, with study completion by the end of August 2025. CONCLUSIONS This study should allow us to assess the interest in using the serious game Poppins Clinical in addition to reading therapy to improve reading abilities in children with SLD. CLINICALTRIAL ClinicalTrials.gov NCT06592911; https://clinicaltrials.gov/study/NCT06592911 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/71326

Background: Rhythm perception and production are related to phonological awareness and reading performance, and rhythmic deficits have been reported in dyslexia. In addition, rhythm-based interventions can improve cognitive function, and there is consistent evidence suggesting that they are an efficient tool for training reading skills in dyslexia. Objective: This paper describes a rhythmic training protocol for children with dyslexia provided through a serious game (SG) called Mila-Learn and the methodology used to test its usability. Methods: We computed Mila-Learn, an SG that makes training remotely accessible and consistently reproducible and follows an educative agenda using Unity (Unity Technologies). The SG’s development was informed by 2 studies conducted during the French COVID-19 lockdowns. Study 1 was a feasibility study evaluating the autonomous use of Mila-Learn with 2500 children with reading deficits. Data were analyzed from a subsample of 525 children who spontaneously played at least 15 (median 42) games. Study 2, following the same real-life setting as study 1, evaluated the usability of an enhanced version of Mila-Learn over 6 months in a sample of 3337 children. The analysis was carried out in 98 children with available diagnoses. Results: Benefiting from study 1 feedback, we improved Mila-Learn to enhance motivation and learning by adding specific features, including customization, storylines, humor, and increasing difficulty. Linear mixed models showed that performance improved over time. The scores were better for older children (P<.001), children with attention-deficit/hyperactivity disorder (P<.001), and children with dyslexia (P<.001). Performance improved significantly faster in children with attention-deficit/hyperactivity disorder (β=.06; t3754=3.91; P<.001) and slower in children with dyslexia (β=−.06; t3816=–5.08; P<.001). Conclusions: Given these encouraging results, future work will focus on the clinical evaluation of Mila-Learn through a large double-blind randomized controlled trial comparing Mila-Learn and a placebo game.

BACKGROUND Rhythm perception and production are related to phonological awareness and reading performance, and rhythmic deficits have been reported in dyslexia. In addition, rhythm-based interventions can improve cognitive function, and there is consistent evidence suggesting that they are an efficient tool for training reading skills in dyslexia. OBJECTIVE This paper describes a rhythmic training protocol for children with dyslexia provided through a serious game (SG) called Mila-Learn and the methodology used to test its usability. METHODS We computed Mila-Learn, an SG that makes training remotely accessible and consistently reproducible and follows an educative agenda using Unity (Unity Technologies). The SG’s development was informed by 2 studies conducted during the French COVID-19 lockdowns. Study 1 was a feasibility study evaluating the autonomous use of Mila-Learn with 2500 children with reading deficits. Data were analyzed from a subsample of 525 children who spontaneously played at least 15 (median 42) games. Study 2, following the same real-life setting as study 1, evaluated the usability of an enhanced version of Mila-Learn over 6 months in a sample of 3337 children. The analysis was carried out in 98 children with available diagnoses. RESULTS Benefiting from study 1 feedback, we improved Mila-Learn to enhance motivation and learning by adding specific features, including customization, storylines, humor, and increasing difficulty. Linear mixed models showed that performance improved over time. The scores were better for older children (P<.001), children with attention-deficit/hyperactivity disorder (P<.001), and children with dyslexia (P<.001). Performance improved significantly faster in children with attention-deficit/hyperactivity disorder (β=.06; t3754=3.91; P<.001) and slower in children with dyslexia (β=−.06; t3816=–5.08; P<.001). CONCLUSIONS Given these encouraging results, future work will focus on the clinical evaluation of Mila-Learn through a large double-blind randomized controlled trial comparing Mila-Learn and a placebo game.