MILA-Learn, a serious game to train rhythmic abilities in children with dyslexia: Feasibility and Usability Study.

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 functions, and consistent evidence suggests that they are an efficient tool for training reading skills in dyslexia.

OBJECTIVE: This paper describes a rhythmic training protocol for dyslexic children provided by a serious game (SG) called MILA-Learn and the methodology used to test its usability.

METHODS: We computed MILA-Learn, an SG that makes the training (i) remotely accessible, (ii) consistently reproducible and (iii) follows an educative agenda using Unity. The SG's development was informed by two studies conducted during the French COVID-19 lockdowns. Study 1 was a feasibility study evaluating the autonomous use of MILA-Learn by 2,500 children with reading deficits. Data was analyzed from a subsample of 525 children who spontaneously played at least 15 games (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 six months in a sample of 3,337 children. Analysis was carried out on 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 (ADHD) (P<.001) and children with dyslexia (P<.001). Performance improved significantly faster in children with ADHD (β=.06, t(3754)=3.91, P<.001) and slower in children with dyslexia (β=-.06, t(3816)=-5.08, P<.001).

CONCLUSIONS: Given the 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.