Made in France, this video game treats dyslexia in children

Long underestimated and misdiagnosed, specific learning disorders, the famous “dys” (dyslexiadysphasia, dysorthography, dyscalculia, dyspraxia…), are now receiving closer attention and support. According to the Assistance Publique – Hôpitaux de Paris (AP-HP), nearly 600,000 children and adolescents in France are affected by neurodevelopmental disorders. Among them, between 3 and 5% of young people under the age of 18 suffer from dyslexia. At the moment, the child and adolescent psychiatry department of the Pitié-Salpêtrière AP-HP hospital, directed by Professor David Cohen, is carrying out a randomized study unprecedented in France. This is to assess the effectiveness of a video game on the reading skills of children with dyslexia. But this is not just any video game.

“Mila Learn” is what is called a serious game (in English serious games) which combines a “serious” background with a playful form. In this case, it is a question of helping children with specific learning and language disorders (Tsal), in particular dyslexia. The video game is based on a universe magic in which music plays a key role in neurological rehabilitation. Concentration, motor skills, memory and rhythm are stimulated together through the adventure offered by Mila Learn. To make the experience more attractive, the designers have used artists and titles known and appreciated by young people such as Big Flo and Oli, KidsUnited Where The Jungle Book again.

To demonstrate the scientific validity of its approach, Mila therefore initiated this clinical study. We spoke with François Vonthron, co-founder of Mila, a start-up from the École polytechnique, founded in 2018. For this trained musician, passionate about mathematics, helping children without stigmatizing them is the driving force behind his approach. .

Futura: How did the idea of ​​making a link between music and rehabilitation for specific learning and language disorders (TsL) come about?

Francois Vonthron: The idea of ​​using music in neurological rehabilitation is not new, it is around thirty years old. It has been used in particular in the treatment of Parkinson disease and some pain in general. With regard to language disorders, for the past 20 years, many researchers in neurology and neuropsychology work on the impact of music for neurological rehabilitation in children.

Mila Learn is the result of the combination of two projects: on the one hand, a CNRS project in Marseille led by the cognitive neuroscience laboratory Professor Michel Habib on the use of music with dyslexic children, which led to the development of protocols giving truly satisfactory results; on the other hand, our project at École Polytechnique focused on data science and how to use data to create scientific studies with larger samples.

Mila is therefore involved in the mathematics and data science part. But what brought you to the field of “dys” disorders?

Francois Vonthron: I am a musician by training and passionate about maths and engineering. For many years I have collaborated on school learning projects through music. It is a subject that fascinates me. When I started my studies, I wanted to specialize in mathematics, music and cognition. That’s how I got into the health business.

You explain that ” people with Tsal have difficulties in estimating changes in the amplitude of the sound envelope over time, in the processing of short durations but also in the processing of rhythmic information. Can you give some examples of how this manifests itself in the child’s daily life and the difficulties this causes?

Francois Vonthron: For these children, the process of learning to read will be complicated. When we read, we call on already stored lexicon with a very weak cognitive process. For these children who do not yet have a lexical stock, there is a learning process which involves cutting words into phonemes to decode them. It is in this work of rapprochement between the phoneme and the meaning that the lack of interconnections at the level of these two areas of the brain will create a disturbance. For example, the child will confuse “ba” and “pa”.

This translates into major reading difficulties at school. It is a problem that is fundamentally neurological and requires a lot of support, very specific rehabilitation. The corollary of this is that these children often have self-esteem degraded by years of stigmatization and failure. This is a crucial point that is at the heart of our work to make Mila Learn accessible, fun and above all non-stigmatising.

On what scientific basis is the development of Mila Learn based?

Francois Vonthron: We are mainly targeting an area of ​​the brain which is called the arcuate beam that connects the two zones at work in this process of encoding for reading. The nerve bundle is the matter white that allows any human being to have fast encoding and interconnection. This bundle has been shown to be underdeveloped in children with dys disorders. It’s an anatomical marker. What we realized is that learning music goes through this same arcuate beam. It is for this reason that dyslexic children are very often bad at rhythm because it is the same cognitive process that is at work.

The work has been based on this problem to develop a rather specific rhythmic learning process which makes the arcuate beam work repeatedly. To simplify, the idea is to proceed in the manner of physiotherapy for the rehabilitation of a cruciate ligament that we will try to strengthen.

Thanks to a stimulation cognitive rhythm, we practice a fairly specific and intensive learning process that will stimulate the same areas of the brain in children than those they use for learning to read. There is a direct correlation between rhythmic learning in these children and the impact on learning to read. This has been demonstrated by several studies, particularly in Marseille, but also in the United States and Canada.

What is the intermodal integration that is at the heart of your rehabilitation method?

Francois Vonthron: Intermodal integration is the fact of being able, in the same exercise, to take into account the auditory and rhythmic dimensions and the motor and language dimensions. A simple rhythmic training has a much lower impact if it is not associated with language and gesture. Managing to combine gestures and sounds is at the heart of this intermodal integration. This requirement is an advantage for us in the development of Mila Learn because it allowed us to give real depth to the game by exploiting this multimodal dimension.

Can Mila Learn be effective regardless of the severity of the disorder?

Francois Vonthron. If we base ourselves on the standard deviation from the national average which is used to measure the dys disorder of the child, we would see an improvement with the use of Mila Learn. For example, a child who starts at -20 standard deviation will approach faster than a child who starts at -3 -4 standard deviation. A child is considered dyslexic from -1.5 standard deviation. The more we advance in the severity of the disorder, the more the delta will be quickly compensated by these therapies. I must point out that we still lack hindsight today on this point and that we are expecting a lot of lessons from the clinical study that we have launched.

What age group is Mila Learn for?

Francois Vonthron: Mainly for children aged 7 to 11 who are the target of our clinical study. We should probably open it to 5-6 year olds and 12-14 year olds in the near future. The whole challenge for us is to succeed in designing a game whose ergonomics and appeal are suitable for these different age groups who have quite different expectations in terms of video games.

Is it an evolving game?

Francois Vonthron: Yes. We use our servers to analyze game data and adjust the difficulty using an elo system that takes into account previous games as well as the age and specific difficulties of the child. For the moment, the universe, the scenario, the course of play do not evolve but we are working on it.

Under what conditions should Mila Learn be used? Is it inseparable from monitoring by a Tsal professional?

Francois Vonthron: It is important to emphasize that Mila Learn is a complementary tool intended to strengthen the therapeutic arsenal of which healthcare professionals remain the pillar. The game is part of a work with the speech therapist. The objective is for the game to be part of the care pathway for these patients to make it an autonomous tool to work at home in addition to therapeutic monitoring.

If you are the parent of a “dys” child, you can absolutely be a driving force in the adoption of Mila Learn. We can use the game spontaneously and appropriate it. On the other hand, we want to prevent parents from adopting the game by freeing themselves from any therapeutic support. We work with professionals to develop the ideal plan.

What is the cost of the game for the user?

Francois Vonthron: The goal is that the cost is zero for the user. We are in discussion with insurers and mutuals who support us financially in the development of the game. The price will be set by the medical service rendered. Negotiations are underway with Social Security to define the benefit provided to the patient.

What horizon for the launch of Mila Learn?

Francois Vonthron: We are aiming for an experimental launch at the end of the year with a small group of 10 to 20 patients at the end of the clinical study. The actual commercial start-up should take place in 2023.

Tell us about the clinical study that is underway

Francois Vonthron: The objective of this study is to measure and demonstrate the positive impact of play on the classic variables used in speech therapy on reading tests. The great novelty is that it is a national study open to all dyslexic children in the target age group. We send them a tablet home and they participate in Mila Learn training for two months.

The other innovation is the use of a placebo, as for pharmacological studies. We created a game similar to Mila but without the cognitive rhythm stimulation. The idea is that the two groups of testers are randomized, the patients and the clinicians are blinded, so as to obtain a study on the standards of medicine.

It is the child psychiatry department of Professor Cohen of the Pitié-Salpêtrière hospital in Paris which is piloting this study. 160 children are recruited. The study is still open to all dyslexic children not treated with speech therapy in order to avoid any bias. You can apply online by following this link.