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Murphy S, Bell K, Cook EJ, Crafter S, Davidson R, Fairhurst C, Hicks K, Joffe V, Messer D, Robinson-Smith L, Strachan L, Torgerson D, Welch C. Enhancing Pragmatic Language skills for Young children with Social communication difficulties (E-PLAYS-2) trial: study protocol for a cluster-randomised controlled trial evaluating a computerised intervention to promote communicative development and collaborative skills in young children. BMC Psychol 2024; 12:266. [PMID: 38741221 DOI: 10.1186/s40359-024-01749-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 04/24/2024] [Indexed: 05/16/2024] Open
Abstract
BACKGROUND A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The E-PLAYS-2 study will test an intervention ('E-PLAYS') aimed at supporting such children. E-PLAYS uses a dyadic computer game to develop collaborative and communication skills. Preliminary studies by the authors show that E-PLAYS can produce improvements in children with social communication difficulties on communication test scores and observed collaborative behaviours. The study described here is a definitive trial to test the effectiveness and cost-effectiveness of E-PLAYS delivered by teaching assistants in schools. METHODS The aim of the E-PLAYS-2 trial is to establish the effectiveness and cost-effectiveness of care as usual plus the E-PLAYS programme, delivered in primary schools, compared to care as usual. Cluster-randomisation will take place at school level to avoid contamination. The E-PLAYS intervention will be delivered by schools' teaching assistants. Teachers will select suitable children (ages 5-7 years old) from their schools using guidelines provided by the research team. Assessments will include blinded language measures and observations (conducted by the research team), non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. A process evaluation will also include interviews with parents, children and teaching assistants, observations of intervention delivery and a survey of care as usual. The primary analysis will compare pragmatic language scores for children who received the E-PLAYS intervention versus those who did not at 40 weeks post-randomisation. Secondary analyses will assess cost-effectiveness and a mixed methods process evaluation will provide richer data on the delivery of E-PLAYS. DISCUSSION The aim of this study is to undertake a final, definitive test of the effectiveness of E-PLAYS when delivered by teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Should E-PLAYS prove to be effective at the end of this trial, we believe it is likely to be welcomed by schools, parents and children. TRIAL REGISTRATION ISRCTN 17561417, registration date 19th December 2022. PROTOCOL VERSION v1.1 19th June 2023.
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Affiliation(s)
- Suzanne Murphy
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK.
| | - Kerry Bell
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Erica Jane Cook
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | - Sarah Crafter
- Open University, Walton Hall, Kents Hill, Milton Keynes, Milton, MK7 6AA, UK
| | - Rosemary Davidson
- University of Bedfordshire, University Square, Luton, Bedfordshire, LU1 3JU, UK
| | | | - Kate Hicks
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Victoria Joffe
- University of Essex, Wivenhoe Park, Colchester, CO4 3SQ, UK
| | - David Messer
- Open University, Walton Hall, Kents Hill, Milton Keynes, Milton, MK7 6AA, UK
| | | | - Luke Strachan
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - David Torgerson
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
| | - Charlie Welch
- York Trials Unit, University of York, Heslington, York, YO10 5DD, UK
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Murphy S, Joffe V, Donald L, Radley J, Sunthararajah S, Welch C, Bell K, Messer D, Crafter S, Fairhurst C, Corbacho B, Rodgers S, Torgerson D. Evaluating 'Enhancing Pragmatic Language skills for Young children with Social communication impairments' (E-PLAYS): a feasibility cluster-randomised controlled trial. Pilot Feasibility Stud 2021; 7:5. [PMID: 33390188 PMCID: PMC7780650 DOI: 10.1186/s40814-020-00724-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Accepted: 11/10/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This article reports the results from a feasibility study of an intervention ('E-PLAYS') aimed at supporting children who experience difficulties with social communication. E-PLAYS is based around a dyadic computer game, which aims to develop collaborative and communication skills. A pilot study found that when E-PLAYS was delivered by researchers, improvements on communication test scores and on collaborative behaviours were observed. The aim of this study was to ascertain the feasibility of running a full-scale trial to test the effectiveness of E-PLAYS in a National Health Service (NHS) setting with delivery by speech and language therapists and teaching assistants. METHODS The study was a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with a treatment as usual control arm. Data relating to recruitment and retention, treatment fidelity, acceptability to participants, suitability of outcomes and feasibility of collecting health economic measures and of determining cost-effectiveness were collected. Speech and language therapists selected suitable children (ages 4-7 years old) from their caseload. E-PLAYS intervention (experimental group) was then delivered by teaching assistants overseen by speech and language therapists. The control group received usual care. Assessments included blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and non-blinded parent-reported use of health and education resources and quality of life. RESULTS Planned recruitment was for 70 children, in the event, 50 children were recruited which was sufficient for feasibility purposes. E-PLAYS was very highly rated by children, teaching assistants and speech and language therapists and treatment fidelity did not pose any issues. We were able to collect health economic data which suggests that E-PLAYS would be a low-cost intervention. CONCLUSION Based on recruitment, retention and adherence rates and our outcome measures, a full-scale randomised controlled trial estimated appears feasible and warranted to assess the effectiveness of E-PLAYS for use by the NHS and schools. TRIAL REGISTRATION ISRCTN 14818949 (retrospectively registered).
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Affiliation(s)
- Suzanne Murphy
- Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Victoria Joffe
- University of Essex, Wivenhoe Park, Colchester, CO4 3SQ UK
| | - Louisa Donald
- Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Jessica Radley
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Sailaa Sunthararajah
- Research and Development Office, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford, IG3 8XJ UK
| | - Charlie Welch
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Kerry Bell
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Messer
- Education & Language Studies, Faculty of Wellbeing, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Sarah Crafter
- School of Psychology, Faculty of Arts & Social Sciences, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Caroline Fairhurst
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Belen Corbacho
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Sara Rodgers
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Torgerson
- Department of Health Sciences, University of York, Heslington, YO10 5DD UK
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Zayeni D, Raynaud JP, Revet A. Therapeutic and Preventive Use of Video Games in Child and Adolescent Psychiatry: A Systematic Review. Front Psychiatry 2020; 11:36. [PMID: 32116851 PMCID: PMC7016332 DOI: 10.3389/fpsyt.2020.00036] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2019] [Accepted: 01/13/2020] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Over the past decade, the use of commercial video games and serious games has developed in child and adolescent psychiatry. These games may become relevant alternatives or adjuncts to traditional psychotherapy, providing that their effectiveness is properly established. The purpose of this literature review was to evaluate the effectiveness of serious games and commercial video games in the treatment or prevention of psychiatric disorders in children and adolescents. METHODS Medline's database was used to search articles published between January 2012 and July 2019. The following keywords were used for this search: "Video games" OR "Active video game" OR "serious gaming" OR "Serious game" OR "Exergame" AND "Child mental disorder" OR "Adolescent" OR "Child" AND "Therapy" OR "Prevention". Only comparative studies which targeted interventions on children and adolescents suffering from psychiatric disorders were included. RESULTS Twenty-two studies, focusing on a wide range of psychiatric conditions, met our inclusion criteria's: 14 evaluated serious games and 8 commercial games. All studies were randomized controlled trials but only two studies compared the intervention game to psychotherapeutic gold standard; other studies used a no-intervention control group or an alternative game as the control group. Eighteen studies reported significant improvements on the symptoms and test scores targeted. CONCLUSION Serious games and commercially available video games can be an effective trajectory for psychotherapy in child and adolescent psychiatry. However, there is a lack of longitudinal studies which assess the sustained effects of these games, and standards for proper evaluation of their effectiveness are missing.
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Affiliation(s)
- Darius Zayeni
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France
| | - Jean-Philippe Raynaud
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France.,UMR 1027, Inserm, Université Toulouse III, Toulouse, France
| | - Alexis Revet
- Service Universitaire de Psychiatrie de l'Enfant et de l'Adolescent, CHU de Toulouse, Toulouse, France.,UMR 1027, Inserm, Université Toulouse III, Toulouse, France
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Jesus LMT, Martinez J, Santos J, Hall A, Joffe V. Comparing Traditional and Tablet-Based Intervention for Children With Speech Sound Disorders: A Randomized Controlled Trial. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2019; 62:4045-4061. [PMID: 31644381 DOI: 10.1044/2019_jslhr-s-18-0301] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
Purpose This article reports on the effectiveness of a novel tablet-based approach to phonological intervention and compares it to a traditional tabletop approach, targeting children with phonologically based speech sound disorders (SSD). Method Twenty-two Portuguese children with phonologically based SSD were randomly assigned to 1 of 2 interventions, tabletop or tablet (11 children in each group), and received intervention based on the same activities, with the only difference being the delivery. All children were treated by the same speech-language pathologist over 2 blocks of 6 weekly sessions, for 12 sessions of intervention. Participants were assessed at 3 time points: baseline; pre-intervention, after a 3-month waiting period; and post-intervention. Outcome measures included percentage of consonants correct, percentage of vowels correct, and percentage of phonemes correct. A generalization of target sounds was also explored. Results Both tabletop and tablet-based interventions were effective in improving percentage of consonants correct and percentage of phonemes correct scores, with an intervention effect only evident for percentage of vowels correct in the tablet group. Change scores across both interventions were significantly greater after the intervention, compared to baseline, indicating that the change was due to the intervention. High levels of generalization (60% and above for the majority of participants) were obtained across both tabletop and tablet groups. Conclusions The software proved to be as effective as a traditional tabletop approach in treating children with phonologically based SSD. These findings provide new evidence regarding the use of digital materials in improving speech in children with SSD. Supplemental Material https://doi.org/10.23641/asha.9989816.
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Affiliation(s)
- Luis M T Jesus
- School of Health Sciences (ESSUA), University of Aveiro, Portugal
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, Portugal
| | - Joana Martinez
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, Portugal
| | - Joaquim Santos
- Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, Portugal
| | - Andreia Hall
- Department of Mathematics, University of Aveiro, Portugal
- Center for Research and Development in Mathematics and Applications, University of Aveiro, Portugal
| | - Victoria Joffe
- School of Health and Social Care, University of Essex, Colchester, United Kingdom
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Murphy S, Joffe V, Messer D, Crafter S, Radley J, Sunthararajah S, Bell K, Corbacho B, Fairhurst C, Rodgers S, Torgerson D, Welch C. Evaluating 'enhancing pragmatic language skills for young children with social communication impairments' (E-PLAYS): protocol for a feasibility randomised controlled trial study. Pilot Feasibility Stud 2019; 5:75. [PMID: 31198579 PMCID: PMC6556014 DOI: 10.1186/s40814-019-0456-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2018] [Accepted: 05/09/2019] [Indexed: 12/17/2022] Open
Abstract
Background A number of children experience difficulties with social communication and this has long-term deleterious effects on their mental health, social development and education. The proposal presented in this article describes a feasibility study for a trial to test an intervention (‘E-PLAYS’) aimed at supporting children with social communication impairments. E-PLAYS harnesses technology in the form of a novel computer game in order to develop collaborative and communication skills. Preliminary studies by the authors show that when E-PLAYS was administered by the research team, children with social communication impairments showed improvements on communication test scores and on observed collaborative behaviours. The study described here is a pragmatic trial to test the application of E-PLAYS delivered by NHS speech and language therapists together with schools. Methods This protocol outlines a two-arm feasibility cluster-randomised controlled trial of the E-PLAYS intervention with treatment as usual control arm, with randomisation at the level of the speech and language therapist. The aim of this study is to ascertain whether it will be feasible to progress to running a full-scale definitive trial to test the effectiveness of E-PLAYS in an NHS setting. Data relating to recruitment and retention, the appropriateness of outcomes and the acceptability of E-PLAYS to participants will be collected. Speech and language therapists will select suitable children (ages 4–7 years old) from their caseloads and deliver either the E-PLAYS intervention (experimental group) or treatment as usual (control group). Assessments will include blinded language measures and observations, non-blinded teacher-reported measures of peer relations and classroom behaviour and parent-reported use of resources and quality of life. There will also be a qualitative process evaluation. Discussion The findings of this study will inform the decision as to whether to progress to a full-scale definitive randomised controlled trial to test the effectiveness of E-PLAYS when delivered by speech and language therapists and teaching assistants within schools. The use of technology in game form is a novel approach in an area where there are currently few available interventions. Trial registration ISRCTN 14818949 (retrospectively registered).
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Affiliation(s)
- Suzanne Murphy
- 1Institute of Health Research, University of Bedfordshire, University Square, Luton, LU1 3JU UK
| | - Victoria Joffe
- 2Division of Language and Communication Science, School of Health Sciences, University of London, Northampton Square, London, EC1V 0HB UK
| | - David Messer
- 3Education & Language Studies, Faculty of Wellbeing, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Sarah Crafter
- 4School of Psychology, Faculty of Arts & Social Sciences, Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA UK
| | - Jessica Radley
- 5Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX UK
| | - Sailaa Sunthararajah
- 6Research and Development Office, North East London NHS Foundation Trust, Goodmayes Hospital, Barley Lane, Ilford, IG3 8XJ UK
| | - Kerry Bell
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Belen Corbacho
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Caroline Fairhurst
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Sara Rodgers
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - David Torgerson
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
| | - Charlie Welch
- 7Department of Health Sciences, University of York, Heslington, YO10 5DD UK
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Nilsen ES, Bacso SA. Cognitive and behavioural predictors of adolescents' communicative perspective-taking and social relationships. J Adolesc 2017; 56:52-63. [PMID: 28157666 DOI: 10.1016/j.adolescence.2017.01.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Revised: 01/08/2017] [Accepted: 01/10/2017] [Indexed: 11/26/2022]
Abstract
Given the pivotal role that social interactions play for adolescents' well-being, understanding the factors that influence communication is key. The present study examined relations between adolescents' communicative perspective-taking, executive function skills, and ADHD traits and explored the role communicative perspective-taking plays in peer relations. Data was collected from a community sample of 15 to 19-years-olds (N = 46) in Waterloo, Canada. Two communicative perspective-taking tasks required participants to infer speakers' communicative intentions. A battery of tasks assessed adolescents' working memory and inhibitory control. Elevated ADHD traits were associated with weaker working memory, inhibitory control, and communicative perspective-taking. Working memory was the strongest predictor of communicative perspective-taking. Highlighting the importance of communicative perspective-taking for social interactions, adolescents with weaker skills in this area reported worse peer relations. Findings underscore the importance of communicative perspective-taking for adolescents' social relations and have relevance for understanding the social difficulties faced by adolescents with elevated ADHD traits.
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Affiliation(s)
- Elizabeth S Nilsen
- Centre for Mental Health Research, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada.
| | - Sarah A Bacso
- Centre for Mental Health Research, Department of Psychology, University of Waterloo, 200 University Avenue West, Waterloo, Ontario, N2L 3G1, Canada
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Children with stronger executive functioning and fewer ADHD traits produce more effective referential statements. COGNITIVE DEVELOPMENT 2015. [DOI: 10.1016/j.cogdev.2015.09.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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