Long underestimated and misdiagnosed specific learning disorders, the famous “dys” (dysphasia, , , …), they are now receiving more 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 it . At the moment, the pediatric and adolescent psychiatry department of the Pitié-Salpêtrière AP-HP hospital, headed by Professor David Cohen, is carrying out a unprecedented in France. This is to evaluate 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 game) which combines a “serious” background with a playful form. In this case, it is about helping children with specific learning and language disorders (Tsal) in particular.. The game is based on a 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 . To make the experience more captivating, the designers used artists and titles that are known and appreciated by young people such as Big Flo and Oli, United boys or The jungle book again.
To prove the scientific validity of her approach, Mila then initiated this. We spoke to François Vonthron, co-founder of Mila, start-up of 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 creating 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, he is about thirty years old. It was used in particular in the treatment ofand some in general. Regarding speech disorders, in the past 20 years, many researchers in 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 byProfessor Michel Habib on the use of music with dyslexic children, who led to the development of protocols giving really satisfying results; on the other hand, our project at the École Polytechnique focused on data science and how to use data to create scientific studies with larger samples.
Mila is therefore involved in the math and data science part. But what brought you to the field of “dys” disorders?
Francois Vonthron: I am a musician by training and a math and engineering enthusiast. 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 math, music and. This is how I entered the world of health.
You explain that ” people with Tsal have difficulty 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 a child’s daily life and the difficulties it causes?
Francois Vonthron: For these children, the learning process of reading will be complicated. When we read, we require already memorized vocabulary with a very weak cognitive process. For these children who do not yet have a lexical stock, there is a learning process that involves cutting out wordsto decode them. It is in this work of rapprochement between phoneme and meaning that the lack of interconnections at the level of these two areas of the will create disturbance. For example, the child will confuse “ba” and “pa”.
This results in severe reading difficulties in school. It is a problem that is fundamentally neurological and requires a lot of support, a very specific rehabilitation. The corollary of this is that these children often have degraded self-esteem from years of stigmatization and failure. This is a crucial point that lies at the heart of our work to make Mila Learn accessible, fun and above all non-stigmatizing.
On what scientific basis is the development of Mila Learn based?
Francois Vonthron: We mainly target an area of thewhich is called the arcuate radius that connects the two zones to work in this process of encoding for reading. The nerve bundle is the white which allows any human to have fast coding and interconnection. This package has been shown to be underdeveloped in children with dys disorders. It is an anatomical marker. What we have come to realize is that learning music goes through the same arcuate radius. It is for this reason that dyslexic children are very often ill rhythmic because it is the cognitive process itself that is at work.
There is a direct correlation between rhythmic learning in these children and the impact on reading learning.
Work has built on this problem to develop a rather specific rhythmic learning process that makes the arcuate ray 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 acognitive rhythm, we practice a fairly specific and intensive learning process that will stimulate the same areas of the in children than in those who use to learn to read. There is a direct correlation between rhythmic learning in these children and the impact on reading learning. This has been shown by several studies, notably 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 linguistic dimensions. Simple rhythmic training has much less impact if it is not associated with language and gesture. Being able to combine gestures and sounds is at the heart of this intermodal integration. This need is an advantage for us in the development of Mila Learn because it has 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 rely on the standard deviation from the national mean that is used to measure the child’s dys disorder, we would see improvement with the use of Mila Learn. For example, a child starting with a standard deviation of -20 will approach faster than a child starting with a standard deviation of -3 -4. A child is considered dyslexic by -1.5 standard deviation. The further we advance in the severity of the disturbance, the more quickly the delta will be compensated by these. I must emphasize that hindsight is still lacking on this point today and that we expect many lessons from the clinical study we have started.
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 at 5-6 years and 12-14 years in the near future. The whole challenge for us is to be able to design 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 specific age and difficulty of the child. For the moment the universe, the scenario, the course of the game are not evolving 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 underline that Mila Learn is a complementary tool aimed at strengthening the therapeutic arsenal of which healthcare professionals remain the pillar. The game is part of a job with. The goal is that the game is part of the care pathway of these patients to make it an autonomous tool for work at home in addition to therapeutic monitoring.
If you are the parent of a “dis” child, you can absolutely be a driving force in adopting Mila Learn. We can use the game spontaneously and appropriate it. Instead, 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.
The goal is that the cost is zero for the user
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 discussing with insurers and mutual societies who support us financially in the development of the game, the price will be set by the medical service provided. Negotiations are underway with the Social Security to define the benefit paid to the patient.
What horizon for the launch of Mila Learn?
Francois Vonthron: We aim 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 trial. The actual commercial launch is expected to take place in 2023.
Tell us about the ongoing clinical study
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 big news 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 the Mila Learn training for two months.
The study is still open to all dyslexic children not treated in speech therapy to avoid bias
The other innovation is the use of, as for pharmacological studies. We created a game similar to Mila but without the stimulation of the cognitive rhythm. The idea is that the two groups of testers are randomized, patients and clinicians blinded, in order to get a study on the standards of medicine.
It is Professor Cohen’s child psychiatry department of the Pitié-Salpêtrière hospital in Paris that is conducting this study. 160 children are recruited. The study is still open to all dyslexic children not treated with speech therapy in order to avoid bias. You can apply online by following this.