Why music?
Context
Access to care for children with neurodevelopmental disorders is still too limited. Inequalities remain, in particular due to significant disparities according to social background and place of residence [1]. For example, children in underprivileged areas have less access to care, even though they are more likely to develop neurodevelopmental disorders [2]. One of the major objectives is to improve the long-term follow-up of children, since care is too often interrupted after the first phases of rehabilitation, as in the case of specific learning disorders [3].
In this context, it is necessary to innovate in terms of care and to vary training methods in order to meet the challenges of managing neurodevelopmental disorders and thus limit their impact. Technology offers new possibilities since it allows the development of remote training protocols, for example via digital tools such as serious games that can be accessed at low cost. Although the use of serious games is a promising solution, this possibility remains little exploited for the moment [4]. Without denying the disparities in use depending on the environment, a large majority of households are now equipped with at least one tablet, smartphone or computer, including among the less developed areas (see for example the Hootsuite/WeAreSocial survey). Training methods can be developed on these platforms, particularly in the example of specific learning disorders, in order to reach a wider population.
Specific Learning Disorder
Dyslexia manifests as reading and spelling difficulties independent of socio-educational deficiencies, intellectual disabilities, or lack of motivation to learn [5]. Beyond phonological difficulties, other abilities are often affected in dyslexia, including motor and sensorimotor control [6][7], attention [8], working memory [9], executive functions [10], and temporal processing [11].
The temporal model of dyslexia postulates that deficits in the time domain (timing), particularly in the ability to process predictive auditory sequences, would be a major cause of reading difficulties. People with dyslexia have difficulties in estimating changes in the amplitude of the sound envelope over time [12], in processing short durations [13] and in processing rhythmic information.
Several studies have thus highlighted the effect of rhythm training on reading and language skills in dyslexia [14][15]. Mila Learn uses these protocols in the form of a musical game designed for children with specific learning disorders.
Mila-Learn
Mila is a serious game designed for children with specific learning disabilities and built around rhythm and language exercises. It is carried by a rich musical universe aiming to lead the child to spontaneously come back on the tool with his parents.
It has been built for the purpose of clinical research and in the continuity of the rich neuroscience literature of recent years dedicated to the implications of auditory and rhythmic stimulation on the strengthening of connections between distant brain areas.
A growing number of studies have shown that rhythm and music training interventions are effective in improving reading skills in dyslexic children [15]; the improvements observed could complement those obtained with methods more conventionally used in clinical practice. The effect of musical and rhythmic interventions also extends to other motor and cognitive functions and therefore may also be beneficial in other developmental disorders (ADHD, language disorders, etc.).
Following 2 pre-clinical studies, a large-scale clinical study is being prepared in collaboration with Pitié-Salpêtrière to confirm the therapeutic impact of this approach.
References
[2] R. H. Bitsko et al., “Health Care, Family, and Community Factors Associated with Mental, Behavioral, and Developmental Disorders and Poverty Among Children Aged 2–8 Years — United States, 2016,” MMWR. Morb. Mortal. Wkly. Rep., vol. 67, no. 50, pp. 1377–1383, 2018.
[3] S. W. van der Kleij, E. Segers, M. A. Groen, and L. Verhoeven, “Post-treatment reading development in children with dyslexia: the challenge remains,” Ann. Dyslexia, vol. 69, no. 3, pp. 279–296, 2019.
[4] L. Zhou and B. Parmanto, “Reaching people with disabilities in underserved areas through digital interventions: Systematic review,” Journal of Medical Internet Research. 2019.
[5] Habib, M., & Giraud, K. Dyslexia. In Handbook of clinical neurology (Vol. 111, pp.229-235). Elsevier. 2019.
[6] Chaix, Y., Albaret, J. M., Brassard, C., Cheuret, E., De Castelnau, P., Benesteau, J., Démonet, J. F. Motor impairment in dyslexia: the influence of attention disorders. European Journal of Paediatric Neurology, 11(6), 368-374. 2007.
[7] Ramus, F. Developmental dyslexia: specific phonological deficit or general sensorimotor dysfunction?. Current opinion in neurobiology, 13(2), 212-218. 2003.
[8] Stoet, Gijsbert, Hayley Markey, and Beatriz López. "Dyslexia and attentional shifting." Neuroscience letters 427.1 : 61-65. 2007.
[9] Beneventi, H., Tønnessen, F. E., Ersland, L., & Hugdahl, K. Working memory deficit in dyslexia: behavioral and FMRI evidence. International Journal of Neuroscience, 120(1), 51-59. 2010.
[10] Lewandowska, M., Milner, R., Ganc, M., Włodarczyk, E., & Skarżyński, H. Attention dysfunction subtypes of developmental dyslexia. Medical science monitor, 20, 2256. 2014.
[11] Leong, V., & Goswami, U. Impaired extraction of speech rhythm from temporal modulation patterns in speech in developmental dyslexia. Frontiers in human neuroscience, 8, 96. 2014.
[12] Goswami, Usha, et al. "Amplitude envelope onsets and developmental dyslexia: A new hypothesis." Proceedings of the National Academy of Sciences 99.16 : 10911-10916. 2002.
[13] Huss, Martina, et al. "Music, rhythm, rise time perception and developmental dyslexia: perception of musical meter predicts reading and phonology." Cortex 47.6 : 674-689. 2011.
[14] M. Habib, C. Lardy, T. Desiles, C. Commeiras, and J. Chobert, “Music and Dyslexia : A New Musical Training Method to Improve Reading and Related Disorders,” vol. 7, no. January, 2016.
[15] Bhide, Adeetee, Alan Power, and Usha Goswami. "A rhythmic musical intervention for poor readers: A comparison of efficacy with a letter‐based intervention." Mind, Brain, and Education 7.2 (2013): 113-123.
