Digital games and computer-based interventions for reading difficulties in Latin American children in Spanish-language and Portuguese-language settings

INTRODUCTION

Dyslexia is a neurodevelopmental disorder characterized by slow and inaccurate word recognition, and it has been reported in every culture studied.(1) Its definition has shifted over the years, and the loosening of diagnostic criteria has been argued to have produced diagnostic confusion.(2) Across languages, reading depends on phonological awareness, while the consistency of the orthography changes the grain size at which children read and the way dyslexia shows itself.(3) Spanish is described as a transparent orthography in a Chilean GraphoGame study and in a Spanish remediation trial, both of which treat letter-sound knowledge as the entry point to word reading.(4,5)

Prevalence figures from Latin American school samples differ widely, and so do the instruments behind them. A representative sample of second to sixth graders from four regions of Brazil gave 7.5% for reading impairment under DSM-5 criteria.(6) A stratified sample of 1,228 fourth and sixth graders in Ecuador gave 25.8% for dyslexia, with higher figures in public than in private schools.(7) The two estimates are not directly comparable. A regional study assessed reading in third and sixth grade in 15 countries.(8)

Outside the region, technology-based reading interventions have a sizeable evidence base. A multilevel meta-analysis of 67 studies with 10,734 primary school children found an average effect size of 0.36 for computer-supported word reading interventions,(9) whereas a best-evidence synthesis of 20 studies with struggling readers found 0.14 for educational technology applications.(10) GraphoGame, a game that trains grapheme-phoneme connections and was first developed for Finnish,(11,12) has been implemented in more than 20 countries, yet a synthesis of 28 studies found no meaningful overall effect on word reading (g = −0.02).(13) Serious games for children with learning disorders improved reading and metaphonological skills in a systematic review, although few had evidence of efficacy.(14)

Latin America teaches reading mainly in Spanish and Portuguese, and the studies on digital tools appear in both languages. A scoping review identified 13 studies of dyslexia interventions in Brazil, one theme of which was computerized technology.(15) An integrative review of information and communication technologies applied to dyslexia included 21 articles, of which 20 were international.(16) A systematic review of 14 articles examined digital games for phonological awareness in literacy teaching.(17) A comparison of the Spanish-language and Portuguese-language settings, of games and other programs, and of designed and tested tools is informative because agreement across independent traditions weighs more than agreement within one.

The aim of this narrative review was to synthesize published reports on digital games and computer-based interventions for reading difficulties and dyslexia that were developed or evaluated with Latin American children. The review pursued four objectives: to map the tools by country, language and design; to contrast the reading outcomes reported for game-based and non-game computer interventions; to contrast the evidence from Spanish-language and Portuguese-language settings; and to identify gaps in design, validation and reporting.

METHODS

DEVELOPMENT

Spanish-language and Portuguese-language settings

Portuguese-language reports exceeded Spanish-language reports by 20 to 17, and the gap widened among evaluated reports, 15 against 7. Comparison groups appeared in 9 Portuguese-language reports and 4 Spanish-language reports, whereas design and usability reports made up 8 of the 17 Spanish-language reports and 5 of the 20 Portuguese-language reports. Improvement was reported in 13 of 15 evaluated Portuguese-language reports and in 6 of 7 evaluated Spanish-language reports (Figure 1, Figure 2).

The type of document also separated the two languages: 8 of the 10 conference papers were Spanish-language, and 17 of the 20 Portuguese-language reports were journal articles. Game-based work dominated the Portuguese-language literature, with 12 games among 20 reports, compared with 8 games among 17 Spanish-language reports. Spanish-language reports spread over more formats: 3 apps, 4 programs, an augmented-reality application and a remotely delivered program, whereas Portuguese-language reports held 6 programs, 1 app and 1 tangible device besides the games.

In Peru, the quasi-experimental study with 64 five-year-olds reported a significant increase in phonological awareness after 3 months with an augmented-reality application,(30) and the adaptive serious game for children aged 7 to 12 with reading difficulties improved word reading, pseudoword reading, word discrimination and error detection in 2 weeks.(31) In Brazil, 12 children aged 4 and 5 improved syllable and phoneme awareness after ten sessions with the Pedro software, and the change in writing hypothesis coincided with that gain.(29)

Remote delivery gained a place after the pandemic in both languages. Argentine children with dyslexia improved phonological skills, fluency and decoding in virtual and in-person formats alike,(36) and GraphoGame Brazil was tested during school closures with children in online classes.(24)

DISCUSSION

The corpus was expected to hold its strongest evidence where the need is stated most often, in children with dyslexia, and the opposite occurred. Tool building outpaced tool testing, and the gap was widest for the population that motivated the work. Reports on reading difficulties and on early literacy supplied most of the outcome data, so the evidence base answers a broader question than the title of many reports suggests.

The direction of the reported outcomes was favorable in nearly every evaluated report, and the international literature explains why that direction should not be read as size. Pooled estimates for computer-supported reading interventions range from 0.36 across 67 studies(9) to 0.14 for struggling readers,(10) and the GraphoGame synthesis found no overall effect on word reading (g = −0.02) until adult interaction was considered, when studies with high interaction averaged 0.48.(13) Against that background, the single standardized effect in the Latin American corpus, d = 0.40 for reading in Escribo Play, lies slightly above the pooled average of 0.36, in preschool children and with a different outcome set.(25)

The control condition separates comparable from non-comparable findings. In the meta-analysis of word reading interventions, effect sizes were higher when the control was education as usual and lower when the control received a reading treatment.(9) Where the abstracts described the comparison, as in the Pedro study, controls received usual instruction,(29) whereas the Brazilian GraphoGame study used an active numeracy control.(24) That design matches the Portuguese, French and Indian GraphoGame and GraphoLearn trials, which reported benefits for spelling and phonological awareness,(63) phoneme awareness, orthographic choice and fluency (effect sizes 0.23, 0.27 and 0.18),(64) and letter-sound knowledge.(65)

Orthography offers a plausible account of why letter-sound and phonological training dominate the Spanish-language and Portuguese-language tools. Phonological awareness contributes to reading in every language studied, while the grain size of lexical representations varies with the consistency of the orthography,(3) and its predictive weight varies along a continuum of orthographic depth.(66) In a transparent orthography, GraphoGame was built to train letter-sound connections first.(11,12) Spanish children with reading disabilities who trained with phoneme and syllable units on a computer improved word recognition compared with untrained controls,(5) which coincides with the gains in letter-sound recognition among Chilean first graders at risk(23) and with the benefit of computer-based letter training for Finnish school beginners at risk.(67)

For dyslexia, the contrast with the international record is sharper. A meta-analysis of 22 randomized trials identified phonics instruction as the only approach whose efficacy for reading and spelling was statistically confirmed.(68) The Argentine report, with its explicit and systematic program, fits that pattern,(36) but the Latin American game reports for dyslexia mostly described a tool without testing phonics content. Action video games offer an alternative route, with improvements in reading found in a meta-analysis of nine experiments with 238 children,(69) in a randomized comparison(70) and in English-speaking children with dyslexia.(71) None of the abstracts reviewed here mentioned action video games.

Games and non-game programs reported similar directions, and the more informative difference lies in what they were asked to deliver. Serious games improved reading and metaphonological skills in a systematic review, but progress generalized poorly to untrained skills,(14) and the GraphoLearn game raised word reading without transfer to fluency, comprehension or spelling.(72) The Latin American reports that measured comprehension showed the same limit: comprehension rose with a computerized program while fluency did not differ between groups.(35) A meta-analysis of digital game-based training in neurodevelopmental disorders found that both task content and game features contributed to effects, and that training could be delivered remotely.(73)

Adult mediation recurs across the Latin American reports and matches the moderator found in the GraphoGame synthesis. The Pedro software was effective with the speech-language pathologist as mediator.(29) The Soletrando study stressed the role of the teacher in mediating software use,(38) and the Argentine report recommended an initial in-person bond before remote work.(36) In Norway, an adaptive and a non-adaptive computer component, each embedded in teacher-led instruction, produced similar reading and spelling gains,(74) which suggests that instruction around the tool may weigh more than the game format. Best-evidence reviews found the largest effects for applications integrated with small-group instruction.(10)

Proximal measures flatter a tool. Three evaluated reports measured phonological awareness or writing level without a reading measure, and when a game trains the same skill that the test measures, improvement is the expected result. The international trials add the distal check: GraphoLearn sped word reading but did not transfer to fluency, comprehension or spelling,(72) and serious games generalized poorly to untrained skills.(14) A report that pairs a proximal measure with a transfer measure, as the Peruvian adaptive game did with word, pseudoword and error-detection tasks,(31) gives readers more than one view of the same effect.

Engagement is the usual argument for games, and the Latin American reports recorded it but rarely linked it to gains. Pocoloto kept children motivated during classroom use,(26) the case study of the Menino Curioso software observed more autonomy and motivation,(39) and a gamified narrative prototype measured motivation and engagement with scales.(43) In the GraphoLearn trial, children judged more cognitively engaged by parents and teachers gained more in word reading, whereas emotional engagement related to playing time but not to gains.(72) Motivation recorded in a design report predicts neither exposure nor learning until outcome data are attached.

Dose and duration varied from 2 weeks to 9 months, and the meta-analysis of word reading interventions found that treatment length moderated effect sizes.(9) The Latin American reports seldom crossed duration with outcome, so that moderator could not be examined, and the two shortest applications, 2 weeks in Peru and 6 weeks in Chile, reported gains in different skills.(4,31) Dutch first graders who played about 28 sessions gained letter knowledge across the classroom and a small benefit in fluency.(75) Session counts, rather than calendar length, are the unit that future Latin American reports could add.

The Chilean study of GraphoGame in Spanish deserves separate mention because it linked intervention to prognosis. Performance at the first level of the game correlated mildly with reading fluency assessed one year later, and none of the children classified as poor readers in second grade reached the highest levels.(4) Whereas the Brazilian version was judged by word reading accuracy against an active control,(24) the Chilean version served as both an intervention and a marker of later reading status. The Dutch trial also exploited data generated by the game itself to evaluate the intervention.(75)

Equity shapes how these tools can be used. The Chilean game improved different skills in low-SES and high-SES first graders,(23) the Ecuadorian prevalence study found higher rates in public schools and pointed to poverty and limited access to educational materials,(7) and a review of ICT and gamification flagged unequal access to technology.(62) The authors of TitíApp presented the tool as a way to narrow the digital divide.(22) Tools that require devices and connectivity compete with the need they serve, and low-cost designs such as Alfaba address that tension while having been rated only by professionals and teachers.(46)

Terminology complicates the synthesis. Reports used dyslexia, reading difficulties, learning difficulties and literacy delay for overlapping groups, and the definition of dyslexia itself has been argued to have loosened, which risks diagnostic confusion.(2) The Brazilian systematic review of phonological awareness training counted 13 studies with learning difficulties against 2 with dyslexia among its 27 intervention studies.(58) A tool tested on children with learning difficulties cannot be assumed to work for dyslexia, and the corpus rarely gave the diagnostic criteria needed to tell them apart.

The geographic contrast sharpens the same point. Brazil supplied most comparison-group designs in the corpus, 9 of 13, and the review of dyslexia interventions in Brazil found a body of studies in which phonological interventions, computerized technology, auditory training and visuomotor training coexisted.(15) In the other countries, a single comparison-group study per country could not be set against another from the same setting, so agreement between independent teams, which would count most, was not testable. The Chilean and Brazilian GraphoGame studies are the closest pair, as both used the same game family in different languages, yet their outcomes (letter, pseudoword and phonological gains versus word reading accuracy) cannot be compared directly.(4,24)

Contextual factors help to read the differences between languages. Portuguese-language evidence came mostly from journals and included more comparison groups, whereas almost half of the Spanish-language evidence appeared in engineering conference proceedings, and Spanish-language reports included more design reports. A review of phonological awareness training in Brazil found that the number of intervention studies was small relative to the variety of populations and the demand from graduate programs.(58) The Brazilian scoping review concluded that most interventions agreed with international theory but showed methodological problems that would strengthen practice if addressed.(15) These patterns describe where reports are published and how they are designed. They do not show that tools in one language work better.

A research agenda follows from these contrasts, and each element answers a limitation. Cluster-randomized trials with an active control, as in Escribo Play and the GraphoGame studies, would separate tool effects from instruction effects.(25,64) Follow-up measures, like the second-grade reading status used in Chile, would show whether gains persist.(4) Common outcome sets would let trials in both languages be pooled, as meta-analyses of computer-assisted word reading already do.(9) Trials in children with dyslexia should state the diagnostic criteria and test phonics content explicitly, because phonics instruction is the approach with confirmed efficacy.(68)

Comparisons with trials outside the region show where Latin American evidence could grow. A Finnish study of 166 school beginners at risk compared computer-assisted remedial reading with regular remedial reading and mainstream instruction, and the computer-assisted arm was highly beneficial.(67) In Norway, 744 first graders were screened and 140 at risk received one of two interventions.(74) In India, 30 third graders reading below first-grade level played GraphoLearn or a math game for 8 weeks and improved letter-sound knowledge.(65) Each of these abstracts names a risk criterion, a control and a duration, and Latin American reports could meet that standard with the same three declarations.

The regional mapping of educational software for literacy points the same way: of the 60 programs it identified, evaluation focused mostly on usability and pedagogical aspects, with experiments, observation of use and user tests as the commonest methods.(56) That profile matches the 15 design-only reports found here. It also matches the Brazilian systematic review of technologies for literacy in neurodevelopmental disorders, in which all experimental studies reported improved repertoires while reports of experience described promising tools and difficulties of school implementation.(55)

Associations in the corpus should not be read as causal. Single-group pre-post designs cannot separate a tool effect from maturation or from regular classroom teaching, and the dose relation in the LEGERE study (r = 0.672) is a correlation within the experimental group.(34) Comparison groups of 11 to 30 children cannot support precise estimates. Large samples, such as the 600 schoolchildren of the Brazilian computerized program, stated significance without an effect size in the abstract.(32)

The review has strengths: it searched five sources in three languages, kept grey literature visible through document types, and computed every count by script from an extraction table. Its limitations are specific. Extraction relied on abstracts, so details of design, dosage and measures may be missing; the authors should verify each row against the full text before submission. Candidates without a retrievable abstract could not be verified and were not retained, which may under-represent conference literature; a systematic update with full-text retrieval would close that gap. Outcomes were heterogeneous, from letter knowledge to comprehension; a shared minimum set of measures, with effect sizes and confidence intervals, would make future reports poolable. Dyslexia reports lacked control groups; cluster trials with an active control, as in the GraphoGame studies, would fit school settings. Indigenous languages and bilingual Spanish-English contexts fell outside the scope, and a separate review should treat them.

For schools and developers, the corpus supports pairing a tool with adult mediation, targeting letter-sound and phonological content explicitly in transparent orthographies, and reporting usability together with outcomes. Open distribution of the tools, including the app designed for rural schools in Ecuador,(47) would let teachers compare them. A framework of accessibility guidelines for dyslexia, as proposed for serious games,(48) gives developers a shared checklist. For policy, regional learning assessments could incorporate the reading outcomes of piloted tools, so that school-level trials report on the same scale as national tests.(8)

CONCLUSIONS

The mapped tools were mostly games, were concentrated in Brazil and Ecuador, and divided between reports that tested a tool and reports that only described its design.

Game-based and non-game computer interventions both received mostly favorable reports from their authors, with no visible difference in direction between them and with scarce effect sizes.

Portuguese-language settings contributed more evaluated reports and more comparison groups, whereas Spanish-language settings contributed more design reports, and conference proceedings made up almost half of the Spanish-language reports.

The main gaps are outcome evidence for children with dyslexia, shared outcome measures, reported effect sizes and independent replication of the tools.

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