Brume

5 to 6% of children are dyspraxic, but dyspraxia is often an underdiagnosed condition. Dyspraxic children can face issues with planning, rhythm, and fine motor skills. Brume is a learning game designed to help all kids master these skills and simultaneously notify adults when potential dyspraxic patterns are detected. This approach is designed to allow wide appeal and reach for effective pre-diagnosis.

Notifying adults that a child may have dyslexia and should seek a diagnosis is key for their wellbeing and learning outcomes. Dyspraxic children need extra help to succeed, and many who were undiagnosed for years later report being labelled clumsy or lazy, losing self-confidence, and facing increasing learning difficulties. 

Brume has the potential to improve the lives of tens of millions of children globally by raising awareness about dyspraxia, helping kickstart the diagnosis process, and by providing valuable and fun pre-writing skills training to all.

5 to 6% of children are dyspraxic, with 2% having a severe form of dyspraxia. This is a type of DCD, Developmental Coordination disorder, that can affect children and adults. Dyspraxia affects around 400 million of people globally, and presents a challenge that gets progressively harder the longer it goes undiagnosed. 

Symptoms can impact motor skills, concentration, ability to make friends, self-esteem, behavior, and more. This may lead to mental health issues especially in teenagers, as undiagnosed dyspraxic persons are sometimes labelled as being clumsy or lazy and bullied for it. While the average age at which dyspraxia is detected is around 7 - 8, studies suggest that because dyspraxia is mostly associated with males, females with dyspraxia often go undiagnosed for much longer.

Different health professionals take part in diagnosing dyspraxia country to country, and treatments vary as well depending on symptoms. They often involve different health professionals in order to provide as comprehensive a treatment as possible. In countries such as France, a diagnosis is also necessary in order to start getting extra support in school for dyspraxic children through a personalized support plan (PPRE).

Brume is a learning game designed to engage children by providing them with a fun and compelling playing experience that calls upon key pre-writing skills: visio-spatial planning, fine motor skills, and rhythm. These skills are used in 8 game modes within the game world. Each of these game modes comes with its own scaffolding system to adapt the difficulty of the challenges given to each player and keep them fun. 

The gameplay and learning mechanics are fused so that players feels like Brume is a true game in its own right.

Fusing gameplay and learning also allows for learning analytics to be collected in the course of normal play, allowing for a dyspraxia pattern analysis to be conducted for each player. This data collection and analysis is key in our attempt to reduce the number of undiagnosed children with dyspraxia. We plan on driving usage by offering a fun playing experience for children, and delivering clear value through learning benefits for their children to parents, and through pre-diagnosis and skills training for use in school and medical settings.

Brume is available on touch devices and optimized for tablets in low connectivity settings, and parents can access an online dashboard.

Brume is geared primarily towards children from ages 5 to 8. This game is designed to be fun for children of all ages - and even adults can have fun with coordination games. Brume has two main impacts.

First, it aims at helping direct towards dyspraxia assessments undiagnosed individuals whose play data suggests thay may be dyspraxic. Early diagnosis is absolutely critical when it comes to mitigating the impact of dyspraxia on children's lives and educational outcomes. Late diagnosis is an issue thought to affect a larger proportion of female individuals, as dyspraxia affects males more, and is less often looked for in females.

Second, it can serve all children by helping them train their coordination through play: fine motor skills, rhythm, and planning. These are also key pre-writing skills, making this game highly relevant to pre-school and early primary school.

It is also designed to include a minimal amount of spoken language, so that language is as little a barrier in the use of Brume as possible, and translations can be made easily.

Brume addresses elements of several dimensions of the challenge: 

• Alerting parents and teachers to the possibility of dyspraxia in a child will help them communicate about this child's specific needs and adapt the pedagogical support for this child
• Dyspraxia can lead to mental health issues for kids and especially teenagers getting singled out and bullied because of it. Helping these kids get support early is key in later outcomes.
• The app format allows for distance or hybrid learning, in low connectivity settings, with only the data collection and analysis requiring a connection

A first prototype of the game has been developed with research partners and has acted as a proof of concept. Tralalere has secured additional funding in order to bring the game to a state allowing for deployment within partner academic regions in France, starting with the schools of the academic region of Poitiers in September. In parallel, we have initiated contacts with organizations and companies in the medical field in order to assess what business model might allow to scale efficiently, while ensuring continued free use for families.

Reseach has focused more on dyslexia than dyspraxia, but even considering this, using games to help diagnose such conditions remains extremely rare. Nothing comparable to Brume exists for dyspraxia, while for dyslexia one example can be found in Dytective, coming from research led by Carnegie Mellon. Dytective remains however a very diagnostic-like experience, with limited game-like features.

While Brume is also a collaborative research project, notably with the Cerca lab of the Poitiers University, and the Cedric lab of CNAM, we have created Brume as a game experience from the start.

Our assessment was that we needed to make early diagnosis of dyspraxia reach more children by providing an experience with learning and playing value for all children, and therefore relevant as part of normal pre-school or primary school activities. This allows avoiding the pitfall of having a pre-diagnosis tool that ends up being used primarily by parents or teachers already suspecting such an assessment might be necessary, rather than promoting a general use for effective general screening. The path we took for this innovation involved embedding a system for pre-diagnosing dyspraxia into a full learning game with wide appeal to children in the age class of interest. 

We hope to demonstrate through our upcoming testing in schools the efficiency of our "useful for all, essential for some" approach to detecting potential learning and developmental conditions in children. We will seek partnerships both amplifying the social impact and proving the economic viability of this approach.

We have served in the past 2 years close to 2000 children in limited public and classroom experimental settings. We aim at reaching around 150 000 thousand children in the coming schoolyear starting in September 2021.

Our target is to reach 12 to 15 million children, yearly, in 5 years.

The indicators we will measure and evaluate impact against are:

• Number of children reached per year
• Pre-diagnosis accuracy in percentage
• Pre-diagnosis reliability in percentage of false negatives
• Average age of pre-diagnosis
• Female children to male children ratio in pre-diagnosis

Internal part-time staff: 5

Contractors: 3

Staff and contractors at partner institutions (part-time, excluding teachers involved in experiments): 11 

Tralalere and its partners bring together skills in digital educational resource creation, in game-based learning, in teaching classes including dyspraxic children, as well as medical expertise on the diagnosis of dyspraxia and treatment/support for dyspraxic children. 

No single person in our team combines all these skills or experiences, and this is why this has been a collaborative effort from the start. Our method has included forming a scientific committee that has been instrumental in bringing our skills together to iterate on the design of Brume while taking into consideration all the different aspects of the mission at hand. 

Discussion and qualitative feedback from dyspraxic children and the associations of parents of dyspraxic children have also been key in formulating and prioritizing our impact objectives, as well as for the testing of our game modes. We will continue to seek qualitative feedback in parallel to quantitative analysis, in particular when it comes to issues of false negatives and undiagnosed children, which are major pain points for children and parents alike.

Tralalere's status as an ESUS, Solidarity Enterprise with Social Usefulness, comes with a set of rules to adhere to, in terms of social impact, equity, inclusion, diversity, team representation in company decisions. 

Our team includes people of different religions as well as without creed, with varying skin pigmentation and ancestral continents of origin. Tralalere was founded and is still led by her president, Deborah Elalouf, who is one of 4 women in the leadership team, along with two men.

We are lucky to work in a compassionate and respectful environment, and continue to explore ways to improve, while being also cognizant of how delicate and precious such an environment is. We are therefore trying to be in a nurturing and organic approach rather than to attempt brutal and sudden changes.

Networking, funding, and media access would allow to accelerate the adoption of Brume in new countries beyond France as we start to look for horizontal scaling. Partnerships with institutions active in education and health would be key for achieving our ambition to make Brume available for as many children as possible, as early as possible.

Funding would also help with the technical costs of scaling, notably translation.

As we are still looking to find the right business model for our scaling efforts, this is an area where we will want to iterate and be both advised and challenged.

Distribution of Brume will be something we achieve through partnerships that will be helped by media and public relations efforts in order to interest the partners we will seek for this.

The organizations we would like to partner with in our current understanding of what scaling will require are educational institutions and medical professional associations - in particular pediatricians' professional associations.

As it appears that many female children go undiagnosed, resulting in adult women being diagnosed with dyspraxia in their 20s or even later, we hope that Brume can contribute to reducing the gap. As Brume relies on data that does not include gender to identify dyspraxia pattern, one of our core aims is to allow female children to be assessed when a possibility of dyspraxia is identified, so that they may get support and help as early as possible when needed.