Our feasibility study of the computer game E-PLAYS, which aims to develop collaborative and communication skills in 4 to 7 year olds, shows that a full trial would be possible and is warranted.
Children with social communication impairments struggle to communicate effectively in social contexts. Difficulties with social communication can manifest themselves as an inability to maintain a topic of conversation or take turns appropriately, misunderstanding of non-literal language such as jokes, irony or sarcasm, failure to make inferences and repair communication breakdowns. Responding appropriately, interpreting others’ communications whilst at the same time understanding society’s norms and expectations constitutes pragmatic language skill.
E-PLAYS is a computer game designed to develop collaborative and communication skills in children with social communication impairments. In this study, we tested recruitment, retention, and adherence rates and our outcome measures to see if a full scale trial was feasible.
We undertook a two-arm, cluster-randomised trial to investigate the feasibility of conducting a sufficiently powered trial to evaluate the effectiveness and cost-effectiveness of E-PLAYS (compared with treatment as usual) for young children with social communication impairment.
Speech and language therapists selected suitable children (ages 4–7 years old) from their caseload. The E-PLAYS intervention was 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.
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.
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.
Murphy, S., Joffe, V., Donald, L. et al. Evaluating ‘Enhancing Pragmatic Language skills for Young children with Social communication impairments’ (E-PLAYS): a feasibility cluster-randomised controlled trial. Pilot Feasibility Stud 7, 5 (2021). https://doi.org/10.1186/s40814-020-00724-9
Murphy, S., Joffe, V., Messer, D. et al. 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 5, 75 (2019). https://doi.org/10.1186/s40814-019-0456-z
The research was funded by the NIHR RfPB programme (Award ID: PB-PG-0416-20035). The project was started in November 2017 and completed in August 2019.
Trial registration: ISRCTN14818949 (retrospectively registered).