Skip to main content
Download PDF
  • Study Protocol
  • Open access
  • Published:

Japi 2.0, a gaming platform to stimulate cognitive and non-cognitive skills in early childhood: protocol for a pilot randomized controlled trial

Pilot and Feasibility Studies volume 11, Article number: 5 (2025) Cite this article

Abstract

Background

Mental health disorders are one of the leading causes of illness globally. The importance of psychosocial skills acquired in early childhood, such as executive functions, inhibitory control, emotional regulation, and social problem-solving, in preventing mental disorders has been reported. Furthermore, mental health care delivery is evolving, and mobile technology is becoming the medium for assessment and intervention. We have developed Japi 2.0, the second iteration of a gaming platform, to stimulate cognitive and non-cognitive skills in early childhood, supported by early years educators using a web-based dashboard integrated into one system. This study aims to assess the acceptability and feasibility of this gaming platform and web-based dashboards.

Methods

This is a pilot randomized controlled trial, parallel-group type, where the school-based implementation of “Japi 2.0” training is compared to standard school curricula in control schools. A total of six schools with low socio-economic status located in the city of Santiago, Chile, are expected to be recruited and randomized with 1:1 allocation. Japi 2.0 has 24 sessions, and 2 sessions of 15 min per week are delivered for 12 weeks. Measures will be conducted using different instruments with children, parents, and early years educators to gain insight into their acceptance of the intervention and the development of cognitive and non-cognitive skills.

Discussion

This is a randomized control trial to assess the acceptability and feasibility of a gaming platform called “Japi 2.0” among preschoolers in Chile. This platform stimulates cognitive and non-cognitive skills with the final objective of reducing emotional and behavioral problems in early childhood. Evaluating the acceptability and feasibility of this technological solution for children is expected to produce relevant information about these novel designs. It may help guide future studies, such as a randomized controlled trial on a larger scale.

Trial registration

Clinical Trials NCT06420544, May 20, 2024 [https://www.clinicaltrials.gov/study/NCT06420544].

Peer Review reports

Background

Mental health disorders are among the leading causes of the Global Burden of Disease [1], and their relative importance is predicted to rise globally. During the COVID-19 pandemic, this scenario has worsened globally. One systematic review has shown that pooled estimates obtained in the first year of the COVID-19 pandemic suggest that 25.2% (95% CI, 21.2–29.7%) of youth globally are experiencing clinically elevated depression symptoms, while 20.5% (95% CI, 17.2–24.4%) of youth are experiencing clinically elevated anxiety symptoms [2]. These pooled estimates, which increased over time, double the prepandemic estimates [3, 4].

On the other hand, scientific evidence has recently indicated that stimulating cognitive and non-cognitive skills in the first years of life promotes general development and has a beneficial long-term impact on health [5, 6] and different economic indicators [7,8,9]. Adequate development of executive functions early in life predicts better self-regulatory capacity later [10]. Executive functions, involving the regulation and control of cognitive processes, are closely linked to skills leading to better problem-solving, task persistence [11], self-esteem, school performance [12,13,14], and better social adjustment with a reduction in aggressive and other behavioral problems [15, 16].

Significant evidence shows that structural and functional plasticity in many brain core centers involved in executive functions and self-regulatory processes develops rapidly during early childhood [17, 18]. However, much of this evidence that led to interventions comes from studies in the USA and Europe of other developed countries, such as the High/Scope Perry Preschool Study [19], the Abecedarian Project [20, 21], Head Start [22, 23], and Early Head Start [23]. Many of these interventions were costly and difficult to implement. Nevertheless, Latin America has been trying to stimulate basic psychosocial skills early in life [24]. Locally in Chile, there is also evidence from other school programs that psychosocial skills are associated with better educational outcomes [25].

In addition, the evidence suggests that children from low-income families may begin the preschool stage with less development of academic (such as pre-calculus and initial language) and non-academic skills (such as emotional, social, and health competence in general) when compared with children from higher-income families [26]. These differences would increase socio-emotional, educational, and health disparities in the long term [15]. Adding to this the evidence that critical aspects of human development occur between 3 and 7 years, such as the recognition of emotions, behavior and emotion regulation [27, 28], and the development of executive functions [29, 30], it is essential to work with children who have greater economic vulnerability and to stimulate these skills early.

The penetration of new technologies (smartphones, tablets, wearable devices) may help overcome the abovementioned disparities. Technology use is increasing worldwide, opening unimaginable opportunities to advance this field, mainly due to the effects of the COVID-19 pandemic [31].

The digital revolution is evolving with an unprecedented explosion of technology development to transform mental health care delivery. With its emphasis on computing power and mobile technology [32], these platforms are becoming the medium through which assessment and intervention occur [32]. The COVID-19 pandemic has fast-forwarded the use of technology in mental health care, with the possibility of scaling up access to mental health interventions, especially after the COVID-19 pandemic [31].

Technological platforms offer an incredible opportunity to reach underserved and remotely located populations. Additionally, gaming-based interventions provide an excellent opportunity to engage young kids and deliver early-life interventions at a low cost and on a large scale [13]. The use of games in the educational sector is broad and continues to grow. There is good evidence that using educational games among preschool kids is feasible [13, 33,34,35,36]. There are recommendations for the features apps need to have to promote learning and creativity among children [37]. We are unaware of other tablet-based games for young children aiming to stimulate several cognitive (e.g., working memory, inhibitory control) and non-cognitive skills (e.g., self-regulation and social problem-solving) within one unified game. Furthermore, technology also allows the capture of large amounts of data, which helps to understand better the mechanisms whereby skills are learned and the pathways to a larger impact later in life. If these interventions effectively strengthen skills vital to improving health, social, and economic outcomes, the gains for society could be substantial.

In this project, we developed the second iteration of a gaming platform to stimulate cognitive and non-cognitive skills in early childhood. Japi 1.0, the first iteration, was created for the research team to stimulate two cognitive (working memory and inhibitory control) and two non-cognitive skills (emotion recognition and social competence). There were ten sessions where children aimed to play throughout eight activities and five tasks per activity: four stimulating either working memory or inhibitory control and four stimulating emotion recognition or social competence. Each session was planned to last 20 min. The audio instructions were recorded using professional actors and inserted into the sessions. The results still need to be published. This iteration helped to get an insight into the game’s usability and the time required to complete the sessions. We found that sessions lasted more than 20 min, which resulted in a reduction of attention in the final tasks. Therefore, we decided to split each session into two with four activities each, becoming Japi 1.5 [38] with 20 sessions in total, expecting to have sessions of no more than 15 min. In a recent RCT of this iteration, promising results showed that students in the intervention group had a better development of inhibitory control and emotion recognition than those in the control group [39].

Later, we decided to include new skills incorporating planning as a cognitive skill and empathy as a non-cognitive skill. To give space to the latest skills, we selected the most acceptable 1616 sessions from Japi 1.5 and created eight new sessions, each stimulating planning and empathy in four activities per session. Therefore, Japi 2.0 has 24 sessions, each aimed at lasting 15 min.

Considering all this, this study aims to assess the acceptability and feasibility of this gaming platform and web-based dashboards.

Methods

Study design and setting

This is a pilot randomized controlled trial, parallel-group type, in which “Japi 2.0”, a gaming platform that stimulates cognitive and non-cognitive skills in early childhood, is compared to standard school curricula in control schools. Six schools with low socio-economic status, located in Santiago, Chile, are expected to be recruited and allocated 1:1 stratified by school size (Strata 1: schools with one class and Strata 2: schools with two classes) to ensure balanced groups.

We will evaluate the acceptability and feasibility of this intervention, including measuring skills and behavioral outcomes. We will use a mixed-method design to understand better the factors that might facilitate or interfere with its delivery and acceptability.

Inclusion criteria for schools

  1. 1)

    Schools located in Santiago (Chile).

  2. 2)

    Schools with Preschool Education.

  3. 3)

    Mixed-sex schools.

  4. 4)

    Schools with high vulnerability (≥ 75%), as stated in the School Vulnerability Index – National System of Equality Allocation (IVE-SINAE). This index is the proportion of students in a given school with high vulnerability, considering socioeconomic variables such as the mother’s educational level, the father’s educational level, and total monthly household income, among others [40].

Exclusion criteria for schools

  1. 1)

    Three or more classes in Preschool. This criterion was considered for economic and practical reasons.

  2. 2)

    Implementing a manualized program to promote cognitive or social-emotional skills.

  3. 3)

    Participating in a similar study.

Inclusion criteria for students

  1. 1)

    Children attending pre-kindergarten (aged around 4 years old).

Exclusion criteria for students

  1. 1)

    Children with intellectual disability.

  2. 2)

    Children unable to understand and speak Spanish.

Intervention

Those children in the intervention group will play with the gaming platform “Japi 2.0” using a tablet device with headphones at a designated time given by school authorities. Research Assistants (RAs) will be present in the classroom each session. At the beginning of the session, the RA will provide brief general instructions, such as being careful when using tablets and headphones to play “Japi 2.0” and asking students questions regarding what skills they learned in the last session. During the session, if the students have questions, they will be asked to raise their hands, and the RA will help them. At the end of the session, RA will gather the students in a circle and will ask them what they have learned and how they can use it daily. Early Year Educators will be present in each session and will be asked to help with the discipline and motivation of the students.

The intervention has 24 sessions, and two sessions of 15 min will be delivered each week for 12 weeks. Each session will have four activities and five tasks per activity with increasing difficulty levels. Sessions 1 to 8 are focused on emotional recognition (e.g., students are asked to complete the drawing of a face of children according to the requested emotion by the instructions) and inhibitory control (e.g., while appearing different moving objects with faces expressing various emotions in the screen, the instruction to students indicates to touch a requested image with a specific emotion and not to touch the other images with other emotions). Sessions 9 to 16 focus on working memory (e.g., students are asked to place objects in a designated area on the screen in the same order as they were heard in the instructions) and social competence (e.g., students are asked to assess several social interactions and have to select which of the images show a social problem). Sessions 17 to 24 promote empathy (e.g., students are asked to evaluate several scenarios and relate those scenarios with specific emotions shown by people) and planning skills (e.g., students are asked to select the tools necessary to perform an activity, such as gardening or brushing their teeth).

Control

The control group receives standard school curricula, which is not a manualized intervention. The Ministry of Education provides the standard curriculum as a guideline called “Curricular Bases for Kindergarten Education” [41], which includes pre-kindergarten directions to Early Year Educators regarding emotion regulation and planning to implement in class.

General objective

This study aims to assess the acceptability and feasibility of a gaming platform that improves cognitive and non-cognitive skills in early childhood at schools with high socio-economic vulnerability. Early Years Educators would support the platform using a web-based dashboard integrated into a whole system housed on a local server.

Specifics objectives

  1. 1.

    To assess the acceptability of the gaming platform, the web-based dashboards, and the measurements by students and Early Year Educators.

  2. 2.

    To assess the feasibility of implementing this intervention using this gaming platform and the measurements among preschool children with Early Year Educators’ assistance in Chile.

Outcomes and data collection

Baseline assessments will include socio-demographic data obtained from the parents.

Primary outcome

Acceptability

The acceptability will be evaluated by establishing how this intervention program is received by students and Early Year Educators and to what extent this intervention responds to the needs of this target population. Specifically, acceptability will be evaluated using surveys that will be answered at the end of the interventions by students and Early Year Educators. Among Early Year Educators, the survey will include questions regarding the fidelity of the implementation (e.g. “How many sessions children were able to play during the week?” “Did you use the web-based dashboard to learn the progress of children?” “How many minutes did you use to support each child during the week?”, “Was this session’s activity interesting/relevant?”, “Did you like the session?”, “What did you like the most?” and “What did you like the least?”). We will also ask for their opinions about potential changes to be included in the future (e.g., “In your opinion, is there something you would change/replace/include?”). The answers to these surveys will be used to improve the sessions in future research. Finally, there will also be a brief assisted survey for the students. It will include questions such as “What did you like most about the game?”, “How did you feel playing the game? and “How did you feel using headphones?”.

Feasibility

The feasibility will be evaluated by measuring the achievement of the study’s objectives and by making a detailed assessment of whether it is possible to develop an evaluation of effectiveness in a study on a larger scale. For this purpose, data will be collected on the number of eligible schools, those contacted, and those who agree to participate. Data will also be collected on the number of students, parents, and Educators contacted and those who consent and agree to participate. Data will also be collected on the time needed to complete the surveys, student assessment tests, and participants’ loss.

Success criteria for feasibility

Feasibility will be considered acceptable if the consent rate is ≥ 70% (over the school enrolment), the completion rate for pre-test assessments is ≥ 70% (over the consented students), and the completion rate for post-test assessments is ≥ 60% (over the consented students).

Secondary outcomes

Working memory

We will use two measures:

  1. 1)

    Corsi Blocks Test [42]. This test assesses visuospatial short-term working memory. It involves repeating a sequence of up to nine identical spatially separated blocks on a screen. The sequence starts out simple but becomes more complex until the subject’s performance declines. It has shown good psychometric characteristics among school children with a reliability mean coefficient of 0.74 (odd–even corrected by the Spearman-Brown) [43]. Pre-kindergarteners take around 7 min to complete this test.

  2. 2)

    Auditive Working Memory test [44]. A sequence of audio messages of increased difficulty is presented, and the child is requested to remember these messages. The test is completed when the child has attempted to repeat the full set of 21 messages. It has shown good psychometric characteristics with reliability correlation coefficients for test–retest scores of 0.77 for 5-year-old children [44]. Pre-kindergarteners take around 5 min to complete this test.

Inhibitory control

We will use the Hearts and Flowers task [45], a hybrid combining elements of Simon and spatial Stroop tasks. This test consists of three consecutive tasks; in the first block, the person must press a key on the same side on which a heart appears (congruent block); in the second task, they must press a key on the opposite side of which a flower appears (incongruent block). Finally, there is a mixed block in which hearts and flowers appear randomly. The individual must follow two rules simultaneously, depending on the stimulus that appears, forming a mixed block [46]. It requires working memory and inhibition control. Pre-kindergarteners take around 10 min to complete this test.

Emotion recognition

We will use the Assessment of Children’s Emotions Skills (ACES) [47]. It consists of a facial expressions task aiming to evaluate emotion expression knowledge and whether the subjects exhibit any anger bias. The 26-item scale consists of color photographs of ethnically diverse elementary schoolchildren depicting four expressions of each of the four basic emotions (happy, sad, angry, and scared) and 10 images of children without obvious facial expressions [48, 49]. The examiner shows the child the photographs one at a time and each time asks, “Is the child in the picture happy, sad, angry, or scared?” Then, the examiner registers the child’s answer. The emotion accuracy score reflects how many items the children answer correctly, and the anger bias score is the percentage of time the children incorrectly identify the faces as displaying anger [50]. Recently, it has shown acceptable psychometric characteristics with reliability among 6-year-old children with Cronbach’s α 0.64 [51]. Pre-kindergarteners take around 10 min to complete this test.

Social competence

We will use the Challenging Situations Task (CST) [52]. This instrument evaluates the ability of children to solve social problems. The children are presented with six vignettes that describe problems between peers. Following the presentation of each challenging situation, four pictures of happy, sad, angry, and neutral affect are presented in random order. The child is asked to point to the picture that best describes how they feel when [this situation] happens. Then, four pictures of behavioral responses (prosocial, aggressive, manipulation of others' feelings, and avoidant) are presented in random order, and the child is asked, “What do you do [in this situation]?” The answers are categorized into four possibilities: prosocial, aggressive, cry, and avoidant. Scores for affective and behavioral responses used are the number of times each effect, and each behavioral response is chosen by each child across the six situations. It has shown acceptable psychometric characteristics of internal consistency with mean inter-item correlations among 4-year-old children ≥ 0.29 [52]. Pre-kindergarteners take around 10 min to complete this test.

Empathy

We will use The Empathy Scale for Children (ESC) [53], a tool developed for measuring children’s empathic skills. The scale consists of 12 essays with picture cards about four basic emotions (happiness, sadness, anger, and fear) and cards about facial expressions, where, for example, a facial expression of a character is missing under a situation, and the evaluated child matches this with emotion. The higher the score, the better the skill. It has shown good psychometric characteristics with reliability correlation coefficients for test–retest scores of 0.89 for 4 to 6-year-old children [53]. Pre-kindergarteners take around 5 min to complete this test.

Cognitive planning

We will use The Tower of London, developed by Shallice (1982), based on the pre-existing Tower of Hanoi [54]. This instrument is applied to children through individual interviews. The participant’s task is to convert the initial position of the balls to the position demonstrated by the evaluator. Ball movements are limited because pegs differ in terms of the maximum number of balls they can hold at any time, and participants cannot move more than one ball at a time. The higher the score, the better the skill. It has shown good psychometric characteristics among school children, which correlate to other executive function tools, with Pearson coefficients ranging from 0.40 to 0.48 [54]. Pre-kindergarteners take around 12 min to complete this test.

Behavioral problems and psychological assessment

We will use two measures:

  1. 1)

    The Strengths and Difficulties Questionnaire (SDQ) [55] is widely used in Chile [56, 57]. This 25-question questionnaire explores different symptoms grouped into 5 sub-scales (with 5 items each): (1) emotional symptoms, (2) behavioral problems, (3) problems with peers, (4) symptoms of lack of attention and hyperactivity, and (5) prosocial skills. The first four sub-scales refer to difficulties that children may have and may be grouped together in a general sub-scale of difficulties (20 items). The sub-scale of prosocial skills refers to positive and adaptive behaviors in social relationships. Each item is answered on a scale of responses from 1 = not true to 3 = absolutely true. There is a version for Educators and parents (to evaluate children from 4 to 16 years old) and a self-report for teenagers (ages 11 to 16 years old). It has been widely used [58] and has shown good psychometric characteristics with Cronbach’s α 0.73 [59]. The Educators’ and parents’ versions of this instrument will be used.

  2. 2)

    The Eyberg Child Behavior Inventory (EBCI) [60]. The ECBI is a behaviourally specific rating scale that assesses the current frequency and severity of disruptive behaviors in the home setting, as well as the extent to which parents find the behavior troublesome. It provides two measures: frequency of disruptive behaviors (intensity score) rated on 7-point scales and number of disruptive behaviors that parents list as problematic (problem score). The ECBI has a high internal consistency for the Intensity Scale (r = 0.95) and for the Problem Scale (r = 0.94) [60, 61]. By evaluating the variety and frequency of behaviors commonly exhibited by all children, the instrument distinguishes normal behavior problems from conduct-disordered behavior in children and adolescents. The established cutoff scores of 127 for the Intensity Scale and 11 for the Problem Scale have been validated in clinical studies for young children [62].

Recruitment

To achieve adequate school enrolment and sample size, research assistants will contact and inform school authorities about the study’s purpose, requirements, randomization, and duration. Regarding randomization, it will be explained that schools allocated to the intervention group will receive “Japi 2.0” as part of their curriculum, while control schools will implement the standard curriculum.

After the school authorities accept participating in the study and sign an agreement form, parents will receive the Informed Consent Form, which they must sign if they agree to let their children participate. Finally, RAs will inform the students about the study and ask them to give verbal assent confirming their participation.

As the program is part of the school curriculum, students in the intervention group who are present in the classroom will participate in all sessions. However, they can interact with the game during this allocated time. Additionally, they can leave the study if they wish to do so without any consequences. Their information and collected data before this withdrawal decision will not be analyzed. On the other hand, the control group will keep its condition during the whole trial.

Randomization and allocation

Randomization will be performed once all schools are recruited. Using computer-generated randomization, schools will be randomly assigned to either group with a 1:1 allocation. Allocation to intervention and control groups will be stratified by school size (Strata 1: one class and Strata 2: two classes) to ensure balanced groups. After the randomization and allocation, schools will be informed by an RA of the group of belonging by email and confirmed by telephone.

Blinding

The main measurements include questions specific to the intervention (acceptability and feasibility outcomes), so children or Educators cannot be blind to these measurements. However, for the secondary outcomes, the team of evaluators will be blind to the groups that schools were assigned to.

Participant timeline

The participant timeline starts in May 2024 with enrolment and ends in December 2024 with dissemination. A general version is presented in Fig. 1: Study flow diagram, and a detailed version is in Table 1.

Fig. 1
figure 1

Study flow diagram

Full size image
Table 1 Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) diagram
Full size table

Plans to promote participant retention and complete follow-up

During recruitment, the schools, students, and their families will receive extensive information about the study setup and requirements. This information will include and stress the importance of completing follow-up. From the start of implementing the assessments and the lessons of “Japi 2.0,” students will be reminded of the value of their active participation throughout the whole project. Throughout the follow-up period, the researchers will check responses and, if necessary, contact schools and participants to complete their follow-up.

Data management and confidentiality

Data will be encrypted to protect identifying information (each participant will be assigned an ID number). Only the statistician will have access to the database. Data management will be monitored by the Scientific and Ethical Committee of Universidad de los Andes. The results of this research will be presented in international peer-reviewed journals. Both positive and negative results will be reported. An executive summary of the results will be given to school authorities.

Provisions for trial care

There is no potential harm or damage in this trial. The intervention group will receive an evidence-based intervention, and the control group will receive the usual educational curriculum. However, any situation that compromises participants’ physical and psychological integrity during the sessions or assessments related to the project will be mitigated by the RA present in the classroom, providing immediate notice to the Early Year Educator so that she/he can activate the school's internal protocol for handling physical or psychological distress. The RA will register in a pre-design form the adverse situation. The Principal Investigator and Project Coordinator will manage this information, and if necessary, they will contact school authorities to handle this situation.

If the study needs substantial amendments, all of them will be notified to the Scientific and Ethical Committee of Universidad de los Andes. In case amendments concern or affect participants in any way, they will be informed about the changes. If needed, additional consent will be requested and registered. Also, online trial registries will be updated accordingly.

Sample size

It has been suggested that n = 30 is an acceptable size for a pilot study [63]. Others have indicated at least n = 12 per group, equivalent to n = 24 for a traditional two-group study [64] or other estimates [65]. However, if we want to estimate the main study´s standard deviation and effect sizes between 0.4 and 0.6, we should probably seek a sample size of at least 50 (for 95% confidence) [66]. In the current pilot study, we expect to invite to participate at least 20 children in each of the 6 schools. This will give us 60 children in each of the 2 arms and a total of 120 children in the study.

Statistical methods for primary and secondary outcomes

General school features (size, number of teachers, etc.) will be used to compare participating schools with those who were invited but did not participate. Additionally, descriptive statistics will compare the two arms at baseline.

Primary outcomes

Acceptability

We will describe the frequencies of the degree of agreement with several statements by Early Year Educators regarding acceptability in the following aspects: general and implementation acceptability, usefulness, and satisfaction. Additionally, we will extract qualitative data from the educators´ surveys in relationship to the positive and negative perceptions of the intervention.

Feasibility

We will present the number of schools and students participating at each study stage, and the response rate for baseline and after-intervention surveys. In addition, we will present the frequencies of the number of sessions played, activities completed, and levels reached by the students.

Secondary outcomes

The analysis will be conducted on an intention-to-treat basis. We will use linear mixed-effects model analysis to compare the intervention and control groups regarding the change in outcome measures from baseline to post-intervention. Considering the hierarchical structure of the data and the cluster effect, a multilevel modeling approach will be followed to analyze the data. To address the small number of clusters, we will apply a degree of freedom correction using the Kenward-Roger approximation [67]. This correction ensures more accurate estimates of standard errors and improves the validity of the statistical inferences. We plan to present effect estimates, 95% confidence intervals, and intracluster correlation coefficients (ICCs) to provide a comprehensive understanding of the findings. Data will be analyzed with Stata 17.0.

Discussion

The proposed study is a pilot Randomized Controlled Trial aiming to test a game platform (“Japi 2.0”) to stimulate cognitive and non-cognitive skills in early childhood in Chile.

This study evaluates the acceptability and feasibility of this newly developed platform game called “Japi 2.0” among pre-kindergarteners in the school context using a tablet device. The intervention promotes cognitive and non-cognitive skills such as working memory, inhibitory control, cognitive planning, emotion recognition, social competence, and empathy. Furthermore, it is theorized that it may reduce emotional and behavioral problems.

Latin America has been implementing initiatives aiming to stimulate basic psychosocial skills early in life [24]. However, few studies have been conducted in Chile to examine cognitive and non-cognitive skills in children [25, 68, 69], and only one of them has targeted early childhood [69]. None of them have integrated several skills in one single intervention.

The study has several strengths. First, the intervention has had several iterations, which have improved its functionality and usability, making it more appealing to preschoolers. Second, the intervention was designed to be accessible and cost-effective for vulnerable schools by using one integrated technological system that included a platform game that stimulates several skills at once. Third, the inclusion of six vulnerable schools in the study will help increase the trial’s external validity [70]. Fourth, implementation in the school context may raise engagement among students and secure future sustainability [71]. Finally, evaluating and monitoring a technological solution for children is expected to produce relevant information about these novel designs and may help guide future studies, including a future randomized controlled trial on a large scale. This larger trial will test the effectiveness of a more refined intervention considering all the possible improvements suggested by the students, Early Year Educators, and parents/caregivers. However, implementation challenges related to the tablets availability in the schools and how much support Early Year Educators will need to conduct the intervention in real scenarios.

There are, however, some potential limitations. First, there might be a risk of difficulty in recruiting enough schools for the pilot study. To minimize this risk, we will prepare the recruitment carefully and inform the schools in good time, using the excellent networks of the research team members. Second, parents or main caregivers are more reluctant to participate in research, as has been shown elsewhere [72], so there is a risk of not completing the expected sample size of students per school. To reduce this risk, we will participate in parent meetings at school to provide as much information as parents need to incentivize their participation. Third, there is a risk of low implementation quality in schools recruited into this pilot study. To avoid this threat, we will arrange face-to-face training sessions with the school personnel to motivate them to implement “Japi 2.0” as intended, as well as ongoing support and coaching during the implementation process. Finally, preschool children who have spent more time using touchscreen tablets had better accuracy rates and faster reaction time in attentional tasks [73]. Therefore, previous experience and familiarity with this technology may influence the outcomes.

The results of this research will lay the foundations for future programs to learn how young children acquire skills, how the developing brain works, whether or not these skills predict future outcomes, and how these interventions can be scaled up in a larger randomized controlled trial.

Data availability

The datasets produced during the current study will be available from the corresponding author on request.

Abbreviations

IVE-SINAE:

School Vulnerability Index–National System of Equality Allocation

RA:

Research Assistant

ACES:

Assessment of Children’s Emotions Skills

CST:

Challenging Situations Task

SDQ:

The Strengths and Difficulties Questionnaire

ECBI:

The Eyberg Child Behavior Inventory

ESC:

The Empathy Scale for Children

References

  1. Global, regional, and national burden of 12 mental disorders in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Psychiatry. 2022;9(2):137–50.

  2. Racine N, McArthur BA, Cooke JE, Eirich R, Zhu J, Madigan S. Global Prevalence of Depressive and Anxiety Symptoms in Children and Adolescents During COVID-19: A Meta-analysis. JAMA Pediatr. 2021;175(11):1142–50.

    Article  PubMed  Google Scholar 

  3. Tiirikainen K, Haravuori H, Ranta K, Kaltiala-Heino R, Marttunen M. Psychometric properties of the 7-item Generalized Anxiety Disorder Scale (GAD-7) in a large representative sample of Finnish adolescents. Psychiatry Res. 2019;272:30–5.

    Article  PubMed  Google Scholar 

  4. Lu W. Adolescent Depression: National Trends, Risk Factors, and Healthcare Disparities. Am J Health Behav. 2019;43(1):181–94.

    Article  PubMed  Google Scholar 

  5. Campbell F, Conti G, Heckman JJ, Moon SH, Pinto R, Pungello E, et al. Early childhood investments substantially boost adult health. Science. 2014;343(6178):1478–85.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Conti G, Heckman JJ. The developmental approach to child and adult health. Pediatrics. 2013;131 Suppl 2(Suppl 2):S133–41.

  7. Doyle O, Harmon CP, Heckman JJ, Tremblay RE. Investing in early human development: timing and economic efficiency. Econ Hum Biol. 2009;7(1):1–6.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Gertler P, Heckman J, Pinto R, Zanolini A, Vermeersch C, Walker S, et al. Labor market returns to an early childhood stimulation intervention in Jamaica. Science. 2014;344(6187):998–1001.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Heckman JJ, Raut LK. Intergenerational long-term effects of preschool - structural estimates from a discrete dynamic programming model. J Econom. 2016;191(1):164–75.

    Article  PubMed  Google Scholar 

  10. Kochanska G, Murray KT, Harlan ET. Effortful control in early childhood: continuity and change, antecedents, and implications for social development. Dev Psychol. 2000;36(2):220–32.

    Article  CAS  PubMed  Google Scholar 

  11. Cunha F, Heckman J, Schennach S. Estimating the technology of cognitive and noncognitive skill formation. Econometrica. 2010;78(3):883–931.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Rojas-Barahona CA, Förster CE, Moreno-Rios S, McClelland MM. Improvement of working memory in preschoolers and its impact on early literacy skills: A study in deprived communities of rural and urban areas. Early Educ Dev. 2015;26(5–6):871–92.

    Article  Google Scholar 

  13. Alloway TP, Bibile V, Lau G. Computerized working memory training: Can it lead to gains in cognitive skills in students? Comput Hum Behav. 2013;29(3):632–8.

    Article  Google Scholar 

  14. Holmes J, Gathercole SE. Taking working memory training from the laboratory into schools. Educ Psychol. 2014;34(4):440–50.

    Article  Google Scholar 

  15. Durlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students’ social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011;82(1):405–32.

    Article  PubMed  Google Scholar 

  16. Schonfeld DJ, Adams RE, Fredstrom BK, Weissberg RP, Gilman R, Voyce C, et al. Cluster-randomized trial demonstrating impact on academic achievement of elementary social-emotional learning. Sch Psychol Q. 2015;30(3):406–20.

    Article  PubMed  Google Scholar 

  17. McClelland MM, Geldhof GJ, Cameron CE, Wanless SB. Development and self-regulation. In: Overton WF, Molenaar PCM, Lerner RM, editors. Handbook of child psychology and developmental science: Theory and method. 7th ed. John Wiley & Sons, Inc.; 2015. p. 523–65. https://doiorg.publicaciones.saludcastillayleon.es/10.1002/9781118963418.childpsy114.

  18. Berger A, Kofman O, Livneh U, Henik A. Multidisciplinary perspectives on attention and the development of self-regulation. Prog Neurobiol. 2007;82(5):256–86.

    Article  PubMed  Google Scholar 

  19. Heckman JJ, Moon SH, Pinto R, Savelyev PA, Yavitz A. The Rate of Return to the High/Scope Perry Preschool Program. J Public Econ. 2010;94(1–2):114–28.

    Article  PubMed  PubMed Central  Google Scholar 

  20. Campbell FA, Pungello EP, Burchinal M, Kainz K, Pan Y, Wasik BH, et al. Adult outcomes as a function of an early childhood educational program: an Abecedarian Project follow-up. Dev Psychol. 2012;48(4):1033–43.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Muennig P, Robertson D, Johnson G, Campbell F, Pungello EP, Neidell M. The effect of an early education program on adult health: the Carolina Abecedarian Project randomized controlled trial. Am J Public Health. 2011;101(3):512–6.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Lee R, Zhai F, Han WJ, Brooks-Gunn J, Waldfogel J. Head Start and Children's Nutrition, Weight, and Health Care Receipt. Early Child Res Q. 2013;28(4). https://doiorg.publicaciones.saludcastillayleon.es/10.1016/j.ecresq.2013.06.003.

  23. Lee VE, Brooks-Gunn J, Schnur E, Liaw FR. Are Head Start effects sustained? A longitudinal follow-up comparison of disadvantaged children attending Head Start, no preschool, and other preschool programs. Child Dev. 1990;61(2):495–507.

    Article  CAS  PubMed  Google Scholar 

  24. Baker-Henningham H, López Bóo F. Early Childhood Stimulation Interventions in Developing Countries: A Comprehensive Literature Review. IZA Discussion Paper No. 5282. https://doiorg.publicaciones.saludcastillayleon.es/10.2139/ssrn.1700451.

  25. Murphy JM, Guzmán J, McCarthy AE, Squicciarini AM, George M, Canenguez KM, et al. Mental health predicts better academic outcomes: a longitudinal study of elementary school students in Chile. Child Psychiatry Hum Dev. 2015;46(2):245–56.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Huaqing Qi C, Kaiser AP. Behavior problems of preschool children from low-income families: Review of the literature. Topics in early childhood special education. 2003;23(4):188–216.

    Article  Google Scholar 

  27. Baird JA, Moses LJ. Do preschoolers appreciate that identical actions may be motivated by different intentions? J Cogn Dev. 2001;2(4):413–48.

    Article  Google Scholar 

  28. Denham SA, Blair K, Schmidt M, DeMulder E. Compromised emotional competence: Seeds of violence sown early? Am J Orthopsychiatry. 2002;72(1):70–82.

    Article  PubMed  Google Scholar 

  29. Caffarena Barcenilla C, Rojas-Barahona C. Self-regulation in early childhood: advances from research. Revista Ecuatoriana de Neurología. 2019;28(2):37–49.

    Google Scholar 

  30. Garon N, Bryson SE, Smith IM. Executive function in preschoolers: a review using an integrative framework. Psychol Bull. 2008;134(1):31–60.

    Article  PubMed  Google Scholar 

  31. Figueroa CA, Aguilera A. The need for a mental health technology revolution in the COVID-19 pandemic. Front Psychiatry. 2020;11:523.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Bucci S, Schwannauer M, Berry N. The digital revolution and its impact on mental health care. Psychol Psychother. 2019;92(2):277–97.

    Article  PubMed  Google Scholar 

  33. Holmes EA, James EL, Coode-Bate T, Deeprose C. Can playing the computer game “Tetris” reduce the build-up of flashbacks for trauma? A proposal from cognitive science. PLoS ONE. 2009;4(1): e4153.

    Article  PubMed  PubMed Central  Google Scholar 

  34. St Clair-Thompson H, Stevens R, Hunt A, Bolder E. Improving children’s working memory and classroom performance. Educ Psychol. 2010;30(2):203–19.

    Article  Google Scholar 

  35. van der Donk ML, Hiemstra-Beernink AC, Tjeenk-Kalff AC, van der Leij AV, Lindauer RJ. Interventions to improve executive functioning and working memory in school-aged children with AD(H)D: a randomised controlled trial and stepped-care approach. BMC Psychiatry. 2013;13:23.

    Article  PubMed  PubMed Central  Google Scholar 

  36. van Dongen-Boomsma M, Vollebregt MA, Slaats-Willemse D, Buitelaar JK. Efficacy of frequency-neurofeedback and Cogmed JM-working memory training in children with ADHD. Tijdschr Psychiatr. 2015;57(7):508–16.

    PubMed  Google Scholar 

  37. Marsh J, Plowman L, Yamada-Rice D, Bishop JC, Lahmar J, Scott F, et al. Exploring play and creativity in pre-schoolers’ use of apps: A guide for parents. Sheffield: University of Sheffield; 2015.

  38. Rojas-Barahona CA, Gaete J, Véliz M, Castillo RD, Ramírez S, Araya R. The effectiveness of a tablet-based video game that stimulates cognitive, emotional, and social skills in developing academic skills among preschoolers: study protocol for a randomized controlled trial. Trials. 2022;23(1):936.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Rojas-Barahona C., Dib M., Fernández Blanco A., Gaete J., Araya R. Development of cognitive and socioemotional skills: the impact of a digital tablet game in preschool children from deprived schools. 18th Annual Conference of the Italian Association of Cognitive Sciences 15–17 December 2022; Rovereto, Trento, Italy.

  40. Gobierno de Chile, Agencia de Calidad de la Educación. Metodología de Construcción de Grupos Socioeconómicos 2013. Available from: https://archivos.agenciaeducacion.cl/Metodologia_de_Construccion_de_Grupos_Socioeconomicos_Simce_2013.pdf.

  41. Gobierno de Chile, Ministerio de Educación. Bases Curriculares Educación Parvularia. Gobierno de Chile; 2018. Available from: https://parvularia.mineduc.cl/wp-content/uploads/2019/09/Bases_Curriculares_Ed_Parvularia_2018-1.pdf.

  42. Kessels RP, van Zandvoort MJ, Postma A, Kappelle LJ, de Haan EH. The Corsi Block-Tapping Task: standardization and normative data. Appl Neuropsychol. 2000;7(4):252–8.

    Article  CAS  PubMed  Google Scholar 

  43. Orsini A. Corsi’s block-tapping test: standardization and concurrent validity with WISC-R for children aged 11 to 16. Percept Mot Skills. 1994;79(3 Pt 2):1547–54.

    Article  CAS  PubMed  Google Scholar 

  44. Gathercole SE, Willis CS, Baddeley AD, Emslie H. The Children’s Test of Nonword Repetition: a test of phonological working memory. Memory. 1994;2(2):103–27.

    Article  CAS  PubMed  Google Scholar 

  45. Davidson MC, Amso D, Anderson LC, Diamond A. Development of cognitive control and executive functions from 4 to 13 years: evidence from manipulations of memory, inhibition, and task switching. Neuropsychologia. 2006;44(11):2037–78.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Rosas R, Espinoza V, Martínez C, Santa-Cruz C. Playful Testing of Executive Functions with Yellow-Red: Tablet-Based Battery for Children between 6 and 11. J Intell. 2022;10(4):125. https://doiorg.publicaciones.saludcastillayleon.es/10.3390/jintelligence10040125.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Schultz D, Izard CE, Bear G. Children’s emotion processing: relations to emotionality and aggression. Dev Psychopathol. 2004;16(2):371–87.

    Article  PubMed  Google Scholar 

  48. Trentacosta CJ, Izard CE, Mostow AJ, Fine SE. Children’s emotional competence and attentional competence in early elementary school. Sch Psychol Q. 2006;21(2):148.

    Article  Google Scholar 

  49. Nix RL, Bierman KL, Domitrovich CE, Gill S. Promoting Children's Social-Emotional Skills in Preschool Can Enhance Academic and Behavioral Functioning in Kindergarten: Findings from Head Start REDI. Early Educ Dev. 2013;24(7). https://doiorg.publicaciones.saludcastillayleon.es/10.1080/10409289.2013.825565.

  50. Domitrovich CE, Cortes RC, Greenberg MT. Improving young children’s social and emotional competence: a randomized trial of the preschool “PATHS” curriculum. J Prim Prev. 2007;28(2):67–91.

    Article  PubMed  Google Scholar 

  51. Chung C, Choi S, Bae J, Jeong H, Lee J, Lee H. Developing and Validating a Korean Version of the Assessment of Children’s Emotional Skills. Child Psychiatry Hum Dev. 2024;55(3):819–30.

    Article  CAS  PubMed  Google Scholar 

  52. Denham SA, Way E, Kalb SC, Warren-Khot HK, Bassett HH. Preschoolers’ social information processing and early school success: the challenging situations task. Br J Dev Psychol. 2013;31(Pt 2):180–97.

    Article  PubMed  Google Scholar 

  53. Köksal Akyol A, Aslan D. The development of Empathy Scale for Children (ESC). In: Yasar M, Ozgun O, Galbraith J, editors. Contemporary Perspectives and Research on Early Childhood Education. Newcastle: Cambridge Scholar Publishing; 2014. p. 113–23.

    Google Scholar 

  54. Anderson P, Anderson V, Lajoie G. The tower of London test: Validation and standardization for pediatric populatons. Clin Neuropsychol. 1996;10(1):54–65.

    Article  Google Scholar 

  55. Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581–6.

    Article  CAS  PubMed  Google Scholar 

  56. Gaete J, Rojas-Barahona CA, Olivares E, Araya R. Brief report: association between psychological sense of school membership and mental health among early adolescents. J Adolesc. 2016;50:1–5.

    Article  PubMed  Google Scholar 

  57. Brown P, Capella C, Antivilo A. Propiedades psicométricas de la versión para padres del Strengths and Difficulties Questionnaire. Revista de Psicología. 2014;23(2):28–44.

    Google Scholar 

  58. Marzocchi GM, Capron C, Di Pietro M, Duran Tauleria E, Duyme M, Frigerio A, et al. The use of the Strengths and Difficulties Questionnaire (SDQ) in Southern European countries. Eur Child Adolesc Psychiatry. 2004;13 Suppl 2:Ii40–6.

  59. Goodman R. Psychometric properties of the strengths and difficulties questionnaire. J Am Acad Child Adolesc Psychiatry. 2001;40(11):1337–45.

    Article  CAS  PubMed  Google Scholar 

  60. Eyberg SM, Ross AW. Assessment of child behavior problems: the validation of a new inventory. J Clin Child Adolesc Psychol. 1978;7(2):113–6.

    Article  Google Scholar 

  61. Robinson EA, Eyberg SM, Ross AW. The standardization of an inventory of child conduct problem behaviors. J Clin Child Psychol. 1980;9(1):22–9.

    Article  Google Scholar 

  62. Webster-Stratton C. Randomized trial of two parent-training programs for families with conduct-disordered children. J Consult Clin Psychol. 1984;52(4):666.

    Article  CAS  PubMed  Google Scholar 

  63. Lancaster GA, Dodd S, Williamson PR. Design and analysis of pilot studies: recommendations for good practice. J Eval Clin Pract. 2004;10(2):307–12.

    Article  PubMed  Google Scholar 

  64. Julious S. Sample size of 12 per group rue of thumb for a pilot study. Pharm Stat. 2005;4:287–91.

    Article  Google Scholar 

  65. Cocks K, Torgerson DJ. Sample size calculations for pilot randomized trials: a confidence interval approach. J Clin Epidemiol. 2013;66(2):197–201.

    Article  PubMed  Google Scholar 

  66. Sim J, Lewis M. The size of a pilot study for a clinical trial should be calculated in relation to considerations of precision and efficiency. J Clin Epidemiol. 2012;65(3):301–8.

    Article  PubMed  Google Scholar 

  67. Kenward MG, Roger JH. Small sample inference for fixed effects from restricted maximum likelihood. Biometrics. 1997;53(3):983–97.

    Article  CAS  PubMed  Google Scholar 

  68. Canenguez KM, Farley AM, Squicciarini AM, Dutta A, Simonsohn A, Holcomb JM, et al. Implementation and Outcomes of a National School-Based Mental Health Program for Middle School Students in Chile. School Ment Health. 2023;15(1):165–76.

    Article  PubMed  Google Scholar 

  69. Rosas R, Espinoza V, Porflitt F, Ceric F. Executive Functions Can Be Improved in Preschoolers Through Systematic Playing in Educational Settings: Evidence From a Longitudinal Study. Front Psychol. 2019;10:2024.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Findley MG, Kikuta K, Denly M. External validity. Annu Rev Polit Sci. 2021;24:365–93.

    Article  Google Scholar 

  71. Veiga FH, Wentzel K, Melo M, Pereira T, Faria L, Galvão D. Students’ engagement in school and peer relations: A literature review. In F. H. Veiga (Coord.), Envolvimento dos Alunos na Escola: Perspetivas Internacionais da Psicologia e Educação / Students' Engagement in School: International Perspectives of Psychology and Education. Lisboa: Instituto de Educação da Universidade de Lisboa; 2014. p. 196–211. ISBN: 978-989-98314-8-3.

  72. Mirick RG. Challenges in recruiting parents to participate in child welfare research: Implications for study design and research practice. Child Fam Soc Work. 2016;21(4):484–91.

    Article  Google Scholar 

  73. Jin Y-R, Lin L-Y. Relationship between touchscreen tablet usage time and attention performance in young children. J Res Technol Educ. 2022;54(2):317–26.

    Article  Google Scholar 

Download references

Acknowledgements

We thank all students, parents/main caregivers, school authorities, and staff who will contribute to this project.

Funding

This research is funded by the National Research and Development Agency [ANID]. Unique ID: FONDEF ID22I10126, and by ANID–Millennium Science Initiative Program–NCS2021_081. The funding body does not play a role in the design of the study, data collection, analysis, interpretation, or writing of the manuscript.

Author information

Authors and Affiliations

  1. Research Center for Students Mental Health (ISME), School of Education, Faculty of Social Sciences, Universidad de los Andes, Santiago, Chile

    Jorge Gaete, Saray Ramírez, Valentina Romo & Natalia Ríos

  2. Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Millennium Science Initiative, Santiago, Chile

    Jorge Gaete & Saray Ramírez

  3. Faculty of Psychology, Universidad de Talca, Talca, Chile

    Cristian A. Rojas-Barahona

  4. Department of Health Service & Population Research, David Goldberg Centre, King’s College London, Denmark Hill, London, UK

    Ricardo Araya

Authors
  1. Jorge Gaete
    View author publications

    You can also search for this author inPubMed Google Scholar

  2. Saray Ramírez
    View author publications

    You can also search for this author inPubMed Google Scholar

  3. Cristian A. Rojas-Barahona
    View author publications

    You can also search for this author inPubMed Google Scholar

  4. Valentina Romo
    View author publications

    You can also search for this author inPubMed Google Scholar

  5. Natalia Ríos
    View author publications

    You can also search for this author inPubMed Google Scholar

  6. Ricardo Araya
    View author publications

    You can also search for this author inPubMed Google Scholar

Contributions

JG, CR, and RA conceived the study, led the proposal, protocol development, study design, and methodology. SR, VR, and NR contributed to developing the protocol and methodology. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Jorge Gaete.

Ethics declarations

Ethics approval and consent to participate

Approval of the Scientific and Ethical Committee of Universidad de los Andes (CEC 2022100, November 9th, 2022) was obtained. Written and informed consent to participate will be obtained from all parents or legal guardians of the participants, and verbally informed assent to participate will be obtained from the students.

Consent for publication

Written and informed consent to publish will be obtained from all parents or legal guardians of the participants. No personal data will be presented in the publications, and personal identification will be removed or encrypted for data analyses. Consent materials are available from the corresponding author on request.

Competing interests

The authors declare that they have no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Rights and permissions

Open Access This article is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License, which permits any non-commercial use, sharing, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if you modified the licensed material. You do not have permission under this licence to share adapted material derived from this article or parts of it. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc-nd/4.0/.

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Gaete, J., Ramírez, S., Rojas-Barahona, C.A. et al. Japi 2.0, a gaming platform to stimulate cognitive and non-cognitive skills in early childhood: protocol for a pilot randomized controlled trial. Pilot Feasibility Stud 11, 5 (2025). https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40814-025-01593-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • DOI: https://doiorg.publicaciones.saludcastillayleon.es/10.1186/s40814-025-01593-w

Keywords

Pilot and Feasibility Studies

ISSN: 2055-5784