Development, usability, and feasibility pilot cluster randomized controlled study of a videogame aiming to stimulate cognitive and non-cognitive skills among low-income preschoolers in Santiago, Chile

Development, usability, and feasibility pilot cluster randomized controlled study of a videogame aiming to stimulate cognitive and non-cognitive skills among low-income preschoolers in Santiago, Chile | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Development, usability, and feasibility pilot cluster randomized controlled study of a videogame aiming to stimulate cognitive and non-cognitive skills among low-income preschoolers in Santiago, Chile Jorge Gaete, Natalia Ríos, Cristian Rojas-Barahona, Saray Ramírez, and 1 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7032367/v1 This work is licensed under a CC BY 4.0 License Status: Under Review Version 1 posted 7 You are reading this latest preprint version Abstract Background . Early childhood is a crucial period for mental health, with many preschoolers experiencing emotional and behavioral issues. Early interventions targeting executive functions and socio-emotional skills are essential. Digital tools, such as tablets, offer promising solutions, despite limited research. This study aims to develop and test a video game to enhance these skills in vulnerable preschoolers, assessing its feasibility, engagement, and impact. Methods . Cluster Randomized Controlled Pilot Study. Eight schools were randomly allocated to the Intervention group (Japi 1.0) and the Control group in a 1:1 ratio. A video game was developed by the research team, aiming to stimulate cognitive and non-cognitive skills. We registered problems in the functionality of the video game while implementing it and student engagement and classroom climate. Additionally, we assessed before and after the intervention cognitive and non-cognitive skills among children's psychological functioning using the parental reports over the Strengths and Difficulties Questionnaire. Results . Before implementing Japi 1.0 in the classroom, the most frequent functional problems detected by the research team were audio volume variations, abrupt changes in activity, and game freezing. Once corrected, during the implementation of an improved version, game freezing and correct answers registered as incorrect were the most frequent problems. Additionally, 26.6% of students had data not recorded on the server. The engagement with the game was high, and there were very few behavioral problems during the implementation. Most of the secondary outcomes were improved after the intervention, but no significant changes were found when compared with the control group. Conclusions . The pilot study demonstrated high student engagement and a positive classroom climate during the implementation of Japi 1.0. While initial functionality issues were identified and corrected, some technical problems persisted, including game freezing and data loss. Although improvements in cognitive and non-cognitive skills were observed post-intervention, no significant differences were found compared to the control group. These findings highlight the feasibility of using digital interventions in preschool settings but underscore the need for further refinement and a larger trial to assess the game’s full impact. Trial registration: Clinical Trials NCT07048119, February 26th, 2025. [https://www.clinicaltrials.gov/study/NCT07048119] Figures Figure 1 INTRODUCTION Mental health disorders are among the leading causes of the Global Burden of Disease (1), and their relative importance is predicted to rise globally. Mental health problems are present at all ages. For instance, the prevalence of emotional and behavioral problems among preschool children is high. In a recent meta-analysis reporting data on N = 18,282 children (12–83 months old) from eight countries, the pooled prevalence of mental disorders in general was 20.1%, 95% CI [15.7, 25.4]. The most common disorders were oppositional defiant disorder (4.9%, 95% CI [2.5, 9.5]) and attention-deficit hyperactivity disorder (4.3%, 95% CI [2.5, 7.2]). The prevalence of any anxiety disorders was 8.5%, 95% CI [5.2, 13.5], and of any depressive disorders was 1.1%, 95% CI [0.8, 1.6] (2). Another study reporting the prevalence of different mental disorders among children aged 3-5 years old, using several datasets of prevalence studies in the USA, found that the prevalence of ADHD was between 1.6 (1.1‒2.3) and 2.2 (1.8‒2.8); the prevalence of current behavioral or conduct problems was 3.8 (3.4–4.4); the prevalence of current depression was 0.1 (0.1–0.3), and anxiety was 1.6 (1.4–2.0) (3). The most important risk factors associated with mental health problems among preschoolers are poverty (3), reduced parental education (3), poor care and home stimulation (4), and family dysfunction (5). In a study with a sample of 391 preschoolers aged 3–6 years using the Strength and Difficulties Questionnaire (SDQ), the bivariate analyses showed that parental mental health problems (MHPs), children’s difficult temperament, and parental low SES increased the likelihood of being classified as ‘borderline or abnormal’ on the total difficulties score of the SDQ. In contrast, high perceived parental competence decreased the likelihood of preschool MHPs. In the multivariate analyses, only difficult child temperament remained significantly associated with preschool MHPs after controlling for other variables. In sum, individual, familial, and contextual factors are essential to explain the presence of mental disorders. The ideal strategy to tackle this gap should be to prevent the onset of these conditions. Most adult mental disorders start in childhood or adolescence (6), and delaying or preventing the onset can have a substantial impact. There is evidence to suggest that strengthening cognitive and psychosocial skills might result in a reduced incidence of mental disorders. For instance, poor emotional regulation (7) or social problem-solving skills (8) have been associated with an increased incidence of depression. Early childhood is a critical time for psychosocial development. Until recently, cognitive skills, years of education, and IQ were the main measures to assess the relationship between human capital and economic development. More recently, researchers have acknowledged that skills such as maintaining good interpersonal relations, self-regulation, and demonstrating goal-directed behavior are critical to individual success and economic productivity. The Nobel prize economist, James Heckman, highlighted the importance of these skills, which he initially called them as non-cognitive skills, for economic development (9-13). Nonetheless, the distinction between cognitive and non-cognitive skills seems redundant, as there is a much overlap, as seen in emotional self-regulation, which is heavily influenced by cognitive processes (14). Several studies have examined the relationship between the capacity to regulate emotions and behaviors and social (15), health (16), educational (17), and labor (18) outcomes. Studies from neurobiology to behavioral economics demonstrate that emotions influence a person’s ability to self-regulate, and this, in turn, impacts cognitive abilities and subsequent self-regulatory capacity. Executive functions, involving the regulation and control of cognitive processes, are closely linked to skills leading to better problem solving, task persistence (19), self-esteem, school performance (20-24), and better social adjustment with a reduction in aggressive and other behavioral problems (25, 26). Healthy development of executive functions early in life predicts better self-regulatory capacity later in life (7). The growing scientific knowledge base on emotional self-regulation and social skills linked to brain development can be leveraged to inform new intervention approaches. There is significant evidence that structural and functional plasticity in many of the brain’s core centers involved in executive functions and self-regulatory processes develops rapidly during early childhood (27, 28). Most of the evidence to support the association between early acquired psychosocial skills and functional outcomes later in life comes from developed countries (11, 19, 29, 30). There is a need to replicate these findings in resource-poor settings. A concerted effort is needed to identify these key psychosocial skills that can be incorporated into interventions to improve the well-being of children globally. Cognitive and non-cognitive skills targets Improvement in several cognitive and non-cognitive skills has been associated with better mental health and academic outcomes. Among these key functions, there is evidence supporting the importance of cognitive functions, such as working memory and inhibitory control, as well as non-cognitive functions, including emotion recognition and social competence. Working memory (WM) is understood as a limited-capacity system that temporarily stores and processes the information necessary to perform complex tasks in human cognition (31). WM undergoes significant development during early childhood, particularly between 3 and 5 years of age. This development progresses through a hierarchical sequence of abilities: first, the capacity to hold information over short delays emerges, followed by the ability to update representations based on new information, and finally, the ability to manipulate information to create new representations. Infants as young as 6 months old can maintain simple representations briefly, but updating abilities begin to emerge around 15 months, and manipulation skills develop around 24 months. During the preschool years, children exhibit significant improvements across these components, with older preschoolers (around 5 years old) performing better on complex tasks that require substitution and transformation compared to their younger peers. This progression reflects not only maturing memory processes but also the development of attentional control systems, which allow children to resist distractions and manage conflicting information more effectively as they grow older (32). WM capacity increases with age in preschoolers, and this development is crucial for cognitive tasks such as problem-solving and language comprehension (32). There is evidence that high performance in WM is a good predictor of future performance in reading (33) and mathematics (34) , and reduced mental health problems (35). For example, children with low scores on working memory tests showed a higher frequency of errors in activities that required remembering instructions (36). Working memory deficits seem to be a common cognitive liability for mental health disorders, and a specific liability for externalizing disorders (37). Working memory (WM) is a trainable cognitive function that can be enhanced through targeted interventions, even in young children. Various studies have demonstrated that both domain-general and domain-specific training programs can improve WM capacity. For instance, computerized games designed to exercise working memory skills have led to significant improvements in preschool and kindergarten children, with gains persisting for several weeks after the intervention (38). Additionally, large-scale randomized controlled trials have shown that simple motivational strategies, such as providing material incentives, can lead to measurable improvements in WM performance, suggesting that children's WM capacity is responsive to both cognitive training and motivational factors (39). Moreover, training executive functions that include WM has also been shown to yield improvements not only in cognitive performance but also in related domains such as emotion regulation (40). These findings collectively underscore the plasticity of WM in early childhood and highlight the potential for interventions to support its development. Even though there is evidence that visuospatial working memory can be improved through training, these improvements may not last long (41). Inhibitory control (IC), can be understood as the control exercised over the predominant or impulsive actions that people have, and that allows achieving desired goals (42). Inhibitory control, a core component of self-regulation involving the suppression of inappropriate or unwanted behaviors, begins to emerge as early as infancy, with 8-month-old infants demonstrating rudimentary abilities to inhibit actions when prompted. However, the most rapid and substantial development of inhibitory control occurs during the preschool years, particularly between ages 2.5 and 6.5. Longitudinal studies indicate a marked improvement in inhibitory control during this period, with growth being most pronounced between 3 and 5 years, followed by a decelerating increase as children approach school age. This developmental trajectory reflects not only the maturation of brain structures involved in self-regulation but also the influence of environmental factors such as parenting (43). Specifically, higher parental sensitivity is associated with higher initial levels of inhibitory control, while parental intrusiveness tends to slow its development over time (44). These findings highlight the dynamic interplay between biological maturation and caregiving in shaping children's emerging ability to regulate their behavior (44). Poor inhibitory control in children is associated with externalizing behaviors such as aggression, hyperactivity, and impulsivity, which can lead to long-term consequences in adulthood, including addictive behavior (45). And high levels of inhibitory control in children with high negative emotionality can increase the risk of internalizing behaviors like anxiety and social withdrawal (46-48). The latter suggests that while inhibitory control is generally beneficial, excessive control in certain temperamental contexts can be maladaptive. Additionally, IC is crucial for academic success. Children with better inhibitory control tend to perform better academically, particularly in language and mathematics (49-51). There is evidence that IC is trainable (52) and that its development positively impacts future academic skills. For example, among kindergarten children IC contributed to phonemic awareness and decoding, regardless of the level of general intelligence presented (53, 54), which aligns with results found by Yoshikawa et al. (2008). Similarly, McClelland et al. (2007) observed that IC was directly related to emergent literacy skills and vocabulary in preschool children (55). Emotion recognition (ER) is the ability to recognize and interpret others’ emotions, and it is an important skill for the development of socioemotional competence (56), which continues to improve over time. Children as young as 3 years old can recognize happy, fearful, and angry expressions, although they often confuse fear and anger (57). By age 3, children can recognize sadness from bodily expressions, with fear recognized around 4-5 years, and anger between 6-8 years (58). Children aged 3 to 5 years show significant development in recognizing happiness, anger, surprise, sadness, and fear, with older children (5 years) performing better than younger ones (3 years)(59). Children aged 6, 8, and 10 show increasing accuracy and faster reaction times in recognizing happiness, anger, and sadness, with older children performing better (60). There is evidence that poor emotion recognition has been associated with problematic outcomes such as poor social functioning, attention problems in school, poor academic performance and mental health symptoms (61-64). Additionally, based on the findings of Lafay et al. (2023), emotional recognition in preschool and kindergarten children is indeed a trainable skill. The study implemented an innovative emotion training program with children aged 3 to 6 years, focusing on the identification, understanding, and expression of primary emotions. The results demonstrated that children who received the training showed significantly greater improvements in emotional abilities compared to those who did not receive the intervention, particularly among younger children (3- and 4-year-olds) (65). Social competence (SC) is the ability to interact effectively with others and navigate personal and social conflicts (66). It usually includes all social, emotional, and cognitive knowledge and skills children need to be effective in their interactions with others (67). These skills follow different developmental sequences (e.g. self-regulation, empathy, prosocial behavior, among others). For example, during the first years of life, important precursors of social competence are the development of social attention (68) and joint intentionality (69, 70) in social play. As children grow older, more general expressions of prosocial behavior, such as helping, comforting, informing, and sharing, begin to emerge (71). However, as children get older, prosocial behaviors become more selective (72). At preschool age, situational factors, as well as characteristics of the recipient, start influencing children’s tendency to behave prosocially (73, 74). In addition, peer interactions become increasingly important in the preschool age and serve a socialization function in the development of children´s social competence (75). Children with poor social competence are often rejected by their peers, suffer low self-esteem (76) and they show a higher risk of problematic behavior patterns as they grow older (77). Based on the findings of Bermejo-Martins et al. (2019), social competence in preschool children appears to be a trainable skill, particularly when integrated into structured educational interventions. The CRECES program, a health education initiative grounded in social and emotional learning, was implemented in a randomized controlled trial with children aged 5 to 6. Qualitative data from interviews with parents suggested improvements in their children's social behavior and emotional regulation. Furthermore, the intervention significantly enhanced emotional perception and resilience over time (78). Another study evaluated an adapted PATHS curriculum for preschoolers in Head Start through a randomized trial in 20 classrooms. Over nine months, teachers in the intervention groups delivered weekly lessons. Compared to controls, children in the program showed better emotion knowledge, greater social competence, and less social withdrawal (79). Traditionally, cognitive and non-cognitive skills, such as those reviewed above have been taught through face-to-face interactions in classroom settings. However, advances in technology now offer new opportunities to support these developmental domains through tablet-based interventions. These digital tools can complement traditional methods by providing engaging, personalized, and scalable learning experiences, particularly in early childhood education. Digital technology means among preschoolers Research on the use of computers and tablets among preschool students has been conducted mainly for educational purposes, and just in recent years. A recent study in seven European countries found that, when children of this age are offered to use different technological devices, they prefer tablets, apparently based on the size of the screen, its portability, and ease of use thanks to their touchscreen technology (80). Tablets are used for gaming and watching cartoons, but also to draw, take photos, and communicate with others using FaceTime or videoconferencing (80). Another independent study in the United Kingdom found similar results (81). Tablets have been used with preschoolers mainly for educational purposes and have been well-received by kids. Its use can be independent, but most of the time, with the assistance of either teachers or parents. It has been found that when tablet use is well-planned, it stimulates children's motivation and concentration (82). Tablets also offer an excellent opportunity for collaboration and independent learning. When asked about their experience using tablets in school settings, early education teachers value the opportunities to deliver the curriculum in new ways (82). In other studies, tablets have helped children to develop emerging literacies, social relationships, and a sense of belonging to the center (83). Nonetheless, much of the impact of using tables for training executive functions and social and emotional learning remains to be learned, especially with certain sub-groups such as low-income kids. However, it is important to consider that parents' and teachers' experiences and values seem to shape how children use the tablets at home and in schools (84). Therefore, training on the use and possibilities of these devices is necessary to build confidence and engagement among practitioners, factors that appear to be crucial when implementing a new tool in school settings (82). Digital technologies may have a role in developing children's identity as effective learners through "figured worlds" (82). There are already some recommendations for the features that apps should have in order to promote learning and creativity (81). For example, they should foster real-world problems, story apps may promote independent reading through highlighting words as the narrator says them and enhance comprehension by asking questions; having regular opportunities for feedback through the app and final feedback at the end of the activity (81). Some people are concerned with excessive exposure to screens, but research highlights that not all screen time is equal. When used thoughtfully, technology can support early learning and development. In fact, there have been recommendations on high-quality educational apps and games for preschoolers, such as those that promote language development, emotional understanding, and problem-solving skills through interactive and age-appropriate content. These tools, when integrated with adult guidance and used in moderation, can enhance traditional learning approaches and contribute positively to young children’s cognitive and social-emotional growth. Aims The objectives of this research are: 1) To develop a video game prototype to be used on tablets by pre-kindergarten students from socio-economically vulnerable schools, which allows stimulating working memory, inhibitory control, emotion recognition, and social competence skills in such a way as to prevent the development of behavioral problems and general psychological distress; 2) To carry out a pilot cluster Randomized Controlled Trial to evaluate several aspects of functionality of this video game, student engagement and behavior, classroom climate, the feasibility of the implementation of the study and to explore the impact of the video game on the development of cognitive and non-cognitive skills. METHODS Study design, participants, and settings This was a cluster Randomized Controlled Trial, performing baseline and after-intervention assessments. The study was conducted during the academic year 2018 (March to December). The baseline assessment took place in May to June. The intervention was implemented between July and October. The after-intervention assessment took place between November and December. Inclusion criteria for schools Schools located in Santiago (Chile). Schools with Preschool Education. Mixed-sex schools. 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 high-vulnerability students in a given school, considering socioeconomic variables such as the mother’s educational level, the father’s educational level, and total monthly household income, among others (85). Exclusion criteria for schools Four or more classes in Preschool. This criterion was considered for economic and practical reasons. Implementing a manualized program to promote cognitive or social-emotional skills. Participating in a similar study. Inclusion criteria for students Children attending pre-kindergarten (aged around 4 years old). Exclusion criteria for students Children with intellectual disability. Children unable to understand and speak Spanish. Sample size It has been suggested that n = 30 is an acceptable size for a pilot study (86). Others have indicated at least n = 12 subjects per group, equivalent to n = 24 for a traditional two-group study (87) or other estimates (88). 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) (89). In the current pilot study, we expected to invite at least 20 children from each of the eight participating schools. This resulted in 80 children in each of the two arms, totaling 160 children in the study. Four schools per group could result in higher variability in the experience with the intervention. Recruitment To recruit schools for the present study, we implemented the strategy of First Come, First Served (FCFS), which implies that schools were invited till the sample size was completed because of the exploratory nature of the project and limited resources. In the registry of schools in Santiago provided by the Ministry of Education, 352 were eligible. We invited 31 schools from our dataset to participate in this study, and eight accepted. All schools shared a similar socioeconomic background of high vulnerability. One of the schools that refused to participate did want to conduct the intervention but objected to the randomization procedure. Other 20 schools did not want to participate because they could not include the activities associated with the research in their academic calendar. The Principal of the other two refused to participate without reason. The Principal of each participating school signed an authorization to conduct the study. Later, an informed and written consent form was sent to the parents or main caregivers for signature. The authorization by the Principal and consent by parents/caregivers were signed before the randomization and allocation procedure. Randomization The randomization was performed at the school level, taking into account the nature of the sample (students nested into schools). We randomized the schools into two groups (control and intervention) in 1:1 ratio. An independent statistician used the command “RAND” in an Excel program to generate random numbers assigned to anonymized schools. After running the command, the schools were sorted from the lowest to the highest random number, and using a pre-stated protocol, the first half of the schools were allocated to the Intervention Group and (IG) the second half to the Control Group (CG). See Figure 1, Flowchart. Finally, a research assistant informed the schools of the allocation within the study. Blinding Due to the nature of the intervention, children, Educators and parents knew the allocation of the school. However, for the secondary outcomes, the team of evaluators were blinded to the groups and the schools and students were assigned to. The design is open label with only outcome assessors and data analysts being blinded, so unblinding did not occur. Intervention Prototype design and development We hired a software company dedicated to developing video games (Octetostudios.com). They had experience developing applications for the target age group (pre-kindergarten). The authors (JG and CR) provided the knowledge related to the development of cognitive and non-cognitive skills of pre-kindergarten children and suggested scripts for the activities and their level of difficulty. Based on the literature review and the evidence presented in the Introduction, four skills (working memory, inhibitory control, emotion recognition, and social competence) were selected to be stimulated during the video game. These skills were selected after an extensive review of basic psychosocial skills that, when learned in early life, have a demonstrable impact later in life (90-93). The research team has already developed and tested a working memory game among socio-economically deprived preschoolers in Chile, where children received sixteen 30-minute sessions to stimulate working memory, resulting in significant improvements in working memory and language skills compared with those in the control group who received a similar number of sessions playing a neutral game(23). One lesson from this experience was to adopt a more comprehensive approach, covering multiple skills simultaneously. When the first version of the video game was complete, we tested the children's understanding of the instructions by reading them to a small group of 4- to 6-year-old children (n=3). Following this experience, the instructions were revised to be shorter and simpler, aiming to achieve a better understanding. Then, we tested the sessions with undergraduate psychology major students to detect errors in the flow and progress between activities. We also tested the synchronicity between the instructions and the activities. At the same time, the scripts were reviewed for each session to detect inconsistencies between the scripts and the images presented in the video game. Two independent research assistants reviewed each session, and any errors regarding the scripts, images, or drawings, as well as the functioning of each activity, were recorded and then discussed in weekly research group meetings. After each meeting, a list of corrections was created and sent to the software company to make the amendments. This process lasted between August 2017 and December 2017. In 2018, we started preparing the pilot study. In the first semester of 2018, two research assistants (one Psychologist and one Early Educator) used, explored, and reviewed all sessions and activities of the video game, and new corrections were presented to the software company to get the video game ready for the pilot study. This first iteration of the video game was called “Japi”. This work provided information about the strengths of the video game. Among the strengths: The video game begins with a login page, where the early educator can introduce the students' identification, making the gaming experience completely individualized. The actions conducted by the students in the game can be followed. At the beginning of the game, students can create their avatar using the physical features they choose. This avatar will be part of all activities in the various sessions, allowing students to feel that they have contributed to creating part of the game. The scenarios, situations, and characters presented in the video game are familiar to preschoolers. The elements presented in each activity are pertinent and adequate for preschoolers' age and day-to-day experience. Each session and its activities were separated from one another, allowing students to distinguish when they were transitioning from one session to the next. This was also important to create the sensation of advancing in the game. Implementation of Japi The children in the intervention group played the videogame “Japi 1.0” using a tablet device with headphones at a designated time set by school authorities. Early Year Educators were present to assist with the discipline and motivation of the students, and two trained Research Assistants were in the classroom to provide technical support for using the equipment. One of the authors (JG) supervised the video game implementation. The intervention consisted of ten sessions, with two 30-minute sessions delivered each week for 6 weeks. Sessions numbers 1 to 5 were focused on emotional recognition and inhibitory control. Sessions numbers 6 to 10 worked on working memory and social competence. Each session consisted of eight activities, each with five tasks, and the tasks increased in difficulty level. The audio instructions were recorded using professional actors and inserted into the sessions. For more details of each session, see Suppl. 1. Control The control group received standard school curricula. The Ministry of Education provides the standard curriculum as a guideline called “Curricular Bases for Kindergarten Education” (94), which includes pre-kindergarten directions to Early Year Educators regarding emotion regulation and planning strategies to implement in class. Measures Primary outcomes Functionality, student behavior, and classroom climate A research assistant registered all issues regarding the video game functionality and individual and collective behaviors during playing in a pre-built observation sheet. The measurement of these problems included quantitative and qualitative descriptions. Regarding the video game functionality, we registered if the video game had problems with the advance in the tasks and activities. These problems were categorized as mechanical (e.g., stuck or frozen screen; wrong reward stimulus after students´ correct responses; non-responsive screen during plays). Additionally, we registered any problem with the server functionality (e.g., the number of students whose data from video game play was not recorded in the server). A detailed definition of all errors detected before and during the implementation of the intervention in the pilot study is presented in Suppl. 2. Regarding the student behavior and classroom climate, we assessed student engagement (e.g., students became bored and frustrated during the play session and quit playing), behavioral problems (e.g., students hitting the table or other students, tantrums, students using the tablets for other purposes such as taking selfies); and general classroom climate (e.g., school early teacher´s engagement, students respect for other). Feasibility recruitment and implementation The number of eligible schools, those contacted, and those who agreed to participate; the number of parents/caregivers and students who were contacted and those who consented and agreed to participate; and the number of participants' losses. Additionally, data was collected on the time needed to complete the intervention, time invested in baseline and after-intervention measurements, and participants’ losses. Finally, we will collect student attendance data by session to play with Japi 1.0. Secondary outcomes We used several validated instruments to evaluate cognitive (working memory, inhibitory control) and non-cognitive skills (emotion recognition and social competence) among preschool children. When needed, we obtained the author´s permission and changed the instruments' administration format from paper-and-pencil to tablet format. These tablet-based measures helped to standardize the administration by different trained research assistants and reduce the time of each instrument, reducing the boredom of children. The administration was in-person and took 30-45 minutes with breaks between tests. Working Memory 1) Corsi Cubes Test (95). 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 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) (95). Pre-kindergarteners take around 7 minutes to complete this test. The higher the score, the better the skill. 2) Woodcock- Muñoz Auditive Working Memory test (96). A sequence of audio messages of words and numbers 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 (96). Pre-kindergarteners take around 5 minutes to complete this test. The higher the score, the better the skill. Inhibitory control Hearts and Flowers task (97), a hybrid combining Simon and spatial Stroop task elements. 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, the child 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. Depending on the stimulus that appears, the individual must follow two rules simultaneously, forming a mixed block (98). It requires working memory and inhibitory control. Pre-kindergarteners take around 10 minutes to complete this test. The higher the score, the better the skill. Emotion recognition . We used the Assessment of Children’s Emotions Skills (ACES) (99). 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 basic emotions (happy, sad, angry, and scared). Ten of these images present children without obvious facial expressions (100, 101). 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 (16 points is the perfect score). The higher the score, the better the skill. Additionally, there is an anger bias score, which is the number of times the children incorrectly identify the faces as displaying anger. The higher the score, the higher the anger bias (79). Recently, it has shown acceptable psychometric characteristics with reliability among 6-year-old children with Cronbach’s α 0.64 (102). Pre-kindergarteners take around 10 minutes to complete this test. Social competence We used the Challenging Situations Task (CST) (103). 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 emotions are presented in random order. The child is asked to point to the picture that best describes their feelings when [this situation] happens. Then, four pictures of behavioral responses (prosocial, aggressive, crying or dysregulated, 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, dysregulated, and avoidant. Scores for affective and behavioral responses used are the number of times each affect, and each behavioral response is chosen by each child across the six situations. The higher the prosocial behavioral response score, the better the skill. It has shown acceptable psychometric characteristics of internal consistency with mean inter-item correlations among 4-year-old children ≥ 0.29 (104). Pre-kindergarteners take around 10 minutes to complete this test. Behavioral problems and psychological assessment . The Strengths and Difficulties Questionnaire (SDQ) (105) is widely used in Chile (106, 107). This 25-question questionnaire explores different symptoms grouped into five sub-scales (with five items each): (1) emotional symptoms, (2) behavioral problems, (3) problems with peers, (4) inattention and hyperactivity, and (5) prosocial skills. The first four sub-scales refer to children's difficulties and may be grouped into a general sub-scale of difficulties (20 items). The sub-scale of prosocial skills refers to positive and adaptive behaviors in 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). It has been widely used (108) and has shown good psychometric characteristics for the difficulties and prosocial sub-scales, with Cronbach’s α 0.84 and 0.73, respectively (109). The research team received permission to use this instrument in all versions from Youth in Mind (https://www.sdqinfo.org) for the validation study (110). The Parents’ version of this instrument was used. Data analysis Firstly, we used descriptive statistics to assess balance across arms at baseline for demographic and secondary outcomes (see Table 1). We registered the frequencies and descriptions of the functionality of the video game, student engagement, and classroom climate. Additionally, we present the descriptive statistics of the recruitment process (e.g., the number of students consented and assessed) as indicators of the implementation of the video game, such as the number of sessions attended by students and the degree of attendance of students by sessions. The primary between-group analysis for the efficacy of the intervention was carried out on an intention-to-treat basis for post-intervention assessment of all secondary outcomes. A maximum likelihood restricted random effects mixed regression (REML) was used to compare the intervention and control groups regarding the change in outcome measures from baseline to post-intervention. We included age, sex, and the baseline score in each model. We conducted a complete data analysis, and no imputation was performed for missing data. All statistical analyses were conducted in Stata using STATA v.17.0 (111). RESULTS Sample description Eight schools were randomly allocated to Intervention (Students enrollment =196) and Control group (Students enrollment =199) Primary outcomes Functionality, student behavior, and classroom climate Once the video game was developed by the Software company and before the implementation in the schools, the research team tested the functionality of the game and three main problems: audio volume variations (37% of the errors), abrupt change of the activity (24% of the errors) and game freezing. We provided this feedback to the company, and they were fixed. The newer version of the game was then implemented in the schools of the intervention group. Even though the number of errors was reduced (from 54 to 48), there was more variation in the types of errors. The most frequent error was when the game was freezing, and students could not continue working in sessions two and three. The second most frequent error was when correct answers were registered as incorrect in sessions 5, 6 , 8 , 9 and 10. This error was not present before. See Table 2 and 3. During the implementation of the game with the students, we lost data for 26.6% of students, considering the total number of opportunities for playing all sessions. This data was not registered in the server and was present, especially for sessions 1-5 and 9. See Table 4. Regarding the student’s engagement, some students lost interest in playing the game, especially in sessions 3, 4, and 10. See Table 5. The primary registered reasons were: there were problems with the game where some parts of it froze, causing frustration in the students and loss of interest, and the number and difficulty of activities related to inhibitory control were considered excessive by the students, causing frustration and less motivation to continue playing. There were very few disruptive behavioral problems (six in total) involving a reduced number of students (5 in total). For example, in session 10, after 20 minutes of playing the game, one girl got up from her seat and walked over to one of her classmates, with whom she started fighting and hitting each other. The Early Year Teacher managed this situation, and the children calmed down. However, this event distracted the rest of the classmates, which caused many students to start saying they were bored and ask for the tablet to be taken away. See Table 6. The classroom climate during the implementation of the video game was generally conducive to the adaptation of the children to the activity. At the beginning of each session, students were engaged and attentive, facilitating the introduction of materials and reinforcing commitments regarding their proper use. Early-year teachers played an active role in managing the group at this stage, helping to capture attention and reinforce routines. This was especially helpful in the first five sessions. See Table 7. However, as the sessions progressed, challenges emerged. Around the 15-20 minute mark, students began showing signs of boredom and frustration, leading to disengagement. Some children stopped playing, verbally expressed their disinterest, or began using the tablets for unrelated activities. This disengagement often spread through imitation, making group management more complex. The Early-year teachers, while initially supportive, tended to adopt a passive role during gameplay, offering minimal assistance when children encountered difficulties. However, they remained active in specific moments, such as modeling breathing techniques and assisting with material collection at the end of the session. Strategies such as timed challenges were introduced to address motivational challenges, which positively affected maintaining engagement. Additionally, some activities, like identifying animal sounds, presented cognitive difficulties that required individualized support. Despite these challenges, children showed increased engagement in later sessions and played for longer periods, indicating a gradual adaptation to the game. Feasibility recruitment and implementation Regarding the recruitment, we started with four schools and with a similar number of students enrolled in each group (IG: n=196; CG: n=199). A similar number of parents did not consent in each group, but in the IG, more students withdrew from schools (n=31 vs n=9), which was unrelated to the participation in the study. The baseline assessment was conducted in 97.8% of consented students in the IG and 92.2% in the CG. The Post-intervention assessment was conducted in 94.1% of consented students in the IG and 88.6% in the CG. The attendance of children to sessions was high, with over 70% of consented children in all sessions and over 80% in five sessions. See Table 8. Secondary outcomes The exploratory analysis of secondary outcomes assessing the efficacy of the intervention revealed minimal differences between the intervention and control groups across various psychological and cognitive domains. At follow-up (T1), both groups showed similar scores in general psychological functioning, with the SDQ Difficulties and Prosocial subscales demonstrating no statistically significant differences (p = 0.748 and p = 0.812, respectively). Emotion recognition, measured by the ACES, showed a slight improvement in the intervention group (mean = 12.04) compared to the control (mean = 11.93), though this was not significant (p = 0.520). Measures of social problem-solving skills (CST), visual and auditory working memory (Corsi’s cubes), and executive function (Heart & Flowers task) also showed no significant group differences. See Table 9. DISCUSSION This pilot study evaluated the development, usability, and feasibility of Japi 1.0, a tablet-based video game designed to stimulate cognitive and socio-emotional skills in preschool-aged children from low-income backgrounds. While the intervention was feasible and well-accepted initially, several development and technical issues likely limited its full potential. Development and Technical Challenges The implementation process revealed key technical challenges, including game freezing, misclassification of correct responses, and substantial data loss (26.6%) during early and middle sessions. These problems were especially disruptive in tasks requiring sustained attention and inhibitory control—core functions the intervention aimed to train. Similar issues have been documented in early-stage digital learning interventions. For example, Alloway et al. (2013) reported that technological inconsistencies undermined engagement and classroom integration in computerized cognitive training for young students (24). Likewise, Ramani et al. (2020) noted that interruptions and usability problems in digital memory games disrupted task fidelity and minimized learning gains (38). Although the development team addressed some issues before school deployment, others persisted or emerged during real-world use. These technical flaws likely disrupted the intended training dosage and progression, decreasing both the cognitive intensity and emotional rewards of the experience. According to Domitrovich et al. (2007), successful early interventions require consistent delivery and minimal distractions to be effective (79). This underscores the importance of robust usability testing prior to scaling. Secondary Outcomes: Cognitive and Non-Cognitive Skills The exploratory analysis of secondary outcomes found no statistically significant differences between the intervention and control groups across cognitive (working memory, inhibitory control) and non-cognitive domains (emotion recognition, social competence, and prosocial behaviors). These findings are not unusual in pilot studies with brief interventions. For example, Roberts et al. (2016) showed that cognitive improvements from working memory training in preschoolers diminished over time and did not translate into broader academic outcomes (112). Moreover, digital-only interventions may not be sufficient to improve complex social-emotional skills without adult facilitation. In our study, teachers’ initial involvement in supporting gameplay decreased over time. Xie et al. (2021) emphasized that cognitive training in preschoolers benefits most when coupled with emotional scaffolding and adult feedback (40). Similarly, PATHS (79) and CRECES (78) programs demonstrated stronger effects when teachers actively reinforced skills beyond structured activities. In our context, motivational dips were reported mid-intervention, especially during more difficult sessions, and teacher engagement waned. These patterns likely reduced the “active ingredient” exposure necessary to drive measurable behavioral or emotional gains. Strengths of this pilot study The study presents several important strengths. First, it is one of the few digital interventions for early childhood education conducted in a Latin American low-resource setting, addressing a significant gap in the literature. Second, the study followed a rigorous cluster-randomized controlled design with high recruitment and retention rates, providing reliable data for feasibility and process evaluation. Third, the integration of standardized and developmentally appropriate measures for both cognitive and non-cognitive domains ensured robust assessment of key child outcomes. Finally, the high levels of early student engagement and successful coordination with school stakeholders underscore the acceptability of digital tools in public preschool settings. Limitations Several limitations must be acknowledged. First, technical problems—especially data loss and gameplay disruptions—compromised fidelity and dosage, potentially obscuring intervention effects. Second, classroom dynamics shifted over time, with decreasing adult engagement and increased child frustration in later sessions. Third, the outcome assessments may have lacked sensitivity to detect small improvements within a short follow-up period. Fourth, the sample size, though adequate for feasibility, limited statistical power to detect modest effects. Lastly, the intervention’s duration may have been too brief to influence developmental outcomes that typically require sustained exposure, especially in socioeconomically vulnerable populations. Conclusion In conclusion, this pilot study demonstrates the feasibility and acceptability of implementing a digital intervention in low-income preschool settings in Chile. While technical challenges and implementation variability limited its short-term impact on cognitive and socio-emotional outcomes, the positive engagement from students and schools highlights its promise. These findings offer important insights to refine the intervention and its delivery. Future trials should address technical reliability, improve adult facilitation strategies, and extend the intervention duration to strengthen its potential effectiveness. Digital tools like Japi 1.0 represent a scalable and innovative opportunity to support early child development in under-resourced contexts when carefully designed and supported. Declarations Ethics approval and consent to participate. All evaluation data were collected in accordance with the Declaration of Helsinki, which was approved by the Research Ethics Committee of the Universidad de los Andes (Ref. 2018–019). Informed written consent was obtained from all participating children’s parents or guardians before the study began. School principals provided institutional authorization for the study. Consent for publication. Not applicable. Availability of data and materials. The datasets generated and/or analyzed during the current study are not publicly available due to institutional data protection policies but are available from the corresponding author on reasonable request. Competing interests. The authors declare that they have no competing interests. Funding This work was supported by the Universidad de los Andes Research Fund Ner UAN 201701, and additional support was provided by ANID Millennium Science Initiative Program (Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, NCS2021_081). The funding sources had no role in the design, analysis, or interpretation of the data or in writing the manuscript. Authors’ contributions. JG, CRB and RA conceptualized the study and led the project. NR coordinated data collection and conducted initial analyses. JG and CRB contributed to the design of cognitive assessments. SR oversaw classroom implementation. RA advised on study design and analysis. All authors contributed to writing and approved the final manuscript. Acknowledgements. We thank the schools, teachers, children, and their families for their generous participation. We also acknowledge the technical support provided by the game development team and the research assistants for their invaluable work in the field. References Cooper C. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a …. Lancet. 2018. Vasileva M, Graf RK, Reinelt T, Petermann U, Petermann F. Research review: A meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years. J Child Psychol Psychiatry. 2021;62(4):372-81. Bitsko RH, Claussen AH, Lichstein J, Black LI, Jones SE, Danielson ML, et al. Mental Health Surveillance Among Children - United States, 2013-2019. MMWR Suppl. 2022;71(2):1-42. Grantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. The Lancet. 2007;369(9555):60-70. Mathiesen KS, Prior M. The impact of temperament factors and family functioning on resilience processes from infancy to school age. European Journal of Developmental Psychology. 2006;3(4):357-87. Jones PB. Adult mental health disorders and their age at onset. British Journal of Psychiatry. 2013;202(SUPPL. 54):s5-s10. Bould H, Araya R, Pearson RM, Stapinski L, Carnegie R, Joinson C. Association between early temperament and depression at 18 years. Depress Anxiety. 2014;31(9):729-36. Garber J. Depression in children and adolescents: linking risk research and prevention. Am J Prev Med. 2006;31(6 Suppl 1):S104-25. Conti G, Heckman JJ. The developmental approach to child and adult health. Pediatrics. 2013;131 Suppl 2:S133-41. 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. 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. 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. 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. Scorza P, Araya R, Wuermli AJ, Betancourt TS. Towards Clarity in Research on “Non-Cognitive” Skills: Linking Executive Functions, Self-Regulation, and Economic Development to Advance Life Outcomes for Children, Adolescents and Youth Globally. Human Development. 2016;58(6):313-7. Onchwari G, Keengwe J. Examining the Relationship of Children's Behavior to Emotion Regulation Ability. Early Childhood Education Journal. 2011;39(4):279-84. Karademas EC, Tsalikou C, Tallarou MC. The impact of emotion regulation and illness-focused coping strategies on the relation of illness-related negative emotions to subjective health. Journal of Health Psychology. 2011;16(3):510-9. Adynski H, Propper C, Beeber L, Gilmore JH, Zou B, Santos HP. The role of emotional regulation on early child school adjustment outcomes. Archives of Psychiatric Nursing. 2024;51:201-11. Loriol M. From the Analysis ofEmotions As Risk to the Construction ofHealth Through the Collective Coloring ofAffects and Situations. PISTES. 2023;25(1). Cunha F, Heckman J, Schennach S. Estimating the Technology of Cognitive and Noncognitive Skill Formation. Econometrica. 2010;78(3):883-931. Holmes J, Gathercole SE. Taking working memory training from the laboratory into schools. Educ Psychol. 2014;34(4):440-50. Dunning DL, Holmes J, Gathercole SE. Does working memory training lead to generalized improvements in children with low working memory? A randomized controlled trial. Dev Sci. 2013;16(6):915-25. Nevo E, Breznitz Z. Effects of working memory and reading acceleration training on improving working memory abilities and reading skills among third graders. Child Neuropsychol. 2014;20(6):752-65. Rojas-Barahona CA, Förster CE, Moreno-Ríos 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. Alloway TP, Bibile V, Lau G. Computerized working memory training: Can it lead to gains in cognitive skills in students? Comput Human Behav. 2013;29(3):632-8. 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. 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. Capilla A, Romero D, Maestú F, Campo P, Fernández S, González-Marqués J, et al. Emergence and brain development of executive functions. Actas Espanolas de Psiquiatria. 2004;32(6):377-86. Zhong J, Rifkin-Graboi A, Ta AT, Yap KL, Chuang KH, Meaney MJ, et al. Functional networks in parallel with cortical development associate with executive functions in children. Cerebral Cortex. 2014;24(7):1937-47. 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. 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). Baddeley A. Working memory: Clarendon Press/Oxford University Press; 1986. Boudreau AM, Dempsey EE, Smith IM, Garon N. A novel working memory task for preschoolers: sensitivity to age differences from 3-5 years. Child Neuropsychology. 2018;24(6):799-822. Morris BM, Lonigan CJ. What components of working memory are associated with children's reading skills? Learning and Individual Differences. 2022;95. Allen K, Higgins S, Adams J. The Relationship between Visuospatial Working Memory and Mathematical Performance in School-Aged Children: a Systematic Review. Educational Psychology Review. 2019;31(3):509-31. Franklin T, Lee A, Hall N, Hetrick S, Ong J, Haslam N, et al. The association of visuospatial working memory with dysthymic disorder in pre-pubertal children. Psychological Medicine. 2010;40(2):253-61. Gathercole S, Alloway T. Working memory and classroom learning. Cognitive development in K-3 classroom learning: Research applications. 2004;15. Huang-Pollock C, Shapiro Z, Galloway-Long H, Weigard A. Is Poor Working Memory a Transdiagnostic Risk Factor for Psychopathology? J Abnorm Child Psychol. 2017;45(8):1477-90. Ramani GB, Daubert EN, Lin GC, Kamarsu S, Wodzinski A, Jaeggi SM. Racing dragons and remembering aliens: Benefits of playing number and working memory games on kindergartners' numerical knowledge. Dev Sci. 2020;23(4):e12908. Suppalarkbunlue W, Duangchaiyoosook S, Khruapradit V, Kilenthong WT. Material incentive motivation and working memory performance of kindergartners: A large-scale randomized controlled trial. J Exp Child Psychol. 2023;235:105730. Xie J, Liu S, Fang P. Cognitive training improves emotion regulation in Chinese preschool children. Pediatr Int. 2021;63(11):1303-10. Roberts G, Quach J, Spencer-Smith M, Anderson PJ, Gathercole S, Gold L, et al. Academic Outcomes 2 Years After Working Memory Training for Children With Low Working Memory: A Randomized Clinical Trial. JAMA Pediatr. 2016;170(5):e154568. Aron AR. From reactive to proactive and selective control: developing a richer model for stopping inappropriate responses. Biol Psychiatry. 2011;69(12):e55-68. Hofstee M, van der Velde B, Huijding J, Endendijk J, Kemner C, Deković M. The direct and indirect effects of parenting behaviors and functional brain network efficiency on self-regulation from infancy to early childhood: A longitudinal mediation model. Infant Behavior and Development. 2022;69. Geeraerts SB, Endendijk JJ, Deković M, Huijding J, Deater-Deckard K, Mesman J. Inhibitory Control Across the Preschool Years: Developmental Changes and Associations with Parenting. Child Development. 2021;92(1):335-50. Donjdee K, Poonpol P, Ruksee N. Causes and Cultivation of Inhibitory Control Among School-Age Children in Thailand. Journal of Behavioral Science. 2024;19(2):135-50. Fox NA. Individual Differences in Child Temperament and Their Effect on Cognitive Control. Minnesota Symposia on Child Psychology: Developing Cognitive Control Processes: Mechanisms, Implications, and Interventions. 372013. p. 181-202. Rodrigues ER, Hassan R, Schmidt LA. Negative Emotionality and Internalizing Behaviors in Preschool Children: Moderating Role of Inhibitory Control. Child Psychiatry and Human Development. 2022;53(6):1110-8. Hassan R, Schmidt LA. Inhibitory control, dyadic social behavior, and mental health difficulties in preschoolers. Child Development. 2022;93(3):e251-e65. Rea-Sandin G, Oro V, Strouse E, Clifford S, Wilson MN, Shaw DS, et al. Educational attainment polygenic score predicts inhibitory control and academic skills in early and middle childhood. Genes, Brain and Behavior. 2021;20(7). Allan NP, Hume LE, Allan DM, Farrington AL, Lonigan CJ. Relations between inhibitory control and the development of academic skills in preschool and kindergarten: A meta-analysis. Developmental Psychology. 2014;50(10):2368-79. Beisly A, Jeon S. Development of inhibitory control in Head Start children: Association with approaches to learning and academic outcomes in kindergarten. Cognitive Development. 2024;70. Liu Q, Zhu X, Ziegler A, Shi J. The effects of inhibitory control training for preschoolers on reasoning ability and neural activity. Scientific Reports. 2015;5(1):14200. Blair C, Razza RP. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Dev. 2007;78(2):647-63. Ng F, Tamis-LeMonda C, Yoshikawa H, Sze I. Inhibitory control in preschool predicts early math skills in first grade: Evidence from an ethnically diverse sample. International Journal of Behavioral Development. 2014;39:139-49. McClelland MM, Cameron CE, Connor CM, Farris CL, Jewkes AM, Morrison FJ. Links between behavioral regulation and preschoolers' literacy, vocabulary, and math skills. Dev Psychol. 2007;43(4):947-59. Izard C, Fine S, Schultz D, Mostow A, Ackerman B, Youngstrom E. Emotion Knowledge as a Predictor of Social Behavior and Academic Competence in Children at Risk. Psychological science. 2001;12:18-23. Bayet L, Behrendt HF, Cataldo JK, Westerlund A, Nelson CA. Recognition of facial emotions of varying intensities by three-year-olds. Developmental Psychology. 2018;54(12):2240-7. Witkower Z, Tracy JL, Pun A, Baron AS. Can Children Recognize Bodily Expressions of Emotion? Journal of Nonverbal Behavior. 2021;45(4):505-18. Greco C, Cuciniello M, Amorese T, Raimo G, Cordasco G, Esposito A. Emotion Recognition in Preschool Children: The Role of Age, Gender and Emotional Categories. Smart Innovation, Systems and Technologies. 3602023. p. 267-77. Ramos-Loyo J, Espinosa-Denenea SE, Sanz-Martin A, Llamas-Alonso LA. Age-Related Effects on Facial Emotion Recognition in Schoolchildren: An ERP Study. Developmental Neuropsychology. 2024;49(8):295-317. Ensor R, Spencer D, Hughes C. ‘You Feel Sad?’ Emotion Understanding Mediates Effects of Verbal Ability and Mother–Child Mutuality on Prosocial Behaviors: Findings from 2 Years to 4 Years. Social Development. 2011;20(1):93-110. Fine SE, Izard CE, Mostow AJ, Trentacosta CJ, Ackerman BP. First grade emotion knowledge as a predictor of fifth grade self-reported internalizing behaviors in children from economically disadvantaged families. Dev Psychopathol. 2003;15(2):331-42. Trentacosta CJ, Fine SE. Emotion Knowledge, Social Competence, and Behavior Problems in Childhood and Adolescence: A Meta-Analytic Review. Soc Dev. 2010;19(1):1-29. Denham SA, Blair KA, DeMulder E, Levitas J, Sawyer K, Auerbach-Major S, et al. Preschool emotional competence: pathway to social competence? Child Dev. 2003;74(1):238-56. Lafay A, Berger C, Alaria L, Angonin S, Dalla-Libera N, Richard S, et al. Impact of Innovative Emotion Training in Preschool and Kindergarten Children Aged from 3 to 6 Years. Children. 2023;10(11):1825. Schüller I, Demetriou Y. Physical activity interventions promoting social competence at school: A systematic review. Educational Research Review. 2018;25:39-55. Rose-Krasnor L, Denham S. Social-emotional competence in early childhood. Handbook of peer interactions, relationships, and groups. Social, emotional, and personality development in context. New York, NY, US: The Guilford Press; 2009. p. 162-79. Schietecatte I, Roeyers H, Warreyn P. Can infants' orientation to social stimuli predict later joint attention skills? British Journal of Developmental Psychology. 2012;30(2):267-82. Reilly EB, Stallworthy IC, Mliner SB, Troy MF, Elison JT, Gunnar MR. Infants’ abilities to respond to cues for joint attention vary by family socioeconomic status. Infancy. 2021;26(2):204-22. Vaughan Van Hecke A, Mundy PC, Acra CF, Block JJ, Delgado CE, Parlade MV, et al. Infant joint attention, temperament, and social competence in preschool children. Child Dev. 2007;78(1):53-69. Malti T, Dys SP. From being nice to being kind: development of prosocial behaviors. Current Opinion in Psychology. 2018;20:45-9. Flook L, Zahn-Waxler C, Davidson RJ. Developmental differences in prosocial behavior between preschool and late elementary school. Frontiers in Psychology. 2019;10(APR). Vogelsang M, Schäfer A, Ehrenreich A, Ebersbach M. Friendship status and recipient's emotions both affect children's sharing behavior. Journal of Experimental Child Psychology. 2025;256. Volland C, Ulich D, Fischer A. Who deserves help? The age-dependent influence of recipient characteristics on the prosociality of children. Zeitschrift fur Entwicklungspsychologie und Padagogische Psychologie. 2004;36(2):69-73. Gagnona SG, Nagle RJ. Relationships between peer interactive play and social competence in at-risk preschool children. Psychology in the Schools. 2004;41(2):173-89. Miles SB, Stipek D. Contemporaneous and longitudinal associations between social behavior and literacy achievement in a sample of low-income elementary school children. Child Dev. 2006;77(1):103-17. Ladd GW. Social competence and peer relations: Significance for young children and their service-providers. Early Childhood Services: An Interdisciplinary Journal of Effectiveness. 2008;2(3):129-48. Bermejo-Martins E, Mujika A, Iriarte A, Pumar-Méndez MJ, Belintxon M, Ruiz-Zaldibar C, et al. Social and emotional competence as key element to improve healthy lifestyles in children: A randomized controlled trial. J Adv Nurs. 2019;75(8):1764-81. Domitrovich C, Cortes R, Greenberg M. Improving Young Children’s Social and Emotional Competence: A Randomized Trial of the Preschool “PATHS” Curriculum. The journal of primary prevention. 2007;28:67-91. Smahel D, Chaudron S, Beutel M, Šmahelová M, V D, Dreier M, et al. Young Children (0-8) and digital technology: A qualitative exploratory study across seven countries2015. Marsh J, Plowman L, Yamada-Rice D, Bishop J, Lahmar J, Scott F, et al. Exploring Play and Creativity in Pre-Schoolers' Use of Apps: Report for Early Years Practitioners2015. Flewitt R, Messer D, Kucirkova N. New directions for early literacy in a digital age: The iPad. Journal of Early Childhood Literacy. 2015;15(3):289-310. Khoo E, Merry R, Nguyễn N, Bennett T, Macmillan N. Early childhood education teachers' iPad-supported practices in young children's learning and exploration. Computers in New Zealand Schools: Learning, teaching, technology. 2014;25:3-20. Parette P, Quesenberry A, Blum C. Missing the Boat with Technology Usage in Early Childhood Settings: A 21st Century View of Developmentally Appropriate Practice. Early Childhood Education Journal. 2010;37:335-43. Agencia de Calidad de la Educación. Metodología de construcción de grupos socioeconómicos pruebas SIMCE 2013 2013 [Available from: Available from: https://archivos.agenciaeducacion.cl/Metodologia_de_Construccion_de_Grupos_Socioeconomicos_Simce_2013.pdf. 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. Julious S. Sample size of 12 per group rue of thumb for a pilot study. Pharmaceutical Statistics. 2005;4:287-91. Cocks K, Torgerson DJ. Sample size calculations for pilot randomized trials: a confidence interval approach. J Clin Epidemiol. 2013;66(2):197-201. 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. Fitzpatrick C, Archambault I, Janosz M, Pagani LS. Early childhood working memory forecasts high school dropout risk. Intelligence. 2015;53:160-5. Eigsti IM, Zayas V, Mischel W, Shoda Y, Ayduk O, Dadlani MB, et al. Predicting cognitive control from preschool to late adolescence and young adulthood. Psychol Sci. 2006;17(6):478-84. Halse M, Steinsbekk S, Bjørklund O, Hammar Å, Wichstrøm L. Emotions or cognitions first? Longitudinal relations between executive functions and emotion regulation in childhood. Child Development. 2024;95(5):1508-21. Valiente C, Eisenberg N, Haugen R, Spinrad TL, Hofer C, Liew J, et al. Children's Effortful Control and Academic Achievement: Mediation Through Social Functioning. Early Education and Development. 2011;22(3):411-33. Ministerio de Educación. Bases Curriculares Educación Parvularia. Gobierno de Chile. 2018. 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. 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. 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. 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). Schultz D, Izard CE, Bear G. Children's emotion processing: Relations to emotionality and aggression. Development and psychopathology. 2004;16(2):371-87. Trentacosta CJ, Izard CE, Mostow AJ, Fine SE. Children's emotional competence and attentional competence in early elementary school. School Psychology Quarterly. 2006;21(2):148. 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 Education & Development. 2013;24(7):1000-19. 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 & Human Development. 2024;55(3):819-30. Denham SA, Blair K, Schmidt M, DeMulder E. Compromised emotional competence: Seeds of violence sown early? American journal of orthopsychiatry. 2002;72(1):70-82. 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. Goodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581-6. Gaete J, Rojas‐Barahona CA, Olivares E, Araya R. Brief report: Association between psychological sense of school membership and mental health among early adolescents. Journal of adolescence. 2016;50(1):1-5. 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. 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. European child & adolescent psychiatry. 2004;13:ii40-ii6. Husky MM, Otten R, Boyd A, Pez O, Bitfoi A, Carta MG, et al. Psychometric properties of the Strengths and Difficulties Questionnaire in children aged 5–12 years across seven European countries. European Journal of Psychological Assessment. 2018. Gaete J, Montero-Marin J, Valenzuela D, Rojas-Barahona CA, Olivares E, Araya R. Mental health among children and adolescents: Construct validity, reliability, and parent-adolescent agreement on the 'Strengths and Difficulties Questionnaire' in Chile. PLoS One. 2018;13(2):e0191809. StataCorp. Stata: Release 17. Statistical Software. College Station, TX: StataCorp LLC; 2021. Roberts G, Quach J, Spencer-Smith M, Anderson PJ, Gathercole S, Gold L, et al. Academic Outcomes 2 Years After Working Memory Training for Children With Low Working Memory: A Randomized Clinical Trial. JAMA Pediatrics. 2016;170(5):e154568-e. Tables Table 1: Sample descriptive features at baseline. Variable n CG (n=166) n IG (n=136) Age, Mean (SD) 159 4.71 (0.48) 134 4.68 (0.48) Sex (%) Female 89 53.61 74 54.41 Male 77 46.39 62 45.59 Cognitive skills, Mean (SD) Visual Memory: Corsi Cubes Test 152 0.38 (0.85) 129 0.40 (0.91) Auditive Memory: Woodcock- Muñoz test 150 2.85 (2.91) 131 3.15 (3.27) Inhibitory Control: Hearts and Flowers task 147 28.50 (7.81) 131 26.82 (7.36) Non-cognitive skills, Mean (SD) Emotion recognition: ACES 153 11.32 (2.49) 133 11.18 (2.93) Social Competence: CST (Competence score) 152 1.18 (1.65) 133 0.95 (1.33) Psychological assessment: SDQ, Mean (SD) Total difficulties sub-scale 121 10.07 (4.31) 111 10.50 (4.71) Prosocial sub-scale 121 8.45 (1.56) 111 8.05 (1.84) Notes: Intervention Group (IG); Control Group (CG); Assessment of Children’s Emotions Skills (ACES); Challenging Situations Task (CST); Strengths and Difficulties Questionnaire (SDQ) Table 2: Functionality of video game. Mechanical errors pre-intervention. Sessions 1 2 3 4 5 6 7 8 9 10 Total n n n n n n n n n n n (%) Audio volume variations 0 0 0 0 0 4 4 4 4 4 20 (37.0) Abrupt change of activity 4 4 1 4 0 0 0 0 0 0 13 (24.0) Game freezing 0 4 0 0 7 0 0 0 0 0 11 (20.3) Images or drawings out of place 2 0 0 0 0 0 1 0 0 0 3 (5.5) Audio problems 0 0 1 0 0 2 1 0 0 0 4 (7.4) Incoherence between instructions and expected performance 0 0 1 1 0 0 0 0 0 0 2 (3.7) Missing elements 0 0 0 0 0 1 0 0 0 0 1 (1.8) Total 6 8 3 5 7 7 6 4 4 4 54 (100) Notes: n = number of errors per session. Table 3: Functionality of video game. Mechanical errors during the intervention. Sessions 1 2 3 4 5 6 7 8 9 10 Total n n n n n n n n n n n (%) Audio volume variations 0 0 0 0 0 1 2 0 0 0 3 (6.2) Abrupt change of activity 0 0 0 0 0 0 0 0 0 0 0 (0) Game freezing 0 7 7 0 0 0 0 0 0 0 14 (29.1) Images or drawings out of place. 0 0 0 0 0 0 0 0 0 0 0 (0) Audio problems 0 0 0 0 1 0 0 0 0 0 1 (2.0) Incoherence between instructions and expected performance 0 0 2 0 0 0 0 0 0 0 2 (4.1) Missing elements 0 0 1 0 0 0 0 0 0 0 0 (0) Small surface of the touchable objects on the screen 0 2 0 0 0 0 0 0 0 0 2 (4.1) Correct answers registered as incorrect 0 0 0 0 1 3 0 2 3 1 10 (20.8) Unexpected responsive surface 0 0 0 4 0 2 0 0 0 0 6 (12.5) Activities without correct answers 0 2 0 1 0 0 0 0 0 0 3 (6.2) Absent remainder 0 0 0 0 0 0 1 0 0 0 1 (2.0) Overlapped elements 0 0 0 0 0 0 0 0 1 0 1 (2.0) Dragging problems 0 0 0 0 0 0 4 0 0 0 4 (8.3) Total 0 11 10 5 2 6 7 2 4 1 48 (100) Notes: n = number of errors detected each time each student played the session. Table 4: Functionality of video game. Failure to record data in the server. Attendance Data registered Missing data Sessions Consent/Assent n N N´ (%) 1 136 116 73 43 (37.0) 2 136 102 70 32 (31.4) 3 136 117 61 56 (47.9) 4 136 117 75 42 (36) 5 136 108 46 62 (59.3) 6 136 119 111 8 (6.7) 7 136 114 106 8 (7.0) 8 136 107 104 3 (2.8) 9 136 97 58 39 (40.2) 10 136 107 106 1 (0.9) Total 1104 810 294 (26.6) Notes: n = number of children presented in the classroom; N = number of children for whom data was registered in the server; N ' = difference between the number of children who were at the school and played with the video game and the number of children whose data was registered. Table 5: Students’ poor engagement. Attendance Quit playing Session n N (%) 1 116 0 (0.0) 2 102 7 (6.7) 3 117 23 (19.7) 4 117 18 (15.4) 5 108 8 (7.4) 6 119 8 (6.7) 7 114 10 (8.8) 8 107 3 (2.8) 9 97 5 (5.2) 10 107 19 (17.8) Total 1104 101 (9.2) Notes: n = number of children presented in the classroom; N = number of children who quit playing with the video game during the session. Table 6. Behavioral problems. Session Behavioral problems description Using other tablet apps 3 One event: Ten minutes into the session, 1 student is caught taking pictures with the tablet. When the facilitator calls her attention, she resists to play the video game, stands up from her seat and begins to act angry, making angry noises. After a few minutes, the facilitator manages to get the student to play again, staying by her side and supporting her the rest of the game. Hitting the table 6 One event: 1 student appears frustrated. He mentions several times that “the game is difficult”, and that he does not know how to play, after a few minutes the child is caught hitting the table very close to the Tablet, so the game is aborted. Getting up from the seat and doing other things during the session 10 One event: 1 child appears frustrated, mentioning that he does not want to continue playing, repeating several times that the game is boring and that he wants to play “another game”. The child is encouraged to continue, but after a few minutes, the child stands up from his seat and starts to move the furniture in the room, looking very frustrated. 9 One event: 1 child shows frustration after 15 minutes playing the game. The kid stops playing, starts to get up from her sit, lies down on the floor and approaches the early year teacher saying she doesn't want to play anymore. Falling asleep 9 One event: 1 student falls asleep while playing the video game, so his tablet must be removed. Hitting other classmate 10 One event: After 20 minutes playing the game, 1 student gets up from her seat and walks over to one of her classmates, with whom she starts fighting and hitting each other. This distracts the rest of the classmates, which causes many students to start saying that they are bored and ask for the tablet to be taken away. Notes: A total of six behavioral problems were observed during the whole intervention. Table 7. Classroom Climate. Sessions Classroom Climate Description 1 During this session, in general, the classroom climate was quite calm and adequate for the adaptation of the children to the game, where the attention of the students allowed the introduction of the various materials to be used (tablet and headphones), as well as the modeling of their proper use and care, through the commitments presented at the beginning of the session. As for the adults in the room, they had a passive attitude during the session, where they were only a support at the beginning and end of the session. Finally, one of the difficulties presented in this session, in relation to the classroom climate, is that some students disconnected the headphones from the tablets, but this was quickly corrected by remembering the commitment. 2 The classroom climate at the beginning is conducive to a good start of the session. On the one hand, the early year teachers are a great support at this time to capture the attention of the students and thus proceed to remember the commitments; in addition, since it is the second session, the children are allowed to participate more actively in the reminder of the commitments, since they themselves mention them according to what they remember from the previous session. However, when it came to the development of the session, the team of adults in the classroom, in general, maintained a passive attitude during the moments when the children were playing and rarely helped to clear up their doubts. Finally, in this session, when several children asked to stop playing, they caused a break in the classroom climate, because the imitation of the students was present in those moments. When the children saw that a classmate stopped playing, the others also wanted to stop playing. On these occasions, students expressed: “I'm bored”, “I don't want to keep playing either”, “the game is too difficult”, “I don't know how to play (...) I can't move forward”, “I don't know how to play (...)”. 3 In general, what happened in the previous sessions is repeated: At the beginning of the class, the children are motivated and attentive, and the classroom team is an active agent to support group management during this time. However, as the minutes of play pass (after approximately 15-20 minutes), students begin to show boredom and frustration, which is expressed in the following behaviors: Students start doing other things unrelated to the game and stop paying attention to the tablet (e.g., standing up from their seats, talking to each other, etc.).Students tell the adults in the room that they are bored and don't want to play anymore, so they ask for the tablet to be taken away. They get up from their seats to talk to other classmates. They get out of the game and start using other applications on the tablet (e.g., camera, google search engine, etc.). The classroom climate starts to become more difficult to manage, once the children by imitation start asking for the tablets to be taken away, since fewer students are playing and the group of students doing other things is much larger. 4 At the beginning, as in the other sessions, the necessary conditions were in place to carry out the game in an adequate classroom climate. The children continue to be enthusiastic and the commitments for the handling of materials are beginning to show as a routine, where the students are able to mention them without help. However, as the minutes pass, group management becomes increasingly difficult to maintain, due to the large number of children who decide to drop out and do other things that distract their classmates, such as chatting with them or playing with nearby items. In relation to the classroom team, it begins to be more and more passive, to a great extent due to the fact that the monitors are more in charge of the group. In this session, support is only shown at the end of the session, which is largely due to the fact that the children were more restless than on previous occasions. 5 The classroom team was active in three key moments of the session: In the modeling of activity 01: In this part of the session, the monitors show the students the three moments to keep calm and be able to solve a problem (breathe through the nose, hold for three seconds and blow through the mouth). In activity 01: In those classes where activity 01 was applied, the adults in the room showed a lot of initiative in helping the students, individually, in their confusions related to that activity. At the closing: At this moment of the session, the classroom team, as in other sessions, shows their support by collecting and putting away the tablets. However, in the rest of the session (development), the classroom team again showed passivity, choosing not to get involved in the activity. In relation to the classroom climate, at the beginning of the session and during the explanation of activity 01, it was adequate for the realization of the game, because the children were attentive and active, however, as the pedagogical hour progressed, the classroom climate was increasingly complicated to maintain, because the students began to be restless and confused by the instructions of the game. The difficulties that the children had with this session also caused difficulties with group management, since the students needed individual assistance in the larger classes, which led to the loss of the general focus of the group of children, so that many students were at a disadvantage in relation to the time it took them to complete the activity. Finally, to facilitate group management and due to the low motivation during the previous session, it was decided to start applying strategies to focus the attention of the students, proposing different challenges to the children in relation to the time they play with the tablet. 6 At the beginning of the session, an environment conducive to the correct application of the game and easy group management was observed. However, as the session progressed, some children became more restless in the activity where they had to listen to the sounds of the animals and memorize the order in order to then drag the image of the animal into the boxes. On this occasion, in general, the students were constantly asking for help, due to three situations presented: Students do not know that when ordering the sounds, this should be done from left to right, so they order them backwards. Students have difficulty identifying to which animal each sound corresponds. During the activity of ordering the animals according to their sound, the students ask for help to corroborate if the action they are carrying out is correct. In these cases, the facilitators chose to just approach the child who asked for help and stay with him/her, reminding the student that, in order to complete the task, he/she only needs to concentrate and listen carefully. This strategy was enough on many occasions for the child to advance to the next trial. In spite of the situations mentioned above, in this session the children managed to play for longer (more than 20 minutes) and dropped out less than on previous occasions. Regarding the role of the classroom team, this again tends to be passive during most of the session, not even assisting the children who ask for help. Finally, the challenge presented to the children in the previous session was a favorable factor to keep the students' attention for a longer time in the game, so that the group management in the development and closing of the session went much more smoothly. 7 In general, the classroom climate was favorable for the realization of the session, highlighting the enthusiasm shown by the students at the beginning of the hour and during the delivery of the tablets. This allowed a good group management during the beginning of the pedagogical hour. As the game progressed, group management also became easier, since the students were calmer and more focused on the activities, without demanding a lot of help. The activity that generated the greatest motivation on the part of the students was number 03. On the other hand, the activity in which some children had difficulties in understanding the instructions was number 04, since they constantly asked for help in order to know what action they had to carry out in the game. Finally, the classroom team maintained a passive role during the entire session, except for the closing of the session in which they supported the collection of the material. 8 In general, the classroom climate was quite adequate to carry out the session and this was favored by the concentration of the students during the course of the pedagogical hour. The only moment in which group management was more difficult to maintain was when the children showed difficulties in activities 03 and 05, since the monitors had to support the children individually, losing the focus of the whole course. Regarding the participation of the classroom team, they remained passive until the end of the session when they supported the children during the collection of materials. 9 The good classroom climate is maintained at the beginning of the session, where students already participate autonomously at this moment, when it is time to remember the commitments. They also demonstrate internalization of the routine by showing actions such as: sitting properly before receiving the tablets, waiting calmly for the monitors to set up the headphones and enter the corresponding session, and remaining silent during the delivery of tablets. This greatly facilitates group management at the beginning of the session, which allows to use the time effectively without wasting it in calling the attention of the students. That good classroom climate is observed during at least the first 10 minutes after starting the game, since once the students begin to have difficulties to advance in the first activity of the puzzle, they begin to ask for help and express their dissatisfaction with the game in a massive way, which causes that the adults in the room had to help the students individually, losing the focus of the rest of the students and therefore, making group management difficult. These difficulties were also increased by the fact that the order of the room was affected when the children who were able to complete the puzzle stopped to put together the puzzles of the students who were having difficulties. 10 In this last session, the classroom climate remained adequate during the beginning of the session due to the autonomy of the children who already know the routine and the commitments for a good use of the tablet, so it is not necessary to dwell on them. However, as the session progressed, the classroom climate was becoming less and less conducive to the fluidity of the session, due to the fact that the children were restless, chatting among themselves, standing up and pacing around the room, so this caused the other students to be distracted. This generated a higher level of noise in the room, making it difficult to manage the group and distracting the students who were still playing with the tablet. On this occasion, the classroom team intervened more, due to the fact that most of the children were more restless during the session. Not only did they provide support at the beginning and end of the session, but they also called the attention of the children who, after handing over their tablet, distracted the students who were still playing. Table 8: Session Attendance Session Attendance, n (%) 1 116 (85.3%) 2 102 (75.0%) 3 117 (86.0%) 4 117 (86.0%) 5 108 (79.4%) 6 119 (87.5%) 7 114 (83.8%) 8 107 (78.7%) 9 97 (71.3%) 10 107 (78.7%) Notes: Total enrollment before intervention = 196; Consent from parents and assent from children = 136; n = number of children who attended school when the session was implemented; % of attendance over consent and assent. Table 9: Exploratory results on the efficacy of the intervention. T0 (Jul-Aug 2018) T1 (Nov 2018) Variables (score range) Control Mean (SD) Intervention Mean (SD) Control Mean (SD) Intervention Mean (SD) p value Cognitive skills Working memory Corsi’s cubes (Visual)(0-18) 0.39 (0.84) 0.40 (0.91) 0.63 (1.2) 0.89 (1.2) 0.212 Auditory (0-42) 2.79 (2.9) 3.17 (3.3) 4.0 (4.2) 3.85 (3.5) 0.104 Control Inhibition (Executive function) Heart & Flowers (0-57) 28.49 (7.7) 26.96 (7.7) 30.77 (9.1) 30.80 (8.9) 0.305 Non-cognitive skills Emotion recognition ACES (0-16) 11.32 (2.5) 11.20 (3.0) 11.93 (2.7) 12.04 (2.6) 0.520 Social competence CST (Competent) (0-6) 1.16 (1.6) 0.95 (1.3) 0.8 (1.3) 0.55 (0.99) 0.407 Psychological assessment SDQ, Mean (SD) General Psychological functioning SDQ Difficulties (0-40) 10.13 (4.4) 10.24 (4.8) 11.94 (6.4) 11.82 (5.7) 0.748 SDQ Prosocial (0-10) 8.35 (1.6) 8.15 (1.8) 8.33 (1.7) 8.26 (1.6) 0.812 Notes: Assessment of Children’s Emotions Skills (ACES); Challenging Situations Task (CST); Strengths and Difficulties Questionnaire (SDQ). Additional Declarations No competing interests reported. Supplementary Files Suppl1Descriptionofthegame.docx Suppl2Errorsdefinition.docx CONSORT2025editablechecklist.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 25 Aug, 2025 Reviewers agreed at journal 15 Aug, 2025 Reviewers invited by journal 01 Aug, 2025 Editor invited by journal 25 Jul, 2025 Editor assigned by journal 25 Jul, 2025 Submission checks completed at journal 21 Jul, 2025 First submitted to journal 21 Jul, 2025 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7032367","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":494711120,"identity":"b1b35433-6c5a-44d4-a3f8-3faba0ba02c7","order_by":0,"name":"Jorge Gaete","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAwklEQVRIiWNgGAWjYBACxgYwZQMiDECEDHFaDjCkwbXwEGfVAYbDJGhh7l/88PGHivOJ/bObNz78wWBHWAvjjGfGBgfO3E6ccedYsTEPQzIxWg6YSRxsu53YcCPHTBroRmK0HP/+4+C/c4nzb+SY//xBlJb+HjOGgw0HEjcAbQH6nShbeIolzhxLNt54I61YmseACL8Y9h/f+KGixk523o3kjR9/VNjJEdYyIwGZa0BQAwODPP8BIlSNglEwCkbByAYAUltCHZgA82QAAAAASUVORK5CYII=","orcid":"","institution":"Universidad de los Andes","correspondingAuthor":true,"prefix":"","firstName":"Jorge","middleName":"","lastName":"Gaete","suffix":""},{"id":494711121,"identity":"1128b00d-9d34-4f9c-9345-757948876525","order_by":1,"name":"Natalia Ríos","email":"","orcid":"","institution":"Universidad de los Andes","correspondingAuthor":false,"prefix":"","firstName":"Natalia","middleName":"","lastName":"Ríos","suffix":""},{"id":494711122,"identity":"63720f5b-e614-4c9f-9b5d-f7e7636b98fa","order_by":2,"name":"Cristian Rojas-Barahona","email":"","orcid":"","institution":"Universidad de Talca","correspondingAuthor":false,"prefix":"","firstName":"Cristian","middleName":"","lastName":"Rojas-Barahona","suffix":""},{"id":494711123,"identity":"99173b0d-cf94-448d-bb8a-3c443a08ab06","order_by":3,"name":"Saray Ramírez","email":"","orcid":"","institution":"Universidad de los Andes","correspondingAuthor":false,"prefix":"","firstName":"Saray","middleName":"","lastName":"Ramírez","suffix":""},{"id":494711124,"identity":"2f5405ca-945c-4d13-a1d4-a3b9ed7e15af","order_by":4,"name":"Ricardo Araya","email":"","orcid":"","institution":"King’s College London","correspondingAuthor":false,"prefix":"","firstName":"Ricardo","middleName":"","lastName":"Araya","suffix":""}],"badges":[],"createdAt":"2025-07-02 20:08:08","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7032367/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7032367/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":88780629,"identity":"3bd99780-284a-4882-9bf2-e9825c6a144a","added_by":"auto","created_at":"2025-08-11 10:48:00","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":98569,"visible":true,"origin":"","legend":"\u003cp\u003eFlowchart\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-7032367/v1/f0bf95d083646850d7734ac7.png"},{"id":88783589,"identity":"af622e6b-ba27-4e73-a31b-ac8a8d8fa8a3","added_by":"auto","created_at":"2025-08-11 11:12:01","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1515662,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7032367/v1/b1bbae90-f147-4ed5-ba27-6282bbb9f557.pdf"},{"id":88781934,"identity":"a5093ef7-119f-4ed8-814c-3248a5431c18","added_by":"auto","created_at":"2025-08-11 10:56:00","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"supplement","size":31561,"visible":true,"origin":"","legend":"","description":"","filename":"Suppl1Descriptionofthegame.docx","url":"https://assets-eu.researchsquare.com/files/rs-7032367/v1/4eadc9dee84f89961cc29c12.docx"},{"id":88780633,"identity":"604d259d-2298-4b15-9b89-f03eb2a7730b","added_by":"auto","created_at":"2025-08-11 10:48:00","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"supplement","size":20080,"visible":true,"origin":"","legend":"","description":"","filename":"Suppl2Errorsdefinition.docx","url":"https://assets-eu.researchsquare.com/files/rs-7032367/v1/581a29cb592f82d33e6bf44f.docx"},{"id":88781937,"identity":"b697b420-b3f9-4784-81ea-19f120ba4c6b","added_by":"auto","created_at":"2025-08-11 10:56:00","extension":"docx","order_by":4,"title":"","display":"","copyAsset":false,"role":"supplement","size":35350,"visible":true,"origin":"","legend":"","description":"","filename":"CONSORT2025editablechecklist.docx","url":"https://assets-eu.researchsquare.com/files/rs-7032367/v1/e7c83e85bf1e842f1c903739.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Development, usability, and feasibility pilot cluster randomized controlled study of a videogame aiming to stimulate cognitive and non-cognitive skills among low-income preschoolers in Santiago, Chile","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eMental health disorders are among the leading causes of the Global Burden of Disease (1), and their relative importance is predicted to rise globally. Mental health problems are present at all ages. For instance, the prevalence of emotional and behavioral problems among preschool children is high. In a recent meta-analysis reporting data on N = 18,282 children (12\u0026ndash;83 months old) from eight countries, the pooled prevalence of mental disorders in general was 20.1%, 95% CI [15.7, 25.4]. The most common disorders were oppositional defiant disorder (4.9%, 95% CI [2.5, 9.5]) and attention-deficit hyperactivity disorder (4.3%, 95% CI [2.5, 7.2]). The prevalence of any anxiety disorders was 8.5%, 95% CI [5.2, 13.5], and of any depressive disorders was 1.1%, 95% CI [0.8, 1.6] (2). Another study reporting the prevalence of different mental disorders among children aged 3-5 years old, using several datasets of prevalence studies in the USA, found that the prevalence of ADHD was between 1.6 (1.1‒2.3) and 2.2 (1.8‒2.8); the prevalence of current behavioral or conduct problems was 3.8 (3.4\u0026ndash;4.4); the prevalence of current depression was 0.1 (0.1\u0026ndash;0.3), and anxiety was 1.6 (1.4\u0026ndash;2.0) (3).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe most important risk factors associated with mental health problems among preschoolers are poverty (3), reduced parental education (3), poor care and home stimulation (4), and family dysfunction (5). In a study with a sample of 391 preschoolers aged 3\u0026ndash;6 years using the Strength and Difficulties Questionnaire (SDQ), the bivariate analyses showed that parental mental health problems (MHPs), children\u0026rsquo;s difficult temperament, and parental low SES increased the likelihood of being classified as \u0026lsquo;borderline or abnormal\u0026rsquo; on the total difficulties score of the SDQ. In contrast, high perceived parental competence decreased the likelihood of preschool MHPs. In the multivariate analyses, only difficult child temperament remained significantly associated with preschool MHPs after controlling for other variables. In sum, individual, familial, and contextual factors are essential to explain the presence of mental disorders.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe ideal strategy to tackle this gap should be to prevent the onset of these conditions. Most adult mental disorders start in childhood or adolescence (6), and delaying or preventing the onset can have a substantial impact. There is evidence to suggest that strengthening cognitive and psychosocial skills might result in a reduced incidence of mental disorders. For instance, poor emotional regulation (7) or social problem-solving skills (8) have been associated with an increased incidence of depression.\u003c/p\u003e\n\u003cp\u003eEarly childhood is a critical time for psychosocial development. Until recently, cognitive skills, years of education, and IQ were the main measures to assess the relationship between human capital and economic development. More recently, researchers have acknowledged that skills such as maintaining good interpersonal relations, self-regulation, and demonstrating goal-directed behavior are critical to individual success and economic productivity. The Nobel prize economist, James Heckman, highlighted the importance of these skills, which he initially called them as non-cognitive skills, for economic development (9-13). Nonetheless, the distinction between cognitive and non-cognitive skills seems redundant, as there is a much overlap, as seen in emotional self-regulation, which is heavily influenced by cognitive processes (14). Several studies have examined the relationship between the capacity to regulate emotions and behaviors and social (15), health (16), educational (17), and labor (18) outcomes. Studies from neurobiology to behavioral economics demonstrate that emotions influence a person\u0026rsquo;s ability to self-regulate, and this, in turn, impacts cognitive abilities and subsequent self-regulatory capacity. Executive functions, involving the regulation and control of cognitive processes, are closely linked to skills leading to better problem solving, task persistence (19), self-esteem, school performance (20-24), and better social adjustment with a reduction in aggressive and other behavioral problems (25, 26). Healthy development of executive functions early in life predicts better self-regulatory capacity later in life (7). The growing scientific knowledge base on emotional self-regulation and social skills linked to brain development can be leveraged to inform new intervention approaches. There is significant evidence that structural and functional plasticity in many of the brain\u0026rsquo;s core centers involved in executive functions and self-regulatory processes develops rapidly during early childhood (27, 28). Most of the evidence to support the association between early acquired psychosocial skills and functional outcomes later in life comes from developed countries (11, 19, 29, 30). There is a need to replicate these findings in resource-poor settings. A concerted effort is needed to identify these key psychosocial skills that can be incorporated into interventions to improve the well-being of children globally.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eCognitive and non-cognitive skills targets\u003c/h2\u003e\n\u003cp\u003eImprovement in several cognitive and non-cognitive skills has been associated with better mental health and academic outcomes. Among these key functions, there is evidence supporting the importance of cognitive functions, such as working memory and inhibitory control, as well as non-cognitive functions, including emotion recognition and social competence.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWorking memory (WM) is understood as a limited-capacity system that temporarily stores and processes the information necessary to perform complex tasks in human cognition (31). WM undergoes significant development during early childhood, particularly between 3 and 5 years of age. This development progresses through a hierarchical sequence of abilities: first, the capacity to hold information over short delays emerges, followed by the ability to update representations based on new information, and finally, the ability to manipulate information to create new representations. Infants as young as 6 months old can maintain simple representations briefly, but updating abilities begin to emerge around 15 months, and manipulation skills develop around 24 months. During the preschool years, children exhibit significant improvements across these components, with older preschoolers (around 5 years old) performing better on complex tasks that require substitution and transformation compared to their younger peers. This progression reflects not only maturing memory processes but also the development of attentional control systems, which allow children to resist distractions and manage conflicting information more effectively as they grow older (32). WM capacity increases with age in preschoolers, and this development is crucial for cognitive tasks such as problem-solving and language comprehension (32). There is evidence that high performance in WM is a good predictor of future performance in reading (33) and mathematics (34)\u0026nbsp; \u0026nbsp;, and reduced mental health problems (35). For example, children with low scores on working memory tests showed a higher frequency of errors in activities that required remembering instructions (36). Working memory deficits seem to be a common cognitive liability for mental health disorders, and a specific liability for externalizing disorders (37). Working memory (WM) is a trainable cognitive function that can be enhanced through targeted interventions, even in young children. Various studies have demonstrated that both domain-general and domain-specific training programs can improve WM capacity. For instance, computerized games designed to exercise working memory skills have led to significant improvements in preschool and kindergarten children, with gains persisting for several weeks after the intervention (38). Additionally, large-scale randomized controlled trials have shown that simple motivational strategies, such as providing material incentives, can lead to measurable improvements in WM performance, suggesting that children\u0026apos;s WM capacity is responsive to both cognitive training and motivational factors (39). Moreover, training executive functions that include WM has also been shown to yield improvements not only in cognitive performance but also in related domains such as emotion regulation (40). These findings collectively underscore the plasticity of WM in early childhood and highlight the potential for interventions to support its development. Even though there is evidence that visuospatial working memory can be improved through training, these improvements may not last long (41).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eInhibitory control (IC), can be understood as the control exercised over the predominant or impulsive actions that people have, and that allows achieving desired goals (42). Inhibitory control, a core component of self-regulation involving the suppression of inappropriate or unwanted behaviors, begins to emerge as early as infancy, with 8-month-old infants demonstrating rudimentary abilities to inhibit actions when prompted. However, the most rapid and substantial development of inhibitory control occurs during the preschool years, particularly between ages 2.5 and 6.5. Longitudinal studies indicate a marked improvement in inhibitory control during this period, with growth being most pronounced between 3 and 5 years, followed by a decelerating increase as children approach school age. This developmental trajectory reflects not only the maturation of brain structures involved in self-regulation but also the influence of environmental factors such as parenting (43). Specifically, higher parental sensitivity is associated with higher initial levels of inhibitory control, while parental intrusiveness tends to slow its development over time (44). These findings highlight the dynamic interplay between biological maturation and caregiving in shaping children\u0026apos;s emerging ability to regulate their behavior (44). Poor inhibitory control in children is associated with externalizing behaviors such as aggression, hyperactivity, and impulsivity, which can lead to long-term consequences in adulthood, including addictive behavior (45). And high levels of inhibitory control in children with high negative emotionality can increase the risk of internalizing behaviors like anxiety and social withdrawal (46-48). The latter suggests that while inhibitory control is generally beneficial, excessive control in certain temperamental contexts can be maladaptive. Additionally, IC is crucial for academic success. Children with better inhibitory control tend to perform better academically, particularly in language and mathematics (49-51). There is evidence that IC is trainable (52) and that its development positively impacts future academic skills. For example, among kindergarten children IC contributed to phonemic awareness and decoding, regardless of the level of general intelligence presented (53, 54), which aligns with results found by Yoshikawa et al. (2008). Similarly, McClelland et al. (2007) observed that IC was directly related to emergent literacy skills and vocabulary in preschool children (55).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eEmotion recognition (ER) is the ability to recognize and interpret others\u0026rsquo; emotions, and it is an important skill for the development of socioemotional competence (56), which continues to improve over time. Children as young as 3 years old can recognize happy, fearful, and angry expressions, although they often confuse fear and anger (57). By age 3, children can recognize sadness from bodily expressions, with fear recognized around 4-5 years, and anger between 6-8 years (58). Children aged 3 to 5 years show significant development in recognizing happiness, anger, surprise, sadness, and fear, with older children (5 years) performing better than younger ones (3 years)(59). Children aged 6, 8, and 10 show increasing accuracy and faster reaction times in recognizing happiness, anger, and sadness, with older children performing better (60). \u0026nbsp;There is evidence that poor emotion recognition has been associated with problematic outcomes such as poor social functioning, attention problems in school, poor academic performance and mental health symptoms (61-64). Additionally, based on the findings of Lafay et al. (2023), emotional recognition in preschool and kindergarten children is indeed a trainable skill. The study implemented an innovative emotion training program with children aged 3 to 6 years, focusing on the identification, understanding, and expression of primary emotions. The results demonstrated that children who received the training showed significantly greater improvements in emotional abilities compared to those who did not receive the intervention, particularly among younger children (3- and 4-year-olds) (65).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eSocial competence (SC) is the ability to interact effectively with others and navigate personal and social conflicts (66). It usually includes all social, emotional, and cognitive knowledge and skills children need to be effective in their interactions with others (67). These skills follow different developmental sequences (e.g. self-regulation, empathy, prosocial behavior, among others). For example, during the first years of life, important precursors of social competence are the development of social attention (68) and joint intentionality (69, 70) in social play. As children grow older, more general expressions of prosocial behavior, such as helping, comforting, informing, and sharing, begin to emerge (71). However, as children get older, prosocial behaviors become more selective (72). At preschool age, situational factors, as well as characteristics of the recipient, start influencing children\u0026rsquo;s tendency to behave prosocially (73, 74). In addition, peer interactions become increasingly important in the preschool age and serve a socialization function in the development of children\u0026acute;s social competence (75). \u0026nbsp; Children with poor social competence are often rejected by their peers, suffer low self-esteem (76) and they show a higher risk of problematic behavior patterns as they grow older (77). Based on the findings of Bermejo-Martins et al. (2019), social competence in preschool children appears to be a trainable skill, particularly when integrated into structured educational interventions. The CRECES program, a health education initiative grounded in social and emotional learning, was implemented in a randomized controlled trial with children aged 5 to 6. Qualitative data from interviews with parents suggested improvements in their children\u0026apos;s social behavior and emotional regulation. Furthermore, the intervention significantly enhanced emotional perception and resilience over time (78). Another study evaluated an adapted PATHS curriculum for preschoolers in Head Start through a randomized trial in 20 classrooms. Over nine months, teachers in the intervention groups delivered weekly lessons. Compared to controls, children in the program showed better emotion knowledge, greater social competence, and less social withdrawal (79).\u003c/p\u003e\n\u003cp\u003eTraditionally, cognitive and non-cognitive skills, such as those reviewed above have been taught through face-to-face interactions in classroom settings. However, advances in technology now offer new opportunities to support these developmental domains through tablet-based interventions. These digital tools can complement traditional methods by providing engaging, personalized, and scalable learning experiences, particularly in early childhood education.\u003c/p\u003e\n\u003ch2\u003eDigital technology means among preschoolers\u003c/h2\u003e\n\u003cp\u003eResearch on the use of computers and tablets among preschool students has been conducted mainly for educational purposes, and just in recent years. A recent study in seven European countries found that, when children of this age are offered to use different technological devices, they prefer tablets, apparently based on the size of the screen, its portability, and ease of use thanks to their touchscreen technology (80). Tablets are used for gaming and watching cartoons, but also to draw, take photos, and communicate with others using FaceTime or videoconferencing (80). Another independent study in the United Kingdom found similar results (81). Tablets have been used with preschoolers mainly for educational purposes and have been well-received by kids. Its use can be independent, but most of the time, with the assistance of either teachers or parents. It has been found that when tablet use is well-planned, it stimulates children\u0026apos;s motivation and concentration (82). Tablets also offer an excellent opportunity for collaboration and independent learning. When asked about their experience using tablets in school settings, early education teachers value the opportunities to deliver the curriculum in new ways (82). In other studies, tablets have helped children to develop emerging literacies, social relationships, and a sense of belonging to the center (83). Nonetheless, much of the impact of using tables for training executive functions and social and emotional learning remains to be learned, especially with certain sub-groups such as low-income kids.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eHowever, it is important to consider that parents\u0026apos; and teachers\u0026apos; experiences and values seem to shape how children use the tablets at home and in schools (84). \u0026nbsp; Therefore, training on the use and possibilities of these devices is necessary to build confidence and engagement among practitioners, factors that appear to be crucial when implementing a new tool in school settings (82).\u003c/p\u003e\n\u003cp\u003eDigital technologies may have a role in developing children\u0026apos;s identity as effective learners through \u0026quot;figured worlds\u0026quot; (82). There are already some recommendations for the features that apps should have in order to promote learning and creativity (81). For example, they should foster real-world problems, story apps may promote independent reading through highlighting words as the narrator says them and enhance comprehension by asking questions; having regular opportunities for feedback through the app and final feedback at the end of the activity (81).\u003c/p\u003e\n\u003cp\u003eSome people are concerned with excessive exposure to screens, but research highlights that not all screen time is equal. When used thoughtfully, technology can support early learning and development. In fact, there have been recommendations on high-quality educational apps and games for preschoolers, such as those that promote language development, emotional understanding, and problem-solving skills through interactive and age-appropriate content. These tools, when integrated with adult guidance and used in moderation, can enhance traditional learning approaches and contribute positively to young children\u0026rsquo;s cognitive and social-emotional growth.\u003c/p\u003e\n\u003ch2\u003eAims\u003c/h2\u003e\n\u003cp\u003eThe objectives of this research are: 1) To develop a video game prototype to be used on tablets by pre-kindergarten students from socio-economically vulnerable schools, which allows stimulating working memory, inhibitory control, emotion recognition, and social competence skills in such a way as to prevent the development of behavioral problems and general psychological distress; 2) \u0026nbsp;To carry out a pilot cluster Randomized Controlled Trial to evaluate several aspects of functionality of this video game, student engagement and behavior, classroom climate, the feasibility of the implementation of the study and to explore the impact of the video game on the development of cognitive and non-cognitive skills.\u0026nbsp;\u003c/p\u003e"},{"header":"METHODS","content":"\u003ch2\u003eStudy design, participants, and settings\u003c/h2\u003e\n\u003cp\u003eThis was a cluster Randomized Controlled Trial, performing baseline and after-intervention assessments. The study was conducted during the academic year 2018 (March to December). The baseline assessment took place in May to June. The intervention was implemented between July and October. The after-intervention assessment took place between November and December.\u003c/p\u003e\n\u003ch3\u003eInclusion criteria for schools\u003c/h3\u003e\n\u003col\u003e\n \u003cli\u003eSchools located in Santiago (Chile).\u003c/li\u003e\n \u003cli\u003eSchools with Preschool Education.\u003c/li\u003e\n \u003cli\u003eMixed-sex schools.\u003c/li\u003e\n \u003cli\u003eSchools with high vulnerability (\u0026ge;\u0026thinsp;75%), as stated in the School Vulnerability Index \u0026ndash; National System of Equality Allocation (IVE-SINAE). This index is the proportion of high-vulnerability students in a given school, considering socioeconomic variables such as the mother\u0026rsquo;s educational level, the father\u0026rsquo;s educational level, and total monthly household income, among others (85).\u003c/li\u003e\n\u003c/ol\u003e\n\u003ch3\u003eExclusion criteria for schools\u003c/h3\u003e\n\u003col\u003e\n \u003cli\u003eFour or more classes in Preschool. This criterion was considered for economic and practical reasons.\u003c/li\u003e\n \u003cli\u003eImplementing a manualized program to promote cognitive or social-emotional skills.\u003c/li\u003e\n \u003cli\u003eParticipating in a similar study.\u003c/li\u003e\n\u003c/ol\u003e\n\u003ch3\u003eInclusion criteria for students\u003c/h3\u003e\n\u003col\u003e\n \u003cli\u003eChildren attending pre-kindergarten (aged around 4 years old).\u003c/li\u003e\n\u003c/ol\u003e\n\u003ch3\u003eExclusion criteria for students\u003c/h3\u003e\n\u003col start=\"2\"\u003e\n \u003cli\u003eChildren with intellectual disability.\u003c/li\u003e\n \u003cli\u003eChildren unable to understand and speak Spanish.\u003c/li\u003e\n\u003c/ol\u003e\n\u003ch2\u003eSample size\u003c/h2\u003e\n\u003cp\u003eIt has been suggested that n = 30 is an acceptable size for a pilot study (86). Others have indicated at least n = 12 subjects per group, equivalent to n = 24 for a traditional two-group study (87) or other estimates (88). However, if we want to estimate the main study\u0026acute;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) (89). In the current pilot study, we expected to invite at least 20 children from each of the eight participating schools. This resulted in 80 children in each of the two arms, totaling 160 children in the study. Four schools per group could result in higher variability in the experience with the intervention.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eRecruitment\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eTo recruit schools for the present study, we implemented the strategy of First Come, First Served (FCFS), which implies that schools were invited till the sample size was completed because of the exploratory nature of the project and limited resources. In the registry of schools in Santiago provided by the Ministry of Education, 352 were eligible. We invited 31 schools from our dataset to participate in this study, and eight accepted. All schools shared a similar socioeconomic background of high vulnerability. One of the schools that refused to participate did want to conduct the intervention but objected to the randomization procedure. Other 20 schools did not want to participate because they could not include the activities associated with the research in their academic calendar. The Principal of the other two refused to participate without reason.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Principal of each participating school signed an authorization to conduct the study. Later, an informed and written consent form was sent to the parents or main caregivers for signature. The authorization by the Principal and consent by parents/caregivers were signed before the randomization and allocation procedure.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eRandomization\u003c/h2\u003e\n\u003cp\u003eThe randomization was performed at the school level, taking into account the nature of the sample (students nested into schools). We randomized the schools into two groups (control and intervention) in 1:1 ratio. An independent statistician used the command \u0026ldquo;RAND\u0026rdquo; in an Excel program to generate random numbers assigned to anonymized schools. After running the command, the schools were sorted from the lowest to the highest random number, and using a pre-stated protocol, the first half of the schools were allocated to the Intervention Group and (IG) the second half to the Control Group (CG). See Figure 1, Flowchart. Finally, a research assistant informed the schools of the allocation within the study.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eBlinding\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eDue to the nature of the intervention, children, Educators and parents knew the allocation of the school. However, for the secondary outcomes, the team of evaluators were blinded to the groups and the schools and students were assigned to. The design is open label with only outcome assessors and data analysts being blinded, so unblinding did not occur.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eIntervention\u003c/h2\u003e\n\u003ch3\u003ePrototype design and development\u003c/h3\u003e\n\u003cp\u003eWe hired a software company dedicated to developing video games (Octetostudios.com). They had experience developing applications for the target age group (pre-kindergarten). The authors (JG and CR) provided the knowledge related to the development of cognitive and non-cognitive skills of pre-kindergarten children and suggested scripts for the activities and their level of difficulty. Based on the literature review and the evidence presented in the Introduction, four skills (working memory, inhibitory control, emotion recognition, and social competence) were selected to be stimulated during the video game. These skills were selected after an extensive review of basic psychosocial skills that, when learned in early life, have a demonstrable impact later in life (90-93). The research team has already developed and tested a working memory game among socio-economically deprived preschoolers in Chile,\u0026nbsp;where children received sixteen 30-minute sessions to stimulate working memory, resulting in significant improvements in working memory and language skills compared with those in the control group who received a similar number of sessions playing a neutral game(23). One lesson from this experience was to adopt a more comprehensive approach, covering multiple skills simultaneously.\u003c/p\u003e\n\u003cp\u003eWhen the first version of the video game was complete, we tested the children\u0026apos;s understanding of the instructions by reading them to a small group of 4- to 6-year-old children (n=3). Following this experience, the instructions were revised to be shorter and simpler, aiming to achieve a better understanding. Then, we tested the sessions with undergraduate psychology major students to detect errors in the flow and progress between activities. We also tested the synchronicity between the instructions and the activities. At the same time, the scripts were reviewed for each session to detect inconsistencies between the scripts and the images presented in the video game. Two independent research assistants reviewed each session, and any errors regarding the scripts, images, or drawings, as well as the functioning of each activity, were recorded and then discussed in weekly research group meetings. After each meeting, a list of corrections was created and sent to the software company to make the amendments. This process lasted between August 2017 and December 2017. In 2018, we started preparing the pilot study. In the first semester of 2018, two research assistants (one Psychologist and one Early Educator) used, explored, and reviewed all sessions and activities of the video game, and new corrections were presented to the software company to get the video game ready for the pilot study. This first iteration of the video game was called \u0026ldquo;Japi\u0026rdquo;. This work provided information about the strengths of the video game. Among the strengths:\u003c/p\u003e\n\u003col start=\"1\" type=\"1\"\u003e\n \u003cli\u003eThe video game begins with a login page, where the early educator can introduce the students\u0026apos; identification, making the gaming experience completely individualized. The actions conducted by the students in the game can be followed.\u003c/li\u003e\n \u003cli\u003eAt the beginning of the game, students can create their avatar using the physical features they choose. This avatar will be part of all activities in the various sessions, allowing students to feel that they have contributed to creating part of the game.\u003c/li\u003e\n \u003cli\u003eThe scenarios, situations, and characters presented in the video game are familiar to preschoolers.\u003c/li\u003e\n \u003cli\u003eThe elements presented in each activity are pertinent and adequate for preschoolers\u0026apos; age and day-to-day experience.\u003c/li\u003e\n \u003cli\u003eEach session and its activities were separated from one another, allowing students to distinguish when they were transitioning from one session to the next. This was also important to create the sensation of advancing in the game.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003e\u003cem\u003eImplementation of Japi\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe children in the intervention group played the videogame \u0026ldquo;Japi 1.0\u0026rdquo; using a tablet device with headphones at a designated time set by school authorities. Early Year Educators were present to assist with the discipline and motivation of the students, and two trained Research Assistants were in the classroom to provide technical support for using the equipment. One of the authors (JG) supervised the video game implementation.\u003c/p\u003e\n\u003cp\u003eThe intervention consisted of ten sessions, with two 30-minute sessions delivered each week for 6 weeks. Sessions numbers 1 to 5 were focused on emotional recognition and inhibitory control. Sessions numbers 6 to 10 worked on working memory and social competence. Each session consisted of eight activities, each with five tasks, and the tasks increased in difficulty level. The audio instructions were recorded using professional actors and inserted into the sessions. For more details of each session, see Suppl. 1.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eControl\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe control group received standard school curricula. The Ministry of Education provides the standard curriculum as a guideline called \u0026ldquo;Curricular Bases for Kindergarten Education\u0026rdquo; (94), which includes pre-kindergarten directions to Early Year Educators regarding emotion regulation and planning strategies to implement in class.\u003c/p\u003e\n\u003ch2\u003eMeasures\u003c/h2\u003e\n\u003ch2\u003ePrimary outcomes\u003c/h2\u003e\n\u003ch3\u003eFunctionality, student behavior, and classroom climate\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003eA research assistant registered all issues regarding the video game functionality and individual and collective behaviors during playing in a pre-built observation sheet. The measurement of these problems included quantitative and qualitative descriptions.\u003c/p\u003e\n\u003cp\u003eRegarding the video game functionality, we registered if the video game had problems with the advance in the tasks and activities. These problems were categorized as mechanical (e.g., stuck or frozen screen; wrong reward stimulus after students\u0026acute; correct responses; non-responsive screen during plays). Additionally, we registered any problem with the server functionality (e.g., the number of students whose data from video game play was not recorded in the server). A detailed definition of all errors detected before and during the implementation of the intervention in the pilot study is presented in Suppl. 2.\u003c/p\u003e\n\u003cp\u003eRegarding the student behavior and classroom climate, we assessed student engagement (e.g., students became bored and frustrated during the play session and quit playing), behavioral problems (e.g., students hitting the table or other students, tantrums, students using the tablets for other purposes such as taking selfies); and general classroom climate (e.g., school early teacher\u0026acute;s engagement, students respect for other).\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eFeasibility recruitment and implementation\u003c/h3\u003e\n\u003cp\u003eThe number of eligible schools, those contacted, and those who agreed to participate; the number of parents/caregivers and students who were contacted and those who consented and agreed to participate; and the number of participants\u0026apos; losses. Additionally, data was collected on the time needed to complete the intervention, time invested in baseline and after-intervention measurements, and participants\u0026rsquo; losses. Finally, we will collect student attendance data by session to play with Japi 1.0.\u003c/p\u003e\n\u003ch2\u003eSecondary outcomes\u0026nbsp;\u003c/h2\u003e\n\u003cp\u003eWe used several validated instruments to evaluate cognitive (working memory, inhibitory control) and non-cognitive skills (emotion recognition and social competence) among preschool children. When needed, we obtained the author\u0026acute;s permission and changed the instruments\u0026apos; administration format from paper-and-pencil to tablet format. These tablet-based measures helped to standardize the administration by different trained research assistants and reduce the time of each instrument, reducing the boredom of children. The administration was in-person and took 30-45 minutes with breaks between tests.\u003c/p\u003e\n\u003ch3\u003eWorking Memory\u003c/h3\u003e\n\u003cp\u003e1) Corsi Cubes Test (95). 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 simple but becomes more complex until the subject\u0026apos;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) (95). Pre-kindergarteners take around 7 minutes to complete this test. The higher the score, the better the skill.\u003c/p\u003e\n\u003cp\u003e2) Woodcock- Mu\u0026ntilde;oz Auditive Working Memory test (96). A sequence of audio messages of words and numbers 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 (96). \u0026nbsp; Pre-kindergarteners take around 5 minutes to complete this test. The higher the score, the better the skill.\u003c/p\u003e\n\u003ch3\u003eInhibitory control\u003c/h3\u003e\n\u003cp\u003eHearts and Flowers task (97), a hybrid combining Simon and spatial Stroop task elements. 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, the child 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. Depending on the stimulus that appears, the individual must follow two rules simultaneously, forming a mixed block (98). It requires working memory and inhibitory control. Pre-kindergarteners take around 10 minutes to complete this test. The higher the score, the better the skill.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eEmotion recognition\u003c/em\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eWe used the Assessment of Children\u0026rsquo;s Emotions Skills (ACES) (99). 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 basic emotions (happy, sad, angry, and scared). Ten of these images present children without obvious facial expressions (100, 101). The examiner shows the child the photographs one at a time and each time asks, \u0026ldquo;Is the child in the picture happy, sad, angry, or scared?\u0026rdquo; Then, the examiner registers the child\u0026rsquo;s answer. The emotion accuracy score reflects how many items the children answer correctly (16 points is the perfect score). The higher the score, the better the skill. Additionally, there is an anger bias score, which is the number of times the children incorrectly identify the faces as displaying anger. The higher the score, the higher the anger bias (79). Recently, it has shown acceptable psychometric characteristics with reliability among 6-year-old children with Cronbach\u0026rsquo;s \u0026alpha; 0.64 (102). Pre-kindergarteners take around 10 minutes to complete this test.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSocial competence\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eWe used the Challenging Situations Task (CST) (103). 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 emotions are presented in random order. The child is asked to point to the picture that best describes their feelings when [this situation] happens. Then, four pictures of behavioral responses (prosocial, aggressive, crying or dysregulated, and avoidant) are presented in random order, and the child is asked, \u0026ldquo;What do you do [in this situation]?\u0026rdquo; The answers are categorized into four possibilities: prosocial, aggressive, dysregulated, and avoidant. Scores for affective and behavioral responses used are the number of times each affect, and each behavioral response is chosen by each child across the six situations. The higher the prosocial behavioral response score, the better the skill. It has shown acceptable psychometric characteristics of internal consistency with mean inter-item correlations among 4-year-old children \u0026ge; 0.29 (104). Pre-kindergarteners take around 10 minutes to complete this test.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eBehavioral problems and psychological assessment\u003c/em\u003e.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Strengths and Difficulties Questionnaire (SDQ) (105) is widely used in Chile (106, 107). This 25-question questionnaire explores different symptoms grouped into five sub-scales (with five items each): (1) emotional symptoms, (2) behavioral problems, (3) problems with peers, (4) inattention and hyperactivity, and (5) prosocial skills. The first four sub-scales refer to children\u0026apos;s difficulties and may be grouped into a general sub-scale of difficulties (20 items). The sub-scale of prosocial skills refers to positive and adaptive behaviors in 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). It has been widely used (108) and has shown good psychometric characteristics for the difficulties and prosocial sub-scales, with Cronbach\u0026rsquo;s \u0026alpha; 0.84 and 0.73, respectively (109). \u0026nbsp; The research team received permission to use this instrument in all versions from Youth in Mind (https://www.sdqinfo.org) for the validation study (110). The Parents\u0026rsquo; version of this instrument was used.\u003c/p\u003e\n\u003ch2\u003eData analysis\u003c/h2\u003e\n\u003cp\u003eFirstly, we used descriptive statistics to assess balance across arms at baseline for demographic and secondary outcomes (see Table 1). We registered the frequencies and descriptions of the functionality of the video game, student engagement, and classroom climate. Additionally, we present the descriptive statistics of the recruitment process (e.g., the number of students consented and assessed) as indicators of the implementation of the video game, such as the number of\u0026nbsp;sessions attended by students and the degree of attendance of students by sessions.\u003c/p\u003e\n\u003cp\u003eThe primary between-group analysis for the efficacy of the intervention was carried out on an intention-to-treat basis for post-intervention assessment of all secondary outcomes. A maximum likelihood restricted random effects mixed regression (REML) was used to compare the intervention and control groups regarding the change in outcome measures from baseline to post-intervention. We included age, sex, and the baseline score in each model. We conducted a complete data analysis, and no imputation was performed for missing data. All statistical analyses were conducted in Stata using STATA v.17.0 (111).\u003c/p\u003e"},{"header":"RESULTS","content":"\u003ch2\u003eSample description\u003c/h2\u003e\n\u003cp\u003eEight schools were randomly allocated to Intervention (Students enrollment =196) and Control group (Students enrollment =199)\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003ePrimary outcomes\u003c/h2\u003e\n\u003ch3\u003eFunctionality, student behavior, and classroom climate\u0026nbsp;\u003c/h3\u003e\n\u003cp\u003eOnce the video game was developed by the Software company and before the implementation in the schools, the research team tested the functionality of the game and three main problems: audio volume variations (37% of the errors), abrupt change of the activity (24% of the errors) and game freezing. We provided this feedback to the company, and they were fixed. The newer version of the game was then implemented in the schools of the intervention group. Even though the number of errors was reduced (from 54 to 48), there was more variation in the types of errors. The most frequent error was when the game was freezing, and students could not continue working in sessions two and three. The second most frequent error was when correct answers were registered as incorrect in sessions 5, 6 , 8 , 9 and 10. This error was not present before. See Table 2 and 3.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eDuring the implementation of the game with the students, we lost data for 26.6% of students, considering the total number of opportunities for playing all sessions. This data was not registered in the server and was present, especially for sessions 1-5 and 9. See Table 4.\u003c/p\u003e\n\u003cp\u003eRegarding the student\u0026rsquo;s engagement, some students lost interest in playing the game, especially in sessions 3, 4, and 10. See Table 5. The primary registered reasons were: there were problems with the game where some parts of it froze, causing frustration in the students and loss of interest, and the number and difficulty of activities related to inhibitory control were considered excessive by the students, causing frustration and less motivation to continue playing.\u003c/p\u003e\n\u003cp\u003eThere were very few disruptive behavioral problems (six in total) involving a reduced number of students (5 in total). For example, in session 10, after 20 minutes of playing the game, one girl got up from her seat and walked over to one of her classmates, with whom she started fighting and hitting each other. The Early Year Teacher managed this situation, and the children calmed down. However, this event distracted the rest of the classmates, which caused many students to start saying they were bored and ask for the tablet to be taken away. See Table 6.\u003c/p\u003e\n\u003cp\u003eThe classroom climate during the implementation of the video game was generally conducive to the adaptation of the children to the activity. At the beginning of each session, students were engaged and attentive, facilitating the introduction of materials and reinforcing commitments regarding their proper use. Early-year teachers played an active role in managing the group at this stage, helping to capture attention and reinforce routines. This was especially helpful in the first five sessions. See Table 7.\u003c/p\u003e\n\u003cp\u003eHowever, as the sessions progressed, challenges emerged. Around the 15-20 minute mark, students began showing signs of boredom and frustration, leading to disengagement. Some children stopped playing, verbally expressed their disinterest, or began using the tablets for unrelated activities. This disengagement often spread through imitation, making group management more complex.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe Early-year teachers, while initially supportive, tended to adopt a passive role during gameplay, offering minimal assistance when children encountered difficulties. However, they remained active in specific moments, such as modeling breathing techniques and assisting with material collection at the end of the session.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eStrategies such as timed challenges were introduced to address motivational challenges, which positively affected maintaining engagement. Additionally, some activities, like identifying animal sounds, presented cognitive difficulties that required individualized support. Despite these challenges, children showed increased engagement in later sessions and played for longer periods, indicating a gradual adaptation to the game.\u0026nbsp;\u003c/p\u003e\n\u003ch3\u003eFeasibility recruitment and implementation\u003c/h3\u003e\n\u003cp\u003eRegarding the recruitment, we started with four schools and with a similar number of students enrolled in each group (IG: n=196; CG: n=199). A similar number of parents did not consent in each group, but in the IG, more students withdrew from schools (n=31 vs n=9), which was unrelated to the participation in the study. The baseline assessment was conducted in 97.8% of consented students in the IG and 92.2% in the CG. The Post-intervention assessment was conducted in 94.1% of consented students in the IG and 88.6% in the CG.\u003c/p\u003e\n\u003cp\u003eThe attendance of children to sessions was high, with over 70% of consented children in all sessions and over 80% in five sessions. See Table 8.\u0026nbsp;\u003c/p\u003e\n\u003ch2\u003eSecondary outcomes\u003c/h2\u003e\n\u003cp\u003eThe exploratory analysis of secondary outcomes assessing the efficacy of the intervention revealed minimal differences between the intervention and control groups across various psychological and cognitive domains. At follow-up (T1), both groups showed similar scores in general psychological functioning, with the SDQ Difficulties and Prosocial subscales demonstrating no statistically significant differences (p = 0.748 and p = 0.812, respectively). Emotion recognition, measured by the ACES, showed a slight improvement in the intervention group (mean = 12.04) compared to the control (mean = 11.93), though this was not significant (p = 0.520). Measures of social problem-solving skills (CST), visual and auditory working memory (Corsi\u0026rsquo;s cubes), and executive function (Heart \u0026amp; Flowers task) also showed no significant group differences. See Table 9.\u003c/p\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis pilot study evaluated the development, usability, and feasibility of Japi 1.0, a tablet-based video game designed to stimulate cognitive and socio-emotional skills in preschool-aged children from low-income backgrounds. While the intervention was feasible and well-accepted initially, several development and technical issues likely limited its full potential.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eDevelopment and Technical Challenges\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe implementation process revealed key technical challenges, including game freezing, misclassification of correct responses, and substantial data loss (26.6%) during early and middle sessions. These problems were especially disruptive in tasks requiring sustained attention and inhibitory control\u0026mdash;core functions the intervention aimed to train. Similar issues have been documented in early-stage digital learning interventions. For example, Alloway et al. (2013) reported that technological inconsistencies undermined engagement and classroom integration in computerized cognitive training for young students (24). Likewise, Ramani et al. (2020) noted that interruptions and usability problems in digital memory games disrupted task fidelity and minimized learning gains (38).\u003c/p\u003e\n\u003cp\u003eAlthough the development team addressed some issues before school deployment, others persisted or emerged during real-world use. These technical flaws likely disrupted the intended training dosage and progression, decreasing both the cognitive intensity and emotional rewards of the experience. According to Domitrovich et al. (2007), successful early interventions require consistent delivery and minimal distractions to be effective (79).\u0026nbsp;This underscores the importance of robust usability testing prior to scaling.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSecondary Outcomes: Cognitive and Non-Cognitive Skills\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe exploratory analysis of secondary outcomes found no statistically significant differences between the intervention and control groups across cognitive (working memory, inhibitory control) and non-cognitive domains (emotion recognition, social competence, and prosocial behaviors). These findings are not unusual in pilot studies with brief interventions. For example, Roberts et al. (2016) showed that cognitive improvements from working memory training in preschoolers diminished over time and did not translate into broader academic outcomes (112).\u003c/p\u003e\n\u003cp\u003eMoreover, digital-only interventions may not be sufficient to improve complex social-emotional skills without adult facilitation. In our study, teachers\u0026rsquo; initial involvement in supporting gameplay decreased over time. Xie et al. (2021) emphasized that cognitive training in preschoolers benefits most when coupled with emotional scaffolding and adult feedback (40). \u0026nbsp;Similarly, PATHS (79) and CRECES (78) programs demonstrated stronger effects when teachers actively reinforced skills beyond structured activities.\u003c/p\u003e\n\u003cp\u003eIn our context, motivational dips were reported mid-intervention, especially during more difficult sessions, and teacher engagement waned. These patterns likely reduced the \u0026ldquo;active ingredient\u0026rdquo; exposure necessary to drive measurable behavioral or emotional gains.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eStrengths of this pilot study\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study presents several important strengths. First, it is one of the few digital interventions for early childhood education conducted in a Latin American low-resource setting, addressing a significant gap in the literature. Second, the study followed a rigorous cluster-randomized controlled design with high recruitment and retention rates, providing reliable data for feasibility and process evaluation. Third, the integration of standardized and developmentally appropriate measures for both cognitive and non-cognitive domains ensured robust assessment of key child outcomes. Finally, the high levels of early student engagement and successful coordination with school stakeholders underscore the acceptability of digital tools in public preschool settings.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eLimitations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eSeveral limitations must be acknowledged. First, technical problems\u0026mdash;especially data loss and gameplay disruptions\u0026mdash;compromised fidelity and dosage, potentially obscuring intervention effects. Second, classroom dynamics shifted over time, with decreasing adult engagement and increased child frustration in later sessions. Third, the outcome assessments may have lacked sensitivity to detect small improvements within a short follow-up period. Fourth, the sample size, though adequate for feasibility, limited statistical power to detect modest effects. Lastly, the intervention\u0026rsquo;s duration may have been too brief to influence developmental outcomes that typically require sustained exposure, especially in socioeconomically vulnerable populations.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eIn conclusion, this pilot study demonstrates the feasibility and acceptability of implementing a digital intervention in low-income preschool settings in Chile. While technical challenges and implementation variability limited its short-term impact on cognitive and socio-emotional outcomes, the positive engagement from students and schools highlights its promise. These findings offer important insights to refine the intervention and its delivery. Future trials should address technical reliability, improve adult facilitation strategies, and extend the intervention duration to strengthen its potential effectiveness. Digital tools like Japi 1.0 represent a scalable and innovative opportunity to support early child development in under-resourced contexts when carefully designed and supported.\u003c/p\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthics approval and consent to participate.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eAll evaluation data were collected in accordance with the Declaration of Helsinki, which was approved by the Research Ethics Committee of the Universidad de los Andes (Ref. 2018\u0026ndash;019). Informed written consent was obtained from all participating children\u0026rsquo;s parents or guardians before the study began. School principals provided institutional authorization for the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConsent for publication.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAvailability of data and materials.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe datasets generated and/or analyzed during the current study are not publicly available due to institutional data protection policies but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eCompeting interests.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;This work was supported by the Universidad de los Andes Research Fund Ner UAN 201701, and additional support was provided by ANID Millennium Science Initiative Program (Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Imhay, NCS2021_081). The funding sources had no role in the design, analysis, or interpretation of the data or in writing the manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthors\u0026rsquo; contributions.\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eJG, CRB and RA conceptualized the study and led the project. NR coordinated data collection and conducted initial analyses. JG and CRB contributed to the design of cognitive assessments. SR oversaw classroom implementation. RA advised on study design and analysis. All authors contributed to writing and approved the final manuscript.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements.\u003c/strong\u003e\u003cbr\u003e\u0026nbsp;We thank the schools, teachers, children, and their families for their generous participation. We also acknowledge the technical support provided by the game development team and the research assistants for their invaluable work in the field.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eCooper C. Global, regional, and national incidence, prevalence, and years lived with disability for 354 diseases and injuries for 195 countries and territories, 1990-2017: a \u0026hellip;. Lancet. 2018.\u003c/li\u003e\n\u003cli\u003eVasileva M, Graf RK, Reinelt T, Petermann U, Petermann F. Research review: A meta-analysis of the international prevalence and comorbidity of mental disorders in children between 1 and 7 years. J Child Psychol Psychiatry. 2021;62(4):372-81.\u003c/li\u003e\n\u003cli\u003eBitsko RH, Claussen AH, Lichstein J, Black LI, Jones SE, Danielson ML, et al. Mental Health Surveillance Among Children - United States, 2013-2019. MMWR Suppl. 2022;71(2):1-42.\u003c/li\u003e\n\u003cli\u003eGrantham-McGregor S, Cheung YB, Cueto S, Glewwe P, Richter L, Strupp B. Developmental potential in the first 5 years for children in developing countries. The Lancet. 2007;369(9555):60-70.\u003c/li\u003e\n\u003cli\u003eMathiesen KS, Prior M. The impact of temperament factors and family functioning on resilience processes from infancy to school age. European Journal of Developmental Psychology. 2006;3(4):357-87.\u003c/li\u003e\n\u003cli\u003eJones PB. Adult mental health disorders and their age at onset. British Journal of Psychiatry. 2013;202(SUPPL. 54):s5-s10.\u003c/li\u003e\n\u003cli\u003eBould H, Araya R, Pearson RM, Stapinski L, Carnegie R, Joinson C. Association between early temperament and depression at 18 years. Depress Anxiety. 2014;31(9):729-36.\u003c/li\u003e\n\u003cli\u003eGarber J. Depression in children and adolescents: linking risk research and prevention. Am J Prev Med. 2006;31(6 Suppl 1):S104-25.\u003c/li\u003e\n\u003cli\u003eConti G, Heckman JJ. The developmental approach to child and adult health. Pediatrics. 2013;131 Suppl 2:S133-41.\u003c/li\u003e\n\u003cli\u003eHeckman JJ, Raut LK. Intergenerational Long-Term Effects of Preschool - Structural Estimates from a Discrete Dynamic Programming Model. J Econom. 2016;191(1):164-75.\u003c/li\u003e\n\u003cli\u003eCampbell 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.\u003c/li\u003e\n\u003cli\u003eDoyle O, Harmon CP, Heckman JJ, Tremblay RE. Investing in early human development: timing and economic efficiency. Econ Hum Biol. 2009;7(1):1-6.\u003c/li\u003e\n\u003cli\u003eGertler 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.\u003c/li\u003e\n\u003cli\u003eScorza P, Araya R, Wuermli AJ, Betancourt TS. Towards Clarity in Research on \u0026ldquo;Non-Cognitive\u0026rdquo; Skills: Linking Executive Functions, Self-Regulation, and Economic Development to Advance Life Outcomes for Children, Adolescents and Youth Globally. Human Development. 2016;58(6):313-7.\u003c/li\u003e\n\u003cli\u003eOnchwari G, Keengwe J. Examining the Relationship of Children\u0026apos;s Behavior to Emotion Regulation Ability. Early Childhood Education Journal. 2011;39(4):279-84.\u003c/li\u003e\n\u003cli\u003eKarademas EC, Tsalikou C, Tallarou MC. The impact of emotion regulation and illness-focused coping strategies on the relation of illness-related negative emotions to subjective health. Journal of Health Psychology. 2011;16(3):510-9.\u003c/li\u003e\n\u003cli\u003eAdynski H, Propper C, Beeber L, Gilmore JH, Zou B, Santos HP. The role of emotional regulation on early child school adjustment outcomes. Archives of Psychiatric Nursing. 2024;51:201-11.\u003c/li\u003e\n\u003cli\u003eLoriol M. From the Analysis ofEmotions As Risk to the Construction ofHealth Through the Collective Coloring ofAffects and Situations. PISTES. 2023;25(1).\u003c/li\u003e\n\u003cli\u003eCunha F, Heckman J, Schennach S. Estimating the Technology of Cognitive and Noncognitive Skill Formation. Econometrica. 2010;78(3):883-931.\u003c/li\u003e\n\u003cli\u003eHolmes J, Gathercole SE. Taking working memory training from the laboratory into schools. Educ Psychol. 2014;34(4):440-50.\u003c/li\u003e\n\u003cli\u003eDunning DL, Holmes J, Gathercole SE. Does working memory training lead to generalized improvements in children with low working memory? A randomized controlled trial. Dev Sci. 2013;16(6):915-25.\u003c/li\u003e\n\u003cli\u003eNevo E, Breznitz Z. Effects of working memory and reading acceleration training on improving working memory abilities and reading skills among third graders. Child Neuropsychol. 2014;20(6):752-65.\u003c/li\u003e\n\u003cli\u003eRojas-Barahona CA, F\u0026ouml;rster CE, Moreno-R\u0026iacute;os 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.\u003c/li\u003e\n\u003cli\u003eAlloway TP, Bibile V, Lau G. Computerized working memory training: Can it lead to gains in cognitive skills in students? Comput Human Behav. 2013;29(3):632-8.\u003c/li\u003e\n\u003cli\u003eSchonfeld 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.\u003c/li\u003e\n\u003cli\u003eDurlak JA, Weissberg RP, Dymnicki AB, Taylor RD, Schellinger KB. The impact of enhancing students\u0026apos; social and emotional learning: a meta-analysis of school-based universal interventions. Child Dev. 2011;82(1):405-32.\u003c/li\u003e\n\u003cli\u003eCapilla A, Romero D, Maest\u0026uacute; F, Campo P, Fern\u0026aacute;ndez S, Gonz\u0026aacute;lez-Marqu\u0026eacute;s J, et al. Emergence and brain development of executive functions. Actas Espanolas de Psiquiatria. 2004;32(6):377-86.\u003c/li\u003e\n\u003cli\u003eZhong J, Rifkin-Graboi A, Ta AT, Yap KL, Chuang KH, Meaney MJ, et al. Functional networks in parallel with cortical development associate with executive functions in children. Cerebral Cortex. 2014;24(7):1937-47.\u003c/li\u003e\n\u003cli\u003eMuennig 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.\u003c/li\u003e\n\u003cli\u003eLee R, Zhai F, Han WJ, Brooks-Gunn J, Waldfogel J. \u0026quot;Head Start and Children\u0026apos;s Nutrition, Weight, and Health Care Receipt\u0026quot;. Early Child Res Q. 2013;28(4).\u003c/li\u003e\n\u003cli\u003eBaddeley A. Working memory: Clarendon Press/Oxford University Press; 1986.\u003c/li\u003e\n\u003cli\u003eBoudreau AM, Dempsey EE, Smith IM, Garon N. A novel working memory task for preschoolers: sensitivity to age differences from 3-5 years. Child Neuropsychology. 2018;24(6):799-822.\u003c/li\u003e\n\u003cli\u003eMorris BM, Lonigan CJ. What components of working memory are associated with children\u0026apos;s reading skills? Learning and Individual Differences. 2022;95.\u003c/li\u003e\n\u003cli\u003eAllen K, Higgins S, Adams J. The Relationship between Visuospatial Working Memory and Mathematical Performance in School-Aged Children: a Systematic Review. Educational Psychology Review. 2019;31(3):509-31.\u003c/li\u003e\n\u003cli\u003eFranklin T, Lee A, Hall N, Hetrick S, Ong J, Haslam N, et al. The association of visuospatial working memory with dysthymic disorder in pre-pubertal children. Psychological Medicine. 2010;40(2):253-61.\u003c/li\u003e\n\u003cli\u003eGathercole S, Alloway T. Working memory and classroom learning. Cognitive development in K-3 classroom learning: Research applications. 2004;15.\u003c/li\u003e\n\u003cli\u003eHuang-Pollock C, Shapiro Z, Galloway-Long H, Weigard A. Is Poor Working Memory a Transdiagnostic Risk Factor for Psychopathology? J Abnorm Child Psychol. 2017;45(8):1477-90.\u003c/li\u003e\n\u003cli\u003eRamani GB, Daubert EN, Lin GC, Kamarsu S, Wodzinski A, Jaeggi SM. Racing dragons and remembering aliens: Benefits of playing number and working memory games on kindergartners\u0026apos; numerical knowledge. Dev Sci. 2020;23(4):e12908.\u003c/li\u003e\n\u003cli\u003eSuppalarkbunlue W, Duangchaiyoosook S, Khruapradit V, Kilenthong WT. Material incentive motivation and working memory performance of kindergartners: A large-scale randomized controlled trial. J Exp Child Psychol. 2023;235:105730.\u003c/li\u003e\n\u003cli\u003eXie J, Liu S, Fang P. Cognitive training improves emotion regulation in Chinese preschool children. Pediatr Int. 2021;63(11):1303-10.\u003c/li\u003e\n\u003cli\u003eRoberts G, Quach J, Spencer-Smith M, Anderson PJ, Gathercole S, Gold L, et al. Academic Outcomes 2 Years After Working Memory Training for Children With Low Working Memory: A Randomized Clinical Trial. JAMA Pediatr. 2016;170(5):e154568.\u003c/li\u003e\n\u003cli\u003eAron AR. From reactive to proactive and selective control: developing a richer model for stopping inappropriate responses. Biol Psychiatry. 2011;69(12):e55-68.\u003c/li\u003e\n\u003cli\u003eHofstee M, van der Velde B, Huijding J, Endendijk J, Kemner C, Deković M. The direct and indirect effects of parenting behaviors and functional brain network efficiency on self-regulation from infancy to early childhood: A longitudinal mediation model. Infant Behavior and Development. 2022;69.\u003c/li\u003e\n\u003cli\u003eGeeraerts SB, Endendijk JJ, Deković M, Huijding J, Deater-Deckard K, Mesman J. Inhibitory Control Across the Preschool Years: Developmental Changes and Associations with Parenting. Child Development. 2021;92(1):335-50.\u003c/li\u003e\n\u003cli\u003eDonjdee K, Poonpol P, Ruksee N. Causes and Cultivation of Inhibitory Control Among School-Age Children in Thailand. Journal of Behavioral Science. 2024;19(2):135-50.\u003c/li\u003e\n\u003cli\u003eFox NA. Individual Differences in Child Temperament and Their Effect on Cognitive Control. Minnesota Symposia on Child Psychology: Developing Cognitive Control Processes: Mechanisms, Implications, and Interventions. 372013. p. 181-202.\u003c/li\u003e\n\u003cli\u003eRodrigues ER, Hassan R, Schmidt LA. Negative Emotionality and Internalizing Behaviors in Preschool Children: Moderating Role of Inhibitory Control. Child Psychiatry and Human Development. 2022;53(6):1110-8.\u003c/li\u003e\n\u003cli\u003eHassan R, Schmidt LA. Inhibitory control, dyadic social behavior, and mental health difficulties in preschoolers. Child Development. 2022;93(3):e251-e65.\u003c/li\u003e\n\u003cli\u003eRea-Sandin G, Oro V, Strouse E, Clifford S, Wilson MN, Shaw DS, et al. Educational attainment polygenic score predicts inhibitory control and academic skills in early and middle childhood. Genes, Brain and Behavior. 2021;20(7).\u003c/li\u003e\n\u003cli\u003eAllan NP, Hume LE, Allan DM, Farrington AL, Lonigan CJ. Relations between inhibitory control and the development of academic skills in preschool and kindergarten: A meta-analysis. Developmental Psychology. 2014;50(10):2368-79.\u003c/li\u003e\n\u003cli\u003eBeisly A, Jeon S. Development of inhibitory control in Head Start children: Association with approaches to learning and academic outcomes in kindergarten. Cognitive Development. 2024;70.\u003c/li\u003e\n\u003cli\u003eLiu Q, Zhu X, Ziegler A, Shi J. The effects of inhibitory control training for preschoolers on reasoning ability and neural activity. Scientific Reports. 2015;5(1):14200.\u003c/li\u003e\n\u003cli\u003eBlair C, Razza RP. Relating effortful control, executive function, and false belief understanding to emerging math and literacy ability in kindergarten. Child Dev. 2007;78(2):647-63.\u003c/li\u003e\n\u003cli\u003eNg F, Tamis-LeMonda C, Yoshikawa H, Sze I. Inhibitory control in preschool predicts early math skills in first grade: Evidence from an ethnically diverse sample. International Journal of Behavioral Development. 2014;39:139-49.\u003c/li\u003e\n\u003cli\u003eMcClelland MM, Cameron CE, Connor CM, Farris CL, Jewkes AM, Morrison FJ. Links between behavioral regulation and preschoolers\u0026apos; literacy, vocabulary, and math skills. Dev Psychol. 2007;43(4):947-59.\u003c/li\u003e\n\u003cli\u003eIzard C, Fine S, Schultz D, Mostow A, Ackerman B, Youngstrom E. Emotion Knowledge as a Predictor of Social Behavior and Academic Competence in Children at Risk. Psychological science. 2001;12:18-23.\u003c/li\u003e\n\u003cli\u003eBayet L, Behrendt HF, Cataldo JK, Westerlund A, Nelson CA. Recognition of facial emotions of varying intensities by three-year-olds. Developmental Psychology. 2018;54(12):2240-7.\u003c/li\u003e\n\u003cli\u003eWitkower Z, Tracy JL, Pun A, Baron AS. Can Children Recognize Bodily Expressions of Emotion? Journal of Nonverbal Behavior. 2021;45(4):505-18.\u003c/li\u003e\n\u003cli\u003eGreco C, Cuciniello M, Amorese T, Raimo G, Cordasco G, Esposito A. Emotion Recognition in Preschool Children: The Role of Age, Gender and Emotional Categories. Smart Innovation, Systems and Technologies. 3602023. p. 267-77.\u003c/li\u003e\n\u003cli\u003eRamos-Loyo J, Espinosa-Denenea SE, Sanz-Martin A, Llamas-Alonso LA. Age-Related Effects on Facial Emotion Recognition in Schoolchildren: An ERP Study. Developmental Neuropsychology. 2024;49(8):295-317.\u003c/li\u003e\n\u003cli\u003eEnsor R, Spencer D, Hughes C. \u0026lsquo;You Feel Sad?\u0026rsquo; Emotion Understanding Mediates Effects of Verbal Ability and Mother\u0026ndash;Child Mutuality on Prosocial Behaviors: Findings from 2 Years to 4 Years. Social Development. 2011;20(1):93-110.\u003c/li\u003e\n\u003cli\u003eFine SE, Izard CE, Mostow AJ, Trentacosta CJ, Ackerman BP. First grade emotion knowledge as a predictor of fifth grade self-reported internalizing behaviors in children from economically disadvantaged families. Dev Psychopathol. 2003;15(2):331-42.\u003c/li\u003e\n\u003cli\u003eTrentacosta CJ, Fine SE. Emotion Knowledge, Social Competence, and Behavior Problems in Childhood and Adolescence: A Meta-Analytic Review. Soc Dev. 2010;19(1):1-29.\u003c/li\u003e\n\u003cli\u003eDenham SA, Blair KA, DeMulder E, Levitas J, Sawyer K, Auerbach-Major S, et al. Preschool emotional competence: pathway to social competence? Child Dev. 2003;74(1):238-56.\u003c/li\u003e\n\u003cli\u003eLafay A, Berger C, Alaria L, Angonin S, Dalla-Libera N, Richard S, et al. Impact of Innovative Emotion Training in Preschool and Kindergarten Children Aged from 3 to 6 Years. Children. 2023;10(11):1825.\u003c/li\u003e\n\u003cli\u003eSch\u0026uuml;ller I, Demetriou Y. Physical activity interventions promoting social competence at school: A systematic review. Educational Research Review. 2018;25:39-55.\u003c/li\u003e\n\u003cli\u003eRose-Krasnor L, Denham S. Social-emotional competence in early childhood. Handbook of peer interactions, relationships, and groups. Social, emotional, and personality development in context. New York, NY, US: The Guilford Press; 2009. p. 162-79.\u003c/li\u003e\n\u003cli\u003eSchietecatte I, Roeyers H, Warreyn P. Can infants\u0026apos; orientation to social stimuli predict later joint attention skills? British Journal of Developmental Psychology. 2012;30(2):267-82.\u003c/li\u003e\n\u003cli\u003eReilly EB, Stallworthy IC, Mliner SB, Troy MF, Elison JT, Gunnar MR. Infants\u0026rsquo; abilities to respond to cues for joint attention vary by family socioeconomic status. Infancy. 2021;26(2):204-22.\u003c/li\u003e\n\u003cli\u003eVaughan Van Hecke A, Mundy PC, Acra CF, Block JJ, Delgado CE, Parlade MV, et al. Infant joint attention, temperament, and social competence in preschool children. Child Dev. 2007;78(1):53-69.\u003c/li\u003e\n\u003cli\u003eMalti T, Dys SP. From being nice to being kind: development of prosocial behaviors. Current Opinion in Psychology. 2018;20:45-9.\u003c/li\u003e\n\u003cli\u003eFlook L, Zahn-Waxler C, Davidson RJ. Developmental differences in prosocial behavior between preschool and late elementary school. Frontiers in Psychology. 2019;10(APR).\u003c/li\u003e\n\u003cli\u003eVogelsang M, Sch\u0026auml;fer A, Ehrenreich A, Ebersbach M. Friendship status and recipient\u0026apos;s emotions both affect children\u0026apos;s sharing behavior. Journal of Experimental Child Psychology. 2025;256.\u003c/li\u003e\n\u003cli\u003eVolland C, Ulich D, Fischer A. Who deserves help? The age-dependent influence of recipient characteristics on the prosociality of children. Zeitschrift fur Entwicklungspsychologie und Padagogische Psychologie. 2004;36(2):69-73.\u003c/li\u003e\n\u003cli\u003eGagnona SG, Nagle RJ. Relationships between peer interactive play and social competence in at-risk preschool children. Psychology in the Schools. 2004;41(2):173-89.\u003c/li\u003e\n\u003cli\u003eMiles SB, Stipek D. Contemporaneous and longitudinal associations between social behavior and literacy achievement in a sample of low-income elementary school children. Child Dev. 2006;77(1):103-17.\u003c/li\u003e\n\u003cli\u003eLadd GW. Social competence and peer relations: Significance for young children and their service-providers. Early Childhood Services: An Interdisciplinary Journal of Effectiveness. 2008;2(3):129-48.\u003c/li\u003e\n\u003cli\u003eBermejo-Martins E, Mujika A, Iriarte A, Pumar-M\u0026eacute;ndez MJ, Belintxon M, Ruiz-Zaldibar C, et al. Social and emotional competence as key element to improve healthy lifestyles in children: A randomized controlled trial. J Adv Nurs. 2019;75(8):1764-81.\u003c/li\u003e\n\u003cli\u003eDomitrovich C, Cortes R, Greenberg M. Improving Young Children\u0026rsquo;s Social and Emotional Competence: A Randomized Trial of the Preschool \u0026ldquo;PATHS\u0026rdquo; Curriculum. The journal of primary prevention. 2007;28:67-91.\u003c/li\u003e\n\u003cli\u003eSmahel D, Chaudron S, Beutel M, \u0026Scaron;mahelov\u0026aacute; M, V D, Dreier M, et al. Young Children (0-8) and digital technology: A qualitative exploratory study across seven countries2015.\u003c/li\u003e\n\u003cli\u003eMarsh J, Plowman L, Yamada-Rice D, Bishop J, Lahmar J, Scott F, et al. Exploring Play and Creativity in Pre-Schoolers\u0026apos; Use of Apps: Report for Early Years Practitioners2015.\u003c/li\u003e\n\u003cli\u003eFlewitt R, Messer D, Kucirkova N. New directions for early literacy in a digital age: The iPad. Journal of Early Childhood Literacy. 2015;15(3):289-310.\u003c/li\u003e\n\u003cli\u003eKhoo E, Merry R, Nguyễn N, Bennett T, Macmillan N. Early childhood education teachers\u0026apos; iPad-supported practices in young children\u0026apos;s learning and exploration. Computers in New Zealand Schools: Learning, teaching, technology. 2014;25:3-20.\u003c/li\u003e\n\u003cli\u003eParette P, Quesenberry A, Blum C. Missing the Boat with Technology Usage in Early Childhood Settings: A 21st Century View of Developmentally Appropriate Practice. Early Childhood Education Journal. 2010;37:335-43.\u003c/li\u003e\n\u003cli\u003eAgencia de Calidad de la Educaci\u0026oacute;n. Metodolog\u0026iacute;a de construcci\u0026oacute;n de grupos socioecon\u0026oacute;micos pruebas SIMCE 2013 2013 [Available from: Available from: https://archivos.agenciaeducacion.cl/Metodologia_de_Construccion_de_Grupos_Socioeconomicos_Simce_2013.pdf.\u003c/li\u003e\n\u003cli\u003eLancaster GA, Dodd S, Williamson PR. Design and analysis of pilot studies: recommendations for good practice. J Eval Clin Pract. 2004;10(2):307-12.\u003c/li\u003e\n\u003cli\u003eJulious S. Sample size of 12 per group rue of thumb for a pilot study. Pharmaceutical Statistics. 2005;4:287-91.\u003c/li\u003e\n\u003cli\u003eCocks K, Torgerson DJ. Sample size calculations for pilot randomized trials: a confidence interval approach. J Clin Epidemiol. 2013;66(2):197-201.\u003c/li\u003e\n\u003cli\u003eSim 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.\u003c/li\u003e\n\u003cli\u003eFitzpatrick C, Archambault I, Janosz M, Pagani LS. Early childhood working memory forecasts high school dropout risk. Intelligence. 2015;53:160-5.\u003c/li\u003e\n\u003cli\u003eEigsti IM, Zayas V, Mischel W, Shoda Y, Ayduk O, Dadlani MB, et al. Predicting cognitive control from preschool to late adolescence and young adulthood. Psychol Sci. 2006;17(6):478-84.\u003c/li\u003e\n\u003cli\u003eHalse M, Steinsbekk S, Bj\u0026oslash;rklund O, Hammar \u0026Aring;, Wichstr\u0026oslash;m L. Emotions or cognitions first? Longitudinal relations between executive functions and emotion regulation in childhood. Child Development. 2024;95(5):1508-21.\u003c/li\u003e\n\u003cli\u003eValiente C, Eisenberg N, Haugen R, Spinrad TL, Hofer C, Liew J, et al. Children\u0026apos;s Effortful Control and Academic Achievement: Mediation Through Social Functioning. Early Education and Development. 2011;22(3):411-33.\u003c/li\u003e\n\u003cli\u003eMinisterio de Educaci\u0026oacute;n. Bases Curriculares Educaci\u0026oacute;n Parvularia. Gobierno de Chile. 2018.\u003c/li\u003e\n\u003cli\u003eOrsini A. Corsi\u0026apos;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.\u003c/li\u003e\n\u003cli\u003eGathercole SE, Willis CS, Baddeley AD, Emslie H. The Children\u0026apos;s Test of Nonword Repetition: a test of phonological working memory. Memory. 1994;2(2):103-27.\u003c/li\u003e\n\u003cli\u003eDavidson 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.\u003c/li\u003e\n\u003cli\u003eRosas R, Espinoza V, Mart\u0026iacute;nez 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).\u003c/li\u003e\n\u003cli\u003eSchultz D, Izard CE, Bear G. Children\u0026apos;s emotion processing: Relations to emotionality and aggression. Development and psychopathology. 2004;16(2):371-87.\u003c/li\u003e\n\u003cli\u003eTrentacosta CJ, Izard CE, Mostow AJ, Fine SE. Children\u0026apos;s emotional competence and attentional competence in early elementary school. School Psychology Quarterly. 2006;21(2):148.\u003c/li\u003e\n\u003cli\u003eNix RL, Bierman KL, Domitrovich CE, Gill S. Promoting children\u0026apos;s social-emotional skills in preschool can enhance academic and behavioral functioning in kindergarten: Findings from Head Start REDI. Early Education \u0026amp; Development. 2013;24(7):1000-19.\u003c/li\u003e\n\u003cli\u003eChung C, Choi S, Bae J, Jeong H, Lee J, Lee H. Developing and validating a Korean version of the assessment of Children\u0026rsquo;s emotional skills. Child Psychiatry \u0026amp; Human Development. 2024;55(3):819-30.\u003c/li\u003e\n\u003cli\u003eDenham SA, Blair K, Schmidt M, DeMulder E. Compromised emotional competence: Seeds of violence sown early? American journal of orthopsychiatry. 2002;72(1):70-82.\u003c/li\u003e\n\u003cli\u003eDenham SA, Way E, Kalb SC, Warren-Khot HK, Bassett HH. Preschoolers\u0026apos; social information processing and early school success: the challenging situations task. Br J Dev Psychol. 2013;31(Pt 2):180-97.\u003c/li\u003e\n\u003cli\u003eGoodman R. The Strengths and Difficulties Questionnaire: a research note. J Child Psychol Psychiatry. 1997;38(5):581-6.\u003c/li\u003e\n\u003cli\u003eGaete J, Rojas‐Barahona CA, Olivares E, Araya R. Brief report: Association between psychological sense of school membership and mental health among early adolescents. Journal of adolescence. 2016;50(1):1-5.\u003c/li\u003e\n\u003cli\u003eBrown P, Capella C, Antivilo A. Propiedades psicom\u0026eacute;tricas de la versi\u0026oacute;n para padres del Strengths and Difficulties Questionnaire. Revista de Psicolog\u0026iacute;a. 2014;23(2):28-44.\u003c/li\u003e\n\u003cli\u003eMarzocchi 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. European child \u0026amp; adolescent psychiatry. 2004;13:ii40-ii6.\u003c/li\u003e\n\u003cli\u003eHusky MM, Otten R, Boyd A, Pez O, Bitfoi A, Carta MG, et al. Psychometric properties of the Strengths and Difficulties Questionnaire in children aged 5\u0026ndash;12 years across seven European countries. European Journal of Psychological Assessment. 2018.\u003c/li\u003e\n\u003cli\u003eGaete J, Montero-Marin J, Valenzuela D, Rojas-Barahona CA, Olivares E, Araya R. Mental health among children and adolescents: Construct validity, reliability, and parent-adolescent agreement on the \u0026apos;Strengths and Difficulties Questionnaire\u0026apos; in Chile. PLoS One. 2018;13(2):e0191809.\u003c/li\u003e\n\u003cli\u003eStataCorp. Stata: Release 17. Statistical Software. College Station, TX: StataCorp LLC; 2021.\u003c/li\u003e\n\u003cli\u003eRoberts G, Quach J, Spencer-Smith M, Anderson PJ, Gathercole S, Gold L, et al. Academic Outcomes 2 Years After Working Memory Training for Children With Low Working Memory: A Randomized Clinical Trial. JAMA Pediatrics. 2016;170(5):e154568-e.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003eTable 1: Sample descriptive features at baseline.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"659\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eVariable\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003eCG (n=166)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;IG (n=136)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eAge, Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e159\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e4.71 (0.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e134\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e4.68 (0.48)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eSex (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eFemale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e89\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e53.61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e74\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e54.41\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eMale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e77\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e46.39\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e62\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e45.59\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eCognitive skills, Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eVisual Memory: Corsi Cubes Test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e0.38 (0.85)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e129\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.40 (0.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eAuditive Memory: Woodcock- Mu\u0026ntilde;oz test\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e150\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e2.85 (2.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e3.15 (3.27)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eInhibitory Control: Hearts and Flowers task\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e147\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e28.50 (7.81)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e131\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e26.82 (7.36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eNon-cognitive skills, Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eEmotion recognition: ACES\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e153\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e11.32 (2.49)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e11.18 (2.93)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eSocial Competence: CST (Competence score)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e152\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e1.18 (1.65)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e133\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e0.95 (1.33)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003ePsychological assessment: SDQ, Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eTotal difficulties sub-scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e10.07 (4.31)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e10.50 (4.71)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 340px;\"\u003e\n \u003cp\u003eProsocial sub-scale\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 57px;\"\u003e\n \u003cp\u003e121\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 94px;\"\u003e\n \u003cp\u003e8.45 (1.56)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 66px;\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 102px;\"\u003e\n \u003cp\u003e8.05 (1.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: Intervention Group (IG); Control Group (CG); Assessment of Children\u0026rsquo;s Emotions Skills (ACES); Challenging Situations Task (CST); Strengths and Difficulties Questionnaire (SDQ)\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 2: Functionality of video game. Mechanical errors pre-intervention.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" align=\"\" width=\"644\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"11\" valign=\"top\" style=\"width: 378px;\"\u003e\n \u003cp\u003eSessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 198px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 38px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 67px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eAudio volume variations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e20 (37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eAbrupt change of activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e13 (24.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eGame freezing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e11 (20.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eImages or drawings out of place\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e3 (5.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eAudio problems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e4 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eIncoherence between instructions and expected performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e2 (3.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 198px;\"\u003e\n \u003cp\u003eMissing elements\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 38px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" style=\"width: 67px;\"\u003e\n \u003cp\u003e1 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 198px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 38px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"bottom\" style=\"width: 67px;\"\u003e\n \u003cp\u003e54 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 0px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: n = number of errors per session.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 3: Functionality of video game. Mechanical errors during the intervention.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"644\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"10\" valign=\"top\" style=\"width: 269px;\"\u003e\n \u003cp\u003eSessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 317px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003en (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eAudio volume variations\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e3 (6.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eAbrupt change of activity\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eGame freezing\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e7\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e14 (29.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eImages or drawings out of place.\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eAudio problems\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e1 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eIncoherence between instructions and expected performance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e2 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eMissing elements\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e0 (0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eSmall surface of the touchable objects on the screen\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e2 (4.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eCorrect answers registered as incorrect\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e3\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e10 (20.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eUnexpected responsive surface\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e6 (12.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eActivities without correct answers\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e2\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e3 (6.2)\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eAbsent remainder\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e1 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eOverlapped elements\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e1\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e1 (2.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 317px;\"\u003e\n \u003cp\u003eDragging problems\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e\u003cstrong\u003e4\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 58px;\"\u003e\n \u003cp\u003e4 (8.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\" style=\"width: 317px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e0\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e11\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 27px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\" style=\"width: 58px;\"\u003e\n \u003cp\u003e48 (100)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: n = number of errors detected each time each student played the session.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTable 4: Functionality of video game. Failure to record data in the server.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"0\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eAttendance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eData registered\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eMissing data\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eConsent/Assent\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eN\u0026acute; (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e73\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e43 (37.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e70\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e32 (31.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e61\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e56 (47.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e75\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e42 (36)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e46\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e62 (59.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e111\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e8 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e8 (7.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e3 (2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e58\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e39 (40.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e136\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e106\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1 (0.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e1104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e810\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"bottom\"\u003e\n \u003cp\u003e294 (26.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: n = number of children presented in the classroom; N = number of children for whom data was registered in the server; N \u0026apos; = difference between the number of children who were at the school and played with the video game and the number of children whose data was registered.\u003c/p\u003e\n\u003cp\u003eTable 5: Students\u0026rsquo; poor engagement.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003eAttendance\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eQuit playing\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003eSession\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003en\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003eN (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e116\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e0 (0.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e102\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e7 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e23 (19.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e117\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e18 (15.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e108\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e8 (7.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e119\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e8 (6.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e114\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e10 (8.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e3 (2.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e97\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e5 (5.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e107\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e19 (17.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 86px;\"\u003e\n \u003cp\u003eTotal\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 95px;\"\u003e\n \u003cp\u003e1104\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 101px;\"\u003e\n \u003cp\u003e101 (9.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: n = number of children presented in the classroom; N = number of children who quit playing with the video game during the session.\u003c/p\u003e\n\u003cp\u003eTable 6. Behavioral problems.\u0026nbsp;\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"624\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003eSession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eBehavioral problems description\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eUsing other tablet apps\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eOne event:\u003c/p\u003e\n \u003cp\u003eTen minutes into the session, 1 student is caught taking pictures with the tablet. When the facilitator calls her attention, she resists to play the video game, stands up from her seat and begins to act angry, making angry noises. After a few minutes, the facilitator manages to get the student to play again, staying by her side and supporting her the rest of the game.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eHitting the table\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eOne event:\u003c/p\u003e\n \u003cp\u003e1 student appears frustrated. He mentions several times that \u0026ldquo;the game is difficult\u0026rdquo;, and that he does not know how to play, after a few minutes the child is caught hitting the table very close to the Tablet, so the game is aborted.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd rowspan=\"2\" valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eGetting up from the seat and doing other things during the session\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eOne event:\u003c/p\u003e\n \u003cp\u003e1 child appears frustrated, mentioning that he does not want to continue playing, repeating several times that the game is boring and that he wants to play \u0026ldquo;another game\u0026rdquo;. The child is encouraged to continue, but after a few minutes, the child stands up from his seat and starts to move the furniture in the room, looking very frustrated.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eOne event:\u003c/p\u003e\n \u003cp\u003e1 child shows frustration after 15 minutes playing the game. The kid stops playing, starts to get up from her sit, lies down on the floor and approaches the early year teacher saying she doesn\u0026apos;t want to play anymore.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eFalling asleep\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eOne event:\u003c/p\u003e\n \u003cp\u003e1 student falls asleep while playing the video game, so his tablet must be removed.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 118px;\"\u003e\n \u003cp\u003eHitting other classmate\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 68px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 438px;\"\u003e\n \u003cp\u003eOne event:\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eAfter 20 minutes playing the game, 1 student gets up from her seat and walks over to one of her classmates, with whom she starts fighting and hitting each other. This distracts the rest of the classmates, which causes many students to start saying that they are bored and ask for the tablet to be taken away.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: A total of six behavioral problems were observed during the whole intervention.\u003c/p\u003e\n\u003cp\u003eTable 7. Classroom Climate.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"621\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eSessions\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\"\u003e\n \u003cp\u003eClassroom Climate Description\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eDuring this session, in general, the classroom climate was quite calm and adequate for the adaptation of the children to the game, where the attention of the students allowed the introduction of the various materials to be used (tablet and headphones), as well as the modeling of their proper use and care, through the commitments presented at the beginning of the session.\u003c/p\u003e\n \u003cp\u003eAs for the adults in the room, they had a passive attitude during the session, where they were only a support at the beginning and end of the session.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFinally, one of the difficulties presented in this session, in relation to the classroom climate, is that some students disconnected the headphones from the tablets, but this was quickly corrected by remembering the commitment.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eThe classroom climate at the beginning is conducive to a good start of the session. On the one hand, the early year teachers are a great support at this time to capture the attention of the students and thus proceed to remember the commitments; in addition, since it is the second session, the children are allowed to participate more actively in the reminder of the commitments, since they themselves mention them according to what they remember from the previous session.\u003c/p\u003e\n \u003cp\u003eHowever, when it came to the development of the session, the team of adults in the classroom, in general, maintained a passive attitude during the moments when the children were playing and rarely helped to clear up their doubts.\u003c/p\u003e\n \u003cp\u003eFinally, in this session, when several children asked to stop playing, they caused a break in the classroom climate, because the imitation of the students was present in those moments. When the children saw that a classmate stopped playing, the others also wanted to stop playing. On these occasions, students expressed: \u0026ldquo;I\u0026apos;m bored\u0026rdquo;, \u0026ldquo;I don\u0026apos;t want to keep playing either\u0026rdquo;, \u0026ldquo;the game is too difficult\u0026rdquo;, \u0026ldquo;I don\u0026apos;t know how to play (...) I can\u0026apos;t move forward\u0026rdquo;, \u0026ldquo;I don\u0026apos;t know how to play (...)\u0026rdquo;.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eIn general, what happened in the previous sessions is repeated: At the beginning of the class, the children are motivated and attentive, and the classroom team is an active agent to support group management during this time. However, as the minutes of play pass (after approximately 15-20 minutes), students begin to show boredom and frustration, which is expressed in the following behaviors: Students start doing other things unrelated to the game and stop paying attention to the tablet (e.g., standing up from their seats, talking to each other, etc.).Students tell the adults in the room that they are bored and don\u0026apos;t want to play anymore, so they ask for the tablet to be taken away.\u003c/p\u003e\n \u003cp\u003eThey get up from their seats to talk to other classmates.\u003c/p\u003e\n \u003cp\u003eThey get out of the game and start using other applications on the tablet (e.g., camera, google search engine, etc.).\u003c/p\u003e\n \u003cp\u003eThe classroom climate starts to become more difficult to manage, once the children by imitation start asking for the tablets to be taken away, since fewer students are playing and the group of students doing other things is much larger.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAt the beginning, as in the other sessions, the necessary conditions were in place to carry out the game in an adequate classroom climate. The children continue to be enthusiastic and the commitments for the handling of materials are beginning to show as a routine, where the students are able to mention them without help. However, as the minutes pass, group management becomes increasingly difficult to maintain, due to the large number of children who decide to drop out and do other things that distract their classmates, such as chatting with them or playing with nearby items.\u003c/p\u003e\n \u003cp\u003eIn relation to the classroom team, it begins to be more and more passive, to a great extent due to the fact that the monitors are more in charge of the group. In this session, support is only shown at the end of the session, which is largely due to the fact that the children were more restless than on previous occasions.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eThe classroom team was active in three key moments of the session:\u003c/p\u003e\n \u003cp\u003eIn the modeling of activity 01: In this part of the session, the monitors show the students the three moments to keep calm and be able to solve a problem (breathe through the nose, hold for three seconds and blow through the mouth).\u003c/p\u003e\n \u003cp\u003eIn activity 01: In those classes where activity 01 was applied, the adults in the room showed a lot of initiative in helping the students, individually, in their confusions related to that activity.\u003c/p\u003e\n \u003cp\u003eAt the closing: At this moment of the session, the classroom team, as in other sessions, shows their support by collecting and putting away the tablets.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eHowever, in the rest of the session (development), the classroom team again showed passivity, choosing not to get involved in the activity.\u003c/p\u003e\n \u003cp\u003eIn relation to the classroom climate, at the beginning of the session and during the explanation of activity 01, it was adequate for the realization of the game, because the children were attentive and active, however, as the pedagogical hour progressed, the classroom climate was increasingly complicated to maintain, because the students began to be restless and confused by the instructions of the game.\u003c/p\u003e\n \u003cp\u003eThe difficulties that the children had with this session also caused difficulties with group management, since the students needed individual assistance in the larger classes, which led to the loss of the general focus of the group of children, so that many students were at a disadvantage in relation to the time it took them to complete the activity.\u003c/p\u003e\n \u003cp\u003eFinally, to facilitate group management and due to the low motivation during the previous session, it was decided to start applying strategies to focus the attention of the students, proposing different challenges to the children in relation to the time they play with the tablet.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eAt the beginning of the session, an environment conducive to the correct application of the game and easy group management was observed. However, as the session progressed, some children became more restless in the activity where they had to listen to the sounds of the animals and memorize the order in order to then drag the image of the animal into the boxes. On this occasion, in general, the students were constantly asking for help, due to three situations presented:\u003c/p\u003e\n \u003cp\u003eStudents do not know that when ordering the sounds, this should be done from left to right, so they order them backwards.\u003c/p\u003e\n \u003cp\u003eStudents have difficulty identifying to which animal each sound corresponds.\u003c/p\u003e\n \u003cp\u003eDuring the activity of ordering the animals according to their sound, the students ask for help to corroborate if the action they are carrying out is correct. In these cases, the facilitators chose to just approach the child who asked for help and stay with him/her, reminding the student that, in order to complete the task, he/she only needs to concentrate and listen carefully. This strategy was enough on many occasions for the child to advance to the next trial.\u003c/p\u003e\n \u003cp\u003eIn spite of the situations mentioned above, in this session the children managed to play for longer (more than 20 minutes) and dropped out less than on previous occasions.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eRegarding the role of the classroom team, this again tends to be passive during most of the session, not even assisting the children who ask for help.\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eFinally, the challenge presented to the children in the previous session was a favorable factor to keep the students\u0026apos; attention for a longer time in the game, so that the group management in the development and closing of the session went much more smoothly.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eIn general, the classroom climate was favorable for the realization of the session, highlighting the enthusiasm shown by the students at the beginning of the hour and during the delivery of the tablets. This allowed a good group management during the beginning of the pedagogical hour.\u003c/p\u003e\n \u003cp\u003eAs the game progressed, group management also became easier, since the students were calmer and more focused on the activities, without demanding a lot of help. The activity that generated the greatest motivation on the part of the students was number 03.\u003c/p\u003e\n \u003cp\u003eOn the other hand, the activity in which some children had difficulties in understanding the instructions was number 04, since they constantly asked for help in order to know what action they had to carry out in the game.\u003c/p\u003e\n \u003cp\u003eFinally, the classroom team maintained a passive role during the entire session, except for the closing of the session in which they supported the collection of the material.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eIn general, the classroom climate was quite adequate to carry out the session and this was favored by the concentration of the students during the course of the pedagogical hour. The only moment in which group management was more difficult to maintain was when the children showed difficulties in activities 03 and 05, since the monitors had to support the children individually, losing the focus of the whole course.\u003c/p\u003e\n \u003cp\u003eRegarding the participation of the classroom team, they remained passive until the end of the session when they supported the children during the collection of materials.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eThe good classroom climate is maintained at the beginning of the session, where students already participate autonomously at this moment, when it is time to remember the commitments. They also demonstrate internalization of the routine by showing actions such as: sitting properly before receiving the tablets, waiting calmly for the monitors to set up the headphones and enter the corresponding session, and remaining silent during the delivery of tablets. This greatly facilitates group management at the beginning of the session, which allows to use the time effectively without wasting it in calling the attention of the students.\u003c/p\u003e\n \u003cp\u003eThat good classroom climate is observed during at least the first 10 minutes after starting the game, since once the students begin to have difficulties to advance in the first activity of the puzzle, they begin to ask for help and express their dissatisfaction with the game in a massive way, which causes that the adults in the room had to help the students individually, losing the focus of the rest of the students and therefore, making group management difficult. These difficulties were also increased by the fact that the order of the room was affected when the children who were able to complete the puzzle stopped to put together the puzzles of the students who were having difficulties.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd\u003e\n \u003cp\u003eIn this last session, the classroom climate remained adequate during the beginning of the session due to the autonomy of the children who already know the routine and the commitments for a good use of the tablet, so it is not necessary to dwell on them. However, as the session progressed, the classroom climate was becoming less and less conducive to the fluidity of the session, due to the fact that the children were restless, chatting among themselves, standing up and pacing around the room, so this caused the other students to be distracted. This generated a higher level of noise in the room, making it difficult to manage the group and distracting the students who were still playing with the tablet.\u003c/p\u003e\n \u003cp\u003eOn this occasion, the classroom team intervened more, due to the fact that most of the children were more restless during the session. Not only did they provide support at the beginning and end of the session, but they also called the attention of the children who, after handing over their tablet, distracted the students who were still playing.\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cbr\u003e\u003c/p\u003e\n\u003cp\u003eTable 8: Session Attendance\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003eSession\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003eAttendance, n (%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e1\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e116 (85.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e2\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e102 (75.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e3\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e117 (86.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e4\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e117 (86.0%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e5\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e108 (79.4%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e6\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e119 (87.5%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e7\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e114 (83.8%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e8\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e107 (78.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e9\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e97 (71.3%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 83px;\"\u003e\n \u003cp\u003e10\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 170px;\"\u003e\n \u003cp\u003e107 (78.7%)\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: Total enrollment before intervention = 196; Consent from parents and assent from children = 136; n = number of children who attended school when the session was implemented; % of attendance over consent and assent.\u003c/p\u003e\n\u003cp\u003eTable 9: Exploratory results on the efficacy of the intervention.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\" width=\"860\" class=\"fr-table-selection-hover\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 255px;\"\u003e\n \u003cp\u003eT0 (Jul-Aug 2018)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd colspan=\"2\" valign=\"top\" style=\"width: 198px;\"\u003e\n \u003cp\u003eT1 (Nov 2018)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eVariables (score range)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003eControl\u003c/p\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003eIntervention Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003eControl\u0026nbsp;\u003c/p\u003e\n \u003cp\u003eMean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003eIntervention Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003ep value\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eCognitive skills\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eWorking memory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eCorsi\u0026rsquo;s cubes (Visual)(0-18)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e0.39 (0.84)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.40 (0.91)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.63 (1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.89 (1.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.212\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eAuditory (0-42)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e2.79 (2.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e3.17 (3.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e4.0 (4.2)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e3.85 (3.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.104\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eControl Inhibition (Executive function)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eHeart \u0026amp; Flowers (0-57)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e28.49 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e26.96 (7.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e30.77 (9.1)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e30.80 (8.9)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.305\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eNon-cognitive skills\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eEmotion recognition\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eACES (0-16)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e11.32 (2.5)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e11.20 (3.0)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11.93 (2.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e12.04 (2.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.520\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eSocial competence\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eCST (Competent) (0-6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e1.16 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e0.95 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.8 (1.3)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e0.55 (0.99)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.407\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003ePsychological assessment SDQ, Mean (SD)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eGeneral Psychological functioning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eSDQ Difficulties (0-40)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e10.13 (4.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e10.24 (4.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e11.94 (6.4)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e11.82 (5.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.748\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 312px;\"\u003e\n \u003cp\u003eSDQ Prosocial (0-10)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 142px;\"\u003e\n \u003cp\u003e8.35 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 113px;\"\u003e\n \u003cp\u003e8.15 (1.8)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e8.33 (1.7)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 104px;\"\u003e\n \u003cp\u003e8.26 (1.6)\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 95px;\"\u003e\n \u003cp\u003e0.812\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eNotes: Assessment of Children\u0026rsquo;s Emotions Skills (ACES); Challenging Situations Task (CST); Strengths and Difficulties Questionnaire (SDQ).\u003c/p\u003e\n"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"","lastPublishedDoi":"10.21203/rs.3.rs-7032367/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7032367/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e. Early childhood is a crucial period for mental health, with many preschoolers experiencing emotional and behavioral issues. Early interventions targeting executive functions and socio-emotional skills are essential. Digital tools, such as tablets, offer promising solutions, despite limited research. This study aims to develop and test a video game to enhance these skills in vulnerable preschoolers, assessing its feasibility, engagement, and impact.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e. Cluster Randomized Controlled Pilot Study. Eight schools were randomly allocated to the Intervention group (Japi 1.0) and the Control group in a 1:1 ratio. A video game was developed by the research team, aiming to stimulate cognitive and non-cognitive skills. We registered problems in the functionality of the video game while implementing it and student engagement and classroom climate. Additionally, we assessed before and after the intervention cognitive and non-cognitive skills among children's psychological functioning using the parental reports over the Strengths and Difficulties Questionnaire.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e. Before implementing Japi 1.0 in the classroom, the most frequent functional problems detected by the research team were audio volume variations, abrupt changes in activity, and game freezing. Once corrected, during the implementation of an improved version, game freezing and correct answers registered as incorrect were the most frequent problems. Additionally, 26.6% of students had data not recorded on the server. The engagement with the game was high, and there were very few behavioral problems during the implementation. Most of the secondary outcomes were improved after the intervention, but no significant changes were found when compared with the control group.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusions\u003c/strong\u003e. The pilot study demonstrated high student engagement and a positive classroom climate during the implementation of Japi 1.0. While initial functionality issues were identified and corrected, some technical problems persisted, including game freezing and data loss. Although improvements in cognitive and non-cognitive skills were observed post-intervention, no significant differences were found compared to the control group. These findings highlight the feasibility of using digital interventions in preschool settings but underscore the need for further refinement and a larger trial to assess the game’s full impact.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eTrial registration:\u003c/strong\u003e Clinical Trials NCT07048119, February 26th, 2025.\u003c/p\u003e\n\u003cp\u003e[https://www.clinicaltrials.gov/study/NCT07048119]\u003c/p\u003e","manuscriptTitle":"Development, usability, and feasibility pilot cluster randomized controlled study of a videogame aiming to stimulate cognitive and non-cognitive skills among low-income preschoolers in Santiago, Chile","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-08-11 10:47:55","doi":"10.21203/rs.3.rs-7032367/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2025-08-25T20:49:44+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"190023789926381483907525414502019439731","date":"2025-08-15T16:08:34+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2025-08-01T13:40:12+00:00","index":"","fulltext":""},{"type":"editorInvited","content":"","date":"2025-07-25T09:20:14+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2025-07-25T09:13:17+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2025-07-21T22:24:18+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Psychology","date":"2025-07-21T22:20:33+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-psychology","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"psyo","sideBox":"Learn more about [BMC Psychology](http://bmcpsychology.biomedcentral.com/)","snPcode":"","submissionUrl":"","title":"BMC Psychology","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":true,"editorialSystem":"stoa","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"7b03fd9e-88d4-46c2-9fe2-84716aea6361","owner":[],"postedDate":"August 11th, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2025-08-11T10:47:55+00:00","versionOfRecord":[],"versionCreatedAt":"2025-08-11 10:47:55","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7032367","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7032367","identity":"rs-7032367","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}