Serious Gaming to Support Communicative Difficulties in Children

Have you ever struggled to communicate with someone, even when you were trying your best? Maybe you recognize such moments in the example below.

Lauren, Max, and Sandra (all 8 years old) are trying to work together. They need to figure out together how they can make an egg land safely on the ground, without breaking. While Lauren and Max do not know where to start, Sandra actually cannot wait to start at all. She enthusiastically grabs all the available crafting material and combines them without thinking, caution or discussing with the others. Max has a wonderful idea: Making a parachute for the egg! But he is too shy to share this idea with his team members and instead watches the fiercely crafting Sandra. Lauren now also knows what they could do: Wrapping the egg in bubble plastic. “Wrapping in bubble plastic” is something difficult to get across, however, and while Lauren tries to put her idea into words, she has difficulty making clear what she means. Lauren interrupts Sandra’s crafting and points to the bubble plastic and tries to say and gesture what they could do with it. But Max and Sandra do not understand her, which upsets them all. In a last attempt to make herself clear, Lauren grabs the egg and wraps it in bubble plastic. But then the egg accidentally drops!

Lauren’s plan has worked! The egg has survived the drop! Lauren, Max and Sandra celebrate their success (and relief).

The above example illustrates two issues: (1) Collaboration is challenging; (2) Collaboration is even more challenging when communication is difficult. In this blog post, I will tell about a current research project regarding how we can support the communicative and interaction skills of children with communicative difficulties using a serious game (i.e. any game that has a serious goal). The research project is an interdisciplinary collaboration between the research groups Developmental Psychology and Inclusive and Special Needs Education from the University of Groningen, Youth, Education and Society from the Hanze University of Applied Sciences, and Serious Gaming from NHL Stenden, funded by the Aanjaagfonds from the Universiteit van het Noorden. I aim to show how the two illustrated issues are real and how to overcome them, first and foremost for children with communicative difficulties, but second for us as partners in this interdisciplinary collaboration.

Children with Communicative Difficulties

In the North of the Netherlands, relatively many children experience communicative difficulties (Veldman et al., 2023). This is partly related to the fact that they live in underserved areas, or speak a first language other than Dutch. Communicative difficulties in children can arise from many interacting factors, such as psychopathology, lack of support from home, school and broader social context; or cognitive delays (Powell et al., 2024; Samson et al., 2020; Singer et al., 2020). Examples of children with potential communicative difficulties include children with autism, ADHD, or Developmental Language Disorder (DLD). Children with communicative difficulties experience problems during interactions with their peers and others, at school, and in other contexts. Moreover, when children are not properly supported these problems tend to become bigger and more pervasive. This puts children in a disadvantaged position in many areas later in life, including (mental) health and being able to participate in our complex society.

Supporting communication skills in these children is thus important, but challenging. First, communicative development is something that often happens seemingly automatically and without effort (Tamis-LeMonda & Masek, 2023). Relatedly, communication is multimodal and involves not only speech, but also things like gestures, posture, facial expressions, and timely attunement of all these different modalities within and between people (de Jonge-Hoekstra, 2021; Iverson, 2022). A lot of this multimodal attunement could be said to follow unspoken rules and nuances, and is therefore difficult to teach. To tackle this issue, working together during so-called STEAM-tasks (STEAM = Science Technology Education Arts and Mathematics) has been suggested as a way to stimulate the development of communication skills in children with communicative difficulties (Taylor & Hwang, 2021).

“…multimodal attunement could be said to follow unspoken rules and nuances, and is therefore difficult to teach.”

Within a previous research project by Carla Geveke (STEAM (Further) Ahead), promising STEAM game prototypes were created and results were found. However, consistent issues remained across several iterations of the development process. For example, we found that teachers’ support during the game is essential to help children go beyond what they can do on their own; but teachers often indicate that they don’t have sufficient time nor space to take on an additional task. To take this approach to the next level, we needed expertise about how to develop a good game, which we were very happy to find in the research group Serious Gaming from NHL Stenden.

Serious Games

Serious Gaming is about how games —in all kinds of forms— can be developed that enable people to reach a serious goal. Serious Gaming is booming at the moment, and reviews emphasize its effectiveness in changing the behavior of patients, teachers, and children (Asadzadeh et al., 2024; Damaševičius et al., 2023; Kuipers et al., 2017). An inspiring example of a game developed by the research group Serious Gaming from NHL Stenden is an escape room to trigger social interactions between children with autism and their peers (Terlouw et al., 2021). In our project, the serious goal is to support the development of communication and interactive skills in children with communicative difficulties. To reach this goal, together we want to create a prototype of a game that elicits interaction between children, increases attunement and understanding between children, can be played at school and multiple times, and that does not burden the teacher more than “typical” education, while still providing the teacher with insight into the communicative processes while children play the game. We need the expertise of all the team members, if we want to accomplish this!

Communication and Interdisciplinary Collaboration

As a project team from multiple disciplines, we engage in interdisciplinary research. Interdisciplinary research is important and promises to teach us things that are not possible when staying within our own discipline. However, that does not mean that it is always easy. One of the main difficulties is communication between disciplines, such as using different words for the same concept and vice versa or using different research paradigms. Within our project, for example, I did not know what design research entailed, while Serious Gaming often engages in design research. If we want our communication to be successful we need to be aware that it may not go as smoothly and automatically as we’re used to. Furthermore, we need to try to recognize our own and other’s unspoken rules for communication. The parallels with the communicative difficulties of the children in our project are visible. But when we do so, we can learn a lot from each other. For example, I really liked the idea by the Serious Gaming partners about developing a game that teachers like so much that they want to participate, instead of seeing it as too time-consuming.

Conclusion

For several reasons, it’s thus important —but also challenging— to support children with communicative difficulties. This may be even more true for teachers supporting children within their classrooms. Interdisciplinary research that combines expertise about serious gaming with expertise about communicative and language development, social interactions between peers and teachers, and education is needed to solve this issue. The prototype of the game that we’re currently developing aims to be an important step towards effectively supporting children with communicative difficulties, while they’re having fun playing a game together.

References

1. 1. Asadzadeh, A., Shahrokhi, H., Shalchi, B., Khamnian, Z., & Rezaei-Hachesu, P. (2024). Serious educational games for children: A comprehensive framework. Heliyon, 10(6). https://doi.org/10.1016/j.heliyon.2024.e28108
   2. Damaševičius, R., Maskeliūnas, R., & Blažauskas, T. (2023). Serious Games and Gamification in Healthcare: A Meta-Review. Information, 14(2), Article 2. https://doi.org/10.3390/info14020105
   3. de Jonge-Hoekstra, L. (2021). How hand movements and speech tip the balance in cognitive development: A story about children, complexity, coordination, and affordances. University of Groningen. https://doi.org/10.33612/diss.172252039
   4. Iverson, J. M. (2022). Developing language in a developing body, revisited: The cascading effects of motor development on the acquisition of language. WIREs Cognitive Science, 13(6), e1626. https://doi.org/10.1002/wcs.1626
   5. Kuipers, D. A., Terlouw, G., Wartena, B. O., Veer, J. T. van ’t, Prins, J. T., & Pierie, J. P. E. (2017). The Role of Transfer in Designing Games and Simulations for Health: Systematic Review. JMIR Serious Games, 5(4), e7880. https://doi.org/10.2196/games.7880
   6. Powell, P. S., Gonzalez, M. G., Pazol, K., Reyes, N., Nadler, C., & Wiggins, L. (2024). Child and family characteristics associated with verbal communication difficulties in adolescents with autism and other developmental disabilities. Research in Developmental Disabilities, 155, 104879. https://doi.org/10.1016/j.ridd.2024.104879
   7. Samson, A. C., Van Den Bedem, N. P., Dukes, D., & Rieffe, C. (2020). Positive Aspects of Emotional Competence in Preventing Internalizing Symptoms in Children with and without Developmental Language Disorder: A Longitudinal Approach. Journal of Autism and Developmental Disorders, 50(4), 1159–1171. https://doi.org/10.1007/s10803-019-04336-y
   8. Singer, I., Klatte, I. S., Welbie, M., Cnossen, I. C., & Gerrits, E. (2020). A Multidisciplinary Delphi Consensus Study of Communicative Participation in Young Children With Language Disorders. Journal of Speech, Language, and Hearing Research, 63(6), 1793–1806. https://doi.org/10.1044/2020_JSLHR-19-00326
   9. STEAM (Further) Ahead. (n.d.). Hanze. Retrieved March 5, 2025, from https://research.hanze.nl/nl/projects/steam-further-ahead
   10. Tamis-LeMonda, C. S., & Masek, L. R. (2023). Embodied and Embedded Learning: Child, Caregiver, and Context. Current Directions in Psychological Science, 32(5), 369–378. https://doi.org/10.1177/09637214231178731
   11. Taylor, J. C., & Hwang, J. (2021). Science, Technology, Engineering, Arts, and Mathematics Remote Instruction for Students With Disabilities. Intervention in School and Clinic, 57(2), 111–118. https://doi.org/10.1177/10534512211001858
   12. Terlouw, G., Kuipers, D., Veer, J. van ’t, Prins, J. T., & Pierie, J. P. E. N. (2021). The Development of an Escape Room–Based Serious Game to Trigger Social Interaction and Communication Between High-Functioning Children With Autism and Their Peers: Iterative Design Approach. JMIR Serious Games, 9(1), e19765. https://doi.org/10.2196/19765
   13. Veldman, M. A., de Boer, H., Dijks, M. A., Hingstman, M., & Bosker, R. (2023). Onderwijskansen werkplaats Noord-Nederland: Eindrapport. GION onderwijs/onderzoek. https://successforall-nederland.nl/publicaties/

Note: Featured image by Vanessa Loring.

Lisette de Jonge-Hoekstra

Lisette de Jonge-Hoekstra is a researcher and lecturer in Developmental Psychology. Her research focuses on children’s gestures and speech as they learn, and how they are coupled to the environment. Specifically, she is interested in explaining the leading role of gestures in cognitive development from a perception-action perspective, building on the theory of complex and dynamic systems. Furthermore, Lisette is an editor for Mindwise.

For an overview of Lisette’s research, please click here.