Developing social-cognitive skills in deaf and hard-of-hearing children through a gamified digital intervention: a multisite class-level quasi-experimental study

Abstract

Introduction This multisite, class-level quasi-experimental study examined whether a 12-week gamified digital intervention was associated with greater improvement in social-cognitive performance among 120 deaf and hard-of-hearing primary-school children from 12 classes in three special education schools in Kazakhstan, compared with an active non-digital programme. Methods The intervention combined visually accessible social scenarios, facial-expression and branching-decision tasks, immediate corrective feedback, repeated attempts, progressive difficulty, and teacher-guided discussion; the comparison condition covered equivalent social-emotional content and instructional time through non-digital activities. Pre-test and post-test data were collected using a study-specific social-cognitive assessment battery, six non-digital transfer scenarios, and structured classroom and break-time observations. Linear mixed-effects models accounted for repeated measurements, class-level clustering, and study site, with small-sample-corrected inference. Results The experimental group showed a greater increase in the primary social-cognitive composite outcome than the comparison group [adjusted difference = 2.48, 95% CI (0.70, 4.25), p = .011; dDiD = 0.58]. Significant adjusted differences were also found for emotion recognition, social-situation interpretation, and performance-based transfer, whereas social decision-making did not remain significant after multiplicity correction and observed social behaviour showed no clear between-group difference. Discussion The findings provide preliminary evidence that an accessible gamified format may support structured social-cognitive performance, although short-term behavioural generalisation was not established.

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