SYSTEMATIC REVIEW
published: 16 Sep embe 2021
doi: 10.3389/ psyg.2021.652948
F on ie s in Psychology | www. on ie sin.o g 1Sep embe 2021 | Volume 12 | A icle 652948
Edi ed by:
Fang Huang,
Qingdao Uni e si y, China
Re iewed by:
Elena Flo i ,
Uni e si y o Ve ona, I aly
Nick P es on,
Uni e si y o Leeds, Uni ed Kingdom
*Co espondence:
Gonzalo A ondo
ga ondo@una .es
Special y sec ion:
This a icle was submi ed o
Educa ional Psychology,
a sec ion o he jou nal
F on ie s in Psychology
Recei ed: 13 Janua y 2021
Accep ed: 10 Augus 2021
Published: 16 Sep embe 2021
Ci a ion:
Os iz-Blanco M, Be nace J,
Ga cia-A bizu I, Diaz-Sanchez P,
Rello L, Lallie M and A ondo G
(2021) Imp o ing Reading Th ough
Videogames and Digi al Apps: A
Sys ema ic Re iew.
F on . Psychol. 12:652948.
doi: 10.3389/ psyg.2021.652948
Imp o ing Reading Th ough
Videogames and Digi al Apps: A
Sys ema ic Re iew
Mikel Os iz-Blanco1, Ja ie Be nace 1, I a i Ga cia-A bizu 1, Pa icia Diaz-Sanchez 1,
Luz Rello2, Ma ie Lallie 3and Gonzalo A ondo 1
*
1Mind-B ain G oup, Ins i u e o Cul u e and Socie y (ICS), Uni e si y o Na a a, Pamplona, Spain, 2IE Business School, IE
Uni e si y, Mad id, Spain, 3Basque Cen e on Cogni ion, B ain and Language, San Sebas ian, Spain
Backg ound: The use o elec onic in e en ions o imp o e eading is becoming a
common esou ce. This sys ema ic e iew aims o desc ibe he main cha ac e is ics o
andomized con olled ials o quasi-expe imen al s udies ha ha e used hese ools
o imp o e i s -language eading, in o de o highligh he ea u es o he mos eliable
s udies and guide u u e esea ch.
Me hods: The whole p ocedu e ollowed he PRISMA guidelines, and he p o ocol
was egis e ed be o e s a ing he p ocess (doi: 10.17605/OSF.IO/CKM4N). Sea ches
in Scopus, PubMed, Web o Science and an ins i u ional e e ence agg ega o (Unika)
yielded 6,230 candida e a icles. A e duplica e emo al, sc eening, and compliance o
eligibili y c i e ia, 55 s udies we e inally included.
Resul s: They we e esea ch s udies on imp o ing i s -language eading, bo h in
child en and adul s, and including a con ol g oup. Thi y- h ee di e en elec onic ools
we e employed, mos o hem in English, and s udies we e e y di e se in sample size,
leng h o in e en ion, and con ol asks. Risk o bias was analyzed wi h he PED o
scale, and all s udies had a medium o low isk. Howe e , isk o bias due o con lic s o
in e es could no be e alua ed in mos s udies, since hey did no include a s a emen
on his issue.
Conclusion: Fu u e esea ch on his opic should include andomized in e en ion and
con ol g oups, wi h sample sizes o e 65 pe g oup, in e en ions longe han 15 h, and
a p ope disclosu e o possible con lic s o in e es .
Sys ema ic Re iew Regis a ion: The whole p ocedu e ollowed he PRISMA
guidelines, and he p o ocol was egis e ed be o e s a ing he p ocess in he Open
Science F amewo k (doi: 10.17605/OSF.IO/CKM4N).
Keywo ds: compu e -based in e en ion, dyslexia, i s -language, PED o, PRISMA
INTRODUCTION
Reading is a mul i ace ed abili y in ol ing he decoding o le e s and wo ds and language
comp ehension, which can be u he b oken in o o he componen s and p ecu so s including
o hog aphy and alphabe ics, phonics, phonemic awa eness, ocabula y, comp ehension, luency,
and mo i a ion and a en ion.
Os iz-Blanco e al. Sys ema ic Re iew on Reading Apps
Reading acquisi ion is one o he main keys o school
success and a c ucial componen o empowe ing indi iduals o
pa icipa e meaning ully in socie y. Ye , o a signi ican numbe
o child en, i is s ill a challenging skill o be acqui ed by.
Globally, a ound 250 million child en a e unable o acqui e basic
li e acy skills (UNESCO). Simila ly, many s uden s will no be
able o acqui e g ade-le el p o iciency o adequa ely s udy o
lea n when hey en e high school, which will, in u n, in luence
hei isk o ea ly d opping om he educa ional sys em and
will possible esul in u u e unde employmen and economic
success (Polidano and Ryan, 2017). Many di e en aspec s ha e
been ela ed o poo eading ou comes such as p ena al and
pe ina al isk ac o s (Liu e al., 2016), gende , socio-economic
ac o s (Linnakyla e al., 2004), o se e al men al heal h p oblems
(F ancis e al., 2019). Speci ic Lea ning Disabili ies (SLD) a e
one o he main challenges. Among SLD, dyslexia is one o he
mos common, accoun ing o up o 80% o diagnosed lea ning
disabili ies (Shaywi z, 1998).
The e is an ex ensi e numbe o in e en ions o
eading di icul ies, gi en he social ele ance and long-
e m consequences o his p oblem. Mos o hem aim
o imp o e skills in i e key a eas, namely (i) phonemic
awa eness, (ii) phonics, (iii) luency, (i ) ocabula y, and
( ) comp ehension (Na ional Reading Panel, 2000). While
adi ional assessmen s ely on pape -based ma e ials, no mally
used wi h he supe ision o a p o essional he apis , he
numbe o compu e -based in e en ion ools o imp o e
eading is g owing apidly (see F anceschini e al., 2015; Rello
e al., 2017 o some examples). Compu e -based in e en ions
ha e se e al ad an ages o e mo e adi ional me hods.
Impo an ly, hey ypically equi e less human esou ces,
and hey can p o ide an a ac i e en i onmen o child en
o wo k wi h. Addi ionally, hey ease he applica ion o a
eading ins uc ion me hod sys ema ically o all s uden s,
educing he in luence o indi idual di e ences among eache s.
Finally, hey a e usually p og ammed o adap hei pace o
ins uc ion o he ad ances o he s uden s, hence acili a ing an
indi idualized a en ion.
Gi en he no el y and he he e ogenei y o elec onic
in e en ions, hei e icacy has no been sys ema ically e alua ed.
I has been no ed ha much o he published esea ch aiming
a e alua ing hese in e en ions ollow un andomized, small,
single-sample, p e and pos aining p o ocols (B ooks, 2016).
Howe e , in o de o be able o e alua e he soundness o hese
p og ams, especially in he case o apidly ma u ing indi iduals
such as child en, i is c i ical o ake in o accoun age- ela ed
imp o emen s. Such age- ela ed imp o emen s can only be
sepa a ed om he e ec s o in e es h ough he inclusion o
expe imen s wi h a con ol g oup. Mo e gene ally, a sys ema ic
app oach o he e idence suppo ing hese in e en ions mus
e alua e he isk o many o he biases ha de i e om design
decisions as he only way o guiding u u e esea ch, such
us he ex en o which all hose in ol ed in he expe imen
we e blinded o he ea men condi ion, o he a-p io i
s a is ical powe o he s udies. Finally, in he case o a
apidly e ol ing ield, i is o pa amoun impo ance ha he
e alua ion o he e idence is up o da e, and includes he mos
ecen li e a u e.
Hence, we p esen a sys ema ic e iew o he elec onic
in e en ions aimed o imp o e i s -language eading skills. This
sys ema ic e iew seeks o compa e any kind o in e en ion
aimed a imp o ing eading o any o i s co e componen s unde
he same s anda dized c i e ia, in o de o de e mine guidelines
o assessing he eliabili y o compu e -based in e en ions, and
disc imina ing which o hose a e e ec i e. Fi s , we p esen
how we selec ed he esea ch pape s o be included in he
e iew. Second, we a emp o analyze he quali y o he selec ed
in e en ions, p oposing key aspec s ha could be imp o ed in
u u e s udies. Finally, we p esen an o e iew o he e icacy o
hose in e en ions, aking in o accoun he isk o bias o he
s udies. We belie e ha his wo k can bene i p o essionals who
a e de eloping echnology-based aining and esea che s who
a e e alua ing hei in e en ions.
MATERIALS AND METHODS
The design and epo ing o esul s o his sys ema ic e iew
was ca ied ou ollowing he guidelines o P e e ed Repo ing
I ems o Sys ema ic e iew and Me a-analysis (PRISMA)
(Mohe e al., 2009, 2015). A p o ocol was w i en and
egis e ed be o e s a ing da a ex ac ion in he Open Science
F amewo k (Os iz-Blanco and A ondo, 2018). I was uploaded
on May 14, 2019, and i is a ailable in he ollowing URL:
h ps://os .io/ckm4n/ Sea ches we e ca ied ou in Scopus
(Else ie ), PubMed (Medline Plus) and Web o Science (co e
collec ion). Addi ionally, we used an ins i u ional e e ence
agg ega o (Unika) based on he EBSCO se ice o combine
e e ences om 61 ex e nal da abases (psychology p o ile)
(EBSCO Disco e y Se ice; Uni e si y o Na a a, Búsqueda
básica: UNIKA). A ull lis o da abases included he psychology
p o ile o Unika can be ound in he Supplemen a y Ma e ial.
Ini ially, sea ches we e limi ed o he pe iod be ween 2008 and
Sep embe o 2017, da e in which hese sea ches we e ca ied
ou . The a ionale o he ime limi was he as pace a which
compu e echnologies ad ance. Hence, any p og am c ea ed
o e 10 yea s ago was likely o be ou da ed. No o he limi a ions
we e imposed du ing he sea ch phase. The sea ch was upda ed
on Ma ch 2, 2020. Sea ch e ms we e adap ed o each da abase
and limi ed o abs ac , i le o keywo ds.
The gene al que y was (dyslexia OR eading OR “ eading
diso de ” OR “ eading di icul ies”) AND (compu e -based OR
ideogame OR “mobile applica ion”). The e e ences sec ion o all
included a icles was used o ind u he a icles o in e es .
The PICO (Pa icipan s, In e en ion, Con ols, Ou comes)
amewo k was used o de ine he key cha ac e is ics o ou
sys ema ic e iew as ollows.
Pa icipan s
Samples conside ed o be d awn om he gene al popula ion,
ha is, wi hou speci ic disabili ies o lea ning diso de s we e
accep ed. The e o e, he ac ha a mino pe cen age o he
sample had some o hese p oblems was no a eason o
exclusion. Addi ionally, pa icipan s wi h dyslexia o eading
diso de s/di icul ies we e also conside ed as a alid popula ion.
The e we e no age limi a ions. A icles we e excluded i hey
we e ca ied ou in popula ions wi h speci ic diso de s o
F on ie s in Psychology | www. on ie sin.o g 2Sep embe 2021 | Volume 12 | A icle 652948
Os iz-Blanco e al. Sys ema ic Re iew on Reading Apps
FIGURE 1 | Re iew lowcha : a lowcha o he sc eening and inclusion o a icles in ou sys ema ic e iew.
disabili ies o he han dyslexia, al hough i he sample had a
p opo ion o pa icipan s wi h such di icul ies he a icle was
no necessa ily excluded.
In e en ions
A icles had o deal wi h any echnologically-based in e en ion
aimed a imp o ing eading skills. In his ega d, ou de ini ion
o eading in e en ion was a heo e ical as we elied on he
desc ip ions p o ided by he au ho s o he p ima y pape s.
Howe e , in e en ions we e b oadly classi ied as suppo ing
eading a he wo d le el (decoding, i.e., phoneme-g apheme
mapping), i s p ecu so s (phonological awa eness - he sound
s uc u e o wo ds- o ocabula y lea ning), o o he ela ed skills
such as hy hm o a en ion.
S udies wi h pa icipan s o any age we e included, al hough
a majo i y o a icles in child en we e expec ed. Whene e an
a icle indica ed ha hei echnological in e en ion was aimed
a imp o ing eading o any o i s co e componen s, i was
accep ed. In e en ions aimed a lea ning a second language
we e excluded.
Con ols
All s udies had o include a con ol g oup and be ween g oup
compa isons. Pa icipan s o he con ol g oup had o ul ill
he same c i e ia han hose desc ibed in he pa icipan s
sec ion. Any in e en ion in he con ol g oup was accep ed.
Hence, we included a icles using passi e con ols such as
“T ea men as Usual” (no mal class oom) o wai -lis , and
also a icles wi h an ac i e con ol (ano he lea ning o e en
eading ask).
Ou comes
A he me hodological le el, all s udies had o be andomized o
non- andomized longi udinal in e en ions (i.e., RCTs o quasi-
expe imen al designs), bu any du a ion o con ol ask was
pe mi ed. We included bo h andomized and non- andomized
s udies, since he ocus o ou s udy was o show how cu en
esea ch is ca ied ou in he ield, and no he e icacy o he
speci ic ools. Any ou come measu ing an imp o emen in any
o he eading componen s was accep ed, including wo d eading
F on ie s in Psychology | www. on ie sin.o g 3Sep embe 2021 | Volume 12 | A icle 652948
Os iz-Blanco e al. Sys ema ic Re iew on Reading Apps
TABLE 1 | A icles included in he sys ema ic e iew, and main cha ac e is ics o he compu e ized aining used in each o hem.
ID T aining name T aining skill Tech Lang. Coun y Popul. T aining
du a ion (h)
Con ol ask Sample size Age Sig. esul s De ec able ES CoI
A ans (2010) Read Na u- ally R PC English USA D 25 SE 82 7–10 No La ge NR
Beaud y (2016) The Fi s 4,000 Wo ds R,M PC English USA G 10 NTLT 37 7–8 No Ve y la ge NR
Bo man e al. (2008) Fas Fo Wo ds R,L,M,A PC English USA D 50 NTLT 141 7–8 No Medium NR
Fas Fo Wo ds R,L,M,A PC English USA D 50 NLT 274 12–13 Yes Medium NR
Daleen e al. (2018) No name V Table isiXhosa Sou h A ica G 2 SE 65 6–8 Yes La ge No
De P imo (2016) Fas Fo Wo ds R,L,M,A PC English USA D 50 SE 318 11–15 Yes Medium Yes*
Deaul e al. (2009) Ab acadab a R,L,Ph PC English Canada G 13 SE 144 6–7 Yes Medium NR
Deshpande e al. (2017) Ta a Aksha R,Ph PC Hindi India A 43, SE 717 33,55 Yes Medium NR
Di S asio e al. (2012) Ab acadab a R,L,Ph PC English Canada G 10 ATT 49 6–7 Yes Ve y la ge NR
Ecalle e al. (2009) No name Ph PC F ench F ance D 10 ATT 26 No in o No Ve y la ge NR
Falke (2012) Success-make R PC English USA G 75 SE 108 10–11 Yes La ge NR
Flis (2018) Ab acadab a R,L,Ph PC English Canada D 13 SE 82 6–7 No La ge NR
F anceschini e al. (2013) Ac ion ideo games A Wii English I aly D 12 ATT 20 7–13 Yes Ve y la ge NR
Gi en e al. (2008) Fas Fo Wo ds R,L,M,A PC English USA G 44 SE 28 11–12 No Ve y la ge NR
Success-make R,V,Ph PC English USA G 44 SE 24 11–12 No Ve y la ge NR
Heikkilä e al. (2013) No name Ph PC Finish Finland D 1 NLT 152 7–9 Yes Medium NR
Hill-S ephens (2013) Ea -obics R,V,Ph PC English USA D 75 SE 8,055 7–8 No Small No
Hu s e e e al. (2010) Head-sp ou Ea ly
eading
R PC English USA D 20 NLT 62 4–5 Yes La ge NR
Jackson (2016) No a–Ne R PC English USA D No in o SE 149 7–8 Yes Medium NR
Jimenez and Mune on
(2010)
No name R PC Spanish Spain D No in o SE 43 8–10 Yes La ge NR
No name R PC Spanish Spain D No in o SE 42 8–10 Yes La ge NR
No name R PC Spanish Spain D No in o SE 42 8–10 Yes La ge NR
Jiménez and Rojas (2008) T adislexia Ph PC Spanish Spain D 9 SE 62 9–12 Yes Ve y la ge NR
Kamykowska e al. (2014) G apho-game Ph PC Polish Poland G 6 NLT 24 6–7 No Ve y la ge NR
Maca uso and Walke
(2008)
Ea ly Reading R,V,Ph PC English USA G 24 NLT 94 4–5 Yes La ge NR
Maca uso and Rodman
(2009)
Lexia Reading R,Ph PC English USA G 21 NLT 47 11–13 Yes Ve y la ge NR
Maca uso and Rodman
(2011)
Ea ly Reading Ph PC English USA G 3 NLT 38 4–5 No Ve y la ge NR
(Con inued)
F on ie s in Psychology | www. on ie sin.o g 4Sep embe 2021 | Volume 12 | A icle 652948
Os iz-Blanco e al. Sys ema ic Re iew on Reading Apps
TABLE 1 | Con inued
ID T aining name T aining skill Tech Lang. Coun y Popul. T aining
du a ion (h)
Con ol ask Sample size Age Sig. esul s De ec able ES CoI
Mcmu ay (2013) Lexia Reading Ph PC English I eland D 20 NTLT 106 6–7 No La ge NR
Messe and Nash (2017) T aine - ex M,Ph PC English UK D 31 SE 78 7–8 No La ge NR
Mose e al. (2017) No name Ph Table English USA G 12 SE 29 9–10 Yes Ve y la ge NR
Nee Chee e al. (2017) Chinese-Skills Ph Sma phone Chinese Malaysia G No in o SE 48 6–7 Yes Ve y la ge NR
O’Callaghan e al. (2016) Lexia Reading Ph PC English I eland D 17 SE 98 4–6 Yes La ge NR
Pindip olu and Fo bush
(2009)
Funnix Ph PC English USA D 223 ATT 25 6–8 No Ve y la ge NR
Plony (2014) Read 180 R,V PC English USA D 225 NTLT 228 11–14 No Medium NR
Ponce e al. (2012) e-PELS R PC Spanish Chile D 45 SE 1,041 9–10 Yes Small NR
Ponce e al. (2013) No name R PC Spanish Chile D 21 SE 1,562 6–14 Yes Small NR
Rasinski e al. (2011) Reading Plus R PC English USA D 36 SE 1,6143 9–16 Yes Small NR
Reed (2013) Fas Fo Wo ds R,L,M,A PC English USA D 35 SE 51 6–9 No Ve y la ge NR
Sonday R,Ph PC English USA D 35 SE 42 6–9 No Ve y la ge NR
Rello e al. (2015) Dys-Eggxia Ph Table Spanish Spain D 4 ATT 48 6–11 No Ve y la ge NR
Rogowsky (2011) Fas Fo Wo ds R,L,M,A PC English USA G 31 SE 81 11–12 Yes La ge NR
Rosas e al. (2017) G apho-game Ph PC Spanish Chile D 13 SE 87 6–7 No La ge No
Saine e al. (2011) G apho-game Ph PC Finish Finland D 66 NTLT 50 7 Yes Ve y la ge NR
G apho-game Ph PC Finish Finland D 66 SE 141 7 Yes Medium NR
Sa age e al. (2013) Ab acadab a R,L,Ph PC English Canada G 22 SE 1,067 5–8 Yes Small NR
Shannon e al. (2015) Accele- a ed Reade R PC English USA G No in o SE 346 6–10 Yes Medium NR
Shelley-T emblay and Eye
(2009)
Reading Plus R PC English USA G 40 SE 49 7–8 Yes Ve y la ge NR
Soboleski (2011) Fas Fo Wo ds R,L,M,A PC English USA G 75 SE 360 7–8 No Medium NR
Tijms (2011) LEXY R PC Du ch The
Ne he lands
D 66 NTLT 96 9–12 Yes La ge NR
Wa son and Hempens all
(2008)
Funnix Ph PC English USA G No in o SE 16 4–5 Yes Ve y la ge NR
Funnix Ph PC English USA G No in o SE 15 6–7 No Ve y la ge NR
Wild (2009) Rhyme and Analogy Ph PC English UK G 7 NLT 84 5–6 Yes La ge NR
Williams (2012) CompassLea ning
Odyssey
R PC English USA G 90 SE 188 11–13 Yes Medium NR
Wolgemu h e al. (2011) Ab acadab a R,L,Ph PC English Aus alia G 20 SE 166 5–9 Yes Medium NR
Wolgemu h e al. (2013) Ab acadab a R,L,Ph PC English Aus alia G 30 SE 308 5–9 Yes Medium NR
T aining Skill: A, a en ion; L, lis ening; M, wo king memo y; Ph, phonology; R, eading; V, ocabula y. Popula ion: A, illi e a e adul s; D, eading diso de s o di icul ies; G, gene al popula ion (child en). Con ol ask: ATT, ano he
echnological aining; NLT, non-li e acy asks; NTLT, non- echnological li e acy ask; SE, s anda d educa ion. De ec able ES: smalles e ec -sizes he s udy could po en ially de ec assuming a wo-sample - es . CoI, Con lic o in e es ;
NR, No epo ed. *Adequa ely managed.
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Os iz-Blanco e al. Sys ema ic Re iew on Reading Apps
accu acy, ex eading accu acy, eading a e and luency and
phonological skills.
Any ype o esea ch o ma was accep ed (a icles, hesis,
cong ess p oceedings, e c.). Re iews ound we e used o iden i y
addi ional e e ences.
Sea ch esul s we e impo ed o Mendeley. Duplica es we e
emo ed au oma ically using he unc ion p o ided by his
so wa e, and also manually in he cases i was no success ul.
Two esea che s independen ly e iewed all i les and abs ac s.
Any a icle deemed po en ially app op ia e was downloaded, and
he ull ex was e iewed o u he conside a ion on whe he i
ul illed inclusion c i e ia, o i had o be excluded de ailing he
easons o exclusion.
Two esea che s ex ac ed da a independen ly and di e ences
we e sol ed by consensus. Da a analysis was ca ied ou
employing ables and na a i e syn hesis. The ollowing da a
was ex ac ed om each a icle: ained skills (di ec eading
o o he skills); ha dwa e modali y; language, coun y and
du a ion o he in e en ion; ype o con ol ask; sample sizes
and age; and esul s. Risk o bias was e alua ed using he
Physio he apy E idence Da abase ool (PED o) (Blobaum, 2006;
Physio he apy E idence Da abase, 2012). This scale e alua es
11 i ems: inclusion c i e ia and sou ce, andom alloca ion,
concealed alloca ion, simila i y a baseline, subjec blinding,
he apis blinding, assesso blinding, comple eness o ollow
up, in en ion- o- ea analysis ( he analysis o he esul s o a
s udy acco ding o he ini ial in e en ion assignmen ins ead
o acco ding o he g oup a he end o he in e en ion ime),
be ween-g oup s a is ical compa isons, and poin measu es and
a iabili y (whe he he s udy includes adequa e measu e o he
size o he ea men e ec and i s a ia ion, e.g., mean e ec
in each o he g oups and i s con idence in e al). Each i em
is a ed as “yes” o “no,” and he o al PED o sco e is he
numbe o i ems me . A e wa ds, s udies we e di ided in o
h ee g oups: high (less han ou poin s), medium (be ween
ou and se en) o low isk o bias (be ween 8 and 11).
Finally, s udies we e di ided in o ou g oups acco ding o
hei combined sample size and he smalles e ec size ha
hey would be able o de ec (assuming a wo-sample - es
be ween wo equally sized g oups and 0.8 powe ): e y la ge
e ec s (Cohen’s d o e 1, combined sample size unde 53),
la ge e ec s (Cohen’s d o e 0.8, combined sample be ween
53 and 128), medium e ec s (Cohen’s d o e 0.5, combined
sample size be ween 128 and 786), and small e ec s (Cohen’s d
o e 0.2, combined sample size o e 786) (Cohen, 1988). This
ca ego iza ion was d i en by he ac ha low powe combined
wi h a high p opo ion o s a is ically signi ican esul s could
indica e a high p opo ion o alse posi i es in he li e a u e
(Szucs and Ioannidis, 2017). Con lic s o in e es decla ed in
he included a icles we e also ex ac ed (C is ea and Ioannidis,
2018).
RESULTS
The sea ch in ou da abases and a e e ence agg ega o yielded
6,230 esul s. A e elimina ion o duplica es, sc eening and ull
ex e alua ion, 48 a icles ul illed inclusion c i e ia (Bo man
e al., 2008; Gi en e al., 2008; Jiménez and Rojas, 2008; Maca uso
and Walke , 2008; Wa son and Hempens all, 2008; Deaul e al.,
2009; Ecalle e al., 2009; Maca uso and Rodman, 2009, 2011;
Pindip olu and Fo bush, 2009; Shelley-T emblay and Eye , 2009;
Wild, 2009; A ans, 2010; Hu s e e e al., 2010; Jimenez and
Mune on, 2010; Rasinski e al., 2011; Rogowsky, 2011; Saine
e al., 2011; Soboleski, 2011; Tijms, 2011; Wolgemu h e al., 2011,
2013; Di S asio e al., 2012; Falke, 2012; Ponce e al., 2012, 2013;
Williams, 2012; F anceschini e al., 2013; Heikkilä e al., 2013;
Hill-S ephens, 2013; Mcmu ay, 2013; Reed, 2013; Sa age e al.,
2013; Kamykowska e al., 2014; Plony, 2014; Rello e al., 2015;
Shannon e al., 2015; Beaud y, 2016; De P imo, 2016; Jackson,
2016; O’Callaghan e al., 2016; Deshpande e al., 2017; Messe and
Nash, 2017; Mose e al., 2017; Nee Chee e al., 2017; Rosas e al.,
2017; Daleen e al., 2018; Flis, 2018). Since some o he a icles
included mo e han one s udy, 55 s udies we e inally analyzed.
A lowcha o he sc eening and inclusion o a icles in ou
e iew is depic ed in Figu e 1. Excluded a icles and he exclusion
c i e ia hey ul illed a e de ailed in Supplemen a y Table 1;
a Venn diag am summa izing he easons o exclusion and
he numbe o a icles excluded o each o hem is shown in
Supplemen a y Figu e 1.
The key cha ac e is ics o all included s udies a e summa ized
in Table 1. S udy me hods and esul s we e e y he e ogeneous,
and 33 di e en aining p og ams we e included. The
mos employed ools we e Fas Fo Wo d (in se en s udies),
Ab acadab a (in six) and G aphogame (in ou ). Mos ools we e
p esen in only one s udy, and se en did no p o ide he name o
he so wa e being e alua ed. Mos ools we e in English (69% o
he s udies), ollowed by Spanish (15%) and six o he languages
wi h only one s udy each. In ac , nea ly hal o s udies had been
ca ied ou in he Uni ed S a es (49%). The as majo i y (91%)
used compu e s as ha dwa e, ins ead o lap ops/ able s (7%) o
ideogame sys ems (2%).
Rega ding he eading- ela ed skill ained, 60% o he
in e en ions di ec ly aimed o imp o e eading, 58% wo ked on
phonology and he emaining s udies add essed indi ec skills
such as o al comp ehension (24%), wo king memo y (15%),
a en ion (15%) o ocabula y (13%). S udies we e mainly ca ied
ou in wo di e en kinds o popula ion: child en/adolescen s
ei he wi h (54%) o wi hou (44%) eading di icul ies. Only one
s udy (Deshpande e al., 2017) included illi e a e adul s (2%).
Consequen ly, he median age o he pa icipan s was 8.6 yea s
old. Du a ion o he in e en ions was highly a iable, anging
be ween 1.25 and 225 h.
The mos common con ol ask agains which he
in e en ions we e compa ed was s anda d educa ion (65%
o he cases), whe eas he emaining s udies used ac i e asks:
15% used a non-linguis ic ask such as ma hema ics o a ,
11% a non- echnological eading in e en ion, and 9% a
di e en echnological eading aining. Sample sizes we e also
he e ogeneous, anging be ween 15 and 16,243, wi h a median
o 82. Only 9% o he s udies had a sample size big enough o be
able o consis en ly de ec small e ec s and 18% o he s udies
could iden i y medium-sized e ec -sizes. Con e sely, 24% would
only ha e been able o de ec la ge e ec s, and 38% o he s udies
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FIGURE 2 | S a is ically signi ican s udies: p opo ion o s udies wi h s a is ically signi ican esul s in ela ion o ou s udy cha ac e is ics: aining skill, du a ion o he
aining, con ol ask used and e ec size ha s udies would ha e been able o consis en ly de ec .
we e only capable o consis en ly showing s a is ically signi ican
e y la ge e ec s.
Thi y- ou s udies (64%) epo ed s a is ically signi ican
e ec s. Figu e 2 shows he p opo ion o s udies wi h signi ican
esul s in ela ion o he di e en s udy cha ac e is ics,
namely aining skill, du a ion o he aining, con ol ask
used and e ec size ha s udies would ha e been able o
consis en ly de ec .
Using he PED o ool, we assessed he isk o bias
o each o he s udies included in he e iew (Figu e 3;
Supplemen a y Table 2.2). Twen y-six and 29 s udies had a
medium and low isk o bias, espec i ely. Rega ding con lic s o
in e es , only one s udy epo ed compe ing in e es s ha could
suppose a isk o bias o hei conclusions, bu such con lic s
we e adequa ely managed. Th ee s udies decla ed no con lic s
o in e es . Impo an ly, 51 s udies did no include a con lic o
in e es s a emen , and he e o e he isk o bias due o his issue
canno be es ima ed.
Nex , we epo in de ail he cha ac e is ics o hose s udies
wi h he highes quali y, since hei esul s should be he mo e
eliable o he esea ch ques ions on his opic. Fi e s udies
we e conside ed o ha e he highes quali y in e ms o a
low isk o bias, a leas a medium ea men leng h (o e
15 h), and a sample size allowing he de ec ion o medium-
sized e ec s. Two o hem we e included wi hin he same
a icle by Bo man e al. and used a simila me hodology: hey
e alua ed he e ec i eness o Fas Fo Wo d (a compu e ized
eading in e en ion ha uses he p inciples o neu oplas ici y
o imp o e eading and lea ning) in samples o indi iduals
wi h low eading skills agains an ac i e con ol condi ion o
a s and gymnas ics ac i i ies, and u ilized he Comp ehensi e
Tes o Basic Skills, Fi h Edi ion (CTBS/5). The i s s udy
es ed 248 child en be ween se en and 8 yea s and he second
453 be ween 12 and 13 yea s. Only he second s udy epo ed
s a is ically signi ican di e ences. Ano he s udy e alua ed
G aphogame (a compu e game designed o p o ide in ensi e
aining in apid ecogni ion o g apheme-phoneme associa ions
and u he eading skills) in Finnish (Saine e al., 2011),
in 50 se en-yea -old child en a isk o de eloping eading
p oblems andomized o ei he a egula eading in e en ion
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FIGURE 3 | Risk o bias assessmen : pe cen age o included a icles ul illing each o he PED o scale i ems.
o a compu e assis ed in e en ion. The aining ook 66 h
and pe o mance was compa ed o usual class oom ac i i ies.
Signi ican aining-induced imp o emen s we e ound on
le e naming, eading luency and spelling. Addi ionally, hese
g oups we e compa ed o he mains eam eading g oup. The
o he wo s udies used Ab acadab a (a ee access, web-based
li e acy ool ha con ains ex s and s a egies o suppo wo d
eading, phonics, eading and lis ening comp ehension, and
eading luency) on Aus alian samples o child en be ween
5 and 9 yea s old ec ui ed om he a e age popula ion
o Canada and Aus alia, espec i ely, u ilizing he no mal
class oom cu iculum as he con ol ask (Sa age e al., 2013;
Wolgemu h e al., 2013). One o he s udies ound s a is ically
signi ican esul s in phonological awa eness and eading a e
30 h wi h a sample size o 308 pa icipan s, whe eas he
o he s udy epo ed di e ences in phonological skill and
le e knowledge a e 22 h o aining, and a sample size
o 1,067 pa icipan s. I is impo an o highligh ha none
o hese a icles ha e a con lic o in e es s a emen , so
he possibili y o undecla ed compe ing in e es s canno be
comple ely disca ded. Also, he a ie y o designs ( andomized
a he indi idual le el o he class oom le el, compa ing
compu e ized ainings agains o he emedia ion measu es
o he no mal class oom dynamic, among o he s), s a is ical
analyses (such as ANCOVA, ANOVA, hie a chical linea models
and linea eg ession) and comple eness o epo ing p ecluded
he calcula ion o any meaning ul common e ec size om
hese s udies.
DISCUSSION
Technologies e ol e a a e y as pace, and educa ional
digi al in e en ions a e no an excep ion nei he a he
school le el (Hubbe e al., 2016), no a he le el o
Uni e si y (A ondo e al., 2017) o non- o mal educa ion
(Os iz-Blanco e al., 2016). The cu en sys ema ic e iew
p o ides an o e iew o he cha ac e is ics o published esea ch
using digi al ools and in e en ions aimed a imp o ing
eading p ocesses. The o e a ching objec i e o ou analysis
is o p o ide a desc ip ion o he esea ch a ailable on
his opic, in o de o guide u u e in es iga ions on his
opic. O ganiza ions such as Wha Wo ks Clea inghouse
p o ide guidance on which speci ic in e en ions ha e a
g ea e e idence-based suppo (U.S. Depa men o Educa ion,
Ins i u e o Educa ion Sciences, 2009, 2010, 2013a,b, 2017),
and he e o e we did no in end o e alua e he e icacy o
exis ing ools. Con e sely, we p esen an o e iew on how
esea ch is ca ied ou on his ield o s udy, showing he
s eng hs and weaknesses o po en ia e he o me and mi iga e
he la e .
F om a me hodological poin o iew, he p o ocol o his
sys ema ic e iew was p e- egis e ed o educe he isk o bias
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(Os iz-Blanco and A ondo, 2018), in e na ional guidelines we e
ollowed h oughou i s de elopmen and epo ing (Mohe
e al., 2009, 2015), and sea ches we e ca ied ou o e h ee
di e en da abases and an agg ega o ha combines esul s
om o e six y addi ional da abases. A e sc eening o e ou
housand ini ial a icles, ou inal e iew comp ised 55 s udies
ha included a con ol g oup and in e -g oup compa isons.
Indeed, among he mos equen easons o exclusion was
he ac ha many s udies did no include such a g oup o
only e alua ed in aindi idual changes be ween p e and pos -
in e en ion phases. Howe e , wi hou p ope con ol g oups
and compa isons, s udies can ha dly assess e icacy, especially
when dealing wi h popula ions de eloping e y as such
as child en.
As s a ed abo e, ou sys ema ic e iew was no designed o
e alua e he e icacy o in e en ions. Mo eo e , he e y di e en
cha ac e is ics o he s udies and ools e iewed hampe he
possibili y o adequa ely compa ing esea ch ou comes, e en i
e ec sizes had been calcula ed. In any case, ou e iew highligh s
a numbe o ea u es ha , om a me hodological poin o iew,
a e sha ed by he highes quali y s udies included in ou analysis.
Fi e s udies ul illed c i e ia o be conside ed as wi h a high
quali y (Bo man e al., 2008; Saine e al., 2011; Sa age e al., 2013;
Wolgemu h e al., 2013): a low isk o bias, a ea men du a ion
o e 15 h and a combined sample size o e 128, and hence
capable o de ec ing a leas medium-sized e ec s. These s udies
showcase he expe imen al design ha u u e s udies should y
o emula e; addi ionally, hei esul s a e he mos in o ma i e
ega ding e ec i eness e alua ion.
Mos in e en ion p og ams we e implemen ed on
compu e s, whe eas we ound ew s udies using sma phones,
able s o ideogame sys ems. This migh seem su p ising since
mobile echnologies o e impo an ad an ages o e desk op
compu e s ega ding usabili y and mo i a ion, including he ac
ha hey a e ouch- and mo emen - esponsi e o ha child en
associa e hem o leisu e ac i i ies. As he e a e big delays
be ween he c ea ion o a p og am, i s es ing and he publica ion
o esul s, i is likely ha his p opo ion would change o e ime,
and upcoming s udies will e lec an in eg a ion o his ha dwa e
wi hin educa ional in e en ions. Simila ly, he majo i y o he
published in e en ions we e ca ied ou in English, some in
Spanish, and e y ew in o he languages. I is unknown whe he
he unde ep esen a ion o o he languages de i es om a lack
o ools o language aining in hose languages o a lack o
publica ion o esea ch esul s in in e na ional jou nals. In
his ega d, hei po en ial wo ld-wide audience could make
digi al sys ems especially sui ed o he implemen a ion o
p og ams ha ain language-independen eading- ela ed skills,
since such p og ams could be dis ibu ed wi h only mino
changes (Bu gs ahle , 2015). Rega ding he ype o language
skill ained, mos s udies p o ided ei he a di ec eading
aining o phonological aining. Ne e heless, he numbe o
s udies cen e ed on he imp o emen o o he skills, such as
hea ing o isual a en ion, was s ill ele an . S udies ha di ec ly
ained eading skills had a highe p opo ion o s a is ically
signi ican esul s in ou e iew, and simila indings ha e
been epo ed in he li e a u e. This could indica e ha di ec
language aining has highe e icacy han o he app oaches
and should be ecommended as he de aul app oach. Howe e ,
indi ec aining could also ha e ad an ages in some cases. Fo
example, i could be use ul as an ea ly in e en ion o e y
young child en a isk o la e de eloping eading p oblems
(Lyy inen e al., 2009; Snowling, 2013). Fu he mo e, i could
inc ease mo i a ion, as he aining does no ocus on an a ea
whe e he indi idual may eel impai ed (Wou e s e al., 2013).
Rema kably, all high-quali y s udies included in ou e iew
used hese di ec - aining app oaches, which indica es bo h a
highe le el o e idence o such in e en ions and he need o
u he high-quali y esea ch on he e ec i eness o non-di ec
ainings. Simila ly, s udies we e ypically aimed a p ima y
school s uden s ha we e ei he acqui ing o consolida ing
hei language skills. Resea ch on o he age segmen s, including
p eschoole s, seconda y school s uden s, o adul s is lacking.
Du a ion o in e en ions was highly a iable. Whe eas, i
is no clea om ou esul s i longe in e en ions lead o
be e ou comes, his seems a easonable assump ion. Wi hou
any doub , e y sho in e en ions we e ela ed o a lowe
a e o posi i e esul s. The c ea ion o engaging games ha
child en can use independen ly o ex ended pe iods could be
an e ec i e s a egy o ob ain eading imp o emen s wi hou
indi iduals eeling an inc ease in hei educa ional wo kload
o e ime.
Among he mos use ul aspec s o ake in o accoun when
de eloping u u e s udies is he isk o bias o p e ious published
esea ch. Mo eo e , i has been ecen ly p oposed ha e iews
should only be conside ed sys ema ic i hey e alua e he isk
o bias o included s udies (K nic Ma inic e al., 2019), a s ep
ha is a ely ca ied ou in sys ema ic e iews in psychology
(Lecle cq e al., 2019). Risk o bias was assessed by using he
PED o scale (Blobaum, 2006; Physio he apy E idence Da abase,
2012). Resul s indica ed ha none o he s udies he e had a
high isk o bias. This is pa ly explained by some o ou a-
p io i c i e ia o inclusion which o some ex en we e mo e
s ingen han he op ions p o ided by he scale. Fo example, by
equi ing ha s udies had o include in e -g oup compa isons,
he i em 10 and he i em 11 o he scale we e sa is ied in
all cases. Howe e , o he i ems o he scale, such as whe he
assessmen agen s we e blinded o he ea men g oup o he
pa icipan s equi e complex o ganiza ion when ca ying school-
based esea ch and we e e y a ely ul illed. Fu u e s udies
should be designed o y o o e come p e ious limi a ions
and should imp o e andomiza ion and blinding o all hose
in ol ed in he esea ch p ojec (pa icipan s, he apis s and
assesso s). While we equi ed ha all s udies included a con ol
g oup, no all esea ch in ol ed he same ype o con ols;
and his could g ea ly in luence he in e p e a ion o esul s.
Two hi ds o he in e en ions we e ca ied ou in addi ion
o ins ead o he s anda d class oom educa ion and compa ed
o he la e , whe eas only a ew s udies used ac i e linguis ic
asks as con ols. Rela edly, he ew s udies using ac i e linguis ic
asks had a educed p opo ion o signi ican esul s. Howe e ,
s udies wi hou such con ols would a mos be able o conclude
ha he me hodology es ed wo ks, bu would no be able
o e alua e i he aining p o ides an imp o emen o e any
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