Design and Evaluation of a Serious Game Prototype to Stimulate Pre-Reading Fluency Processes in Paediatric Hospital Classrooms

Didactic digital tools can commence, enhance, and strengthen reading fluency in children undergoing long-term hospitalization due to oncology conditions. However, resources specifically designed to support rapid naming and decoding in Spanish remain scarce. This study presents the design, development, and evaluation of a game prototype aimed at addressing this gap among Spanish-speaking preschoolers in hospital settings. Developed using Unity through a design-based research methodology, the game comprises three narratively linked levels targeting rapid naming, decoding, and fluency. A sequential exploratory mixed-methods design (QUAL-quan) guided the evaluation. Qualitative data were obtained from a focus group of hospital teachers (N = 6) and interviews with experts (N = 30) in relevant fields. Quantitative validation involved 274 experts assessing the game’s contextual, pedagogical, and technical quality. The prototype was also piloted with four end-users using standardised tests for rapid naming, decoding, and fluency in Spanish. Results indicated strong expert consensus regarding the game’s educational value, contextual fit, and usability. Preliminary findings suggest potential for fostering and supplementing early literacy skills in hospitalised children. Further research with larger clinical samples is recommended to validate these outcomes.