Liltoda: The Cork start-up with an app to ensure no child is left behind

Cork start-up Liltoda sets out to “revolutionise” how children under three are assessed on their attention and ability to problem-solve.

“For many years, the feeling was that direct assessment at this age was not possible,” said founder and CEO Prof Deirdre Murray. “We have developed touchscreen tasks that can screen for early learning delay and build a cognitive profile for the child.”

As well as being available for early-stage assessment, Murray explained that Liltoda has been developed for use in multi-ethnic populations. “We are ensuring that children who have speech delay or for whom English is not their first language can also be assessed properly,” she said.

According to Murray, about half of children with learning delays go undetected until they start school. “They usually have to fail academically for several years before formal assessment and intervention takes place,” she said. “This affects their self-esteem and behaviour which, without the right supports, often become the bigger challenge for these children.”

‘Launching Liltoda will allow our research to become something that can really help children and their families’
– PROF DEIRDRE MURRAY

After graduating in medicine from University College Cork (UCC) in the mid-90s, Murray specialised in paediatrics and paediatric intensive care in Dublin, Bristol then Melbourne. She returned to Cork to complete a PhD in newborn brain injury. She remained in Ireland, becoming a consultant paediatrician in Cork University Hospital in 2008 and then head of the department of paediatrics there since 2018. She is also a principal investigator in paediatric research at the Infant research centre hosted by UCC.

With all her expertise as a paediatrician, Murray was frustrated by assessment methods for early childhood learning. She turned to her brother Sean Murray for help in improving this situation. Sean is director of UK-based gaming company Hello Games and is best known as the creative lead behind No Man’s Sky, a notably ambitious video game with an infinite procedurally generated galaxy to explore.

“He asked one of his top programmers, Stevie Burgess, to work on the touchscreen tasks with us,” said Murray. “This was the easy part.”

What followed was six years of testing and trials with children aged 18 months to three years. Only then did Murray feel she had “the evidence” she needed to launch a start-up in August last year.

“Launching Liltoda will allow our research to move from being ‘on the shelf’ to something that can really help children and their families,” she said.

‘An exciting thing about using gaming technology for cognitive assessment is that there is a constant feedback loop’
– PROF DEIRDRE MURRAY

Liltoda centres on core product CogniTot, which combines touchscreen and gaming technologies for cognitive assessment. The CogniTot tablet app is built using the cross-platform Unity game engine and runs on both iOS and Android devices.

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Murray likes the use of tablet-based apps because they are “very unobtrusive”.

“While a child is completing the tasks in the CogniTot app, in the background we collect a very rich dataset around how the child interacts with the game,” she explained.

This data includes processing speed, selective attention, working memory, acquired learning, problem solving, cognitive shift and sustained attention.

“Another exciting thing about using gaming technology for cognitive assessment is that there is a constant feedback loop,” Murray added. “As we are collecting so much data, it provides an excellent insight into what elements of CogniTot could be modified by our product development team to make it even better and also provides lots of hypotheses from which new products could be developed.”

For a start-up like this, spinning out from university research and dealing in data related to children, “You need good legal advice to get everything safely in place from the start,” Murray said.

For Liltoda, legal support came from Kieran Moran at local Cork firm JRAP O’Meara Solicitors, who had experience working with academic spin-outs. Murray herself also had experience dealing with the UCC Technology Transfer Office built up over many years working on different projects.

“We had to navigate licensing IP from both UCC and Hello Games. Making sure that all the right protections and licensing agreements are in place was important,” she said.

“Navigating an academic start-up is difficult,” Murray added. “You are negotiating with a very cautious and risk-avoidant partner who has the absolute veto on everything. UCC has to ensure overall that the reputation and the intellectual property of the university is protected. As university employees, we understood that, which helped.”

Liltoda has benefitted from the support of the UCC Health Innovation Hub. CTO Mike Cunneen also recently completed the Sprint accelerator at UCC, which Murray said has given him “the skills to commercialise research”.

‘The next steps will be to develop better tools for the early diagnosis of language delay and autism’
– PROF DEIRDRE MURRAY

Since Liltoda launched last August, Murray has been building the team and optimising the technology needed to share CogniTot securely with multiple users. “We are using this development time to establish links with academics in the UK, Denmark and USA,” she said.

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It’s early days yet for this start-up but Liltoda has already been invited to participate in a large international study to assess any learning impacts on hundreds of children who were born preterm.

“Trials take time to plan and deliver and so we aim to add additional studies over the next 18 months,” said Murray.

The plan is to continue working with paediatrics researchers, providing the technology to assist their investigations. “Our touchscreen tasks can reduce the time needed from over two hours to 20 minutes and can be administered by staff with basic training. It does not require a clinical psychologist,” Murray said of the advantages offered by using Liltoda’s tech in research.

“Down the line, we hope to have the ability to offer this type of assessment directly to parents in their homes,” Murray expanded. “We are developing the systems for home assessment by video link which will bring the opportunity for early cognitive assessment to all children.”

This broadening of access is important to Murray, whose ultimate goal is to create an environment in which “no child starts school with an undetected learning difficulty”.

“The next steps will be to develop better tools for the early diagnosis of language delay and autism,” said Murray. “We have been looking at eye tracking to map how infants interact socially and how we can use this to track early language development. Social skills have long been linked to early eye contact. In addition, infants with better language skills spend more time looking at the mouths of others.”

So far, Liltoda has not actively sought investment, choosing instead to “go as far as we can as a small focused team”, according to Murray.

While the CEO is assured that the technology has scope for scale without the need for a significant expansion of the team, she keeps that prospect on her horizon for later this year.

“We think that by the end of 2022 we will look to generate investment to expand,” she said.

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