Strategies for Teaching Verbs
Phase: NA
Conditions: Language Development Disorders, Down Syndrome, Child Language
Sponsor: Vanderbilt University Medical Center

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Study Title: Strategies for Teaching Verbs 
NCT number: NCT03441685 
Document date: Uploaded 11/23/2020  

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Strategies for Teaching Verbs – Study Protocol and Statistical Analysis Plan  
 
BACKGROUND 
Purpose 
This study is designed to evaluate whether children with language impairment, children with 
Down syndrome, and children with typical development exhibit different levels of accuracy 
demonstrating and labeling novel verbs taught under three conditions: semantic cues (perform 
action), syntactic cues (sentence frame), and combined (syntactic and semantic cues).  
 
Conditions 
1. Semantic cues (perform action) 
2. Syntactic cues (sentence frame) 
3. Combined (syntactic and semantic cues) 
 
Primary Dependent Variable 
Percent accuracy identifying taught words from a field of two  
 
Secondary Dependent Variable  
Percent accuracy labeling taught words  
 
 
 

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TEACHING PHASE 
Prior to session 
Obtain list specifying the order of conditions and the order of words for each condition. Also note 
that the sets are counterbalanced across conditions across participants (i.e., 1/3 of participants 
will be taught Set 1 in the semantic condition, 1/3 have Set 1 in the syntactic cues condition, and 
1/3 have Set 1 in the combined condition).  
 
During the Session 
I. Turn on camera and announce the date and participant ID.   
II. Make sure examiner and participant are in appropriate view of camera.  
III. Complete two trial items including testing. First do syntactic cues then do semantic cues.   
 
Introduce the task: “Today I will teach you some new moves that have special names. 
Some of these moves are silly. After I show you how to do these moves, I’m going to ask 
you show me how to do them and I will ask you their names. Remember, I’m going to 
show you these moves, and then I’m going to ask you to find them. Do your best to 
remember their names. First it is my turn. You sit with a quiet body and watch. Then it 
will be your turn. Let’s try some.”  
 
Note about feedback: The examiner must provide some type of evaluative feedback. The 
examiner is not required to say “Yes” or “No” specifically.  
 
Possible positive/correct responses (not an exhaustive list): “Yes,” “Correct,” “Right,” and 
“You go it!”  
 
Possible negative/incorrect responses (not an exhaustive list): “No,” “Close,” “Not quite,” 
“Oops,” and “Listen again.”  
 
Nood: /nud/; place hands on hips and turn (similar to “washing machine” exercise from 
elementary school)  
 
Syntactic Cues 
1. Demonstrate and label target 
word  
Examiner says, “I am nooding,” while acting out the 
action.  
2. Demonstrate and label target 
word 
Examiner says, “See. I nood,” while acting out the action. 
3. Elicit label from participant  
Examiner says, “Tell me that.”  
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
4. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. I am nooding,” while acting out the action 
(or an equivalent form).  
If incorrect: “No. I am nooding,” while acting out the action 
(or an equivalent form).  
 
  
5. Demonstrate and label target 
word 
Examiner says, “I nood,” while acting out the action. 
6. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
7. Provide feedback on label  
Examiner provides feedback:  

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If correct: “Yes. I nood,” while acting out the action (or an 
equivalent form).  
If incorrect: “No. I nood,” while acting out the action (or an 
equivalent form). 
 
 
8. Demonstrate and label target 
word 
Examiner says, “See. I am nooding,” while acting out the 
action. 
 
 
“Let’s stand up for this one. Remember, I’m going to show you these moves, and then 
I’m going to ask to find them. Do your best to remember their names. I will show you how 
to do the moves. Then it will be your turn.” 
 
Bome: /bom/; moving on leg in a circle close the floor with toe pointed  
 
Semantic Cues 
1. Demonstrate and label target 
word  
Examiner says, “Boming,” while acting out the action.  
2. Demonstrate and label target 
word 
Examiner says, “Boming,” while acting out the action. 
3. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
4. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. Boming,” while acting out the action (or 
an equivalent form).  
If incorrect: “No. Boming,” while acting out the action (or 
an equivalent form). 
5. Elicit demonstration  
Examiner says, “Show me.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Show me what I did.” 
6. Provide feedback on 
demonstration  
Examiner provides feedback:  
If correct: “Yes. Boming,” while acting out the action (or 
an equivalent form).  
If incorrect: “No. Boming,” while acting out the action (or 
an equivalent form). 
7. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
8. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. Boming,” while acting out the action (or 
an equivalent form).  
If incorrect: “No. Boming,” while acting out the action (or 
an equivalent form). 
9. Elicit demonstration 
Examiner says, “Show me.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Show me what I did.” 
10. Provide feedback on 
demonstration  
Examiner provides feedback:  
If correct: “Yes. Boming,” while acting out the action (or 
an equivalent form).  

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If incorrect: “No. Boming,” while acting out the action (or 
an equivalent form). 
 
IV. Testing Practice Words with Feedback  
a. Using the powerpoint with the side-by-side options 
b. Say, “I’m going to ask you to point to the actions I just taught you. Be sure to 
look at both pictures. Sometimes the pictures switch sides, so look carefully. 
If you are not sure of the answer, take your best guess. Let’s practice some.”  
c. “Point to jumping.” (Examiner may say, “Which one?” is the child does not 
respond after a few seconds.)   
i. If correct → “You’re right! That’s jumping.” 
ii. If incorrect → “This is jumping.” 
d. “Let try another one. Point to eating.” 
i. If correct → “You’re right! That’s eating.” 
ii. If incorrect → “This is eating,” while pointing to the correct video on the 
screen. 
e. “Point to nading.” (Examiner may say, “Which one?” is the child does not 
respond after a few seconds.)   
i. If correct → “You’re right! That’s nading.” 
ii. If incorrect → “This is nading,” while pointing to the correct video on the 
screen.  
f. “Point boming.” (Examiner may say, “Which one?” is the child does not respond 
after a few seconds.)   
i. If correct → “You’re right! That’s boming.” 
ii. If incorrect → “This is boming,” while pointing to the correct video on the 
screen. 
 
V. Complete the following steps for each target word in all three conditions. Be sure to follow 
the order of conditions for that particular participant. NOTE THAT TESTING IS 
COMPLETING IMMEDIATELY AFTER TEACHING FOR EACH CONDITION (e.g., Teach 
2 Combined → Test 2 Combined → Teach 2 Combined → Test 2 Combined → Teach 2 
Semantic → Test 2 Semantic → Teach 2 Semantic → Test 2 Semantic → Teach 2 
Syntactic → Test 2 Syntactic → Teach 2 Syntactic → Test 2 Syntactic).  
a. For feedback, if the participant does not provide a response or the examiner 
cannot determine whether it is accurate in the moment, it is acceptable to only 
perform and label the action as long as it is clear the examiner is labeling the 
ongoing action.  
b. Provide participants with a brief (approximately 10-min) break between conditions.  
c. If a participant shows signs of low motivation, limited motivation, and/or inattention 
as evidenced by reduced responsiveness and/or turning away from the examiner, 
for example, the examiner may implement use of additional social praise, external 
reinforcers (e.g., stickers, stamps), and/or reminders of how much work is left 
before a break.  
 
Semantic Cues: Introduce the task:  
“Let’s learn some more. Remember, I’m going to show you these moves, and then 
I’m going to ask you to point to them. Do your best to remember their names. 
Let’s stand up. I will show you how to do the moves. Then it will be your turn. 
Let’s try some.” 
 

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Semantic Cues 
1. Demonstrate and label target 
word  
Examiner says, “______ing,” while acting out the action.  
2. Demonstrate and label target 
word 
Examiner says, “______ing,” while acting out the action. 
3. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
4. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. ______ing,” while acting out the action 
(or an equivalent form).  
If incorrect: “No. ______ing,” while action out the action 
(or an equivalent form). 
5. Elicit demonstration  
Examiner says, “Show me.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Show me what I did.” 
6. Provide feedback on 
demonstration  
Examiner provides feedback:  
If correct: “Yes. ______ing,” while action out the action 
(or an equivalent form).  
If incorrect: “No. ______ing,” while acting out the action 
(or an equivalent form). 
7. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
8. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. ______ing,” while acting out the action 
(or an equivalent form).  
If incorrect: “No. ______ing,” while acting out the action 
(or an equivalent form). 
9. Elicit demonstration 
Examiner says, “Show me.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Show me what I did.”  
10. Provide feedback on 
demonstration  
Examiner provides feedback:  
If correct: “Yes. ______ing,” while acting out the action 
(or an equivalent form).  
If incorrect: “No. ______ing,” while acting out the action 
(or an equivalent form). 
 
To transition to the next item, say, “Let’s do another one.”  
 
Syntactic Cues: Introduce the task:  
“Let’s learn some more. Remember, I’m going to show you these moves, and then 
I’m going to ask you to point to them. Do your best to remember their names. First 
it is my turn. You sit with a quiet body and watch. Then it will be your turn. Let’s 
try some.” 
 
Syntactic Cues 
1. Demonstrate and label target 
word  
Examiner says, “I am ______ing,” while acting out the 
action.  

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2. Demonstrate and label target 
word 
Examiner says, “See. I ______,” while acting out the 
action. 
3. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
4. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. I am ______ing,” while acting out the 
action (or an equivalent form).  
If incorrect: “No. I am ______ing,” while acting out the 
action (or an equivalent form). 
 
  
5. Demonstrate and label target 
word 
Examiner says, “I  ______,” while acting out the action. 
6. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
7. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. I ______,” while acting out the action (or 
an equivalent form).  
If incorrect: “No. I ______,” while acting out the action (or 
an equivalent form). 
 
 
8. Demonstrate and label target 
word 
Examiner says, “See. I am ______ing,” while acting out 
the action. 
 
Combined Cues: Introduce the task:  
“Let’s learn some more. Remember, I’m going to show you these moves, and then 
I’m going to ask you to point to them. Do your best to remember their names. 
Let’s stand up. I will show you how to do the moves. Then it will be your turn. 
Let’s try some.” 
 
Combined Cues 
1. Demonstrate and label target 
word  
Examiner says, “I am ______ing,” while acting out the 
action.  
2. Demonstrate and label target 
word 
Examiner says, “See. I ______,” while acting out the 
action. 
3. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
4. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. I am ______ing,” while acting out the 
action (or an equivalent form).  
If incorrect: “No. I am ______ing,” while acting out the 
action (or an equivalent form). 
5. Elicit demonstration  
Examiner says, “Show me.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Show me what I did.” 
6. Provide feedback on 
demonstration  
Examiner provides feedback:  
If correct: “Yes. I ______,” while acting out the action (or 
an equivalent form).  

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If incorrect: “No. I ______,” while acting out the action (or 
an equivalent form). 
7. Elicit label from participant  
Examiner says, “Tell me that.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Tell me what I did.” 
8. Provide feedback on label  
Examiner provides feedback:  
If correct: “Yes. I ______,” while acting out the action (or 
an equivalent form).  
If incorrect: “No. I ______,” while acting out the action (or 
an equivalent form). 
9. Elicit demonstration 
Examiner says, “Show me.” 
If the child asks about what he or she is supposed to do, 
the examiner may say, “Show me what I did.” 
10. Provide feedback on 
demonstration  
Examiner provides feedback:  
If correct: “Yes. I am ______ing,” while acting out the 
action (or an equivalent form).  
If incorrect: “No. I am ______ing,” while acting out the 
action (or an equivalent form). 
 
TESTING PHASE 
Receptive probes are administered after every two words are taught within a condition. 
Expressive probes are at the end of the condition. Testing after each condition is designed to 
minimize the order effects due to increased memory load as time progresses. Testing after two 
items is designed to decrease the memory load for the task and reduce interference of other 
words. Participants will have a brief break (e.g., receive a sticker and play with a toy appropriate 
for their developmental level) between teaching and testing.  
 
Prior to Session 
Obtain list of randomly ordered words for each set. Words are tested in a random order 
independent of the order they were taught.  
 
Receptive Trials 
a. Examiner and participant stand up for the duration of the assessment.   
b. Say, “I’m going to ask you to point to the actions I just taught you. 
Remember to look at both pictures. If you are not sure of the answer, take 
your best guess. Let’s practice some.”  
c. “Point to jumping.” (Examiner may say, “Which one?” is the child does not 
respond after a few seconds.)   
i. If correct → “You’re right! That’s jumping.” 
ii. If incorrect → “This is jumping,” while pointing to the correct video. 
d. “Let try another one. Point to eating.”  
i. If correct → “You’re right! That’s eating.” 
ii. If incorrect → “This is eating,” while pointing to the correct video. 
e. Test each word based on the list of randomly ordered words prepared before the 
session.  
f. 
Say, “Point to (target word)-ing” Be sure to use the “-ing” marker. For example, 
“Point to meebing.”  
g. Wait for 5 seconds or until the participant provides a response.  
i. If the participant does not respond in approximately 5 seconds, repeat the 
prompt (e.g., “Point to meebing.”) or say, “Which one?” 

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ii. If the participant still does not respond, proceed to the next word and record 
NR for “no response.”  
iii. The prompt may also be repeated if the participant requests a repetition or 
the participant appears to not have heard the prompt (e.g., participant 
sneezed when examiner said the word).  
h. When the participant responds, acknowledge the response without providing any 
feedback regarding the accuracy of the response (e.g., “Okay.”).  
i. 
Score item as correct (1) or incorrect (0).  
i. If the participant makes a self-correction after the examiner says the next 
trial, the examiner says, “That’s okay. Point to what I just said.” In addition 
to that statement, one repetition is permitted. If a participant makes a self-
correction prior to the examiner presenting the next item, the 5-second 
guideline does not apply.  
ii. If the participant says, “I don’t know,” or an equivalent statement, the trial is 
scored as incorrect.  
iii. If the participant does not respond, the trial is scored as incorrect. 
iv. If the examiner repeats the prompt more than once and the participant does 
not respond until after the third presentation (second repetition), the trial is 
scored as incorrect because the examiner is not allowed to repeat prompts 
more than once.  
 
a. Repeat for the two words that have been taught in the set. 
b. Repeat for the next two words of the set after teaching those words. Introduce the 
second and subsequent testing sessions by saying, “I’m going to ask you to 
point to the actions I JUST taught you. I will only ask about the new ones. If 
you are not sure of the answer, take your best guess. Let’s practice some.”  
c. Administer the two practice items.  
d. “Point to jumping.”  
e. “Point to eating.” 
f. 
After teaching the next set of words (i.e., in a different condition), probe them with 
the steps above.  
g. Repeat for the final set of words.  
  
II. For expressive trials 
a. Say, “This time I am going to show you the actions one at a time and ask you 
what they are doing. If you are not sure of the answer, take your best guess. 
Let’s practice some.”  
b. Show practice video of person jumping. “What is she doing?”  
c. Provide feedback on the participant’s accuracy.  
i. If correct → “You’re right! She is jumping.” 
ii. If incorrect → “She is jumping.” 
d. Say, “Now try this one.”  
e. Show video of person walking.  
f. 
Provide feedback on the participant’s accuracy.  
i. If correct → “You’re right! She is eating.” 
ii. If incorrect → “She is eating.” 
g. Then test each word based on the list of randomly ordered words prepared before 
the session. This list includes the four taught words for the current condition 
randomly mixed.   
h. Play first video. “What is she doing?” 
i. 
Wait for 5 seconds or until the participant provides a response.  

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i. If the participant does not respond in approximately 5 seconds, repeat the 
prompt (e.g., “What is she doing.”) and replay the video.  
ii. If the participant still does not respond, proceed to the next word and record 
NR for “no response.”  
iii. The prompt may also be repeated if the participant requests a repetition or 
the participant appears to not have heard the prompt or seen the video 
(e.g., participant sneezed when examiner said the word).  
j. 
When the participant responds, acknowledge the response without providing any 
feedback regarding the accuracy of the response.  
k. Record that the participant says in IPA (International Phonetic Alphabet), including 
any articulation errors.  
l. 
Score item as correct (1) or incorrect (0).  
i. For expressive items, the examiner scores each trial as correct if the 
participant says the name of the object or an intelligible approximation that 
includes acceptable speech production errors within approximately 5 
seconds of the examiner’s prompt. Appendices B.1 and B.2 should be used 
a references to determine whether speech errors are acceptable. Only the 
word root is scored for accuracy. Word endings (e.g., “-ing,” “-ed” and “-s”) 
are not scored.  
ii. If the participant makes a self-correction after the examiner says the next 
trial, the examiner says, “That’s okay. Show me what I just said.” In addition 
to that statement, one repetition is permitted. If a participant makes a self-
correction prior to the examiner presenting the next item, the 5-second 
guideline does not apply.  
iii. If the participant says, “I don’t know,” or an equivalent statement, the trial is 
scored as incorrect.  
iv. If the participant does not respond, the trial is scored as incorrect. 
v. If the examiner repeats the prompt more than once and the participant does 
not respond until after the third presentation (second repetition), the trial is 
scored as incorrect because the examiner is not allowed to repeat prompts 
more than once.  
m. Repeat for all four words in the set. 
n. After teaching the next set of words, probe then with the steps above.  
o. Repeat for the final set of words.  
III. Stop the recording device.  
 
STATISTICAL ANALYSIS PLAN 
 
Primary research questions:  
1. Do children identify novel verbs taught under three conditions with greater than chance 
accuracy (i.e., >50%): semantic cues (perform action), syntactic cues (sentence frame), 
or combined semantic and syntactic cues (perform action and sentence frame)?  
a. One-sample Wilcoxon signed rank test with comparison value of 6 
2. Do children exhibit different levels of accuracy identifying novel verbs taught under the 
three conditions? 
a. Wilcoxon signed ranks test comparing each condition to one another using the 
primary outcome variable of receptive accuracy.  
 
Secondary research questions:  
3. Do children accurately label novel verbs taught under the three conditions? 

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a. One-sample Wilcoxon signed rank test with comparison value of 0  
4. Do children exhibit different levels of accuracy labeling novel verbs taught under the 
three conditions? 
a. Wilcoxon signed ranks test comparing each condition to one another using the 
secondary outcome variable of expressive accuracy.