Retrieval Practice for Word Learning for Deaf and Hard of Hearing Children

Study Overview
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Brief Summary
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This study is designed to advance the promising yet underutilized research on retrieval practice by evaluating the effectiveness and efficiency of two key retrieval practice features (feedback and spacing). The study uses four single case adapted alternating treatments studies, each with four 5- to 8-year-old children who are deaf and hard of hearing to evaluate the effects of feedback and spacing on the efficiency of word learning and retention.

Detailed Description
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The proposed research addresses a long-standing and important challenge of improving language skills of children who are deaf and hard of hearing, a historically under researched group. The study aims to leverage retrieval practice - an empirically validated intervention approach - for improving how efficiently children who are deaf and hard of hearing learn and retain new words. To advance the promising yet underutilized research on retrieval practice, the study completes the next logical step of evaluating the effectiveness and efficiency of two key retrieval practice features: feedback and spacing. Feedback is predicted to result in more efficient learning because it focuses attention on unmastered material, prevents the illusion of success, and reduces repeated errors. Spacing trials are predicted to result in more efficient learning than massed trials because they require more effort with fewer cues provided. The study will accomplish these aims through four single case adapted alternating treatments design studies with sixteen 5- to 8- year-old children who are deaf and hard of hearing. Study innovations include the critical evaluation of retention and use of a multi-session intervention context. The knowledge gained will guide language intervention for children who are deaf and hard of hearing.

Official Title
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Increasing Word Learning Efficiency in Children Who Are Deaf and Hard of Hearing Through Retrieval Practice

Conditions
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Hearing Loss, Language Impairment

Intervention / Treatment
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* Behavioral: Feedback with massed trials
* Behavioral: Feedback with spaced trials
* Behavioral: No feedback with massed trials
* Behavioral: No feedback with spaced trials
* Behavioral: No teaching control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: At least minimal prelingual hearing loss Standard scores of at least 70 for receptive and expressive vocabulary skills English is only spoken language Exclusion Criteria: Below average nonverbal cognition Uncorrected vision impairment Evidence of severe motor impairment

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 8 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Parallel Assignment
Interventional Model Description: Adapted alternating treatments research design with 3 conditions per participant. Four participants are randomly assigned to each contrast (arm).
Masking: None (Open Label)


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Contrast A<br>Feedback vs no feedback with massed trials | Behavioral: Feedback with massed trials<br>* The participant receives feedback on their accuracy completing retrieval practice tasks. Exposures for one word are provided before moving to the next word in each session.<br>Behavioral: No feedback with massed trials<br>* The participant does not receive feedback on their accuracy completing retrieval practice tasks. Exposures for one word are provided before moving to the next word in each session.<br>Behavioral: No teaching control<br>* The words in this set are not taught, only assessed.<br>|
| Experimental: Contrast B<br>Feedback vs no feedback with spaced trials | Behavioral: Feedback with spaced trials<br>* The participant receives feedback on their accuracy completing retrieval practice tasks. Exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.<br>Behavioral: No feedback with spaced trials<br>* The participant does not receive feedback on their accuracy completing retrieval practice tasks. Exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.<br>Behavioral: No teaching control<br>* The words in this set are not taught, only assessed.<br>|
| Experimental: Contrast C<br>Spaced vs massed trials without feedback | Behavioral: No feedback with massed trials<br>* The participant does not receive feedback on their accuracy completing retrieval practice tasks. Exposures for one word are provided before moving to the next word in each session.<br>Behavioral: No feedback with spaced trials<br>* The participant does not receive feedback on their accuracy completing retrieval practice tasks. Exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.<br>Behavioral: No teaching control<br>* The words in this set are not taught, only assessed.<br>|
| Experimental: Contrast D<br>Spaced vs massed trials with feedback | Behavioral: Feedback with massed trials<br>* The participant receives feedback on their accuracy completing retrieval practice tasks. Exposures for one word are provided before moving to the next word in each session.<br>Behavioral: Feedback with spaced trials<br>* The participant receives feedback on their accuracy completing retrieval practice tasks. Exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.<br>Behavioral: No teaching control<br>* The words in this set are not taught, only assessed.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Labeling - acquisition | Percent accuracy labeling target words expressively (number of target words correctly labeled when shown the object divided by the number of words in the set [i.e., 4] times 100) | End of intervention. The intervention ends when the participant achieves >75% accuracy 3 sessions in a row (up to 6 months). | 
| Labeling - retention | Percent accuracy labeling target words expressively (number of target words correctly labeled when shown the object divided by the number of words in the set [i.e., 4] times 100) | Four weeks after the intervention ends | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Identifying - acquisition | Percent accuracy identifying target words receptively (number of objects correctly identified when target word is named divided by the number of words in the set [i.e., 4] times 100) | End of intervention. The intervention ends when the participant achieves >75% accuracy for labeling 3 sessions in a row (up to 6 months). | 
| Semantic - acquisition | Percent accuracy labeling associated semantic information (i.e., location; number of target objects' locations correctly named when shown the object divided by the number of words in the set [i.e., 4] times 100) | End of intervention. The intervention ends when the participant achieves >75% accuracy for labeling 3 sessions in a row (up to 6 months). | 
| Identifying - retention | Percent accuracy identifying target words receptively (number of objects correctly identified when target word is named divided by the number of words in the set [i.e., 4] times 100) | Four weeks after the intervention ends | 
| Semantic - retention | Percent accuracy labeling associated semantic information (i.e., location; number of target objects' locations correctly named when shown the object divided by the number of words in the set [i.e., 4] times 100) | Four weeks after the intervention ends |