Training Language and Literacy for Children Who Use CIs

Study Overview
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Brief Summary
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This study aims to determine the effectiveness of computer games to improve language and literacy outcomes for children who have hearing loss. Children will be assigned to one of four conditions: phonological awareness training, working memory training, phonological awareness + working memory training, or active control.

Detailed Description
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Both phonological awareness and working memory are known to be important for children's language and literacy learning. Though there are computer games that claim to improve phonological awareness and working memory, it is unknown if these games will improve language and literacy skills for children who have hearing loss. The investigators will first determine if the games are effective for improving language and phonological awareness in children with hearing loss relative to an active control condition. Secondly, the investigators will determine if gains in phonological awareness and working memory translate into gains in language and literacy skills relative to active control.

Official Title
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Training-Induced Language and Literacy Improvement in Children With Cochlear Implants

Conditions
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Hearing Loss, Sensorineural

Intervention / Treatment
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* Behavioral: Phonological Awareness
* Behavioral: Working Memory
* Behavioral: Phonological Awareness + Working Memory
* Behavioral: Active Control


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Prelingual hearing loss Use of amplification device (hearing aid and/or cochlear implant) for at least one year Able to visit the clinic 3x/week for 12 weeks Exclusion Criteria: No developmental delays (Down's syndrome, Autism spectrum disorder)

Ages Eligible for Study
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Minimum Age: 5 Years
Maximum Age: 7 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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Accepts Healthy Volunteers

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Randomized
Intervention Model: Factorial Assignment
Interventional Model Description: The efficacy of phonological awareness (Earobics) and working memory (Cogmed) training alone and in combination are compared to an active control (Splashmath).
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Phonological Awareness<br>Children will play games to practice their rhyming, sound sequencing, and letter-sound knowledge. These games are all implemented in the Earobics program. | Behavioral: Phonological Awareness<br>* Earobics training<br>|
| Experimental: Working Memory<br>Children will play games designed to help them hold and manipulate objects in memory. These games are implemented in Cogmed. | Behavioral: Working Memory<br>* Cogmed training<br>|
| Experimental: Phonological Awareness + Working Memory<br>Children will practice both their sound skills (Earobics) and their memory skills (Cogmed). | Behavioral: Phonological Awareness + Working Memory<br>* Earobics + Cogmed training<br>|
| Active Comparator: Active Control<br>Children will play games to practice their addition and subtraction skills (Splashmath). | Behavioral: Active Control<br>* Spashmath<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Phonological Awareness Test scores | Change in a standardized test of phonological awareness. Scores are from 0-100 with higher scores indicating better performance. | Baseline, post-intervention (8 weeks post-baseline), 6 months post-baseline | 
| Change inComprehensive Test of Phonological Awareness | Change in a standardized test of phonological awareness. Scores are from 0-100 with higher scores indicating better performance. | Baseline, post-intervention (8 weeks post-baseline), 6 months post-baseline | 
| Change in Children's Test of Nonword Repetition | Change in a standardized test of verbal working memory | Baseline, post-intervention (8 weeks post-baseline), 6 months post-baseline | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Change in Oral Written Language Scales | Change in a standardized test of language and literacy skills. Measures performance on expressive and receptive language, and reading and writing abilities. Scores are age-adjusted. | Baseline, post-intervention (8 weeks post-baseline), 6 months post-baseline | 
| Change in Receptive/Expressive One Word Picture Vocabulary Test | Change in a standardized test of vocabulary knowledge. Scores are from 0-100 with higher scores indicating better performance. | Baseline, post-intervention (8 weeks post-baseline), 6 months post-baseline | 
| Change in Woodcock Johnson Reading Mastery Test | Change in a standardized test of early literacy skills. Scores are from 0-100 with higher scores indicating better performance. | Baseline, post-intervention (8 weeks post-baseline), 6 months post-baseline |