Clinical trial NCT05692973: The Role of Knowledge Retrieval in Inference-making
Official title: The Role of Knowledge Retrieval in Inference-making Among Struggling Readers
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Reading Disability
Reading Problem
Keywords: Inference-making
Knowledge retrieval
Reading comprehension
Lead sponsor: William Jewell College
Sponsor class: OTHER
First posted: 2023-01-20
Enrollment: 316
Sex: ALL
Minimum age (years): 8
Maximum age (years): 14
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Intervention model description: In year 1 , Participants will be randomized to a variable test condition; repeated test condition; or a placebo condition to determine if the retrieval of knowledge through testing leads to improved inference making. In year 2, participants in the variable and repeated test conditions will receive a short intervention to determine if direct instruction in inferencing leads to improved inferencing and comprehension.
Primary purpose: TREATMENT

Brief summary: This project will (a) examine the relationship between knowledge retrieval and inferencing; (b) determine the effectiveness of an intervention that improves knowledge retrieval and inferencing among struggling readers; and (c) expand research opportunities for undergraduates. The research design uses 316 struggling readers in grades 4-6 of diverse backgrounds. The effects of knowledge retrieval (accuracy and speed) on inferencing will be modeled without dichotomizing the distribution. Linear mixed effect models will be fit to determine whether reader characteristics make unique contributions to inferencing across the posttest and follow-up data collection time points. First, several structural models will be considered as students may be nested in teachers, schools, and tutors. Unconditional models will estimate the intraclass correlation for each level of the study design. If significant interclass correlations emerge, multilevel models will be fit to evaluate the effectiveness of the intervention while controlling for covariates such as pre-test performance on inference-related measures and child-attributes such as English learner status. The primary analysis plan assumes an intent-to-treat model in which the efficacy of two intact conditions will be tested. Effect sizes will be estimated to report the magnitude of difference between the two conditions. Expected outcomes include (a) the identification of a method that effectively facilitates knowledge retrieval and the application of relevant knowledge to form inferences among elementary struggling readers from diverse backgrounds; (b) the validation of an intervention that teaches struggling readers how to activate, retrieve, and interweave relevant knowledge with information in the text and accurately form inferences while reading that can be broadly implemented in general education classrooms; and (c) expansion of undergraduate research opportunities, particularly among students from diverse backgrounds who have been historically underserved.

Detailed description: Theory and research suggest that inferencing serves as a critical aspect of comprehension and that inferencing fails when readers do not possess sufficient background knowledge or slowly retrieve and integrate knowledge from memory or text when reading. Research suggests that readers fluently retrieve and use knowledge that is well-connected to form inferences while reading. Further, inferencing among skilled comprehenders depends considerably on knowledge retrieval, thus implicating the important role knowledge plays in inferencing. Yet, very little research has examined how inferencing changes as a function of changes in knowledge. Understanding how inferencing adapts as a function of knowledge acquisition and knowledge use provides a necessary mechanism for refining how to improve this learning process, especially for older students with reading comprehension difficulties. This project fills this critical need. This project's goal is to determine if knowledge retrieval is a mechanism for improving inferencing among middle grade struggling readers attending rural schools. The central hypothesis is that knowledge is malleable, with fluent retrieval of relevant knowledge associated with improved inferencing. This hypothesis will be tested with the objective to evaluate knowledge retrieval methods and then test the effectiveness of an intervention that facilitates knowledge retrieval and inferencing among middle grade struggling readers attending rural schools. This proposal is scientifically important because it informs theory by determining whether fluent retrieval of relevant knowledge enables inferencing among struggling readers. It is practically important because it identifies the learning strategies struggling readers need to retrieve knowledge to make inferences. The rural context also becomes critically important here. Long-standing disparities in educational access exist for students of minority backgrounds, English-learners, and children at risk for learning disabilities who attend rural schools. However, fully powered randomized control trials rarely occur in rural settings and existing literature of studies in rural schools commonly contains methodological limitations. These gaps in the literature will be addressed through the following Aims.

Aim 1: Evaluate the relationship between knowledge retrieval and inferencing. This Aim will examine whether retrieval practice - a powerful and proven technique for enhancing knowledge retrieval, inferencing, and transfer among skilled adult readers - also improves knowledge retrieval and inferencing among rural, middle grade, struggling readers. Past research conducted in the middle grades shows that retrieval practice is associated with improved end-of-unit performance in content area classrooms. But no study has examined how, why, when, and for whom knowledge retrieval works and under what conditions for struggling readers. The primary hypothesis is that fluent retrieval of relevant knowledge facilitates inferencing. The expected outcome is the identification of a method that effectively facilitates knowledge retrieval and the application of relevant knowledge to form inferences among rural, middle grade, struggling readers.

Aim 2: Determine the effectiveness of an intervention that improves knowledge retrieval and inferencing. No intervention study has used knowledge retrieval techniques to help struggling readers retain new knowledge or retrieve and use relevant knowledge to form inferences while reading. The primary hypothesis is that changes in inferencing are associated with changes in knowledge retrieval; however, knowledge retrieval and inferencing must be explicitly taught and sufficiently practiced for inferencing to occur with the same regularity as skilled comprehenders use it. The expected outcome is the validation of an intervention that teaches rural, struggling middle grade readers how to activate, retrieve, and interweave relevant knowledge with information in the text to accurately form inferences while reading. Furthermore, very few reading intervention studies have occurred with middle grade struggling readers attending rural schools. The rural setting is important; existing practices do not consider the cumulative effects of rural poverty on general knowledge development and reading achievement or the long-term impact of limited access to academic support services. Additionally, only one inference intervention study has included English Learners. The English Learner population has increased substantially in rural communities, but past research shows that generalizing vocabulary and knowledge building interventions designed for monolinguals have not proven effective.

Aim 3. To expand undergraduate research opportunities by integrating undergraduate students on the research team with the knowledge and skills to successfully implement these randomized controlled trials.

Eligibility criteria: Inclusion Criteria:

* performance below a a standard score of 93 on the Test of Silent Reading Efficiency

Exclusion Criteria:

* clinical diagnosis of a significant cognitive impairment
* clinical diagnosis of a significant behavioral disability

Primary outcomes:
measure: Gates-MacGinite Reading Test-4th Edition; Change is being assessed
timeFrame: pre-intervention
measure: Gates-MacGinite Reading Test-4th Edition; change is being assessed
timeFrame: immediately after the intervention
measure: Test of Language Competence-Expanded; Change is being assessed
timeFrame: pre-intervention
measure: Test of Language Competence-Expanded; change is being assessed
timeFrame: immediately after the intervention
measure: Bridge-IT; change is being assessed
timeFrame: pre-intervention
measure: Bridge-IT; change is being assessed
timeFrame: immediately after the intervention
measure: Clinical Evaluation of Language Fundamentals-5; change is being assessed
timeFrame: pre-intervention
measure: Clinical Evaluation of Language Fundamentals-5; change is being assessed
timeFrame: immediately after the intervention
Secondary outcomes:
measure: Knowledge Retrieval; change is being assessed
timeFrame: pre-intervention
measure: Knowledge Retrieval; change is being assessed
timeFrame: Immediately after the intervention
measure: Knowledge Retrieval; change is being assessed
timeFrame: one-week after the intervention
measure: Knowledge Retrieval; change is being assessed
timeFrame: one-month after the intervention
measure: Test of Word Reading Efficiency-2; change is being assessed
timeFrame: pre-intervention
measure: Test of Word Reading Efficiency-2; change is being assessed
timeFrame: immediately after the intervention
measure: Metacognition survey; change is being assessed
timeFrame: pre-intervention
measure: Metacognition survey; change is being assessed
timeFrame: immediately after the intervention
measure: Contextualized Reading Strategy Survey; change is being assessed
timeFrame: pre-intervention
measure: Contextualized Reading Strategy Survey; change is being assessed
timeFrame: immediately after the intervention
measure: Working Memory Test Battery for Children
timeFrame: pre-intervention
measure: Kauffman Brief Intelligence Test-2
timeFrame: pre-intervention
measure: Gates-MacGinitie Vocabulary Test; change is being assessed
timeFrame: pre-intervention
measure: Gates-MacGinitie Vocabulary Test; change is being assessed
timeFrame: immediately after the intervention
measure: Egyptian Content Knowledge; change is being assessed
timeFrame: pre-intervention
measure: Egyptian Content Knowledge; change is being assessed
timeFrame: immediately after the intervention
measure: Test of Silent Reading Efficiency and Comprehension; change is being assessed
timeFrame: pre-intervention
measure: Test of Silent Reading Efficiency and Comprehension; change is being assessed
timeFrame: immediately after the intervention
measure: Test of Silent Contextual Reading Fluency; change is being assessed
timeFrame: pre-intervention
measure: Test of Silent Contextual Reading Fluency; change is being assessed
timeFrame: immediately after the intervention
measure: CBM-Maze Task; change is being assessed
timeFrame: pre-intervention
measure: CBM-Maze Task; change is being assessed
timeFrame: immediately after the intervention
Other outcomes:
measure: Test of Silent Reading Efficiency and Comprehension
timeFrame: baseline screening of participants; pre-intervention
Locations:
city: Excelsior Springs
country: United States
facility: Excelsior Springs School District
state: Missouri
Study officials:
affiliation: William Jewell College
name: Amy E Barth, Ph.D
role: PRINCIPAL_INVESTIGATOR
References:
citation: Barth AE, Elleman A. Evaluating the Impact of a Multistrategy Inference Intervention for Middle-Grade Struggling Readers. Lang Speech Hear Serv Sch. 2017 Jan 1;48(1):31-41. doi: 10.1044/2016_LSHSS-16-0041.
citation: Barth AE, Daniel J, Roberts G, Vaughn S, Barnes MA, Ankrum E, Kincaid H. The Role of Knowledge Availability in Forming Inferences with Rural Middle Grade English Learners. Learn Individ Differ. 2021 May;88:102006. doi: 10.1016/j.lindif.2021.102006. Epub 2021 May 12.