Clinical trial NCT05678634: Optimizing Feedback-based Learning in Children With Developmental Language Disorder
Official title: Optimizing Feedback-based Learning in Children With Developmental Language Disorder
Study type: INTERVENTIONAL
Overall status: RECRUITING
Phase: NA
Conditions: Developmental Language Disorder
Lead sponsor: MGH Institute of Health Professions
Sponsor class: OTHER
First posted: 2023-01-10
Enrollment: 100
Sex: ALL
Minimum age (years): 8
Maximum age (years): 12
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: NA
Intervention model: SINGLE_GROUP
Primary purpose: BASIC_SCIENCE

Brief summary: This project aims to optimize a critical but understudied ingredient of language intervention provided to children with developmental language disorder (DLD) - feedback. The project will bridge a gap between previous findings in our lab of inefficient feedback processing in DLD and clinical practice by identifying the conditions under which feedback-based learning can be improved in DLD. The investigators hypothesize that the effectiveness of feedback can be significantly enhanced for children with DLD when it is tailored to their unique learning strengths. The rationale for this project is based on evidence that feedback-based learning can be improved by enhancing the dominance of an intact learning system. The project will achieve its aim by manipulating (1) the timing of the feedback (immediate vs. delayed) and (2) the level of the learner's involvement in error correction dictated by feedback (active vs. passive correction). Aim 1 will determine the effect of manipulating feedback timing on learning in 140 school-age children (8-12 years) with DLD. While immediate feedback is processed by the striatum, which is also implicated in implicit learning, delaying the feedback by a few seconds shifts feedback processing to the mediate temporal lobe (MTL)-based declarative learning system. Evidence that delaying feedback improves learning in DLD would support the hypothesis of the implicit deficit theory that intervention should capitalize on declarative learning mechanisms. The project will test a novel alternative feedback-learning parity hypothesis whereby feedback-based learning is optimized when the timing of the feedback is aligned with the dominant learning system at a given time (i.e., immediate feedback during striatal-based probabilistic learning; delayed feedback during MTL-based declarative learning). Within the same group of children, Aim 2 will compare feedback-based learning in children with DLD when feedback (a) prompts active self-correction or (b) passively exposes learners to error corrections (corrective recast). Children will engage in two nonword-object paired-associate learning tasks. In one task, feedback will promote active self-correction, which is in line with declarative learning. In the other task, feedback will passively expose the learner to corrective feedback in a manner consistent with teaching approaches aiming at reducing awareness of errors. The project will determine whether children with DLD learn better when feedback prompts self-correction or when they are exposed to passive corrections. Electrophysiological measures will indicate whether passive corrections (corrective recast) are processed as negative feedback by children with DLD. For both aims, behavioral indicators of response to feedback will be complemented by electrophysiological measures of feedback processing that can determine the involvement of the striatum and MTL brain systems during the learning process. This work is scientifically and clinically significant because elucidating what manipulations optimize feedback-based learning will enhance our understanding of the impaired learning mechanism in DLD and will provide clinical guidance on what type of feedback to use during an intervention.


Eligibility criteria: Inclusion Criteria:

* English as the primary language Nonverbal intelligence quotient (IQ) score on the Wechsler Intelligence Scale for Children-5th Edition (WISC-V) Standard Score \>70 Identification Core score on the Test of Integrated Language \& Literacy Skills (TILLS) equal to or less than 34

Exclusion Criteria:

* Hearing loss or other known neurological deficits, or diagnoses (e.g., Autism, Traumatic Brain Injury)
* Evidence of color blindness as measured by the EnChroma computer base color blindness screening test for children

Primary outcomes:
measure: Accuracy (percent correct) on a two-choice paired associate test immediately after the task
timeFrame: Immediately after learning task
measure: Accuracy (percent correct) on a two-choice paired associate test 1 week after the task
timeFrame: 1 week after the learning task
measure: FRN amplitude
timeFrame: During each learning task
measure: N170 amplitude
timeFrame: During each learning task
Secondary outcomes:
Other outcomes:
Locations:
city: Boston
country: United States
facility: MGH Institute of Health Professions
state: Massachusetts
Study officials:
affiliation: MGH Institute of Health Professions
name: Yael Arbel, PhD
role: PRINCIPAL_INVESTIGATOR
References: