Feedback-Based Learning for Developmental Language Disorder

Overseen By research coordinator

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: MGH Institute of Health Professions

Disqualifiers: Hearing loss, Neurological deficits, others

No Placebo Group All trial participants will receive the active study treatment (no placebo)

Compensation: Varies

Number of Visits: 1

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to enhance language learning in children with developmental language disorder (DLD) by focusing on feedback. Researchers seek to determine if altering the timing of feedback (immediate vs. delayed) and the method of feedback (active self-correction vs. passive correction) can improve learning outcomes. Children who primarily speak English and have identified language challenges, without other neurological issues, may be suitable for this study. The goal is to identify the most effective feedback strategies in language interventions, such as declarative learning with delayed feedback, to support children with DLD. As an unphased trial, this study offers a unique opportunity to contribute to groundbreaking research that could transform language learning strategies for children with DLD.

Will I have to stop taking my current medications?

The trial information does not specify whether participants need to stop taking their current medications.

What prior data suggests that this feedback-based learning method is safe for children with developmental language disorder?

Research shows that learning treatments using feedback, studied to assist children with developmental language disorder (DLD), are generally safe. Studies have examined how children with DLD respond to various feedback types, including immediate or delayed feedback, and whether they correct their own mistakes or are shown the correct answers.

Current evidence reveals no major safety issues with these learning tasks, which primarily engage the brain's learning and memory systems. The focus remains on how well children understand and use feedback, rather than on any physical treatment. Therefore, these treatments are expected to be as well-tolerated as regular school activities. However, participants should always discuss any concerns with the clinical trial team. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about this trial because it explores innovative learning techniques for children with developmental language disorder. Unlike traditional speech therapy, which often focuses on repetition and structured practice, these methods incorporate declarative and probabilistic learning strategies with varying feedback timings. By examining how immediate versus delayed and active versus passive feedback affects language acquisition, the trial aims to uncover more effective ways to enhance language learning. The hope is to tailor interventions to individual learning needs, potentially leading to more personalized and efficient language development support.

What evidence suggests that this trial's treatments could be effective for developmental language disorder?

Research has shown that feedback-based learning can be customized to help children with developmental language disorder (DLD) learn more effectively. This trial will explore various feedback strategies, including declarative learning with both delayed and immediate feedback, as well as probabilistic learning with delayed and immediate feedback. Studies have found that delayed feedback can enhance learning by engaging the brain's memory for facts and events, making it easier for children to retain information. In contrast, immediate feedback might not be as beneficial for these children. Additionally, research suggests that feedback encouraging self-correction can improve word learning, while feedback that doesn't actively involve the child may be less effective. ^{1 3 6 7 8}

Who Is on the Research Team?

Yael Arbel, PhD

Principal Investigator

MGH Institute of Health Professions

Are You a Good Fit for This Trial?

This trial is for English-speaking children aged 8-12 with developmental language disorder (DLD), having an IQ score above 70 and specific language test scores. It excludes those with hearing loss, neurological issues like ADHD or autism, traumatic brain injury, or color blindness.

Inclusion Criteria

Your IQ score is higher than 70 on a specific test for kids.

Your score on the Test of Integrated Language & Literacy Skills (TILLS) is 34 or lower.

English as the primary language

Exclusion Criteria

I have hearing loss or a neurological condition like ADD, Autism, or TBI.

You have been tested and found to have color blindness using a special computer test for children.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Learning Task

Children engage in nonword-object paired-associate learning tasks with feedback manipulation

4 weeks

Weekly sessions

Immediate Post-Task Assessment

Accuracy on a two-choice paired-associate test immediately after the learning task

Immediately after learning task

Follow-up Assessment

Accuracy on a two-choice paired-associate test to evaluate learning retention

1 week

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• Declarative learning with delayed feedback
• Declarative learning with immediate feedback
• Probabilistic learning with delayed feedback
• Probabilistic learning with immediate feedback
• Word learning task with active feedback
• Word learning task with passive feedback

Trial Overview The study tests how different types of feedback affect learning in children with DLD. It varies the timing (immediate vs delayed) and involvement (active self-correction vs passive exposure to corrections) during tasks designed to enhance language skills through tailored feedback.

How Is the Trial Designed?

Group I: Children with developmental language disorder Experimental Treatment 6 Interventions

Who Is Running the Clinical Trial?

MGH Institute of Health Professions

Lead Sponsor

Trials

19

Recruited

2,200+

Published Research Related to This Trial

Elaborative feedback (EF) during learning activates brain regions associated with both reward processing and orthography-phonology conversion, making it more effective than simple positive feedback (PF) or content feedback (CF).

The study found that EF not only enhances learning by engaging multiple brain areas but is also perceived as more pleasant, indicating that combining reward and skill information may improve the learning experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Elaborative feedback: Engaging reward and task-relevant brain regions promotes learning in pseudoword reading aloud. Mattheiss, SR., Alexander, EJ., Graves, WW.[2019]

In a study using event-related potentials (ERPs) during a weather prediction task, it was found that declarative learners showed a more pronounced P300 response to feedback compared to non-declarative learners, indicating different neural processing mechanisms for feedback.

The differences in feedback processing persisted even when declarative learners switched to a non-declarative strategy later in the task, suggesting that these neural mechanisms are robust and distinct across learning strategies.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

On the relationship between learning strategy and feedback processing in the weather prediction task--Evidence from event-related potentials. Rustemeier, M., Schwabe, L., Bellebaum, C.[2015]

The study used functional magnetic resonance imaging (fMRI) to explore how the mesencephalic dopaminergic system (MDS) neurons respond to feedback and uncertainty during probabilistic classification learning in humans.

Results showed that MDS activity was significantly different for negative versus positive feedback, indicating that these neurons play a role in coding prediction errors and are sensitive to uncertainty, which may enhance learning processes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Human midbrain sensitivity to cognitive feedback and uncertainty during classification learning. Aron, AR., Shohamy, D., Clark, J., et al.[2013]

Children with developmental language disorder (DLD) showed lower accuracy in classifying stimuli and were less likely to repeat correct responses after positive feedback compared to their typically developing (TD) peers, indicating challenges in feedback processing.

Electrophysiological data revealed that children with DLD had a diminished response to feedback, as evidenced by a smaller feedback-related negativity effect, suggesting they may struggle to effectively use feedback for learning compared to TD children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feedback Processing During Probabilistic Learning in Children With Developmental Language Disorder: An Event-Related Potential Study. Gul, A., Baron, L., Arbel, Y.[2022]

Failed tests can actually enhance learning, especially when followed by immediate feedback, as shown in three experiments that demonstrated greater retention compared to just presenting information.

The mechanism behind this effect involves activating related knowledge while suppressing the correct answer, which can lead to better learning outcomes when feedback is provided right away.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

When and why a failed test potentiates the effectiveness of subsequent study. Hays, MJ., Kornell, N., Bjork, RA.[2013]

Information-integration learning is most effective with a feedback delay of 500 milliseconds, especially when the stimulus disappears after the response, highlighting the importance of timing in learning processes.

Variability in feedback delay negatively impacts learning; a large variance (SD=150ms) reduces effectiveness, while a smaller variance (SD=75ms) does not, indicating that consistent timing is crucial for optimal learning outcomes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Feedback and stimulus-offset timing effects in perceptual category learning. Worthy, DA., Markman, AB., Todd Maddox, W.[2021]

In a study using rapid event-related functional magnetic resonance imaging with normal human volunteers, positive feedback during learning activated brain areas associated with the reward system, such as the ventral striatum and anterior cingulate cortex.

The study found that positive feedback led to increased blood flow in certain brain regions, while negative feedback resulted in decreased activity, highlighting the importance of positive reinforcement in learning processes.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning by doing: an fMRI study of feedback-related brain activations. Marco-Pallarés, J., Müller, SV., Münte, TF.[2013]

Children with developmental language disorder (DLD) showed poorer learning outcomes compared to their peers, but both groups performed better in a feedback-free learning environment than in one with performance feedback.

The study found that children with DLD did not process feedback effectively, as they did not show a difference in response to positive and negative feedback, suggesting that feedback-based learning may not be beneficial for them.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Learning With and Without Feedback in Children With Developmental Language Disorder. Arbel, Y., Fitzpatrick, I., He, X.[2021]

Children with developmental language disorder (DLD) showed lower accuracy in learning tasks that involved performance feedback compared to typically developing (TD) peers, indicating a specific challenge in processing feedback for language acquisition.

However, when feedback was removed, children with DLD performed similarly to TD children, suggesting that their learning abilities can match those of their peers when the task does not require feedback processing.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

With or without Feedback?-How the Presence of Feedback Affects Processing in Children with Developmental Language Disorder. Baron, LS., Gul, A., Arbel, Y.[2023]

Parkinson's Disease (PD) patients OFF medication show a stronger bias towards negative feedback learning compared to healthy controls, indicating a significant impact of diminished dopamine levels on learning processes.

While PD patients were impaired in learning from immediate feedback, they did not show the same impairment with delayed feedback, suggesting that feedback timing does not significantly alter their negative learning bias.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Effects of feedback delay on learning from positive and negative feedback in patients with Parkinson's disease off medication. Weismüller, B., Ghio, M., Logmin, K., et al.[2019]

Citations

1. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC10742330/

Declarative Learning Mechanisms Support Declarative but ... Declarative and probabilistic feedback-based learning was evaluated in 8–12-year-old school-age children with developmental language disorder (DLD)

2. pmc.ncbi.nlm.nih.gov pmc.ncbi.nlm.nih.gov/articles/PMC8608225/

Learning With and Without Feedback in Children With ... The behavioral and electrophysiological data provide evidence that feedback processing is impaired in children with developmental language disorders. Future ...

3. researchgate.net researchgate.net/publication/376006263_Declarative_Learning_Mechanisms_Support_Declarative_but_Not_Probabilistic_Feedback-Based_Learning_in_Children_with_Developmental_Language_Disorder_DLD

(PDF) Declarative Learning Mechanisms Support ... Declarative and probabilistic feedback-based learning was evaluated in 8–12-year-old school-age children with developmental language ...

4. sciencedirect.com sciencedirect.com/science/article/abs/pii/S1074742721001404

Delaying feedback compensates for impaired ... These findings attest to a dissociation between procedural-based and declarative-based learning in developmental dyslexia within a single task, a finding that ...

5. mdpi.com mdpi.com/2076-3425/13/9/1263

With or without Feedback?—How the Presence of ... Children with TD achieved higher accuracy than children with DLD following feedback-based training, while the two groups achieved similar levels of accuracy ...

6. pubmed.ncbi.nlm.nih.gov pubmed.ncbi.nlm.nih.gov/38137097/

Declarative Learning Mechanisms Support ... - PubMed Declarative and probabilistic feedback-based learning was evaluated in 8-12-year-old school-age children with developmental language disorder (DLD)

7. researchgate.net researchgate.net/publication/344563296_THE_EFFECTS_OF_IMMEDIATE_AND_DELAYED_CORRECTIVE_FEEDBACK_ON_L2_DEVELOPMENT

the effects of immediate and delayed corrective feedback ... This article reports on a study exploring the differential effects of immediate and delayed corrective feedback (CF) on the acquisition of the English past ...

8. nature.com nature.com/articles/s41599-024-03983-6

Timing of feedback and retrieval practice: a laboratory ... This study aims to examine the effects of both immediate and delayed feedback on retrieval practice using prose passages among EFL students.