Retrieval Practice Strategies for Language Learning in Deaf and Hard of Hearing Children

Overseen By Jena C McDaniel, PhD

Age: < 18

Sex: Any

Trial Phase: Academic

Sponsor: Vanderbilt University Medical Center

Disqualifiers: Below average cognition, vision impairment, motor impairment

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

Compensation: Varies

Number of Visits: Unknown

16 Participants Needed

Trial Summary

What is the purpose of this trial?

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.

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 data supports the effectiveness of the treatment Feedback, No teaching control for language learning in deaf and hard of hearing children?

The research on auditory and audiovisual word learning for children with hearing loss shows that children can learn effectively with both auditory-only and audiovisual conditions compared to a no-teaching control, suggesting that feedback in language learning can be beneficial. Additionally, studies indicate that deaf children exposed to spoken language with signs tend to understand and produce more words, highlighting the potential effectiveness of feedback in language learning. ^{1 2 3 4 5}

Is retrieval practice safe for deaf and hard of hearing children?

The studies reviewed do not provide specific safety data for retrieval practice strategies in deaf and hard of hearing children, but they do not report any adverse effects related to similar educational interventions. ^{6 7 8 9 10}

How does the treatment for language learning in deaf and hard of hearing children differ from other treatments?

This treatment is unique because it focuses on retrieval practice strategies, which involve actively recalling information to enhance learning, rather than relying solely on visual or contextual cues. This approach is different from other methods that may emphasize explicit instruction or orthographic (spelling-related) facilitation, as it specifically targets the cognitive process of memory retrieval to improve language skills. ^{1 11 12 13 14}

Eligibility Criteria

This trial is for deaf and hard of hearing children aged 5-8 who only speak English, have some prelingual hearing loss, and normal nonverbal cognition. They should have basic receptive and expressive vocabulary skills but can't participate if they have severe motor impairments or uncorrected vision issues.

Inclusion Criteria

You have some level of hearing loss from birth.

You need to have good vocabulary skills, scoring at least 70 in tests for understanding and using words.

I only speak English.

Exclusion Criteria

You have difficulty with thinking and problem-solving skills without using words.

I have severe difficulty moving or controlling my movements.

You have vision problems that have not been fixed with glasses or contacts.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention

Participants undergo retrieval practice interventions focusing on feedback and spacing to improve word learning and retention

Up to 6 months

Follow-up

Participants are monitored for retention of word learning after the intervention

4 weeks

Treatment Details

Interventions

• Feedback
• No teaching control

Trial Overview The study tests how well different teaching methods help these children learn words. It compares giving feedback versus no feedback, and doing learning sessions close together (massed) versus spread out over time (spaced). There's also a control group with no teaching.

Participant Groups

Group I: Contrast D Experimental Treatment 3 Interventions

Spaced vs massed trials with feedback

Group II: Contrast C Experimental Treatment 3 Interventions

Spaced vs massed trials without feedback

Group III: Contrast B Experimental Treatment 3 Interventions

Feedback vs no feedback with spaced trials

Group IV: Contrast A Experimental Treatment 3 Interventions

Feedback vs no feedback with massed trials

Who Is Running the Clinical Trial?

Vanderbilt University Medical Center

Lead Sponsor

Trials

922

Recruited

939,000+

Findings from Research

Children with congenital hearing impairment showed better performance in non-word recall compared to real word recall, indicating specific challenges in verbal short-term memory related to spoken language.

Despite difficulties in recalling words, these children demonstrated strengths in visual working memory, suggesting that targeted interventions could help improve their spoken language skills and address their learning difficulties.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The strengths and weaknesses in verbal short-term memory and visual working memory in children with hearing impairment and additional language learning difficulties. Willis, S., Goldbart, J., Stansfield, J.[2014]

In a study involving four preschool children with prelingual hearing loss, both auditory-only (AO) and audiovisual (AV) interventions were effective for receptive word learning, showing that children can learn well with either method.

No significant difference in learning rates was found between the AO and AV conditions, suggesting that visual speechreading cues do not provide a clear advantage over auditory input alone in developing spoken language skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Comparing Auditory-Only and Audiovisual Word Learning for Children With Hearing Loss. McDaniel, J., Camarata, S., Yoder, P.[2020]

Deaf Italian preschoolers showed significant delays in vocabulary and grammar compared to hearing peers, but their language development was comparable to hearing children when matched for the duration of formal language experience, suggesting that the length of language education is crucial.

Deaf children who received language education that included both spoken language and sign language demonstrated better vocabulary and grammar skills than those who were taught only spoken language, highlighting the benefits of a multimodal approach to language learning.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Lexical and grammatical abilities in deaf Italian preschoolers: the role of duration of formal language experience. Rinaldi, P., Caselli, C.[2008]

Children with cochlear implants (CIs) showed significant improvement in language skills over time but still scored lower than their normal hearing (NH) peers, indicating ongoing challenges in language development.

Executive functioning (EF) skills in children with CIs were generally poorer than those of NH peers, and while language delays do not fully account for these differences, EF skills were found to predict future language development in children with CIs.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Longitudinal Development of Executive Functioning and Spoken Language Skills in Preschool-Aged Children With Cochlear Implants. Kronenberger, WG., Xu, H., Pisoni, DB.[2021]

Children with cochlear implants (CIs) showed difficulties in word learning, particularly in retaining new words over time, as they did not improve in retention like their hearing peers did.

While children with CIs performed similarly to their vocabulary-matched peers in fast mapping and extension tasks, their overall word learning abilities were less effective compared to age-matched hearing children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Word learning processes in children with cochlear implants. Walker, EA., McGregor, KK.[2021]

The study involved 42 deaf adolescents who were randomly assigned to either a treatment group using repeated readings or a control group practicing different material, showing that repeated readings significantly improved reading rates and word recognition accuracy.

In contrast, the control group, which did not use the repeated reading method, showed only minimal improvement, highlighting the effectiveness of this technique for enhancing reading skills in deaf students.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The effect of the method of repeated readings on the reading rate and word recognition accuracy of deaf adolescents. Ensor, A., Koller, J.[2019]

A study involving 108 bilingual deaf children aged 7-13 found that deafness has a negligible impact on cognitive functions like sustained attention and response inhibition.

The research highlighted that better language skills in both English and American Sign Language (ASL) positively correlate with cognitive performance, suggesting that language acquisition plays a significant role in cognitive development for deaf children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Development of visual sustained selective attention and response inhibition in deaf children. Dye, MWG., Terhune-Cotter, B.[2023]

Children with normal hearing performed better on a novel-word learning task (60% accuracy) compared to hearing-impaired children (41% accuracy), indicating that hearing status significantly affects word learning ability.

The study found that factors such as vocabulary size, stimulus level, and number of repetitions were important predictors of performance, suggesting that these elements can be crucial in developing effective learning strategies for children with hearing loss.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Novel-word learning in children with normal hearing and hearing loss. Stelmachowicz, PG., Pittman, AL., Hoover, BM., et al.[2016]

Congenitally deaf subjects showed lower accuracy and slower response times compared to normal-hearing subjects when recalling lists of consonant letters, indicating differences in memory retention strategies.

After being taught specific rehearsal strategies, both groups improved their performance, with deaf subjects matching the normal-hearing group's proficiency in primary memory tasks, but still showing slower responses for initial list items, suggesting challenges in secondary memory.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Instructed rehearsal strategies' influence on deaf memory processing. Belmont, JM., Karchmer, MA., Pilkonis, PA.[2019]

Deaf children with cochlear implants (CIs) demonstrated comparable verbal learning and memory (VLM) performance to normal-hearing (NH) peers, as both groups recalled the same number of words during tests.

However, CI users employed different strategies, showing increased use of serial clustering across trials, and their verbal working memory was linked to their ability to resist proactive interference, indicating unique cognitive processing related to their hearing experience.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Verbal learning and memory in prelingually deaf children with cochlear implants. Kronenberger, WG., Henning, SC., Ditmars, AM., et al.[2022]

In a study of prelingually and profoundly deaf children (average age 8.75 years), good readers utilized both speech and fingerspelling codes to recall printed letters, indicating effective use of linguistic strategies in reading.

Poor readers, on the other hand, did not show reliance on these linguistic codes, suggesting that the ability to use language-based representations is crucial for reading success, similar to hearing children.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Linguistic coding by deaf children in relation to beginning reading success. Hanson, VL., Liberman, IY., Shankweiler, D.[2019]

The vocabulary intervention combining explicit instruction and in-context activities was more effective for teaching new words to Deaf or Hard-of-Hearing children, as shown in a study with four participants who learned words more rapidly with this method.

In a second study with five participants, all children not only learned the targeted vocabulary but also improved their ability to express definitions and used the new words in spontaneous communication, highlighting the intervention's effectiveness in enhancing both vocabulary breadth and depth.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Explicit and Contextual Vocabulary Intervention: Effects on Word and Definition Learning. Antia, SD., Catalano, JA., Rivera, MC., et al.[2021]

In a study of 19 deaf or hard-of-hearing preschoolers, most children (11 out of 19) were able to learn new words using both a novel mapping strategy and explicit reference, indicating strong word-learning skills despite hearing challenges.

All children eventually developed the ability to learn new words in both contexts over time, suggesting that word-learning strategies can be acquired even in atypical language environments, and their vocabulary size was linked to their word-learning abilities.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Word-learning skills of deaf preschoolers: the development of novel mapping and rapid word-learning strategies. Lederberg, AR., Prezbindowski, AK., Spencer, PE.[2022]

The study found that the presence of written words (orthography) significantly helps children with hearing loss learn new vocabulary, showing lasting benefits over a week.

Children with hearing loss benefited more from the inclusion of spellings in vocabulary learning compared to their hearing peers, suggesting that incorporating orthography in teaching strategies could enhance their language skills.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Orthographic Facilitation of Oral Vocabulary Acquisition in Children With Hearing Loss. Salins, A., Leigh, G., Cupples, L., et al.[2021]

References

1. Ireland pubmed.ncbi.nlm.nih.gov

The strengths and weaknesses in verbal short-term memory and visual working memory in children with hearing impairment and additional language learning difficulties. [2014]

2. United States pubmed.ncbi.nlm.nih.gov

Comparing Auditory-Only and Audiovisual Word Learning for Children With Hearing Loss. [2020]

3. United States pubmed.ncbi.nlm.nih.gov

Lexical and grammatical abilities in deaf Italian preschoolers: the role of duration of formal language experience. [2008]

4. United States pubmed.ncbi.nlm.nih.gov

Longitudinal Development of Executive Functioning and Spoken Language Skills in Preschool-Aged Children With Cochlear Implants. [2021]

5. United States pubmed.ncbi.nlm.nih.gov

Word learning processes in children with cochlear implants. [2021]

6. United States pubmed.ncbi.nlm.nih.gov

The effect of the method of repeated readings on the reading rate and word recognition accuracy of deaf adolescents. [2019]

7. United States pubmed.ncbi.nlm.nih.gov

Development of visual sustained selective attention and response inhibition in deaf children. [2023]

8. United States pubmed.ncbi.nlm.nih.gov

Novel-word learning in children with normal hearing and hearing loss. [2016]

9. United States pubmed.ncbi.nlm.nih.gov

Instructed rehearsal strategies' influence on deaf memory processing. [2019]

10. England pubmed.ncbi.nlm.nih.gov

Verbal learning and memory in prelingually deaf children with cochlear implants. [2022]

11. United States pubmed.ncbi.nlm.nih.gov

Linguistic coding by deaf children in relation to beginning reading success. [2019]

12. United States pubmed.ncbi.nlm.nih.gov

Explicit and Contextual Vocabulary Intervention: Effects on Word and Definition Learning. [2021]

13. United States pubmed.ncbi.nlm.nih.gov

Word-learning skills of deaf preschoolers: the development of novel mapping and rapid word-learning strategies. [2022]

14. United States pubmed.ncbi.nlm.nih.gov

Orthographic Facilitation of Oral Vocabulary Acquisition in Children With Hearing Loss. [2021]