Signing Instruction for Deafness

(SISI Trial)

Age: Any Age

Sex: Any

Trial Phase: Academic

Sponsor: The University of Tennessee, Knoxville

Disqualifiers: Hearing students, others

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

Compensation: Varies

Number of Visits: Unknown

Duration: 9 academic months

150 Participants Needed

Trial Summary

Do I need to stop my current medications to join the trial?

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

What data supports the effectiveness of the treatment Strategic and Interactive Signing Instruction (SISI) for deafness?

Research on a similar approach, Strategic and Interactive Writing Instruction (SIWI), shows it improved writing and language skills in deaf and hard of hearing students, suggesting that interactive and strategic methods can be effective in enhancing communication skills. ^{1 2 3 4 5}

How is the Strategic and Interactive Signing Instruction (SISI) treatment different from other treatments for deafness?

The Strategic and Interactive Signing Instruction (SISI) treatment is unique because it focuses on improving communication skills through interactive signing, which involves teaching individuals to initiate and respond to signed communication in natural settings. This approach is distinct from other treatments as it emphasizes interactive dialogue and practical application, rather than just theoretical learning. ^{1 2 6 7 8}

What is the purpose of this trial?

Strategic and interactive approaches driven by sociocultural, cognitive, and language theories have accumulated a large body of evidence documenting improvements in more complex oral and written language skills. Growing evidence demonstrates that more complex sign language skills positively predict literacy skills and may lead to improved health outcomes. This project involves new applications of theory-driven strategic and interactive approaches in an intervention program to target sign language development in deaf children between 5 and 8 years old who are at high risk of language delays.

Eligibility Criteria

This trial is for deaf children aged 5 to 8 who are at high risk of language delays. It aims to improve their sign language skills, which may help with literacy and health outcomes.

Inclusion Criteria

I am a deaf student in grades pre-K to 3.

I am a teacher for the deaf from pre-K to 3rd grade.

Exclusion Criteria

Non-teachers of the deaf

Hearing students

I am a teacher for the deaf from 4th grade upwards.

Timeline

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Intervention Development

Development of the Strategic and Interactive Signing Instruction (SISI) manual and protocols

3 months

Teacher Training

Teachers receive training on SISI implementation and fidelity

2 months

Treatment

Implementation of SISI to improve sign language skills in deaf children

9 academic months

Follow-up

Participants are monitored for improvements in sign language and written language skills

3 months

Treatment Details

Interventions

• Strategic and Interactive Signing Instruction

Trial Overview The trial tests a new program based on sociocultural, cognitive, and language theories. It uses strategic and interactive methods to enhance complex sign language skills in these children.

Participant Groups

Group I: Single Case Research Design: Deaf Children's Language Growth Experimental Treatment 1 Intervention

Single case research design will provide robust day-to-day data of causal relations between SISI and sign language skills. Given teachers' high fidelity in SISI implementation, a noncurrent multiple baseline design across child participants will be applied to assess the extent of SISI improving deaf children's target sign language skills in a year. The independent variable of this study is the SISI implementation, which is used to improve the dependent variables which will be target sign language skills.

Group II: Pre- and Post- Descriptive Study Data of Language Outcomes Children Experimental Treatment 1 Intervention

Up to 40 children from 4 classes will provide pre- and post-data in which they respond to a prompt in sign language on video.

Group III: Improving Teacher Fidelity to SISI Experimental Treatment 1 Intervention

A noncurrent multiple baseline design across teacher participants will be utilized to assess the extent of support required by teachers to become proficient in SISI implementation. In this study, the independent variable is the SISI training, and the dependent variable is teacher fidelity to the SISI program as measured by the SISI fidelity checklist.

Group IV: Control and Experimental Groups: SISI Efficacy Experimental Treatment 1 Intervention

This pre- and post- study provides baseline data on deaf children's sign language development prior to receiving SISI. Additionally, each participating teacher will submit a recorded instructional unit showcasing their best methods for supporting sign language development. This provides a further layer of baseline analysis, allowing the PI to assess the instructional methods already in use prior to SISI professional development and implementation. Demographic data for both teachers and students will also be collected in preparation for the quasi-experiment study. Then, teachers will be assigned to either an experimental group, which will receive SISI professional development, or a control group that will continue with their usual teaching practices. In this quasi-experiment study, SISI's efficacy will be evaluated by comparing outcomes between the two groups.

Who Is Running the Clinical Trial?

The University of Tennessee, Knoxville

Lead Sponsor

Trials

93

Recruited

19,500+

National Institute on Deafness and Other Communication Disorders (NIDCD)

Collaborator

Trials

377

Recruited

190,000+

Findings from Research

Strategic and Interactive Writing Instruction (SIWI) significantly improved the writing skills of deaf and hard of hearing elementary students, particularly in information reports and persuasive writing, as shown by five case studies.

A larger group study with 31 students also demonstrated statistically significant improvements across all writing genres, indicating that SIWI is an effective instructional method for enhancing written expression in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

The Writing Performance of Elementary Students Receiving Strategic and Interactive Writing Instruction. Wolbers, KA., Dostal, HM., Graham, S., et al.[2015]

A training program effectively taught manual sign language skills to various staff members (including paraprofessionals, habilitation specialists, and nurses) in three studies, ensuring they could communicate with severely and profoundly mentally retarded individuals.

The staff not only learned the signs quickly but also maintained their skills over time and incorporated them into daily interactions, highlighting the importance of training caregivers for functional communication in this population.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A rapid training procedure for teaching manual sign language skills to multidisciplinary institutional staff. Fitzgerald, JR., Reid, DH., Schepis, MM., et al.[2019]

Over a 12-month period, five hearing parents of hearing-impaired children showed significant improvements in their communication skills, including spoken and signed input, after receiving targeted feedback and intervention sessions.

All parents made progress in at least one area of communication, enabling them to deliver clear and understandable messages to their children, which is crucial for effective interaction and support.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Enhancing parents' use of SEE-2. Progress and retention. Luetke-Stahlman, B., Moeller, MP.[2019]

A 66-week sign language training program for a brain-damaged, aphasic patient resulted in the learning of 14 signs, demonstrating the potential for communication improvement in such patients.

Inclusion of a peer during training significantly enhanced the patient's performance and socialization, leading to increased eye contact, gestures, and attempted speech, with retention of skills observed even months after the program ended.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

Peer-facilitated sign language training for a geriatric stroke victim with chronic brain damage. Wisocki, PA., Mosher, PM.[2015]

The DAVID instructional system combines motion, color, and audio from instructional television with interactive features to meet the unique educational needs of deaf students, enhancing their learning experience.

Preliminary testing of the DAVID system, developed for the National Technical Institute for the Deaf, showed promising results in effectively engaging deaf students through individualized instruction and immediate feedback.

NCBI (Pubmed)

pubmed.ncbi.nlm.nih.gov

A description of the DAVID interactive instructional television system and its application to post-high school education of the deaf. vonFeldt, JR.[2019]

References

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

The Writing Performance of Elementary Students Receiving Strategic and Interactive Writing Instruction. [2015]

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

A rapid training procedure for teaching manual sign language skills to multidisciplinary institutional staff. [2019]

3. Brazil pubmed.ncbi.nlm.nih.gov

[Effect of sound amplification on parent's communicative modalities]. [2019]

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

Enhancing parents' use of SEE-2. Progress and retention. [2019]

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

Peer-facilitated sign language training for a geriatric stroke victim with chronic brain damage. [2015]

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

A description of the DAVID interactive instructional television system and its application to post-high school education of the deaf. [2019]

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

Teaching interactive signing in a dialogue situation to mentally retarded individuals. [2019]

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

A comparison of the learnability of manual sign and Blissymbolics with nonhandicapped adults. [2019]