Optimizing Feedback-based Learning in Children With Developmental Language Disorder

NCT ID: NCT05678634

Last Updated: 2025-05-08

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

RECRUITING

Clinical Phase

NA

Total Enrollment

100 participants

Study Classification

INTERVENTIONAL

Study Start Date

2023-07-20

Study Completion Date

2027-10-01

Brief Summary

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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.

Detailed Description

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Conditions

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Developmental Language Disorder

Study Design

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Allocation Method

NA

Intervention Model

SINGLE_GROUP

Primary Study Purpose

BASIC_SCIENCE

Blinding Strategy

NONE

Study Groups

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Children with developmental language disorder

Group Type EXPERIMENTAL

Declarative learning with immediate feedback

Intervention Type BEHAVIORAL

Children will complete a paired associate learning task on a computer. Each response on half of the blocks will be followed by performance feedback. Feedback will be provided 500 ms following a response (button press)

Declarative learning with delayed feedback

Intervention Type BEHAVIORAL

Children will complete a paired associate learning task on a computer. Each response on half of the blocks will be followed by performance feedback. Feedback will be provided 5000 ms following a response (button press)

Probabilistic learning with immediate feedback

Intervention Type BEHAVIORAL

Children will complete a probabilistic learning task on a computer. Each response on half of the blocks will be followed by feedback. Feedback will be provided 500 ms following a response (button press)

Probabilistic learning with delayed feedback

Intervention Type BEHAVIORAL

Children will complete a probabilistic learning task on a computer. Each response on half of the blocks will be followed by feedback. Feedback will be provided 5000 ms following a response (button press)

Word learning task with active feedback

Intervention Type BEHAVIORAL

Children will complete a two-choice nonword learning task in which they will be tasked with learning to associate novel objects with novel nonword names through trial and error guided by feedback. Each response will be followed by feedback either indicating that the response is correct or prompting the child to try again (i.e., to correct an error)

Word learning task with passive feedback

Intervention Type BEHAVIORAL

Children will complete a two-choice nonword learning task in which they will be tasked with learning to associate novel objects with novel nonword names. Regardless of response accuracy on each trial, each response will be followed by a visual presentation of the correct response.

Interventions

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Declarative learning with immediate feedback

Children will complete a paired associate learning task on a computer. Each response on half of the blocks will be followed by performance feedback. Feedback will be provided 500 ms following a response (button press)

Intervention Type BEHAVIORAL

Declarative learning with delayed feedback

Children will complete a paired associate learning task on a computer. Each response on half of the blocks will be followed by performance feedback. Feedback will be provided 5000 ms following a response (button press)

Intervention Type BEHAVIORAL

Probabilistic learning with immediate feedback

Children will complete a probabilistic learning task on a computer. Each response on half of the blocks will be followed by feedback. Feedback will be provided 500 ms following a response (button press)

Intervention Type BEHAVIORAL

Probabilistic learning with delayed feedback

Children will complete a probabilistic learning task on a computer. Each response on half of the blocks will be followed by feedback. Feedback will be provided 5000 ms following a response (button press)

Intervention Type BEHAVIORAL

Word learning task with active feedback

Children will complete a two-choice nonword learning task in which they will be tasked with learning to associate novel objects with novel nonword names through trial and error guided by feedback. Each response will be followed by feedback either indicating that the response is correct or prompting the child to try again (i.e., to correct an error)

Intervention Type BEHAVIORAL

Word learning task with passive feedback

Children will complete a two-choice nonword learning task in which they will be tasked with learning to associate novel objects with novel nonword names. Regardless of response accuracy on each trial, each response will be followed by a visual presentation of the correct response.

Intervention Type BEHAVIORAL

Eligibility Criteria

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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
Minimum Eligible Age

8 Years

Maximum Eligible Age

12 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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MGH Institute of Health Professions

OTHER

Sponsor Role lead

Responsible Party

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Yael Arbel

Professor

Responsibility Role PRINCIPAL_INVESTIGATOR

Principal Investigators

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Yael Arbel, PhD

Role: PRINCIPAL_INVESTIGATOR

MGH Institute of Health Professions

Locations

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MGH Institute of Health Professions

Boston, Massachusetts, United States

Site Status RECRUITING

Countries

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United States

Central Contacts

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research coordinator

Role: CONTACT

(617) 724-7363

Facility Contacts

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Research Coordinator

Role: primary

(617) 724-7363

Other Identifiers

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2022P003376

Identifier Type: -

Identifier Source: org_study_id

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