~81 spots leftby Oct 2027

Feedback-Based Learning for Developmental Language Disorder

Recruiting in Palo Alto (17 mi)
YA
Overseen byYael Arbel, PhD
Age: < 18
Sex: Any
Travel: May Be Covered
Time Reimbursement: Varies
Trial Phase: Academic
Recruiting
Sponsor: MGH Institute of Health Professions
Disqualifiers: Hearing loss, Neurological deficits, others
No Placebo Group

Trial Summary

What is the purpose of this trial?

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.

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-Based Learning for Developmental Language Disorder?

Research indicates that children with developmental language disorder (DLD) may not benefit as much from feedback-based learning as their peers with typical development. Studies show that children with DLD perform better in feedback-free learning environments, suggesting that feedback processing is impaired in these children.12345

Is feedback-based learning safe for humans?

The research does not provide specific safety data for feedback-based learning, but it involves cognitive tasks and brain imaging, which are generally considered safe for human participants.36789

How does the feedback-based learning treatment for developmental language disorder differ from other treatments?

This treatment is unique because it focuses on how feedback timing and type (immediate or delayed, positive or negative) affect learning in children with developmental language disorder, highlighting that these children may benefit more from feedback-free environments compared to traditional feedback-based methods.123510

Research Team

YA

Yael Arbel, PhD

Principal Investigator

MGH Institute of Health Professions

Eligibility Criteria

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.

Trial Timeline

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)

Treatment Details

Interventions

  • Declarative learning with delayed feedback (Behavioural Intervention)
  • Declarative learning with immediate feedback (Behavioural Intervention)
  • Probabilistic learning with delayed feedback (Behavioural Intervention)
  • Probabilistic learning with immediate feedback (Behavioural Intervention)
  • Word learning task with active feedback (Behavioural Intervention)
  • Word learning task with passive feedback (Behavioural Intervention)
Trial OverviewThe 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.
Participant Groups
1Treatment groups
Experimental Treatment
Group I: Children with developmental language disorderExperimental Treatment6 Interventions

Find a Clinic Near You

Who Is Running the Clinical Trial?

MGH Institute of Health Professions

Lead Sponsor

Trials
19
Recruited
2,200+

Findings from Research

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.
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.
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.
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]

References

Learning With and Without Feedback in Children With Developmental Language Disorder. [2021]
With or without Feedback?-How the Presence of Feedback Affects Processing in Children with Developmental Language Disorder. [2023]
Feedback and stimulus-offset timing effects in perceptual category learning. [2021]
Effects of feedback delay on learning from positive and negative feedback in patients with Parkinson's disease off medication. [2019]
Feedback Processing During Probabilistic Learning in Children With Developmental Language Disorder: An Event-Related Potential Study. [2022]
When and why a failed test potentiates the effectiveness of subsequent study. [2013]
Learning by doing: an fMRI study of feedback-related brain activations. [2013]
Human midbrain sensitivity to cognitive feedback and uncertainty during classification learning. [2013]
On the relationship between learning strategy and feedback processing in the weather prediction task--Evidence from event-related potentials. [2015]
10.United Statespubmed.ncbi.nlm.nih.gov
Elaborative feedback: Engaging reward and task-relevant brain regions promotes learning in pseudoword reading aloud. [2019]