Retrieval Practice for Word Learning for Deaf and Hard of Hearing Children

Increasing Word Learning Efficiency in Children Who Are Deaf and Hard of Hearing Through Retrieval Practice

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 5- to 9-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.

Study Overview

• Status: Completed
• Conditions: Hearing Loss; Language Impairment
• Intervention / Treatment: Behavioral: Feedback with massed trials; Behavioral: No feedback with massed trials; Behavioral: Feedback with spaced trials; Behavioral: No feedback with spaced trials

Detailed Description

The proposed research addresses a long-standing and important challenge of improving language skills of children who are deaf and hard of hearing, a historically under researched group. The study aims to leverage retrieval practice - an empirically validated intervention approach - for improving how efficiently children who are deaf and hard of hearing learn and retain new words. To advance the promising yet underutilized research on retrieval practice, the study completes the next logical step of evaluating the effectiveness and efficiency of two key retrieval practice features: feedback and spacing. Feedback is predicted to result in more efficient learning because it focuses attention on unmastered material, prevents the illusion of success, and reduces repeated errors. Spacing trials are predicted to result in more efficient learning than massed trials because they require more effort with fewer cues provided. The study will accomplish these aims through four single case adapted alternating treatments design studies with 5- to 9- year-old children who are deaf and hard of hearing. Study innovations include the critical evaluation of retention and use of a multi-session intervention context. The knowledge gained will guide language intervention for children who are deaf and hard of hearing.

• Study Type: Interventional
• Enrollment (Actual): 13
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Tennessee
    • Nashville, Tennessee, United States, 37232
      • Vanderbilt University Medical Center

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: 5 years to 8 years (Child)
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• At least minimal prelingual hearing loss
• Standard scores of at least 70 for receptive and expressive vocabulary skills
• English is only spoken language

Exclusion Criteria:

• Below average nonverbal cognition
• Uncorrected vision impairment
• Evidence of severe motor impairment

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: Randomized
• Interventional Model: Parallel Assignment
• Masking: None (Open Label)

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Contrast A; Feedback vs no feedback with massed trials	Behavioral: Feedback with massed trials; The participant receives feedback on their accuracy completing retrieval practice tasks. For massed trials, exposures for one word are provided before moving to the next word in each session.; Behavioral: No feedback with massed trials; The participant does not receive feedback on their accuracy completing retrieval practice tasks. For massed trials, exposures for one word are provided before moving to the next word in each session.
Experimental: Contrast B; Feedback vs no feedback with spaced trials	Behavioral: Feedback with spaced trials; The participant receives feedback on their accuracy completing retrieval practice tasks. For spaced trials, exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.; Behavioral: No feedback with spaced trials; The participant does not receive feedback on their accuracy completing retrieval practice tasks. For spaced trials, exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.
Experimental: Contrast C; Spaced vs massed trials without feedback	Behavioral: No feedback with massed trials; The participant does not receive feedback on their accuracy completing retrieval practice tasks. For massed trials, exposures for one word are provided before moving to the next word in each session.; Behavioral: No feedback with spaced trials; The participant does not receive feedback on their accuracy completing retrieval practice tasks. For spaced trials, exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.
Experimental: Contrast D; Spaced vs massed trials with feedback	Behavioral: Feedback with massed trials; The participant receives feedback on their accuracy completing retrieval practice tasks. For massed trials, exposures for one word are provided before moving to the next word in each session.; Behavioral: Feedback with spaced trials; The participant receives feedback on their accuracy completing retrieval practice tasks. For spaced trials, exposures for each word are interspersed with one another (e.g., an exposure for word 1, then one for word 3, then one for word 2, etc.) in each session.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Labeling - Acquisition Effectiveness	Count of participants for whom the intervention is successful based on percent accuracy labeling target words expressively (number of target words correctly labeled when shown the object divided by the number of words in the set [i.e., 4] times 100). The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for at least one active intervention condition versus the control condition within the comparison phase.	End of intervention. The intervention ends when the participant achieves >75% accuracy 3 sessions in a row (up to 6 months).
Labeling - Acquisition Efficiency	Count of participants for whom the intervention is successful based on percent accuracy labeling target words expressively (number of target words correctly labeled when shown the object divided by the number of words in the set [i.e., 4] times 100). The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for the condition hypothesized to be superior (i.e., "feedback" or "spaced") within the comparison phase.	End of intervention. The intervention ends when the participant achieves >75% accuracy 3 sessions in a row (up to 6 months).
Labeling - Retention Effectiveness	Count of participants for whom the intervention is successful based on percent accuracy labeling target words expressively (number of target words correctly labeled when shown the object divided by the number of words in the set [i.e., 4] times 100). The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for at least one active intervention condition versus the control condition within the maintenance phase.	Four weeks after the intervention ends
Labeling - Retention Efficiency	Count of participants for whom the intervention is successful based on percent accuracy labeling target words expressively (number of target words correctly labeled when shown the object divided by the number of words in the set [i.e., 4] times 100). The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for the condition hypothesized to be superior (i.e., "feedback" or "spaced") within the maintenance phase.	Four weeks after the intervention ends

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Identifying - Acquisition Effectiveness	Count of participants for whom the intervention is successful based on percent accuracy identifying target words receptively (number of objects correctly identified when target word is named divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for at least one active intervention condition versus the control condition within the comparison phase.	End of intervention. The intervention ends when the participant achieves >75% accuracy for labeling 3 sessions in a row (up to 6 months).
Identifying - Acquisition Efficiency	Count of participants for whom the intervention is successful based on percent accuracy identifying target words receptively (number of objects correctly identified when target word is named divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for the condition hypothesized to be superior (i.e., "feedback" or "spaced") within the comparison phase.	End of intervention. The intervention ends when the participant achieves >75% accuracy for labeling 3 sessions in a row (up to 6 months).
Semantic - Acquisition Effectiveness	Count of participants for whom the intervention is successful based on percent accuracy labeling associated semantic information (i.e., location; number of target objects' locations correctly named when shown the object divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for at least one active intervention condition versus the control condition within the comparison phase.	End of intervention. The intervention ends when the participant achieves >75% accuracy for labeling 3 sessions in a row (up to 6 months).
Semantic - Acquisition Efficiency	Count of participants for whom the intervention is successful based on percent accuracy labeling associated semantic information (i.e., location; number of target objects' locations correctly named when shown the object divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for the condition hypothesized to be superior (i.e., "feedback" or "spaced") within the comparison phase.	End of intervention. The intervention ends when the participant achieves >75% accuracy for labeling 3 sessions in a row (up to 6 months).
Identifying - Retention Effectiveness	Count of participants for whom the intervention is successful based on percent accuracy identifying target words receptively (number of objects correctly identified when target word is named divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for at least one active intervention condition versus the control condition within the maintenance phase.	Four weeks after the intervention ends
Identifying - Retention Efficiency	Count of participants for whom the intervention is successful based on percent accuracy identifying target words receptively (number of objects correctly identified when target word is named divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for the condition hypothesized to be superior (i.e., "feedback" or "spaced") within the maintenance phase.	Four weeks after the intervention ends
Semantic - Retention Effectiveness	Count of participants for whom the intervention is successful based on percent accuracy labeling associated semantic information (i.e., location; number of target objects' locations correctly named when shown the object divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for at least one active intervention condition versus the control condition within the maintenance phase.	Four weeks after the intervention ends
Semantic - Retention Efficiency	Count of participants for whom the intervention is successful based on percent accuracy labeling associated semantic information (i.e., location; number of target objects' locations correctly named when shown the object divided by the number of words in the set [i.e., 4] times 100) The count of participants indicates the number of participants who exhibited a functional relation indicating greater performance for the condition hypothesized to be superior (i.e., "feedback" or "spaced") within the maintenance phase.	Four weeks after the intervention ends

Collaborators and Investigators

• Sponsor: Vanderbilt University Medical Center

Publications and helpful links

General Publications

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• Carpenter SK. Cue strength as a moderator of the testing effect: the benefits of elaborative retrieval. J Exp Psychol Learn Mem Cogn. 2009 Nov;35(6):1563-9. doi: 10.1037/a0017021.
• Carpenter, S. K., & Yeung, K. L. (2017). The role of mediator strength in learning from retrieval. Journal of Memory and Language, 92, 128-141.
• Coyne JH, Borg JM, DeLuca J, Glass L, Sumowski JF. Retrieval practice as an effective memory strategy in children and adolescents with traumatic brain injury. Arch Phys Med Rehabil. 2015 Apr;96(4):742-5. doi: 10.1016/j.apmr.2014.09.022. Epub 2014 Oct 13.
• Geers AE, Sedey AL. Language and verbal reasoning skills in adolescents with 10 or more years of cochlear implant experience. Ear Hear. 2011 Feb;32(1 Suppl):39S-48S. doi: 10.1097/AUD.0b013e3181fa41dc.
• Goossens, N. A., Camp, G., Verkoeijen, P. P., & Tabbers, H. K. (2014). The effect of retrieval practice in primary school vocabulary learning. Applied Cognitive Psychology, 28(1), 135-142.
• Haebig E, Leonard LB, Deevy P, Karpicke J, Christ SL, Usler E, Kueser JB, Souto S, Krok W, Weber C. Retrieval-Based Word Learning in Young Typically Developing Children and Children With Development Language Disorder II: A Comparison of Retrieval Schedules. J Speech Lang Hear Res. 2019 Apr 15;62(4):944-964. doi: 10.1044/2018_JSLHR-L-18-0071.
• Jones, A. C., Wardlow, L., Pan, S. C., Zepeda, C., Heyman, G. D., Dunlosky, J., & Rickard, T. C. (2016). Beyond the rainbow: Retrieval practice leads to better spelling than does rainbow writing. Educational Psychology Review, 28(2), 385-400.
• Karpicke JD, Blunt JR, Smith MA. Retrieval-Based Learning: Positive Effects of Retrieval Practice in Elementary School Children. Front Psychol. 2016 Mar 11;7:350. doi: 10.3389/fpsyg.2016.00350. eCollection 2016.
• Karpicke, J. D., Blunt, J. R., Smith, M. A., & Karpicke, S. S. (2014). Retrieval-based learning: The need for guided retrieval in elementary school children. Journal of Applied Research in Memory and Cognition, 3(3), 198-206.
• Knouse, L. E., Rawson, K. A., Vaughn, K. E., & Dunlosky, J. (2016). Does Testing Improve Learning for college students with attention-deficit/hyperactivity disorder? Clinical Psychological Science, 4(1), 136-143.
• Kyle FE, Harris M. Longitudinal patterns of emerging literacy in beginning deaf and hearing readers. J Deaf Stud Deaf Educ. 2011 Summer;16(3):289-304. doi: 10.1093/deafed/enq069. Epub 2011 Feb 9.
• Leonard LB, Deevy P, Karpicke JD, Christ S, Weber C, Kueser JB, Haebig E. Adjective Learning in Young Typically Developing Children and Children With Developmental Language Disorder: A Retrieval-Based Approach. J Speech Lang Hear Res. 2019 Dec 5;62(12):4433-4449. doi: 10.1044/2019_JSLHR-L-19-0221. Print 2019 Dec 18.
• Leonard LB, Karpicke J, Deevy P, Weber C, Christ S, Haebig E, Souto S, Kueser JB, Krok W. Retrieval-Based Word Learning in Young Typically Developing Children and Children With Developmental Language Disorder I: The Benefits of Repeated Retrieval. J Speech Lang Hear Res. 2019 Apr 15;62(4):932-943. doi: 10.1044/2018_JSLHR-L-18-0070.
• Lipowski SL, Pyc MA, Dunlosky J, Rawson KA. Establishing and explaining the testing effect in free recall for young children. Dev Psychol. 2014 Apr;50(4):994-1000. doi: 10.1037/a0035202. Epub 2013 Dec 2.
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• McDaniel J, Benitez-Barrera CR, Soares AC, Vargas A, Camarata S. Bilingual Versus Monolingual Vocabulary Instruction for Bilingual Children with Hearing Loss. J Deaf Stud Deaf Educ. 2019 Apr 1;24(2):142-160. doi: 10.1093/deafed/eny042.
• McDaniel J, Camarata S, Yoder P. Comparing Auditory-Only and Audiovisual Word Learning for Children With Hearing Loss. J Deaf Stud Deaf Educ. 2018 Oct 1;23(4):382-398. doi: 10.1093/deafed/eny016.
• Nittrouer S, Lowenstein JH, Antonelli J. Parental Language Input to Children With Hearing Loss: Does It Matter in the End? J Speech Lang Hear Res. 2019 Dec 13;63(1):234-258. doi: 10.1044/2019_JSLHR-19-00123. Print 2020 Jan 22.
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• Lehman M, Smith MA, Karpicke JD. Toward an episodic context account of retrieval-based learning: dissociating retrieval practice and elaboration. J Exp Psychol Learn Mem Cogn. 2014 Nov;40(6):1787-94. doi: 10.1037/xlm0000012. Epub 2014 May 5.
• Antia SD, Lederberg AR, Easterbrooks S, Schick B, Branum-Martin L, Connor CM, Webb MY. Language and Reading Progress of Young Deaf and Hard-of-Hearing Children. J Deaf Stud Deaf Educ. 2020 May 30;25(3):334-350. doi: 10.1093/deafed/enz050.
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• Kaipa R, Danser ML. Efficacy of auditory-verbal therapy in children with hearing impairment: A systematic review from 1993 to 2015. Int J Pediatr Otorhinolaryngol. 2016 Jul;86:124-34. doi: 10.1016/j.ijporl.2016.04.033. Epub 2016 May 3.
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• Lund E, Miller C, Douglas WM, Werfel K. Teaching Vocabulary to Improve Print Knowledge in Preschool Children with Hearing Loss. Perspect ASHA Spec Interest Groups. 2020 Dec;5(6):1366-1379. doi: 10.1044/2020_persp-20-00023. Epub 2020 Aug 17.
• McGregor KK, Gordon K, Eden N, Arbisi-Kelm T, Oleson J. Encoding Deficits Impede Word Learning and Memory in Adults With Developmental Language Disorders. J Speech Lang Hear Res. 2017 Oct 17;60(10):2891-2905. doi: 10.1044/2017_JSLHR-L-17-0031. Erratum In: J Speech Lang Hear Res. 2018 May 17;61(5):1293. doi: 10.1044/2018_JSLHR-L-18-0067.
• Reimer CK, Grantham H, Butler AC. The effect of retrieval practice on vocabulary learning for DHH children. J Deaf Stud Deaf Educ. 2024 Jun 24;29(3):377-387. doi: 10.1093/deafed/enae005.

Study record dates

Study Major Dates

• Study Start (Actual): February 5, 2023
• Primary Completion (Actual): July 11, 2025
• Study Completion (Actual): July 11, 2025

Study Registration Dates

• First Submitted: August 11, 2022
• First Submitted That Met QC Criteria: August 19, 2022
• First Posted (Actual): August 23, 2022

Study Record Updates

• Last Update Posted (Actual): March 16, 2026
• Last Update Submitted That Met QC Criteria: February 20, 2026
• Last Verified: August 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Neurobehavioral Manifestations; Otorhinolaryngologic Diseases; Sensation Disorders; Ear Diseases; Hearing Disorders; Communication Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Language Disorders; Hearing Loss
• Other Study ID Numbers: 221773

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Graphs with individual data points will be reported in manuscripts that share the primary study findings. Sharing of such graphical data will permit inclusion of the project's results in future meta-analyses.
• IPD Sharing Time Frame: Data will become available when manuscripts are published.
• IPD Sharing Access Criteria: Data will become available through the published manuscript(s).
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; SAP; ICF

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No