Single Case Research Design: Teacher Outcomes

Strategic and Interactive Signing Instruction

This study examines whether a professional development program helps teachers implement Strategic and Interactive Signing Instruction (SISI) with higher fidelity. The training includes review of an intervention manual, live modeling of SISI components, and discussion of implementation expectations. Teacher fidelity is evaluated with the Strategic and Interactive Signing Instruction Fidelity Tool, which rates the extent to which core components are used during a intervention session. The study also documents how often teachers receive additional support (e.g., coaching) to understand which procedures help strengthen implementation.

Study Overview

• Status: Completed
• Conditions: Teacher Practice
• Intervention / Treatment: Behavioral: Strategic and Interactive Signing Instruction

Detailed Description

This project uses a nonconcurrent multiple-baseline design across four teachers who serve deaf children in a deaf education program. The goal is to examine changes in teachers' SISI implementation fidelity following training and coaching.

At baseline, the PI observes each teacher's typical language arts instruction using the SISI Fidelity Tool. Three stable data points are collected for each teacher before intervention. Every SISI component is scored as 1 (fully implemented), 0.5 (partially implemented), or 0 (not implemented), and then summarized as a percentage of components implemented.

After baseline, the PI provides a two-day training in SISI procedures. Teachers then begin implementing SISI in a staggered fashion: Teacher 1 starts immediately after training for three weeks; Teacher 2 begins in Week 4; Teachers 3 and 4 begin in Weeks 7 and 10. All instructional sessions are video-recorded and uploaded to a cloud platform, where the PI and a second rater review them for daily fidelity monitoring.

Throughout the study, the PI offers coaching as needed to support implementation. The PI also tracks children's progress on their individually targeted sign language skills to confirm that intervention adjustments are appropriate and timely. If implementation challenges arise or if data collection procedures are insufficiently clear or consistent, refinements may be made. Any refinements are put in place immediately and monitored for their influence on teacher fidelity and the feasibility of study procedures.

• Study Type: Interventional
• Enrollment (Actual): 4
• Phase: Not Applicable

Contacts and Locations

Study Locations

• United States
  • Tennessee
    • Knoxville, Tennessee, United States, 37996
      • University of Tennessee, Knoxville

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

Description

Inclusion Criteria:

• Teachers of the deaf working in a school for the deaf across kindergarten to 3rd grade levels

Exclusion Criteria:

• Not teachers of the deaf working in a school for the deaf across kindergarten to 3rd grade levels

Study Plan

How is the study designed?

Design Details

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

Number of Arms

4

Arms and Interventions

Participant Group / Arm	Intervention / Treatment
Experimental: Single Case Research Design: Teacher 1; The PI worked with teachers to increase SISI implementation fidelity using a nonconcurrent multiple-baseline design across teacher participants. Four teachers who served deaf children were recruited from a school for the deaf. The SISI Fidelity Tool was used to observe teachers' business-as-usual language arts instruction and to establish three stable baseline data points for each teacher. Each SISI component was scored as 1 (fully implemented), 0.5 (partially implemented), or 0 (not implemented) and reported as the percentage of components implemented. After baseline observations were completed, the PI provided a two-day training on SISI implementation. Teacher 1 began implementing SISI for three weeks following the training, Teacher 2 began in Week 4, and Teachers 3 and 4 began in Weeks 7 and 10, respectively.	Behavioral: Strategic and Interactive Signing Instruction; Evidence-based instructional methods, grounded in cognitive, sociocultural, and linguistic theories, are applied to interventions that support sign language development in deaf children.
Experimental: Single Case Research Design: Teacher 2; The PI worked with teachers to increase SISI implementation fidelity using a nonconcurrent multiple-baseline design across teacher participants. Four teachers who served deaf children were recruited from a school for the deaf. The SISI Fidelity Tool was used to observe teachers' business-as-usual language arts instruction and to establish three stable baseline data points for each teacher. Each SISI component was scored as 1 (fully implemented), 0.5 (partially implemented), or 0 (not implemented) and reported as the percentage of components implemented. After baseline observations were completed, the PI provided a two-day training on SISI implementation. Teacher 1 began implementing SISI for three weeks following the training, Teacher 2 began in Week 4, and Teachers 3 and 4 began in Weeks 7 and 10, respectively.	Behavioral: Strategic and Interactive Signing Instruction; Evidence-based instructional methods, grounded in cognitive, sociocultural, and linguistic theories, are applied to interventions that support sign language development in deaf children.
Experimental: Single Case Research Design: Teacher 3; The PI worked with teachers to increase SISI implementation fidelity using a nonconcurrent multiple-baseline design across teacher participants. Four teachers who served deaf children were recruited from a school for the deaf. The SISI Fidelity Tool was used to observe teachers' business-as-usual language arts instruction and to establish three stable baseline data points for each teacher. Each SISI component was scored as 1 (fully implemented), 0.5 (partially implemented), or 0 (not implemented) and reported as the percentage of components implemented. After baseline observations were completed, the PI provided a two-day training on SISI implementation. Teacher 1 began implementing SISI for three weeks following the training, Teacher 2 began in Week 4, and Teachers 3 and 4 began in Weeks 7 and 10, respectively.	Behavioral: Strategic and Interactive Signing Instruction; Evidence-based instructional methods, grounded in cognitive, sociocultural, and linguistic theories, are applied to interventions that support sign language development in deaf children.
Experimental: Single Case Research Design: Teacher 4; The PI worked with teachers to increase SISI implementation fidelity using a nonconcurrent multiple-baseline design across teacher participants. Four teachers who served deaf children were recruited from a school for the deaf. The SISI Fidelity Tool was used to observe teachers' business-as-usual language arts instruction and to establish three stable baseline data points for each teacher. Each SISI component was scored as 1 (fully implemented), 0.5 (partially implemented), or 0 (not implemented) and reported as the percentage of components implemented. After baseline observations were completed, the PI provided a two-day training on SISI implementation. Teacher 1 began implementing SISI for three weeks following the training, Teacher 2 began in Week 4, and Teachers 3 and 4 began in Weeks 7 and 10, respectively.	Behavioral: Strategic and Interactive Signing Instruction; Evidence-based instructional methods, grounded in cognitive, sociocultural, and linguistic theories, are applied to interventions that support sign language development in deaf children.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
SISI Fidelity	The Strategic and Interactive Signing Instruction (SISI) Fidelity Tool is a 45-item observational checklist assessing adherence to the model-guided-independent cycle, scaffolding quality, and use of targeted ASL skills. Each item is rated from 0 to 1 (0 = not implemented, 0.5 = partially implemented, 1 = fully implemented). Scores are summed and converted to a percentage (0-100%). Higher scores indicate stronger fidelity of implementation.	Baseline began at the start of the school year for all participants. Because intervention start times were staggered in the multiple-baseline design, intervention duration ranged from approximately 12 to 40 weeks across participants.

Collaborators and Investigators

• Sponsor: The University of Tennessee, Knoxville
• Collaborators: National Institute on Deafness and Other Communication Disorders (NIDCD)
• Investigators: Principal Investigator: Leala Holcomb, PhD, Center of Deafness

Study record dates

Study Major Dates

• Study Start (Actual): August 23, 2024
• Primary Completion (Actual): July 1, 2025
• Study Completion (Actual): September 30, 2025

Study Registration Dates

• First Submitted: December 5, 2024
• First Submitted That Met QC Criteria: December 6, 2024
• First Posted (Actual): December 11, 2024

Study Record Updates

• Last Update Posted (Actual): December 19, 2025
• Last Update Submitted That Met QC Criteria: November 26, 2025
• Last Verified: September 1, 2025

More Information

Terms related to this study

• Keywords: Deaf; Teacher Training; Sign Language
• Additional Relevant MeSH Terms: Behavior; Communication; Nonverbal Communication; Language; Manual Communication; Sign Language
• Other Study ID Numbers: 514092; 1R21DC021024-01A1 (U.S. NIH Grant/Contract)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: YES
• IPD Plan Description: Under a data-sharing agreement that is in compliance with the internal policy at UTK, non-identifying data can be shared with other researchers for a minimum of 10 years on the University of Tennessee Research and Creative Exchange (TRACE). The raw data consists of videos of teachers, which will not be shared to maintain confidentiality. The processed data will be in the form of percentages for individual teachers across an academic year documented in a .csv file (Excel). Center for Open Science Foundation (OSF) is a free and open source project management tool that supports researchers throughout their entire project lifecycle. OSF also allows people to locate this data through project names, author names, and study keywords.
• IPD Sharing Time Frame: December, 2026 to December, 2036
• IPD Sharing Access Criteria: Researchers may contact the principal investigator for additional supporting information not available on OSF.
• IPD Sharing Supporting Information Type: STUDY_PROTOCOL; ANALYTIC_CODE; CSR

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No
• product manufactured in and exported from the U.S.: No