Sentence Shaping - DHH

Sentence Shaping: Written Language Intervention for Deaf and Hard of Hearing Middle Schoolers

The proposed research addresses a long-standing and important challenge of improving literacy skills of children who are deaf and hard of hearing, a historically under researched group. The investigators aim to leverage shape coding - an empirically validated intervention approach for constructing sentences in spoken English - for improving how efficiently children who are deaf and hard of hearing learn to correctly construct sentences in written English. To advance the promising yet underutilized research on shape coding, the investigators complete the next logical step of applying the visual supports provided with shape coding to written language for deaf and hard of hearing children. Shape coding has been effective for teaching sentence structure in spoken English to children with language disabilities and has recently been applied to sentence structure in American Sign Language with deaf and hard of hearing children. Intervention involving shape coding is predicted to result in increased accuracy of word order in sentences in written English because deaf and hard of hearing children often benefit from visual information. The investigators will accomplish this aim using single case multiple probe across participants design studies with 30 fifth through eighth grade children who are deaf and hard of hearing. The knowledge gained will guide language and literacy intervention for children who are deaf and hard of hearing.

Study Overview

• Status: Recruiting
• Conditions: Hearing Loss, Bilateral
• Intervention / Treatment: Behavioral: Shape Coding

• Study Type: Interventional
• Enrollment (Estimated): 30
• Phase: Not Applicable

Contacts and Locations

• Study Contact: Name: Adriana M Valtierra, M.S.; Phone Number: 219-614-5980; Email: adriana.m.valtierra@vanderbilt.edu
• Study Contact Backup: Name: Jena McDaniel, PhD; Phone Number: 615-936-5114; Email: jena.mcdaniel@vumc.org

Study Locations

• United States
  • Tennessee
    • Nashville, Tennessee, United States, 37232
      • Recruiting
      • Vanderbilt University Medical Center
      • Contact: Adriana M Valtierra, M.S.; Phone Number: 219-614-5980; Email: adriana.m.valtierra@vanderbilt.edu
      • Principal Investigator: Adriana M Valtierra, M.S.

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Child
• Accepts Healthy Volunteers: No

Description

Inclusion Criteria:

• Children in grades five through eight
• deaf or hard of hearing
• use spoken English and American Sign Language (ASL)
• bilateral hearing loss
• the ability to read and understand the grammatical structures of interest
• already be writing sentences, but demonstrate errors in word order and/or grammar.

Exclusion Criteria:

• diagnosis of dyslexia
• uncorrected vision impairment (i.e., identified vision loss without use of corrective lenses that interferes with eligibility evaluation tasks)
• evidence of severe motor impairment (i.e., insufficient motor skills to complete eligibility evaluation tasks independently).

Study Plan

How is the study designed?

Design Details

• Primary Purpose: Treatment
• Allocation: N/A
• Interventional Model: Single Group Assignment
• Masking: None (Open Label)

Number of Arms

1

Arms and Interventions

Participant Group / Arm

Intervention / Treatment

Experimental: Shape coding; Intervention will be introducing and utilizing Shape Coding to construct sentences.

Behavioral: Shape Coding; Intervention will include introducing and reviewing the relevant shapes from Shape Coding and the order in which the shapes go in a sentence. The researcher will then model how to put the word tiles in order according to the shapes. Next the researcher and student work together to construct sentences. The student is then given the opportunity to independently construct sentences using the word tiles and Shape Coding. At the end of instruction, the researcher and student review the shapes and the student has the opportunity to independently construct sentences without shape coding.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of children for whom the intervention is successful	The investigators will calculate the proportion of children for whom the intervention is successful, defined as at least 80% accuracy for 3 consecutive data collection days.	Baseline to up to 8 weeks maximum

Secondary Outcome Measures

Outcome Measure	Measure Description	Time Frame
Proportion of children that generalize targeted skill to unpracticed words within targeted structure	The investigators will calculate the proportion of children that generalize the targeted skill to novel/unpracticed words within the targeted structure.	Baseline to up to 8 weeks maximum
Proportion of children that generalize targeted skill to unpracticed modality within targeted structure	The investigators will calculate the proportion of children that generalize the targeted skill to an unpracticed modality (i.e., writing, typing) using practiced words within the targeted structure.	Baseline to up to 8 weeks maximum.
Proportion of children that maintain targeted skill after intervention has ended	The investigators will calculate the proportion of children that maintain higher percent accuracy after intervention is removed compared to baseline	Begins no more than 2 weeks after intervention phase ends; lasts up to 3 weeks

Collaborators and Investigators

• Sponsor: Vanderbilt University

Study record dates

Study Major Dates

• Study Start (Actual): August 28, 2025
• Primary Completion (Estimated): April 1, 2026
• Study Completion (Estimated): October 1, 2026

Study Registration Dates

• First Submitted: February 27, 2025
• First Submitted That Met QC Criteria: February 27, 2025
• First Posted (Actual): March 5, 2025

Study Record Updates

• Last Update Posted (Estimated): October 22, 2025
• Last Update Submitted That Met QC Criteria: October 20, 2025
• Last Verified: October 1, 2025

More Information

Terms related to this study

• Additional Relevant MeSH Terms: Neurologic Manifestations; Nervous System Diseases; Otorhinolaryngologic Diseases; Sensation Disorders; Ear Diseases; Hearing Loss; Hearing Disorders; Pathological Conditions, Signs and Symptoms; Signs and Symptoms; Hearing Loss, Bilateral
• Other Study ID Numbers: 240927

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: UNDECIDED

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