R3: Evaluation of the Errorless Learning Technique in Children
with Traumatic Brain Injury

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CENTER DIRECTOR
Walter M. High, Ph.D.
713- 666-9550

DIRECTOR OF RESEARCH
Angelle Sander, Ph.D.
713- 666-9550

DIRECTOR OF TRAINING
Karen A. Hart, Ph.D.
713-797-5946

Co-Investigators: Linda Ewing-Cobbs, Ph.D., Gerri Hanten, Ph.D., James X. Song, M.S.

Specific Aims:

• To compare the effectiveness of the errorless learning technique to a traditional trial-and-error technique in children with memory disorders following TBI on acquisition, maintenance, and transfer of declarative knowledge.
• To compare the effectiveness of the errorless learning technique to a traditional trial-and-error technique in children with memory disorders following TBI on acquisition, maintenance, and transfer of procedural knowledge.
• Relate memory profile subgroups in children with TBI to effectiveness of the EL and T&E techniques.
• Develop case studies of children with TBI defined by site of focal brain lesions on MRI to elucidate dissociations in memory performance and response to interventions.

Sample:  280 children with mild, moderate, and severe TBI, age 6-14, who are within 1 year of injury; 90 orthopedic controls matched for demographic and sociodemographic characteristics. 

Design:  A baseline assessment of memory abilities will be conducted to screen for memory impairments that could benefit from intervention.  Children eligible for the study will undergo a pre-treatment assessment of mathematical facts and computer keyboard skills.  They will then participate in the intervention phase, which will consist of 24 1-hour sessions (2 per week) of training in mathematical facts (declarative learning) and computer keyboard skills (procedural learning).  For each types of learning, ½ of the sessions will be conducted using trial-and-error learning, while ½ will be conducted using the errorless learning technique.  The last session will involve cumulative testing of skills learned, as well as transfer of knowledge to related tasks.  Follow-up assessment of skills learned and transfer of knowledge will be conducted at 4 weeks following the last session. 

Predictor Variables:  Demographic variables; injury severity; CT/MRI lesions; current medications; cognitive test performance (Wechsler Intelligence Scale for Children-III; California Verbal Learning Test-Children; Children’s Memory Scale-Dot Locations; Rivermead Behavioral Memory Test-Children; Woodcock-Johnson Psycho-Educational Battery; Children’s Test of Nonword Repetition; Word and Nonword List Repetition; Visual and Auditory Digit Matching Span; Age of Acquisition and Imageability Repeated List-Learning; Concreteness and Relatedness Word Recall; Structured and Unstructured Word List Recall; Subject-determined pointing; Behavioral Assessment System for Children. 

Primary Outcome Measures: 
Declarative learning outcome: Cued-recall task of knowledge of trained mathematical facts (using horizontal problem presentation); transfer of math skills to word problems and to problems presented in a vertical orientation).

Procedural learning outcome:  Cued-recall task of knowledge of trained computer keyboard sequences; transfer of trained keyboard skills to typing of words.

Contact Information:

Harvey S. Levin, Ph.D.
(713) 798-4860

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