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Background: Virtual reality (VR) offers much potential for learning, but it challenges learners' orientation. Objectives: This paper investigates whether it is possible to use light or movement cues to facilitate orientation in a search task in a desktop‐VR environment so that participants can better attend to the learning content presented simultaneously. Methods: In two pre‐registered online experiments, we investigated the effects of cueing (light and movement) on search time, learning, and several evaluation variables. Participants were asked to find tools in a virtual workshop, while information about the respective tool was narrated. Experiment 1 (N = 60) used a within‐subject design, that is, the objects were alternately highlighted by light, movement or not. For Experiment 2 (N = 159) the narration was substantially shortened, and a between‐subject design was used. Cognitive load and presence were measured additionally. Results and conclusions: In Experiment 1, only the movement cue decreased search time, indicating automatic guidance of learners' attention. There was no effect of cueing on learning, which may be due to the average search time being substantially shorter than the narration, leaving sufficient time to attend to the narration exclusively. In Experiment 2 search times were significantly faster for both cueing methods, but only the light cue resulted in better learning outcomes, which could be explained by the slightly lower presence in the movement cue condition. Implications: Results imply that it is important to develop cues that automatically guide attention without reducing presence. Lay Description: What is already known about this topic: Virtual reality (VR) offers a lot of opportunities for the integration of educational scenarios.VR is challenging for learners with regard to orientation in a 360° environment.Regarding learning outcomes, research on the effects of cues to highlight important content in a 360° environment is still rare.Presence, defined as the feeling of being there in a VR environment, is an important prerequisite for learning in VR. What this paper adds: The influence of light and movement cues on search times and learning outcomes in a desktop‐VR environment was tested.Movement cues can reliably reduce search times (indicating successful orientation), whereas light cues only reduced search times in predictable scenarios.In a predictable scenario, light cues enhanced learning outcomes compared with movement cues.Movement cues reduced presence, which is one potential reason why movement cues did not improve learning. Implications for practice and/or policy: Using light cues might assist orientation and enhance overall performance in predictable scenarios (i.e., when learners know what kind of cue to expect).In an unpredictable setting with variable cues, light cues did not facilitate orientation, whereas movement cues did.However, movement cues reduced presence, which may have negatively affected learning outcomes. It is important to develop cueing methods that also work in more unpredictable settings, but that do not reduce presence. [ABSTRACT FROM AUTHOR]

Background Study: The effects of the flipped classroom (FC) on students' academic performance remain ambiguous, and the use of pre‐class videos may be one of the main factors hindering students' progress. A software package called GeoGebra has been proposed as a substitute for pre‐class videos to aid students' learning. Objective: This study investigates the effect of the FC using GeoGebra (FCG) on mathematical performance and memory among senior secondary students. Methods: One hundred and sixty students of a senior high school in China were selected. A quasi‐experimental design was implemented in which the classes were split into the intervention group (FCG), control group A (FCV) and control group B (TL) by random assignment. Pretest, Post‐test 1 and Post‐test 2 were introduced. Results and Conclusion: The results indicate that both the FCG and the FC with pre‐class videos (FCV) were more effective than traditional lectures in enhancing students' academic test scores, and that the effect of the FCG was comparable to its video counterpart, F(2, 136) = 3.752, ρ = 0.026, η2 = 0.052. Although their effects were similar, the qualitative results revealed some hidden benefits associated with the replacement of pre‐class video with GeoGebra. Furthermore, although they were equally effective in promoting students' performance in the short‐term, the long‐term effects on academic performance of both forms of FC were non‐significant when compared with traditional lectures. Lay Description: What is already known about this topic: Flipped classroom is an effective strategy in teaching mathematics.Among those challenges, video may be one of the main factors hindering the effect of flipped classroom. What this paper adds: GeoGebra could be an effective alternative to video.Effect between the flipped classroom using GeoGebra and the flipped classroom using video were similar.Both the flipped classroom with GeoGebra and the flipped classroom with videos were more effective than traditional lectures. Implications for practice and/or policy: Students' short‐term performance could be enhanced by visualisation provided by flipped classroom.To enhance students' long‐term performance, an appropriate amount of homework is suggested. [ABSTRACT FROM AUTHOR]

Background: Continued professional development (CPD) is required for updated skills and knowledge. This study evaluates the efficacy of a CPD programme for mainstream school teachers. Aims: In an 11‐week intervention programme, speech–language therapists (SLTs) presented the participating teachers with whole‐class teaching techniques aimed at creating a language and communication‐supporting classroom environment. The effects of the intervention on the language development of the students in the teachers' classes were assessed. Methods & Procedures: A total of 211 first‐ and second‐year students (Mage = 7;6, range = 6;5–8;9) underwent standardized language assessments of receptive and expressive language abilities before and after their teachers' participation in the CPD. The students were divided into intervention and delayed intervention groups to enable randomized intervention allocation. Linear mixed modelling was used to estimate the individual and interaction effects of group, time and demographic factors. Outcomes & Results: Significant effects of time, group and school, respectively, but no interaction between time and group indicates that while all students advanced between assessments, the progress was not attributable to the teachers' participation in the CPD. Conclusions & Implications: Results are discussed in light of those of recent studies of universal services to support optimal language development. WHAT THIS PAPER ADDS: What is already known on this subject: Although inconclusive, previous research indicates that intervention delivered to teachers by SLTs has the potential to improve the language abilities of the students in the teachers' classrooms. What this paper adds to existing knowledge: This study explored the language development of first‐ and second‐year mainstream school students whose teachers took part in a CPD programme aimed at establishing language and communication‐supporting teaching techniques. Results indicate that the development of the students' language abilities could not be attributed to the teachers' participation in the CPD. What are the potential or actual implications of the work?: SLTs are often asked to guide teachers and teaching staff rather than themselves conduct individual assessments and interventions. The results of this trial can be used to inform the discussion on how to prioritize between tasks. [ABSTRACT FROM AUTHOR]

Background: Very young children from lower socioeconomic status (SES) backgrounds often show poorer language development. Whilst there have been attempts to provide early intervention programmes, these sometimes miss the most disadvantaged groups. Aims: This report presents preliminary feasibility and effectiveness data for a novel language intervention designed for parents of toddlers in the United Kingdom. Methods and Procedures: In total, 43 UK families of 2–4‐year‐olds were recruited to the study, half of whom completed an 8‐week course (Tots Talking) focussed on parent interaction, and half of whom acted as wait‐list controls. Results and Outcomes: Results suggest that such programmes are feasible for families with 86% staying in the intervention. In addition, greater changes in underlying communication skills such as joint attention and gesture were evident compared to wait‐list controls. Conclusions and Implications: We conclude that pre‐verbal skills may be more important to measure as initial outcomes than language or vocabulary change in this population. What This Paper Adds: What is already known on the subject: Children from lower socioeconomic status (SES) backgrounds are at higher risk of communication difficulties and there is a need for community intervention programmes for very young children. What this study adds: This study suggests that such programmes can be feasible and effective, but that very early/basic communicative skills (such as joint attention) may be boosted first rather than language or vocabulary. What are the clinical implications of this work?: Children's centres and other community services could feasibly run short parent facing courses emphasising contingent communication in low SES families and other diverse groups. These may be more successful run with younger preschoolers. Joint attention may be a better focus of intervention before expecting vocabulary or language change. Community health professionals may find this information useful in referring and supporting families in need. [ABSTRACT FROM AUTHOR]

Background: Learning which letters correspond to which speech sounds is fundamental for learning to read. Based on previous experimental studies, we developed a serious game aiming to boost letter‐speech sound (L‐SS) correspondences in a motivational game environment. Objectives: The goal of this study was to determine the efficacy of this game in training L‐SS correspondences in pre‐readers. Additionally, an extended version of the game was developed given the importance of handwriting in audio‐visual integration. We established whether including a motoric component in the game boosted the letter‐speech sound training on top of the effect of the game without the motoric component. Methods: One‐hundred forty‐five kindergartners were randomly allocated to play either the standard audio‐visual version of the game, the motoric version or a control math game. All children were pre‐ and post‐tested on L‐SS knowledge and reading accuracy. Results and conclusions: We found that playing the game enhanced pre‐readers' L‐SS knowledge, but not reading accuracy, after a short, intensive intervention period of 3 weeks. However, children who played the motoric version of the game did not differ significantly from either the standard or the control condition. Implications: This game was efficient in training L‐SS correspondences in pre‐readers. These results suggest that this game might be useful as a preventive evidence‐based intervention for at‐risk children in kindergarten who might benefit from a head start before learning how to read. Future studies are needed to examine whether a longer intervention period results in L‐SS knowledge being translated into reading skills. Lay Description: What is already known about this topic: Automatised and fluent reading requires much exposure and practice, but intensive teacher support for all at‐risk readers is economically and practically unfeasibleHandwriting movement likely to enhance coupling of auditory and visual informationOne way to provide high exposure is with game‐based interventionsLack of studies examining the efficacy of these interventions What this paper adds: Serious game enhances letter‐speech sound knowledge in pre‐readers after 3 weeks of intensive interventionThis effect did not transfer to reading performanceNo additional effect of the handwriting movement, possibly due to the short intervention periodIn‐game measures slightly mediated intervention progress Implications for practice and/or policy: Growing evidence of game‐based interventions as promising tools to support reading developmentGame can possibly serve as evidence‐based intervention for at‐risk children in kindergarten who might benefit from a head start before learning how to read [ABSTRACT FROM AUTHOR]

Background: Morphological awareness (MA) is the awareness and ability to manipulate morphemes, the smallest units of meaning in a language. It is identified as a strong cognitive precursor of word reading and reading comprehension. The current MA instructions are limited to classroom settings and delivered by teachers or experimenters. Few studies have included technology and its novel features to deliver MA instructions. Objectives: This study proposes a gamified learning approach embedded with self‐regulated learning support for MA learning and examines its effects on improving English reading performance and intrinsic motivation among junior secondary grade students who learn English as a foreign language. Methods: This study adopted a randomized controlled trial design. Participants (N = 104) were randomly assigned into one of three conditions: self‐regulated gamified programme, gamified programme, or non‐gamified programme. Students received 16 sessions of instructions (30 min/session) and were evaluated on reading abilities (i.e., MA, word reading and reading comprehension) and intrinsic motivation before and after the programme implementation. Results and conclusions: Results from repeated measures ANOVA and follow‐up ANCOVA showed that while the two gamified groups demonstrated greater improvement in MA (i.e., near transfer effect) and intrinsic motivation than non‐gamified group, only the self‐regulated gamified group showed more gains in multisyllabic word reading (i.e., far transfer effect) than non‐gamified group. There was no significant time X group interaction effect on reading comprehension. Implications: Taken together, this research suggests gamification leads to better morphology learning and increases students' intrinsic motivation. The incorporation of self‐regulated learning in gamification is recommended to achieve the far transfer effect on multisyllabic word reading. Lay Description: What is already known about this topic: Morphological awareness is an important reading‐related skill that predicts students' word reading and reading comprehension. However, existing morphological awareness instructions are mostly delivered by teachers or experimenters.Gamification, which is emerging as an effective approach that enhances learning and motivation, has not yet been widely applied to improve students' reading‐related skills, such as morphological awareness.Gamification is usually implemented in online learning environments where students' self‐regulated learning critically affects their online learning performance. However, few studies have provided self‐regulated learning support in a gamified learning environment. What this paper adds: We proposed a self‐regulated gamified approach specifically targeting morphological awareness and compared its effectiveness with gamified learning and non‐gamified learning.The two gamified groups led to significant gain in students' morphological awareness and intrinsic motivation than the non‐gamified group.Only the self‐regulated gamified group led to significant gain in multisyllabic word reading than the non‐gamified group. Implications for practice and/or policy: The self‐regulated gamified approach represents an effective way for learning morphological awareness. [ABSTRACT FROM AUTHOR]

Background: Performance monitoring plays a key role in self‐regulated learning, but is difficult, especially for complex visual tasks such as navigational map reading. Gaze displays (i.e. visualizations of participants' eye movements during a task) might serve as feedback to improve students' performance monitoring. Objectives: We hypothesized that participants who review their performance based on screen recordings that also display their gaze would have a higher monitoring accuracy and increase in post‐test performance and would remember more executed actions than participants who review based on a screen recording only (i.e. control condition). Methods: Sixty‐four higher education students were randomly assigned to a gaze‐display or control condition. After watching an instruction video, they practiced five navigational map‐reading tasks and then reviewed their performance while thinking aloud, either prompted by a screen recording with gaze display or a screen recording only. Before and after reviewing, participants estimated the number of correctly solved tasks and finally made a five‐item post‐test. Results and conclusions: Analyses with frequentist and Bayesian statistics showed that gaze displays did not improve monitoring accuracy (i.e. estimated minus actual performance), post‐test performance, or the number of reported actions. It is concluded that scanpath gaze displays do not provide useful cues to improve monitoring accuracy in this task. Takeaways: Gaze displays are a promising tool for education, but scanpath gaze displays did not help to enhance monitoring accuracy in a navigational map‐reading task. Lay description: What is currently known?: Monitoring performance is central in self‐regulated learning.Monitoring is often difficult for learners, in particular in complex visual tasks.Gaze displays visualize viewing behaviour that was measured with eye tracking.Gaze displays can improve task performance, but effects on monitoring are unknown. What does the paper add?: We expected gaze displays to help learners to monitor their performance on a map‐reading task.However, dynamic gaze displays did not help to improve monitoring accuracy in this study.Further research should investigate whether other types of gaze displays improve monitoring. Implications for practitioners: Eye tracking provides promising ways to support monitoring and learning.However, not all forms of using gaze displays enhance monitoring or learning.The specific implementation of gaze displays might matter. [ABSTRACT FROM AUTHOR]

Background: A total of 68% of pre‐school children with cleft palate have speech problems requiring speech therapy. There is a lack of access to regular targeted therapy. Parent training leads to positive outcomes in early communication skills in cleft palate and non‐cleft speech disorders. Connected health has been used to address inadequate access to therapy, providing intervention to those who would not otherwise receive therapy. Aims: To evaluate the speech, activity and participation outcomes of Parent Led, Therapist Supervised, Articulation Therapy (PLAT) compared with routine speech therapy intervention in parent–child dyads. Methods & Procedures: A total of 44 children, aged 2.9–7.5 years, were included in a two‐centre, two‐phase randomized controlled trial. Informed consent and assent were obtained. Participants and speech and language therapists (SLTs) were unblinded to the groups. Parents, in the parent‐trained group (n = 23), attended 2 days' training, received a detailed speech therapy programme, and undertook intervention over 12 weeks supported by the cleft specialist SLT using FaceTime and one face‐to‐face session. In the control arm (n = 21), parent–child dyads received six therapy sessions over 12 weeks with a research SLT, comparable with usual care. Speech recordings were undertaken pre‐ and post‐intervention. Percent consonant correct (PCC) was analysed by external SLTs blinded to the time and group. Activity and participation were measured using the Intelligibility in Context Scale (ICS) and Focus on Outcomes for Children Under Six (FOCUS) questionnaire. Outcomes & Results: There was no evidence of an interaction between Time and Group or an overall statistical difference between groups for PCC scores. There was a statistically significant difference over time for both groups (words: p < 0.002; confidence interval (CI) = 9.38–16.27; d = 0.57; sentences: p < 0.002; CI = 16.04–25.97; d = 0.23). Effect sizes were medium for words and small for sentences. For intelligibility and participation, there was no evidence of an interaction between Time and Group or an overall statistical difference between groups. A statistically significant difference over time was found for intelligibility (F = 29.97, d.f. = 1, 42, p < 0.001, 95 % CI = 1.45–3.15 d = 0.46) and for participation (F = 14.19, d.f. = 1, 41, p < 0.001 95% CI = 7.63–25.03; d = 0.36) with FOCUS results indicating clinically meaningful (parent‐led group) and significant (control group) change in participation. Conclusions & Implications: PLAT can be as effective as routine care in changing speech, activity and participation outcomes for children with cleft palate, when supported by a specialist cleft SLT using connected health. What this paper addsWhat is already known on this subjectOver 50% of children with cleft palate require speech therapy. However, there is a lack of timely, accessible speech therapy services in the UK and Ireland. Previous studies have shown that parents can deliver therapy effectively, and that connected health can support the delivery of speech therapy. This study aims to provide evidence that parent‐led therapy with the supervision of a specialist cleft therapist using FaceTime is effective.What this paper adds to existing knowledgeThis randomized controlled trial indicates that parents can be trained to deliver therapy for children with cleft palate speech disorders, under the supervision of an SLT. This approach results in improved speech, activity and participation outcomes similar to routine care.What are the potential or actual clinical implications of this work?This study indicates that both parent‐led articulation therapy and routine care showed meaningful gains in speech, activity and participation, and that parent‐led articulation therapy when supported by a cleft SLT using connected health could be an additional service delivery model for children with cleft palate speech disorders. [ABSTRACT FROM AUTHOR]

Background: Though pedagogical artificial agents are expected to play a crucial role in the years to come, earlier studies provide inconsistent results regarding their effect on learning. This might be because their potential for exhibiting subtle nonverbal behaviours we know from human teachers has been untapped. What is more, there is little evidence of the processes underlying the effect of nonverbal behaviours of teachers (either human or artificial) on learning, so as to better guide their practical application. Objectives: The aims of the current research were threefold: firstly, to examine the effect of an artificial agent's vocal expressiveness on non‐verbal immediacy (teachers' ability to increase psychological closeness through nonverbal communication). Secondly, to test whether an artificial agent showing strong vocal expressiveness will enhance affective and cognitive learning (perceived and actual), as compared to an artificial agent that shows weak vocal expressiveness. Thirdly, to examine whether the underlying mechanisms of motivation and attention explain the effect of immediacy (and thereby also of vocal expressiveness) on the two learning outcomes. Methods: The study used a between‐participants design, with the participants being randomly assigned to one of the two experimental conditions: artificial modelling with strong expressiveness and artificial modelling with weak vocal expressiveness. Results and conclusions: Results showed that an artificial agent with strong vocal expressiveness increased affective and perceived cognitive learning. Partial support was found for actual cognitive learning. What is more, our findings revealed that vocal expressiveness is related to affective and perceived cognitive learning because it promotes nonverbal immediacy. Finally, results provided evidence of motivation as a mediator of the path from immediacy to affective learning. Major takeaways: The current findings verify the important role of nonverbal immediacy found in traditional educational settings. However, showing that these results also apply to artificial teachers is essential, given that the educational landscape is changing and reshaping by artificial intelligence. Thus, taking into consideration the role of vocal expressiveness in the development of artificial teachers or voice assistants like Alexa, Siri, and Google assistant, as a way to enhance immediacy and affective experience of learners is of imperative value, since they will be found more and more in our societies. Lay Description: What is currently known about the subject matter: There is a positive effect of nonverbal cues of human teachers on students' learningThe artificial agent's voice is important for learning. What their paper adds to this: Provides strong evidence of the positive effect of vocal expressiveness of artificial agents on learning outcomes.Reveals that vocal expressiveness is related to learning outcomes because it enhances immediacy.Examines the proposed mechanisms of motivation and attention as mediators of the path from immediacy to affective and cognitive learning. Implications of study findings for practitioners: Taking into consideration vocal expressiveness of artificial agents during the design process is essential for increased learning.The combination of the vocal parameters of pitch and speech rate is effective for constructing vocal expressiveness.By showing the underlying mechanisms of artificial agents' nonverbal cues (i.e., vocal cues) on learning, it helps designers to make a better decisions during construction.The study's findings are also pertinent for human teachers in improving students' learning in traditional educational settings. [ABSTRACT FROM AUTHOR]

Background: The feedback offered to students in audience response systems may enhance conformity bias, while asking closed‐type questions alone does not allow students to externalize and elaborate on their knowledge. Objectives: The study explores how writing short justifications and accessing peer justifications as collective feedback could affect students' performance, confidence and opinions in multiple‐choice audience response systems that apply the Peer Instruction model of voting/revoting. Methods: For 8 weeks, 98 students, enrolled in an undergraduate course, attended each lecture following a flipped classroom approach. At the beginning of each lecture, students participated in a quiz with eight multiple‐choice questions. Four of these questions included a justification form in which students could elaborate on their answers. The students were randomly grouped into two conditions according to the collective feedback they received: the Shared group (n = 54) could see both the percentage each question choice received from the class and the respective peer justifications, while the Unshared group (n = 44) could only see the percentage information. Results: Analysis showed that students in both groups performed significantly better in questions with the justification form being available. Also, the two groups were comparable in terms of performance and self‐reported level of confidence suggesting no main effect for making peer justification available. Despite this, students in the Shared group expressed a significantly more positive opinion in the end‐of‐activity questionnaire in terms of perceived learning gains and the helpfulness of writing justifications for their answers. Take Away: Writing short justifications can have a positive impact on students' academic performance. Lay Description: What is currently known about the subject matter: Audience response systems (ARS) typically include closed‐type items.Therefore, students do not have the opportunity to elaborate on their answers.Externalizing and elaborating on one's answer could enhance understanding. What their paper adds to this: Integration of short justifications alongside multiple‐choice questions.System feedback includes percentage, confidence and peer justifications.Analysis on how writing/reading justifications affect performance in ARS. Implications of study findings for practitioners: Writing short justifications enhances student performance.Being able to read peer justifications does not affect student performance.Being able to read peer justifications increases activity acceptance. [ABSTRACT FROM AUTHOR]

Introduction: Occupational therapy often involves handwriting acquisition practices that include the non‐dominant hand when improvements in the dominant hand function are not possible because of trauma or stroke. This study explored whether character tracing and using a pegboard can effectively improve the handwriting of the non‐dominant hand. Methods: A randomised controlled trial involving 60 healthy university students aged ≥18 years was conducted. Participants were randomly assigned to the writing group, peg group or control group. The character recognition rate was evaluated by computer software. Furthermore, character quality and writing speed were evaluated by humans using global legibility scales. Evaluations were performed before the intervention (baseline) and on days 5 and 10 of the intervention. Using the non‐dominant hand, the writing group traced characters on paper with a ballpoint pen, and the peg group used a pegboard for 15 min/day for 10 days. Results: Compared with the peg and control groups, the writing group showed significant improvements in the character recognition rate and global legibility scale score. However, the global legibility scale score did not improve to the same level as that achieved with the dominant hand. None of the evaluation scores of the peg group showed significant improvements compared with those of the control group. There were no significant differences in improvements in the writing speed of the writing and peg groups compared with the control group. Conclusion: Tracing characters can improve the handwriting ability of the non‐dominant hand, but using a pegboard may be less effective. Future research is needed to examine how much practice is necessary to improve the handwriting ability of the non‐dominant hand sufficiently. [ABSTRACT FROM AUTHOR]

Objectives: The aim of the current study was to investigate the robustness of the human movement effect and its stability over time by comparing the effectiveness of dynamic and static presentations on acquisition and retention of a gross motor skill. Methods: One hundred and seven first‐year students studying for the certificate in Physical Education course were randomly divided into three groups: (i) static pictures (N = 32), (ii) enriched static pictures with arrows (N = 34), and (iii) video (N = 41). They were instructed to observe the demonstration of the Ippon‐Seoi‐Nage (a Judo technique) and reproduce it during the acquisition phase or after a delay of 1 week during the retention phase. Results and Conclusions: The results showed that enriched static pictures (with arrows) resulted in more efficient learning than the static pictures (without arrows). Most importantly, it was shown that learners receiving the video presentation outperformed learners receiving the static presentations, with regard to acquisition and retention, indicating therefore a robust human movement effect. Implications: These findings provide confirmation of the superiority of video presentations for teaching and learning motor skills involving the entire human body. Lay Description: What is already known about this topic:External visualizations are broadly used in Physical education (PE) and sport context.Static visualizations are regarded as the fundamental tools used by PE teachers to communicate visual information that is difficult to verbally describe.Increasing use of dynamic visualizations such as videos largely supplanted the use of static pictures in PE contextWhat this paper adds:Comparing the effectiveness of static pictures and digital videos in tactical learningExploring the human movement effect and its stability over timeImplications for practice and/or policy:The human movement effect is a robust phenomenon not only when it is evaluated immediately after the learning phase but also after a notable delay.Dynamic visualizations remain the most powerful computer‐based technique by which people can learn complex motor skills. [ABSTRACT FROM AUTHOR]

Background: Many people with aphasia have word‐finding difficulties, with some showing particular difficulties with verbs. Picture‐naming therapy is often used to improve naming, but gains are usually limited to therapy items and do not transfer to conversation. Therapy where words are produced in sentences and in real‐life activities may be more effective. Aims: The current pilot study investigated whether an activity‐oriented therapy approach would be accepted and viable if implemented in a community setting, and whether communicating whilst cooking was more beneficial than using paper‐based activities. If successful, it would be expected that verb production would improve in structured and unstructured tasks in both naming and narrative tasks. Methods & Procedures: The study employed a case‐series repeated‐measures design, with testing of treated and control items. Seven adults with anomia participated, although only five completed the full programme. Participants were divided into two groups and each group completed both treatments, but in different orders. Each treatment was employed for six 2‐h sessions over a 3‐week period. Outcomes & Results: Naming of both treated and untreated verbs showed a statistically significant improvement following both treatments and this continued into the maintenance phase. There was a numerical but not statistically significant gain in the variety of verbs used in spoken narratives. Participants predominantly chose positive terms to describe their experience of the programme, but did not prefer one therapy over the other. Conclusions & Implications: Preliminary findings suggest that an activity‐oriented therapy approach, whether it involves carrying out tasks or paper‐based activities, can result in clinically meaningful improvements for people with chronic aphasia. Further research using a randomized control trial is required to determine whether cooking therapy alone is effective. [ABSTRACT FROM AUTHOR]

A promising method to support game‐based learning is to facilitate learners' externalization of cognitive and metacognitive processes. Externalizing Problem Representation (EPR) refers to a cognitive behaviour in which a learner constructs her own representations overtly. The purpose of this study is to investigate whether learning supports promoting EPR enhance qualitative understanding and quantitative proficiency in ratios and proportional relationships in a learning game (i.e., E‐Rebuild) context. Specifically, this study investigated the effects of representation format in problem representation on qualitative understanding and quantitative proficiency in a learning game context. The results of this study indicate that (a) symbolic learning supports better facilitate comprehension of math concepts and their relations than iconic learning supports in video game contexts, (b) symbolic learning supports better facilitate players' reflection for implicit understanding and promote their math problem‐solving skills, (c) participants in the symbolic learning support group increased significantly in qualitative understanding but not in quantitative proficiency after gameplay, and (d) participants in the iconic learning support group experienced significant growth in quantitative proficiency but not in qualitative understanding after gameplay. Lay Description: What is already known about this topic: Video games potentially facilitate implicit qualitative understanding more than quantitative knowledge test performance.Educational game designers lack a good understanding of the design and development of effective learning supports in educational games. What this paper adds: Symbolic learning supports for problem representation better facilitate comprehension of math concepts and their relations than iconic learning supports in video game contexts.Participants experienced significant growth in quantitative proficiency after they processed the iconic in‐game learning supports in game‐based math tasks.Participants' qualitative understanding in the symbolic learning support group increased significantly after playing E‐Rebuild‐based math game task. Implications for practice and/or policy: This study informs scholars and designers of game‐based learning about designing learning support and its properties in video game contexts: Learning support design to promote math problem representation across problem translation and problem integration.This study provides design principles for learning supports in math learning game; symbolic learning supports facilitate qualitative understanding whereas iconic learning supports facilitate quantitative proficiency in math learning game. [ABSTRACT FROM AUTHOR]

The present study defined three levels of contextualized media and investigated their influences on students' science attitudes, comprehension, and argumentation. To achieve the purpose, an online game‐based science argumentation (OGSA) program was developed for the experiments (N = 148). The OGSA included three versions for student argumentation regarding the use of contextualized medias: the mildly, moderately, and highly contextualized medias. For each version, the students had to play two types of games, find‐the‐fault and find‐the‐difference games, to complete one topic of argumentation learning. We found that the highly contextualized group students had the best performances of their science learning and argumentation. However, to produce highly contextualized media was a time‐consuming task although it provided the students with contextualization cues to connect the learning to their prior knowledge. Lay Description: What is already known about this topic: Teaching argumentation has become increasingly prevalent and also an essential goal for science education.The use of images in learning plays an important role in facilitating students' understanding of science concepts and theories, because it makes the learning contextualizing and can boost the learning outcomes. However, the explanation on the relationship among the use of images, contextualized environment, and learning outcomes remain few.A number of online learning environments were developed to support students' science argumentation. However, few studies based on the elements of gameplay for the design. What this paper adds: The present study defined three levels of contextualized images and investigated their influences on students' science attitudes, comprehension, and argumentation.High school students needed images that are at least moderately contextualized and related to their prior knowledge in order to achieve high‐quality (that is, rational and evidence‐based) argumentation in terms of claims, warrants, rebuttals, and questions.We found that contextualized level of image is a factor significantly affecting on students' learning of science attitudes, comprehension of science concepts, and argumentation. Implications for practice and/or policy: The integration of multiple types of game‐based learning (e.g., find fault and find difference) into the development of online learning environments would constitute an innovative approach for educational instructions.We provided an example on how to integrate different images in terms of their contextualized level into the development of online game‐based program for the learning of science argumentation. [ABSTRACT FROM AUTHOR]

OBJECTIVES This study aimed to investigate the relationship between the authenticity of instructional formats and outcome measures within a pre-clerkship clinical reasoning course. METHODS We conducted a randomised, prospective, crossover study with Year 2 medical students taking a pre-clerkship clinical reasoning course. Students were randomised to small groups and exposed to three formats of differing instructional authenticity (paper case, DVD presentation, standardised patient [SP] presentation) across three subject areas (abdominal pain, anaemia, polyuria). Three student cohorts were taught using one instructional format per subject area so that each cohort received a different instructional format for each of the three subject areas. Outcome measures (objective structured clinical examination, video quiz, written examination) were selected to determine the effect of each instructional format on the clinical reasoning of students. RESULTS Increasingly authentic instructional formats did not significantly improve clinical reasoning performance across all outcome measures and subject areas. However, the results of the video quiz showed significant differences in the anaemia subject area between students who had been instructed using the paper case and live SP-based formats (scores of 47.4 and 57.6, respectively; p = 0.01) and in the abdominal pain subject area, in which students instructed using the DVD format scored higher than students instructed using either the paper case or SP-based formats (scores of 41.6, 34.9 and 31.2, respectively; p = 0.002). CONCLUSIONS Increasing the authenticity of instructional formats does not appear to significantly improve clinical reasoning performance in a pre-clerkship course. Medical educators should balance increases in authenticity with factors such as cognitive load, subject area and learner experience when designing new instructional formats. [ABSTRACT FROM AUTHOR]

Background/aim Engagement in desired occupations can promote health and wellbeing in older adults. Assessments of engagement often measure frequency, amount or importance of specific activities. This study aimed to develop a scale to measure older adults' evaluation of the extent to which their everyday activities are contributing to their health and wellness. Methods Eighteen items, each scored with a seven-point rating scale, were initially developed by content experts, covering perceptions of how daily activities contribute to physical and mental health, as well as satisfaction and activity participation in the last six months. Rasch analysis methods were used to refine the scale using the pencil and paper responses of 460 community-living older adults. Results Initial Rasch analysis indicated three unlabelled rating scale categories were seldom used, reducing measurement precision. Five items were conceptually different by misfit statistics and principal component analysis. Subsequently, those items were removed and the number of rating scale steps reduced to 4. The remaining 13-item, 4-step scale, termed the Activity Significance Personal Evaluation ( ASPEn), formed a unidimensional hierarchy with good fit statistics and targeting. Person separation reliability (2.7) and internal consistency (.91) indicated the tool is appropriate for individual person measurement. Relative validity indicated equivalence between Rasch measures and total raw scores. Conclusions ASPEn is a brief, easily administered assessment of older adults' perception of the contribution of everyday activities to personal health and wellness. ASPEn may facilitate occupational therapy practice by enabling clinicians to assess change in meaning of an older adult's activity over time. [ABSTRACT FROM AUTHOR]

Background The effectiveness of two treatment approaches (phonological therapy and articulation therapy) for treatment of 14 children, aged 4;0-6;7 years, with phonologically based speech-sound disorder (SSD) has been previously analysed with severity outcome measures (percentage of consonants correct score, percentage occurrence of phonological processes and phonetic inventory). Considering that the ultimate goal of intervention for children with phonologically based SSD is to improve intelligibility, it is curious that intervention studies focusing on children's phonology do not routinely use intelligibility as an outcome measure. It is therefore important that the impact of interventions on speech intelligibility is explored. Aims This paper investigates the effectiveness of the two treatment approaches (phonological therapy and articulation therapy) using intelligibility measures, both in single words and in continuous speech, as the primary outcome. Methods & Procedures Fourteen children with phonologically based SSD participated in the intervention. The children were randomly assigned to phonological therapy or articulation therapy (seven children in each group). Two assessment methods were used for measuring intelligibility: a word identification task (for single words) and a rating scale (for continuous speech). Twenty-one unfamiliar adults listened and judged the children's intelligibility. Reliability analyses showed overall high agreement between listeners across both methods. Outcomes & Results Significant improvements were noted in intelligibility in both single words (paired t(6) = 4.409, p = 0.005) and continuous speech (asymptotic Z = 2.371, p = 0.018) for the group receiving phonology therapy pre- to post-treatment, but no differences in intelligibility were found for those receiving the articulation therapy pre- to post-treatment, either for single words (paired t(6) = 1.763, p = 0.128) or continuous speech (asymptotic Z = 1.442, p = 0.149). Conclusions & Implications Intelligibility measures were sensitive enough to show changes in the phonological therapy group but not in the articulation therapy group. These findings emphasize the importance of using intelligibility as an outcome measure to complement the results obtained with other severity measures when exploring the effectiveness of speech interventions. This study presents new evidence for the effectiveness of phonological therapy in improving intelligibility with children with SSD. [ABSTRACT FROM AUTHOR]

Background Previous studies have reported that obese people with trisomy 21 suffer from lowgrade systemic inflammation. A recent study has found that aerobic training reduced inflammation in obese women with Down syndrome. To the best of our knowledge, the study reported in this paper is the first to determine for how long these effects were maintained after completion of the programme. Methods Twenty premenopausal obese women (18-30 years old) with Down syndrome volunteered for this study. Eleven were randomly assigned to the intervention group and performed a 10-week aerobic training programme, 3 sessions per week, consisting of warming-up followed by treadmill exercise (30-40 min) at a work intensity of 55-65% of peak heart rate and a cooling-down period. The control group included 9, age, sex and BMI matched women with Down syndrome that did not perform any training programme. Fat mass percentage and distribution were measured. Plasma level of IL-6 and high-sensitive C-reactive protein (hs-CRP) were monitored. Time-course changes for these outcomes were assessed at pre- and post-intervention. Further, they were re-evaluated at 1, 3 and 6 months after completion of the programme. Results Three months after completion of the programme, plasma levels of IL-6 and hs-CRP were significantly increased. Up to 6 months later, both fat mass percentage and waist circumference (WC) were significantly increased. Furthermore, physical fitness was also impaired in the intervention group. No changes were observed in the control group. Conclusion A 3-month detraining period significantly impaired chronic inflammation in obese women with DS. [ABSTRACT FROM AUTHOR]

This paper reports on a study investigating the potential effect of synchronous and asynchronous text-based computer-mediated communication ( CMC) on oral fluency development of second-language ( L2) learners. Sixty-three intermediate learners of English were randomly assigned to one of three groups (two experimental groups and one control group), each consisting of 21 participants. The participants in the experimental groups completed four communicative tasks under two different instructional environments: synchronous text-based CMC environment and asynchronous text-based CMC environment. The average length of pauses, the articulation rate, the fluent-run, the phonation-time ratio and the speaking rate served as dependent variables. The study found that the participants in synchronous CMC group improved their L2 oral fluency significantly compared with their peers in the other two groups. The results also revealed the students in asynchronous CMC group obtained higher mean scores than those in the control group, although the differences between groups were not statistically significant. [ABSTRACT FROM AUTHOR]