Fastelli Ambra

Neuroscience, Technology, and Society, XXXII series
Grant sponsor

Fondazione Bruno Kessler

Barbara Arfè
Ornella Mich (FBK)

Implicit Learning and Deafness: from the Assessment to the Design and Implementation of a Serious Game-based Training for Deaf Children with Cochlear Implants.
Full text of the dissertation book can be downloaded from:

Experiencing auditory deprivation during early childhood affects adversely children’s ability to process and acquire spoken languages. Deaf and hard-of-hearing children are therefore at risk of language delays. If compared with typically hearing peers, deaf children with cochlear implants are reported having poorer outcomes in spoken language and literacy, and that has been associated with deficient verbal working memory skills (Burkholder & Pisoni, 2003; Geers, 2003; Harris, et al., 2013; Pisoni & Cleary, 2003). Despite the ongoing investigation of the factors influencing speech, language, and literacy, large individual differences in language outcomes that are typically found in deaf children following cochlear implantation (Pisoni et al., 1999), and a considerable amount of this variability remains unexplained (Geers, 2002, 2006). A recent hypothesis suggests that it might be partially explained by deficits in implicit learning processes (Conway et al., 2009). Implicit learning is a domain-general ability to learn patterns of recurrent information without intention to learn, or awareness of the learning process. It was first described by Reber (1989) as an evolutionary precursor to explicit learning that happens incidentally, without intention, and in a manner that is opaque to explanation. It allows the implicit detection and elaboration of distributional statistical regularities that are recurring in inbound information. It plays a crucial role during the early stages of language development (Saffran & Kirkham, 2018; Romberg & Saffran, 2010), and is considered a fundamental mechanism for human development and everyday life (Abrahamse, 2012). According to the “auditory scaffolding hypothesis”, a lack of auditory stimulation at an early age, could affect language development directly due to the poor exposition to spoken language, and indirectly, adversely affecting implicit learning of linguistic regularities and therefore language development (Conway et al., 2009). This hypothesis is controversial and widely debated. In this thesis work, we investigated this hypothesis using two different paradigms: the artificial grammar learning and the simple reaction times. Our studies involved orally educated profoundly deaf children with cochlear implants between the age of 5 and 11 years old. These studies are described in the first part of the thesis. Their aim is to contribute to the lively discussion about cognitive processes behind language acquisition in deaf children with cochlear implants. Also, based on these findings, we aim to develop a serious-game-based training that could potentially boost the basic cognitive processes that are deficient in this population, hopefully maximizing the language learning potential of hard-of-hearing children and deaf children with cochlear implants. The design, the implementation and the cycles of user experience assessment of “SELEDE” (a SErious game for training sequence LEarning in DEaf children) are described in the second part of the thesis. Proposing a training as a serious game captivates the children’s interest, and contributing to the success of the training. SELEDE was developed in collaboration with Fondazione Bruno Kessler (Trento). It comprises three mini-games in which auditory and visual sequences are used to train implicit and explicit sequence learning processes. The games were implemented using a co-design approach in which psychologists, computer scientists, audiologists, and speech and language therapists were involved. The design process resulted in the development of a game prototype that has been subjected to two cycles of evaluation of the user experience. To the best of our knowledge, this might be the first known attempt for developing a training tool that integrates implicit and explicit learning processes. SELEDE could represent an innovative starting point for new interventions addressed to all those children who are showing difficulties in processing temporally and sequentially distributed pieces of information (e.g. language).