This manuscript&#160;was supported by funding from the National Science Foundation (DRL#1660878, DRL#1661202, DUE#1761178, DRL#1916417), the Social Sciences and Humanities Research Council of Canada (SSHRC 895-2011-1006), the Ministry of Sciences and Innovation I+D+i (PID2019-107201GB-100), and the European Union through the European Regional Development Funds (ERDF) and the Principality of Asturias (FC-GRUPIN-IDI/2018/000199). Any opinions, findings, conclusions, or recommendations expressed in this material are those of the author(s) and do not necessarily reflect the views of the National Science Foundation or Social Sciences and Humanities Research Council of Canada.&#160;The authors would also like to thank members of the SMART Lab at UCF for their assistance and contributions.

The research ethics committee of the Principality of Asturias and the University of Oviedo approved this protocol.
1. Session 1: diagnosis assessment
NOTE: In this session of the protocol, evaluation tests from different publishers are used, which have their own specific application and interpretation manuals. Since these tests, or other similar ones, are widely known by the scientific community in the field of psychology and education, the procedure to apply them is not detailed step by step (for example, given the aim of this paper, it does not make sense to detail each step of the WAIS-IV35 application).
<ol>
	<li>Informed consent
	<ol>
		<li>Explain to the participants the ethical and confidentiality aspects of the research and ask them to acknowledge and sign the individual informed consent.</li>
	</ol>
	</li>
	<li>Structured interview
	<ol>
		<li>Explain the following instructions to the participant: &#34;Now, I&#180;m going to interview you in order to get important information about your life and academic issues. There are open and closed questions but you can interrupt me whenever you want. Please, let me know if you need me to clarify any point. After this initial interview, I may ask you to do some evaluation tests and questionnaires. I will tell you the specific instructions for each one. Are you ready?&#34;</li>
		<li>Collect the biographical information along with the presence of symptoms related to SLD and exclusion criteria that are referred in the DSM-51 following the interview script (see <a href="https://www.jove.com/files/ftp_upload/60331/Supplemental_documents_A.pdf" target="_blank">Supplemental File A</a>&#160;).</li>
	</ol>
	</li>
	<li>First decision point in relation to the structured interview (exclusion criteria)
	<ol>
		<li>Finish the assessment if the participant meets the initial exclusion criteria, that is, they explain that they have a motor disability (upper segments), sensory disability (visual or auditory), a diagnosis of intellectual disability or a serious mental disorder.</li>
		<li>Continue the assessment if it seems that the participant has or thinks he/she has an SLD and does not meet exclusion criteria.</li>
	</ol>
	</li>
	<li>Intellectual ability
	<ol>
		<li>Apply the WAIS-IV35 test to collect information about participant&#8217;s intellectual ability following the instructions in the manual.</li>
	</ol>
	</li>
	<li>Second decision point in relation to intellectual ability (exclusion criteria)
	<ol>
		<li>Finish the assessment if the participant does not understand the instructions of the test, if cannot be evaluated, or they have an IQ of less than 70.</li>
		<li>Continue the assessment if the person has normal or limited intellectual ability. 
		NOTE: The limit of the IQ accepted in the present study has been set as a score of over 70.</li>
	</ol>
	</li>
	<li>ADHD
	<ol>
		<li>Ask the participant to complete the six items of the Self-reported Screening Questionnaire of the Adult-v1.1. (ASRS39) of the World Health Organization (WHO) International Composed Diagnostic Interview. 
		NOTE: This questionnaire provides information on the presence of symptoms related to ADHD that are referred to in the DSM-IV54.</li>
		<li>Apply the Nesplora Aquarium test40 if the participant scores 12 or more in the previous ASRS36 questionnaire.</li>
	</ol>
	</li>
	<li>Reading difficulties
	<ol>
		<li>Apply the PROLEC SE-R Screening Test of reading difficulties37 follow the instructions in the manual.</li>
	</ol>
	</li>
	<li>Autism spectrum disorder (level 1)
	<ol>
		<li>Ask the participant to complete the 28 items of the Autism Spectrum Quotient (AQ-Short) questionnaire from Hoekstra et al.41 
		NOTE: This questionnaire provides information on the presence of symptoms related to social behavior, social skills, routine, switching, imagination and numbers/patterns.</li>
	</ol>
	</li>
	<li>Analyze the results.
	<ol>
		<li>Analyze each participant&#8217;s interview, questionnaires and test results and decide if they have significant learning difficulties or not or are at risk of having them. 
		NOTE: Two members of the expert committee (the evaluator and another member of the research team) analyze each participant&#8217;s learning profile and decide if they is a student with SLD, ADHD and/or ASD or not or are at risk of having them. No test can substitute the expert&#180;s judgment.</li>
	</ol>
	</li>
	<li>Final decision point
	<ol>
		<li>Finish the assessment if the participant is clearly not a student with learning difficulties.</li>
		<li>Continue the assessment if the participant is a person with LDs (or at risk) and go to Session 2.</li>
	</ol>
	</li>
</ol>
2. Session 2: multimodal assessment
NOTE: Session 2 must be done between 1 and 7 days after Session 1.
<ol>
	<li>Prepare the participant.
	<ol>
		<li>Remind the participants that the session lasts approximately 2 hours, and that they are going to complete some questionnaires and tasks in the MetaTutor learning environment while some devices are recording their performance throughout the session.</li>
		<li>Ask the participants tie back their hair, clear their neck, remove their glasses and remove chewing gum if applicable. 
		NOTE: If the participant is wearing glasses, has long hair or bangs that cover part of their face, the eye tracker will not be able to read their eyes movements.</li>
		<li>Introduce MetaTutor to the participants. Explain that the objective of the session is to autonomously learn about the circulatory system using the tool.</li>
		<li>Make sure the speakers are connected and working. 
		NOTE: The participant can also use headphones if preferred.</li>
	</ol>
	</li>
	<li>Galvanic skin response preparation and calibration 
	NOTE: Remember that there are many types of GSRs manufactured by different companies. Use it according to the supplier&#39;s specifications.
	<ol>
		<li>Clean the GSR and the participant&#180;s fingers with alcohol.</li>
		<li>Put the finger/wristband GSR sensors on the index and ring fingers with the connectors on the fingertip side or according to the manufacturer&#39;s instructions.</li>
		<li>Ask the participant to rest their hand on the table quietly and try to relax for 5 min.</li>
		<li>Open the software in the computer.</li>
		<li>Make sure the registration graph is working. Check the registration graph is registering.</li>
		<li>Click Run experiment &#62; Rate 10 per second &#62; Duration &#62; 10 &#62; Minute. Record the information for ten minutes to establish the baseline. 
		NOTE: Rate 10 per second means the frequency with which measures are taken.</li>
		<li>Minimize the screen.</li>
		<li>Continue with the calibration of other devices, and after 10 minutes save the information in a .csv file.</li>
	</ol>
	</li>
	<li>Eye tracking and webcam preparation and calibration 
	NOTE: Remember that there are many types of eye tracking and webcam manufactured by different companies. Use them according to the supplier&#39;s specifications.
	<ol>
		<li>Open the software in the side laptop and in the computer. 
		NOTE: The eye movements are captured on the PC the participant is working on, but the data is recorded on the side laptop. In addition, in the side laptop, the experimenter can see the movements that the participant is making and correct the participant&#8217;s position if necessary.</li>
		<li>Indicate which session will be recorded (Metatutor in this case) and the participant&#8217;s registration data: File &#62; Recent Experiment &#62; Metatutor &#62; Include Registration data of the participant &#62; OK.</li>
		<li>Check that the two computers are connected to each other and that the eye tracking infrared lights are on and ready to capture the movement of the eyes.</li>
		<li>Adjust the webcam on the computer to the participant&#8217;s position.</li>
		<li>Ask the participant to sit facing forward and be as neutral as possible, although it is expected that their facial expressions will vary during the learning session. 
		NOTE: During the learning session a video of the participant&#180;s face is recorded with the webcam which is later analyzed using a desktop app55.</li>
		<li>Ask the participant to be still and to stare at the different points of the screen with their nose put in line with/slightly over the edge of the desk (at 90&#176;).</li>
		<li>Click Record &#62; Write the registration data of the participant &#62; Ok to start the calibration process.</li>
		<li>Ask the participant to press the space bar and follow the points on the screen with their eyes.</li>
		<li>Make sure that the participant&#8217;s eyes, when looking at the screen, are centered before moving on to the next step, using the side laptop to check this information. 
		NOTE: The participant&#39;s gaze is centered when the movements of their eyes are registered on the side laptop screen with two white circles. When the gaze leaves the registration area, the software warns with yellow arrows (if slightly deviated), with red arrows (if deviated a lot) or without white circles (if not registering). The path of the movement of the eyes is reflected with a yellow light (attentional focus) and the track through the screen with a green line.</li>
		<li>Ask the participants to avoid touching their face or resting their head in their hands as much as possible.</li>
		<li>Minimize the screen.</li>
	</ol>
	</li>
	<li>Multimodal tracking of the learning session
	<ol>
		<li>Maximize the GSR screen and click Run experiment &#62; Rate 10 per second &#62; Duration &#62; 5 &#62; hours &#62; Record and minimize the screen again.</li>
		<li>Maximize the eye tracking and webcam screen, make sure the software is working correctly, click Record on the computer and on the side laptop to register and record the session and minimize the screen again. 
		NOTE: Once the devices have been calibrated, do not forget to start recording the evaluation session in each of them. From this point, the entire participant interaction with the learning tool will be recorded until the end of the session.</li>
	</ol>
	</li>
	<li>Questionnaires and learning session in MetaTutor
	<ol>
		<li>Open the software in the PC and complete the participant&#8217;s registration data. Complete ID &#62; Experimenter &#62; Day &#62; Questionnaires yes &#62; Continue. 
		NOTE: All the logs will be registered during the session in a file-data log.</li>
		<li>Explain to the participant that they must follow the instructions in the tool and that they will only be interacting with the computer during the learning session. Explain that the researcher will be in the next room in case anything happens.
		<ol>
			<li>Ask the participant for sociodemographic and academic information. Complete Name &#62; Gender &#62; Age &#62; Ethnic group &#62; Educational level &#62; University &#62; Degree &#62; GPA &#62; Information about biology courses taken if applicable &#62; Continue. Before clicking Continue, explain to the participants that they must follow all the instructions that the tool will give them. Also, that they will only interact with the computer during the learning session.</li>
			<li>Ask the participant to complete some questionnaires. 
			NOTE: The participant has to complete five metacognitive and self-regulated learning questionnaires: a) The Mini International Personality Item Pool49; b) The Connotative Aspects of Epistemological Beliefs50; c) The Rosenberg Self-esteem Scale51; d) The Emotion Regulation Questionnaire52; e) The Achievement Emotions Questionnaire (AEQ)53 and one questionnaire about general knowledge about the circulatory system.</li>
			<li>Show the participant the interface of MetaTutor and its different parts.
			<ol>
				<li>Explain the participant that the content area is where the learning content is displayed throughout the session in text form.</li>
				<li>Show the participant that they can navigate through a table of contents at the side of the screen to go to different pages.</li>
				<li>Show the participant that the overall learning goal is displayed at the top of the screen during the session.</li>
				<li>Show the participant that the sub-goals learners set are displayed at the top in the middle of the screen, and they can manage sub-goals or prioritize them here.</li>
				<li>Show the participant that there is a timer located at the top left corner of the screen displays the amount of time remaining in the session.</li>
				<li>Show the participant the list of self-regulating processes, which are displayed in a palette on the right hand side of the screen, and the participant can click on them throughout the session to deploy planning, monitoring and learning strategies.</li>
				<li>Show the participant the static images relevant to content pages are displayed beside the text to help learners coordinate information from different sources.</li>
				<li>Show the participant the text entered on the keyboard and how students&#180; interactions with agents are displayed and recorded in this part of the interface.</li>
				<li>Show the participant the four artificial agents who help students in their learning throughout the session. 
				NOTE: These agents are Gavin the Guide, Pam the Planner, Mary the Monitor, and Sam the Strategizer.</li>
			</ol>
			</li>
			<li>Ask the participant to click Start to begin the learning session whenever they are ready. 
			NOTE: The participant interacts with the tool.</li>
			<li>Once the session is finished, ask the participant to complete the knowledge questionnaire again.</li>
		</ol>
		</li>
	</ol>
	</li>
</ol>
3. Logoff
<ol>
	<li>At the end of the session save the recorded data from GSR, eye tracking/webcam and Metatutor along with the registration data of the participant. Extract the data in a .csv file for easier use.</li>
	<li>Remove the GSR sensors from the participant&#39;s hand and clean the galvanic sensors with alcohol again.</li>
	<li>Thank the participants for their collaboration and say goodbye.</li>
</ol>
4. Analysis of learning difficulties
<ol>
	<li>Analyze each participant&#8217;s learning performance based on the different reports produced (see Results section) to obtain a multimodal profile. 
	NOTE: At least two members of the expert committee analyze each participant&#8217;s learning process. Although the evaluation can be done exhaustively using new instruments and tools, no report can replace the expert&#39;s judgment.</li>
</ol>

The authors have nothing to disclose.

The current protocol proposes a multimodal evaluation focused on metacognitive, self-regulation, and emotional processes, which make up the basis of the difficulties in adults with LDs.
Session 1 is essential because it is intended to be a diagnostic assessment of the participant&#8217;s learning disabilities. Note that this session here is carried out by therapists with experience in diagnosing developmental and learning difficulties in the research and clinical context. We use these tools in...

Specific learning disorders (SLDs) encompass disorders of those who have difficulty learning and using academic skills, exhibiting performance below expectations for their chronological age in the areas of reading, writing, and/or mathematics1,2. There are different estimations of prevalence rates depending on the age, language and culture analyzed but they are between 5% and 15%1,3. Within the global category of neurodevelopmental disorders in the Diagnostic and Statistical Manual of Mental Disorders (5th Ed.)1, it is also necessary to focus on the incidence of Attention-Deficit/Hyperactivity Disorder (hereinafter ADHD) as it is a common disorder that has given rise to various controversies about how to approach it in recent years. Based on the DSM-51, it can be defined as a pattern of persistent behaviors of inattention and/or hyperactivity-impulsivity. Likewise, autism spectrum disorder (hereinafter ASD) is a category in the same manual that includes students who present neurodevelopmental disorders as a result of multifactorial dysfunctions of the central nervous system, which result in qualitative dysfunctions in three fundamental areas of the development of the person: social interaction, communication and interests and behaviors1,2.
On these lines, a new concept has emerged moving away from the sense of deficit and offering a more positive approach to these disorders to be consistent with current ideas of neurodevelopmental difficulties as highly coexistent and overlapping4. From these new models, it is understood that the skills involved in high-level cognitive processes, which allow managing and regulating one&#39;s behavior in order to achieve a desired goal, are crucial for self-regulation and, therefore, for activities of daily living, including the academic ones5. In the context of adulthood, neurodiversity has evolved to include various types of difficulties, including ADHD and ASD, as well as dyslexia, dyspraxia, and/or dyscalculia. Accordingly, we are approaching this neurodiversity from a broad conception of learning difficulties (LDs). The increase in students with this diversity enrolled in postsecondary education is well documented and is due, in part, to the increase in high school graduation rates for students with disabilities6, but at the same time, there is less research about the learning process of these students than necessary7.
Each of the disorders approached in isolation involve different deficits and manifestations; however, some commonality can be found within that heterogeneity in terms of LD, such as metacognitive, self-regulatory, and emotional malfunctioning8,9,10,11. Three fundamental foundations in the literature of learning in general, and LDs in particular, that represent the basis of successful learning and play an essential role in these well-known difficulties at the academic level12. As well as this, other approaches understand that there could be a certain commonality between deficits in executive functions, such as problems in automatic processing or working memory, that occur in different disorders such as ADHD and reading disorders13 or ADHD and ASD5. However, there is still work to be done in this field, since not all studies reach the same conclusions about these points in common in relation to executive functions. It could be due to the variations presented by the samples from which the studies are based and the evaluation procedures of the executive functions used in the investigations5,14.
In educational terms, this diverse mix affects not only the quality of learning, due to the fundamental nature of the affected functions, but also phenomena such as school dropout, change of degree, etc., with economic implications for governments and universities15. The dropout rate for students with LDs is higher than for students in the general population16 but also higher than the dropout rates for any other category of psychological disabilities except for those students with emotional disturbances17. In contrast, the number of students with LDs who are accessing post-compulsory education (vocational training, college, etc.) is increasing15, specifically in higher education19,20,21,22. Moreover, one might well assume that there are many more students with LD than those who officially pass through student services and typically make up the prevalence statistics23.
These difficulties are not always detected during childhood, especially in adults born before these disorders were considered in the regular academic system, and the symptoms of these disorders persist throughout people&#8217;s lives and cause difficulties in work, education and personal lives24. Research has shown that although people might overcome some of their difficulties, most continue to exhibit struggles with learning during adulthood and their persistence is still problematic at those higher educational levels25.
Paradoxically, unlike in previous educational levels and earlier ages, there are hardly any evidence-based instruments or evaluation protocols for adults with LDs. Despite the proliferation of diagnostic tools to evaluate LDs during childhood, the availability of valid, reliable instruments and methodologies for the adult population is significantly limited24. A recent literature review about learning disabilities in higher education found that most of the information collected in this regard is done through interviews, and only occasionally are self-report questionnaires used26. Self-report methodology and interviews, although valuable, are not enough to accurately assess metacognitive, self-regulation, and emotional skills processes, in fact, among others, because of the process nature. The importance of scales and interview methodology for measuring those processes is undeniable27,28, but so too are the associated problems of validity29 and incongruence with other innovative methods of assessment30. An additional problem in the detection of LDs is the bias in the diagnosis of the disorder due to the absence of comprehensive assessment protocols. The fact that professionals do not have a reference protocol based on objective variables is frequently causing many false positive and false negative cases of LDs31.
In response to both scarcity of instruments for adults and the need to improve existing methodology, the current study proposes a multimodal evaluation protocol focused on metacognitive, self-regulation, and emotional processes, which make up the basis of the difficulties in adults with LDs. In line with the current literature, we propose a move toward integrative and multichannel measurement32,33. The assessment is carried out through an analysis of the on-line learning process using several methods, techniques, and sensors (e.g., hypermedia learning environment, virtual reality, eye tracking, facial expressions of emotion, physiological responses, log files, screen recordings of human-machine interactions) and off-line methods (e.g., questionnaires, interviews, and self-report measures). This mixed methodology provides evidence of the deployment of target processes before, during, and after learning that can be triangulated to enhance the understanding of how students learn and where the problem lies, if there is one34.
The evaluation protocol is carried out over two sessions. The sessions can be done in one sitting or may need partial applications depending on the person. The first is focused on the detection or confirmation of LDs and what specific kind of disorder we are facing, and the second is designed to go into the metacognitive, self-regulation, and emotional processes of each individual case in depth.
Session 1 is intended to be a diagnostic or confirmation assessment of the participant&#8217;s learning disabilities: SLD, ADHD and/or ASD (high functioning) to determine what type of specific problems the participants have. This assessment is essential for two reasons. 1) Adults with Learning Disabilities rarely have accurate information about their dysfunctional behavior. Some of them suspect that they have a LD but have never been evaluated. Others may have been assessed when they were children but do not have any reports or further information. 2) There may be discrepancies with previous diagnoses (e.g., a previous dyslexia diagnosis as opposed to a current diagnosis of attention deficit and slow processing speed; previous ASD diagnosis in contrast to current limited intellectual ability, etc.). The participant is interviewed, and questionnaires and standardized tests are applied. This session here is carried out by therapists with experience in diagnosing developmental and learning difficulties in the research and clinical context in different offices of a Spanish Psychology Faculty. The session begins with a structured interview that collects biographical information along with the presence of symptoms related to SLDs that are referred to in the DSM-51. Following that, the reference intellectual ability test WAIS-IV35 is used in case of exclusion criterion implementation and because it provides very valuable information for learning difficulties from the scales &#8220;work memory&#8221; and &#8220;processing speed&#8221;36. Additionally, the PROLEC SE-Revised Test37 is extensively used to evaluate reading disabilities (lexical, semantic and/or syntactic processes of reading), one of the most prevalent and disabling difficulties for learning in current academic contexts, which overlaps with other disorders such as ADHD38. This evaluation collects reading accuracy, speed and fluency along with reading disabilities, and more importantly, in which reading process the failure occurs37 (this test has been evaluated with pre-university students. Currently, there are no tests in Spain that are adapted to the general adult population, so this test was selected because it is the closest to the target population). Then, we screen symptoms of ADHD through the World Health Organization Adult ADHD Self-Report Scale (ASRS)39 and refine the evaluation of this disorder, introducing multimodality with a cutting-edge virtual reality continuous performance test for the evaluation of attentional processes and working memory in adults, the Nesplora Aquarium31,40. This test is a very useful tool when diagnosing ADHD in adults and adolescents over 16 years old in an ecological scenario, providing objective, reliable data. It evaluates selective and sustained attention, impulsivity, reaction time, auditory and visual attention, perseverance, quality of attentional focus, motor activity, work memory and cost of change of task. Additionally, along with the WAIS-IV35 as a whole for collecting information about the participant&#8217;s intellectual ability, we pay special attention to the scales &#8220;work memory&#8221; and &#8220;processing speed&#8221; because they are related to learning difficulties and the results of these scales are used in the final decision. Finally, we include the Autism Spectrum Quotient (AQ-Short)41 in the protocol, the short version of the reliable AQ-Adult from Baron-Cohen, Wheelwright, Skinner, Martin and Clubley42.
Session 2 focuses on a multimodal assessment of the participant&#8217;s learning process. The key to understanding complex learning lies in understanding the deployment of students&#8217; cognitive, metacognitive, motivational, and affective processes43. To that end, participants work with MetaTutor, where the use of metacognitive and cognitive strategies deployed are observed while they are learning. MetaTutor is a hypermedia learning environment that is designed to detect, model, trace, and foster students&#8217; self-regulated learning while learning different science topic44. The design of MetaTutor is based on extensive research by Azevedo and colleagues43,45,46,47 and belongs to a new trend in the measurement of SRL, the so called third wave, which is characterized by combined use of measurement and advanced learning technologies33. The use of MetaTutor also provides multimodal trace data, incorporating measures such as, eye tracking, emotional physiological responses (galvanic skin response (GSR) and facial expressions of emotions)48, log-data and questionnaires. All these measures are combined to reach a deeper understanding of the participants SRL and metacognition.
Eye tracking provides an understanding of what attracts immediate attention, which target elements are ignored, in which order elements are noticed, or how elements compare to others; electrodermal activity lets us know how emotional arousal changes in response to the environment; facial-emotion-recognition allows the automatic recognition and analysis of facial expressions; and data logging collects and stores the student&#180;s interaction with the learning environment for further analysis. Concerning the questionnaires, the Mini International Personality Item Pool49 informs about a range of activities and thoughts that people experience in everyday life assessing each of the five major personality traits (extraversion, agreeableness, conscientiousness, neuroticism and openness). The Connotative Aspects of Epistemological Beliefs50 provides information about participants&#8217; beliefs about knowledge. The Rosenberg Self-esteem scale shows how the participants feel about themselves overall51. The Emotion Regulation Questionnaire52 provides information about participants&#8217; emotion regulation. The Achievement Emotions Questionnaire (AEQ)53 informs about emotions typically experienced at university.
In short, assessing LDs during adulthood is particularly difficult. Education and experience allow many adults to compensate for their deficits and later show undifferentiated or masked symptoms, on which scientific knowledge is still scarce. Taking into account the critical research gap that arises, this current work aims to ensure theoretically-driven, empirically-based guidelines for accurate assessment of LDs during adulthood in order to design effective prevention and intervention actions.
To help readers decide whether the method described is appropriate or not, it is necessary to specify that the protocol is not suitable for people with intellectual disabilities because their diagnosis invalidates the diagnosis of learning difficulties. In addition, due to the singularities of the equipment used and the format of showing the learning content, it is still not possible to evaluate people with motor disabilities (upper limbs, neck and/or face), hearing or visual impairment. Nor would it be suitable for participants with severe psychiatric disorders. It would require the use of drugs that could alter information processing or the physiological expression of emotions.

<table border="0" cellpadding="0" cellspacing="0" style="width:787px;" width="787">
	<colgroup>
		<col />
		<col />
		<col />
		<col />
	</colgroup>
	<tbody>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">AQUARIUM</td>
			<td style="width:242px;">Nesplora</td>
			<td style="width:161px;"></td>
			<td style="width:167px;"></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Eye-tracker RED500 Systems</td>
			<td style="width:242px;">SensoMotoric Instruments GmbH</td>
			<td style="width:161px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">Face API</td>
			<td style="width:242px;">Microsoft</td>
			<td style="width:161px;"></td>
			<td></td>
		</tr>
		<tr height="21">
			<td height="21" style="height:21px;width:216px;">GSR NUL-217</td>
			<td style="width:242px;">NeuLog</td>
			<td style="width:161px;"></td>
			<td></td>
		</tr>
	</tbody>
</table>

multimodal protocol for assessing metacognition and self-regulation in adults with learning difficulties

Learning disabilities (LDs) encompass disorders of those who have difficulty learning and using academic skills, exhibiting performance below expectations for their chronological age in the areas of reading, writing, and/or mathematics. Each of the disorders making up the LDs involve different deficits; however, some commonalities can be found within that heterogeneity, such in terms of learning self-regulation and metacognition. Unlike in early ages and later educational levels, there are hardly any evidence-based evaluation protocols for adults with LDs. LDs influence academic performance but also have serious consequences in professional, social, and family contexts. In response to this, the current work proposes a multimodal evaluation protocol focused on metacognitive, self-regulation of learning, and emotional processes, which make up the basis of the difficulties in adults with LDs. The assessment is carried out through analysis of the on-line learning process using a variety methods, techniques, and sensors (e.g., eye tracking, facial expressions of emotion, physiological responses, concurrent verbalizations, log files, screen recordings of human-machine interactions) and off-line methods (e.g., questionnaires, interviews, and self-report measures). This theoretically-driven and empirically-based guideline aims to provide an accurate assessment of LDs in adulthood in order to design effective prevention and intervention proposals.

This section illustrates the representative results obtained from the protocol, including an example of conjoint results of Session 1 and an example of each source of information from Session 2.
The results about disorders are collected in Session 1 through diagnostic tests taking into account the procedures and cut-off points specified for the diagnostic assessment of participants&#8217; learning difficulties (SLD, ADHD, and ASD). The expert committee decides whether the participant has learn...

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Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties

The current work proposes a multimodal evaluation protocol focused on metacognitive, self-regulation of learning, and emotional processes, which make up the basis of the difficulties in adults with LDs.

Learning disabilities (LDs) encompass disorders of those who have difficulty learning and using academic skills, exhibiting performance below expectations ...

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Serie: Multimodal Protocol for Assessing Metacognition and Self-Regulation in Adults with Learning Difficulties

Community-based Adapted Tango Dancing for Individuals with Parkinson's Disease and Older Adults

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple step elements. Adapted tango involves movement initiation and cessation, multi-directional perturbations, varied speeds and rhythms. Focus on foot placement, whole body coordination, and attention to partner, path of movement, and aesthetics likely underlie adapted tango&#8217;s demonstrated efficacy for improving mobility and balance. In this paper, we describe the methodology to disseminate the adapted tango teaching methods to dance instructor trainees and to implement the adapted tango by the trainees in the community for older adults and individuals with Parkinson&#8217;s Disease (PD). Efficacy in improving mobility (measured with the Timed Up and Go, Tandem stance, Berg Balance Scale, Gait Speed and 30 sec chair stand), safety and fidelity of the program is maximized through targeted instructor and volunteer training and a structured detailed syllabus outlining class practices and progression.

Community-based Adapted Tango Dancing for Individuals with Parkinson&#039;s Disease and Older Adults

Adapted tango has demonstrated efficacy for improving mobility and balance. We describe the dissemination of adapted tango teaching methods to dance instructor trainees and the implementation of adapted tango by the trainees in the community for improving mobility and balance in older adults and individuals with Parkinson&#8217;s disease.

Adapted tango dancing improves mobility and balance in older adults and additional populations with balance impairments. It is composed of very simple ...

Measuring Attentional Biases for Threat in Children and Adults

Investigators have long been interested in the human propensity for the rapid detection of threatening stimuli. However, until recently, research in this domain has focused almost exclusively on adult participants, completely ignoring the topic of threat detection over the course of development. One of the biggest reasons for the lack of developmental work in this area is likely the absence of a reliable paradigm that can measure perceptual biases for threat in children. To address this issue, we recently designed a modified visual search paradigm similar to the standard adult paradigm that is appropriate for studying threat detection in preschool-aged participants. Here we describe this new procedure. In the general paradigm, we present participants with matrices of color photographs, and ask them to find and touch a target on the screen. Latency to touch the target is recorded. Using a touch-screen monitor makes the procedure simple and easy, allowing us to collect data in participants ranging from 3 years of age to adults. Thus far, the paradigm has consistently shown that both adults and children detect threatening stimuli (e.g., snakes, spiders, angry/fearful faces) more quickly than neutral stimuli (e.g., flowers, mushrooms, happy/neutral faces). Altogether, this procedure provides an important new tool for researchers interested in studying the development of attentional biases for threat.

Here we describe a touch-screen visual search paradigm that can be used to study threat detection across the lifespan. The paradigm has already been used in various studies demonstrating that both children and adults detect threatening stimuli like snakes, spiders, and angry faces faster than non-threatening stimuli.

Investigators have long been interested in the human propensity for the rapid detection of threatening stimuli. However, until recently, research in this ...

Assessing the Multiple Dimensions of Engagement to Characterize Learning: A Neurophysiological Perspective

In a recent theoretical synthesis on the concept of engagement, Fredricks, Blumenfeld and Paris1 defined engagement by its multiple dimensions: behavioral, emotional and cognitive. They observed that individual types of engagement had not been studied in conjunction, and little information was available about interactions or synergy between the dimensions; consequently, more studies would contribute to creating finely tuned teaching interventions. Benefiting from the recent technological advances in neurosciences, this paper presents a recently developed methodology to gather and synchronize data on multidimensional engagement during learning tasks. The technique involves the collection of (a) electroencephalography, (b) electrodermal, (c) eye-tracking, and (d) facial emotion recognition data on four different computers. This led to synchronization issues for data collected from multiple sources. Post synchronization in specialized integration software gives researchers a better understanding of the dynamics between the multiple dimensions of engagement. For curriculum developers, these data could provide informed guidelines for achieving better instruction/learning efficiency. This technique also opens up possibilities in the field of brain-computer interactions, where adaptive learning or assessment environments could be developed.

This paper aims to describe the techniques involved in the collection and synchronization of the multiple dimensions (behavioral, affective and cognitive) of learners&#8217; engagement during a task.

In a recent theoretical synthesis on the concept of engagement, Fredricks, Blumenfeld and Paris1 defined engagement by its multiple dimensions: ...

Combined Shuttle-Box Training with Electrophysiological Cortex Recording and Stimulation as a Tool to Study Perception and Learning

Shuttle-box avoidance learning is a well-established method in behavioral neuroscience and experimental setups were traditionally custom-made; the necessary equipment is now available by several commercial companies. This protocol provides a detailed description of a two-way shuttle-box avoidance learning paradigm in rodents (here Mongolian gerbils; Meriones unguiculatus) in combination with site-specific electrical intracortical microstimulation (ICMS) and simultaneous chronical electrophysiological in vivo recordings. The detailed protocol is applicable to study multiple aspects of learning behavior and perception in different rodent species.
Site-specific ICMS of auditory cortical circuits as conditioned stimuli here is used as a tool to test the perceptual relevance of specific afferent, efferent and intracortical connections. Distinct activation patterns can be evoked by using different stimulation electrode arrays for local, layer-dependent ICMS or distant ICMS sites. Utilizing behavioral signal detection analysis it can be determined which stimulation strategy is most effective for eliciting a behaviorally detectable and salient signal. Further, parallel multichannel-recordings using different electrode designs (surface electrodes, depth electrodes, etc.) allow for investigating neuronal observables over the time course of such learning processes. It will be discussed how changes of the behavioral design can increase the cognitive complexity (e.g. detection, discrimination, reversal learning).

Shuttle-box avoidance learning is well-established in behavioral neuroscience. This protocol describes how shuttle-box learning in rodents can be combined with site-specific electrical intracortical microstimulation (ICMS) and simultaneous chronical in vivo recordings as a tool to study multiple aspects of learning and perception.

Shuttle-box avoidance learning is a well-established method in behavioral neuroscience and experimental setups were traditionally custom-made; the ...

Psychophysical Tracking Method to Measure Taste Preferences in Children and Adults

The Monell two-series, forced-choice, paired-comparison tracking method provides a reliable measure of sweet taste preferences from childhood to adulthood. The method, which is identical for children, adolescents, and adults, is of short duration (&#60; 15 min), does not rely on sustained attention or place demands on memory (which would yield spurious age differences), and minimizes the impact of language development, making this method amenable to the cognitive limitations of pediatric populations. In this whole-mouth tasting method, subjects are asked to taste (without swallowing) pairs of solutions of different sucrose concentrations and to point to the solution they prefer. Each subsequent pair contains the participant&#39;s preceding preferred concentration and an adjacent stimulus concentration. The procedure continues until the subject chooses either a given concentration of sucrose when paired with both a higher and a lower concentration, or the highest or lowest concentration two consecutive times. Subjects are prevented from reaching response criteria on the basis of first or second position bias by the two-series design of the method, which counterbalances the order of solution presentation within each pair between the series (the weaker concentration is presented first in Series 1, second in Series 2). The geometric mean of the two sucrose concentrations chosen in Series 1 and 2 is an estimate of the participant&#39;s most preferred level of sucrose. Sucrose preference as determined with this laboratory-based measure has been shown to be associated with preference for sugars in foods and beverages and with taste receptor genotype, family history of alcoholism, and race/ethnicity, as well as depressive symptomatology among pediatric populations. The method has real-world relevance and has been applied to determine most preferred level of other tastes (e.g., salt), making it a valuable psychophysical tool.

Sweet taste has powerful hedonic appeal among people of all ages, particularly children. Described herein is a reliable and valid method that can be used to determine the level of sweetness most preferred, making it a valuable psychophysical tool for scientists.

The Monell two-series, forced-choice, paired-comparison tracking method provides a reliable measure of sweet taste preferences from childhood to ...

Investigating Motor Skill Learning Processes with a Robotic Manipulandum

Skilled reaching tasks are commonly used in studies of motor skill learning and motor function under healthy and pathological conditions, but can be time-intensive and ambiguous to quantify beyond simple success rates. Here, we describe the training procedure for reach-and-pull tasks with ETH Pattus, a robotic platform for automated forelimb reaching training that records pulling and hand rotation movements in rats. Kinematic quantification of the performed pulling attempts reveals the presence of distinct temporal profiles of movement parameters such as pulling velocity, spatial variability of the pulling trajectory, deviation from midline, as well as pulling success. We show how minor adjustments in the training paradigm result in alterations in these parameters, revealing their relation to task difficulty, general motor function or skilled task execution. Combined with electrophysiological, pharmacological and optogenetic techniques, this paradigm can be used to explore the mechanisms underlying motor learning and memory formation, as well as loss and recovery of function (e.g. after stroke).

A paradigm is presented for training and analysis of an automated skilled reaching task in rats. Analysis of pulling attempts reveals distinct subprocesses of motor learning.

Skilled reaching tasks are commonly used in studies of motor skill learning and motor function under healthy and pathological conditions, but can be ...

Modeling Verbal Behavior Deficits with the Stimulus Control Ratio Equation, SCoRE

Verbal operant analyses are the extension of functional analysis technology to the field of verbal behavior, of particular relevance to autism spectrum disorders and associated developmental disabilities. Similarly, a verbal operant analysis carefully controls specific environmental factors that influence language, and measures strength of responding across four verbal operant classes: tact, mand, echoic, and sequelic. The frequency of each independent verbal operant is then measured against one another using the stimulus control ratio equation (SCoRE) to summarize the relative strength of the speaker&#8217;s repertoire. The verbal behavior SCoRE yields a statistic that can be compared against itself (e.g., for the purposes of pre/post testing) or against others (e.g., for the purposes of randomized controlled trials). The results of this evaluation provide an individualized hierarchy for diverging stimulus control across the verbal operants, from which a treatment plan for errorless language learning may be prescribed.

This article describes the procedures for conducting a verbal operant analysis (VOA), calculating the stimulus control ratio equation (SCoRE), and developing individualized verbal behavior treatment plans, specifically significant to address the deficits characteristic of autism.

Verbal operant analyses are the extension of functional analysis technology to the field of verbal behavior, of particular relevance to autism spectrum ...

Lexical Decision Task for Studying Written Word Recognition in Adults with and without Dementia or Mild Cognitive Impairment

Older adults are slower at recognizing visual objects than younger adults. The same is true for recognizing that a letter string is a real word. People with Alzheimer&#39;s disease (AD) or Mild Cognitive Impairment (MCI) demonstrate even longer responses in written word recognition than elderly controls. Despite the general tendency towards slower recognition in aging and neurocognitive disorders, certain characteristics of words influence word recognition speed regardless of age or neuropathology (e.g., a word&#8217;s frequency of use). We present here a protocol for examining the influence of lexical characteristics on word recognition response times in a simple lexical decision experiment administered to younger and older adults and people with MCI or AD. In this experiment, participants are asked to decide as quickly and accurately as possible whether a given letter string is an actual word or not. We also describe mixed-effects models and principal components analysis that can be used to detect the influence of different types of lexical variables or individual characteristics of participants on word recognition speed.

This article describes how to implement a simple lexical decision experiment to assess written word recognition in neurologically healthy participants and in individuals with dementia and cognitive decline. We also provide a detailed description of reaction time analysis using principal components analysis (PCA) and mixed-effects modeling.

Older adults are slower at recognizing visual objects than younger adults. The same is true for recognizing that a letter string is a real word. People ...

Assessing the Coherence of Parents' Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure

Valid and efficient measures for assessing the quality of parent-child relationships are needed to facilitate research and evidence-based practice with parents. This paper focuses on such a method, namely Five-Minute Speech Sample-Coherence (FMSS-Coherence). In this method, a parent is asked to speak for five uninterrupted minutes about her/his child and their relationship. The resulted narrative is coded for coherence, namely the extent to which the parent provides&#160;in the narrative&#160;a clear, consistent, multidimensional and well-supported portrayal of the child. FMSS-Coherence is based on attachment research that shows that the coherence of parents&#8217; narratives is indicative of the quality of the parent-child relationship and child adjustment. It overcomes the limitations of attachment narrative measures which are typically labor intensive. FMSS-Coherence is less nuanced than extant attachment narrative measures. Yet, studies of families from different cultural backgrounds, across different child ages and in the context of typically developing children as well as children with special needs suggest that coherence can be reliably evaluated using the FMSS procedure. Furthermore, parents&#8217; FMSS-Coherence is associated with parenting quality and children&#8217;s socio-emotional adjustment. Thus, it holds promise for researchers and practitioners who seek a relatively time- and cost-effective method for assessing the coherence of parents&#8217; narratives regarding their child.

Assessing the Coherence of Parents&#039; Short Narratives Regarding their Child Using the Five-Minute Speech Sample Procedure

This paper introduces a method for assessing the coherence of parents' short narratives regarding their child and their relationship using the five-minute speech sample procedure.

Valid and efficient measures for assessing the quality of parent-child relationships are needed to facilitate research and evidence-based practice with ...

A Methodology for Capturing Joint Visual Attention Using Mobile Eye-Trackers

With the advent of new technological advances, it is possible to study social interactions at a microlevel with unprecedented accuracy. High frequency sensors, such as eye-trackers, electrodermal activity wristbands, EEG bands, and motion sensors provide observations at the millisecond level. This level of precision allows researchers to collect large datasets on social interactions. In this paper, I discuss how multiple eye-trackers can capture a fundamental construct in social interactions, joint visual attention (JVA). JVA has been studied by developmental psychologists to understand how children acquire language, learning scientists to understand how small groups of learners work together, and social scientists to understand interactions in small teams. This paper describes a methodology for capturing JVA in colocated settings using mobile eye-trackers. It presents some empirical results and discusses implications of capturing microobservations to understand social interactions.

Using multimodal sensors is a promising way to understand the role of social interactions in educational settings. This paper describes a methodology for capturing joint visual attention from colocated dyads using mobile eye-trackers.

With the advent of new technological advances, it is possible to study social interactions at a microlevel with unprecedented accuracy. High frequency ...