BHS 499-07 Memory and Amnesia Memory Improvement Memory Improvement Improving normal memory Improving memory in those with brain injury. • What works, what does not. • Unlike previously thought, research in the • past 15 years shows that memory can be improved. Functioning can also be improved. What Does Not Work Hypnosis and new age approaches: • Suggestive Accelerated Learning and • Teaching Techniques – SALTT No evidence supporting value of physical relaxation techniques, alternation of active and passive review accompanied by music, suggestions that learning will be fun, songs and rhythms, cooperative learning, frequent self-testing – exam scores 40% below normal. What Works Organizing the material to be learned. • Establishing a link between the items to be • learned, so recall of one will cue the others. Tree diagrams that capture a conceptual framework – use table of contents of book. PQ4R method – elaborative rehearsal based on meaning (like PQRST). • Preview for structure, then read for answers to questions, repeatedly review. Mnemonics Interactive imagery – bizarre is better. First-letter mnemonics – Real Old Yokels Guzzle Beer In Volume (spectrum). Rhymes – a before e, except after c. Reduction mnemonics – strings of letters represent info in acronym or acrostic. • STOMACH – symptoms of anxiety disorder. More Mnemonics Method of Loci – picture items in a familiar location. • Simonides remembered where guests were sitting after the roof collapsed. Peg-word system – items are linked to a series of pre-learned pegs. Face-name mnemonic – combines imagery with parts of face. More Mnemonics Keyword method – link new vocabulary in a foreign language to some familiar image. • Herisson (hedgehog) = hairy son + hedgehog. Yodai mnemonics – think of parts of a binominal as wrestlers in a match: • (a + b)(c + d) becomes ac + ad + bc + bd Memory and Practice Distributed practice is better than massed practice. • Massed practice shows some benefits if there • is a lengthy rest period afterward. This doesn’t happen with “cramming”. Lag effect -- spaced repetition helps but not simple repetition. • Encoding variability may be occurring, which strengthens memory. Remediation Effects of remediation are modest, but very important to those with brain injury. Ignorance about amnesia prevents use of residual memory capacities. • Because procedural memory is spared, a person with amnesia can learn to program a computer. Support Memory With Devices Label drawers and cupboards. Put reminder signs up in visible places. • Put things by the front door to be taken out. Use a wall chart to show days of week and upcoming events. Use a diary and write notes. Make locations distinctive – paint doors different colors. More Suggestions Put a flow-chart on the wall with instructions for searching for frequently lost items (e.g., keys). Stick to a regular routine and keep the environment the same. Keep a notepad by the telephone and use speed-dial features. Display photos labeled with names. External Aids External cuing devices must provide the reminder as close as possible to the time something is to be done. It should specify what is to be done. Timers with specific messages are ideal. • Knotted handkerchiefs are useless. Is Memory Like a Muscle? Does repeated practice strengthen memory abilities? • No evidence of this – it improves a specific task but it does not generalize. Teaching patients to use mnemonics produces better results. • However, patients do not seem to use these spontaneously in everyday life. Other Approaches Expanded spaced retrieval – gradually expanding the time between spaced rehearsals showed improvement. Vanishing cues – start by presenting prompts which gradually fade away. • Initially seemed promising but tests show no advantage over rote rehearsal. Memory Groups People find out they aren’t the only ones having difficulty, gain support from sharing their problems with others. No direct benefit in improving memory. Members share their tips for coping with daily life, which is very useful.