Friday, May 03, 2013

10 Ways to Make Memory Rehab Work

Physical exercise can rehabilitate bodies that have grown soft and flabby. Can mental exercise rehabilitate brains that have deteriorated because of disease or age? Maybe.
A published scholarly review has examined the research literature on this issue and arrived at several useful conclusions:

1.      Focus, Reduce Distractions. The two common causes of forgetting, in both normal people and those with impaired memory, are a) failure to register new information effectively, and b) interference from conflicting sensations and thoughts.
2.      Customize the Rehabilitation Needed. Rehab need to take into account the type of memory therapy and the cause and severity of the impaired memory capability.
3.      Learn in Small, Frequently Repeated Chunks. New information has to be re-packaged for memory-impaired people so that it is in simple, concrete form, in small chunks, and repeated frequently — with patients required to re-state the information and make explicit associations with what they already know. (Notice how this sounds like the way one needs to teach young children).
4.      Practice Attentiveness. Attentiveness to new information can be enhanced by self-cueing, wherein patients remind themselves to be more attentive at crucial moments. This can even be done by creating a conditioned reflex in which a cue signal conditions greater attentiveness. (Notice how this sounds like how you “clicker” train dogs).
5.      Uses Mnemonics. Mnemonic tips and tricks can help. This includes using acronyms, rhymes, stories, and constructing mental images.
6.      Find Ways to Compensate. Even in patients with severe impairments, some aspects of memory, such as subliminal or implicit memory, may have been spared and can be exploited to compensate for the lost ability.
7.      Spread Rehearsals Over Time. Memory rehearsal is more effective if it is spread out over time rather than bunched into a few closely spaced sessions.
8.      Manipulate the Cues. Be more aware of cues you are using. A “vanishing clues” approach can help. For example, in a rehearsal session, cued retrieval might begin with cueing the first three letters of a target word, then repeating later with two, then  one, and eventually no letter cues.
9.      Minimize Error, Lest you Learn the Errors. Trial-and-error learning is generally less effective than learning conditions that minimize error, because error responses can get stored as memories that compete with the right answers. In short, it is better to not know than to generate wrong answers.
10.  Use Memory Crutches. Using external memory aids (sticky notes, wall charts, notebooks, etc.) should help, bearing in mind, however, that using such aids may themselves be a memory task. It is like having a schedule calendar and forgetting to check the calendar. Smart phones and radio paging devices (“NeuroPage”) can be especially helpful because they remind the patient when to check on the stored information. In some patients, repeated use of such aids develops a habit for target tasks and these may even generalize to certain non-target tasks.

These ten approaches are some of the same approaches that work especially well in people with normal memory capabilities. To make them work in patients with impaired memory just takes more effort, patience, and time.

Source: Ptak, R., Van der Linden, M., and Schneider, A. 2010. Cognitive rehabilitation of episodic memory disorders: from theory to practice. Frontiers in Human Research. 4 (57): 1-11. doi: 10.3389/fnhum.2010.00057.

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