BHS 499-07 Memory and Amnesia

1. BHS 499-07Memory and Amnesia Memory Improvement

2. Memory Improvement • Improving normal memory • What works, what does not. • Improving memory in those with brain injury. • Unlike previously thought, research in the past 15 years shows that memory can be improved. • Functioning can also be improved.

3. 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.

4. 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.

5. 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.

6. 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.

7. 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

8. 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.

9. 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.

10. 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.

11. 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.

12. 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. • Knotted handkerchiefs are useless. • Timers with specific messages are ideal.

13. 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.

14. 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.

15. 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.