Leveraging the test effect to improve maintenance of the gains achieved through cognitive rehabilitation.

Abstract

Objective An important aspect of the rehabilitation of cognitive and linguistic function subsequent to brain injury is the maintenance of learning beyond the time of initial treatment. Such maintenance is often not satisfactorily achieved. Additional practice, or overtraining, may play a key role in long-term maintenance. In particular, the literature on learning in cognitively intact persons has suggested that it is testing, and not studying, that contributes to maintenance of learning. The present study investigates the hypothesis that continuing to test relearned words in persons with anomia will lead to significantly greater maintenance compared with continuing to study relearned words. Method The current study combines overtraining with the variable of test versus study in examining the effects of overtesting and overstudying on maintenance of word finding in 3 persons with aphasia. First, treatment successfully reestablished the connections between known items and their names. Once the connections were reestablished (i.e., items could be named successfully), each item was placed into 1 of 4 overtraining conditions: test and study, only test, only study, or no longer test or study. Maintenance was probed at 1 month and 4 months following the end of overtraining. Results The results are consistent with an advantage of testing compared with studying. All 3 participants showed significantly greater maintenance for words that were overtested than for words that were overstudied. This testing benefit persisted at 1 month and 4 months after completion of the treatment. In fact, there was no clear evidence for any benefit of overstudying. Conclusions The present study demonstrates that overtesting, but not overstudying, leads to lasting maintenance of language rehabilitation gains in patients with anomia. The implications for the design of other treatment protocols are immense.

Retrieval Practice Fails to Insulate Episodic Memories against Interference after Stroke

“…In contrast, on the basis of recent clinical work showing reliable backward testing effects in memory-impaired patient groups, one may expect the backward testing effect to be also present in patients with stroke. Reliable backward testing effects have been demonstrated in patients with Alzheimer’s disease, MS and severe TBI ( Sumowski et al, 2010a , b ; Small, 2012 ; Pastötter et al, 2013 ), and, with regard to semantic memory impairment, have also been shown in patients with stroke and chronic aphasia ( Middleton et al, 2015 ; Friedman et al, 2017 ). On the basis of these finding and the present results, a dissociation between the backward testing effect and the interference reduction effect in patients with stroke may be expected, which would point to partially different mechanisms mediating the two effects.…”

Intervenção fonoaudiológica na afasia expressiva: revisão integrativa

“…Picture naming and word to picture matching were the strategies most used (46) . Most studies used picture naming, and tablets and computers were frequently used, especially for the purpose of presenting the stimuli (13,25,26,32,37,40,47) . To improve word retrieval, some studies used progressive cueing (16,17,20,21,26,35,37,43) as it appears in the literature.…”

“…M o s t s t u d i e s u s e d l e x i c a l -p h o n o l o g i c a l stimuli (16)(17)(18)20,22,23,(26)(27)(28)(29)33,35,40,41,43,44) and semantic stimuli (13,15,25,30,31,36,38,39,42) , and some studies used verbs (19,21,24,32,37) . Another study also reported picture naming as the main task used during word retrieval treatment.…”

The relationship between baseline volume in temporal areas and post-treatment naming accuracy in primary progressive aphasia

“…Fourteen out of 21 participants were tested on Exemplar set 1 before Exemplar set 2 (each set was tested in a different session). Thus, the first testing session provided an opportunity for retrieval practice (Friedman, Sullivan, Snider, Luta, & Jones, in press; Middleton, Schwartz, Rawson, & Garvey, 2015; Roediger & Butler, 2011). This opportunity followed a seven-month period during which testing of these items did not occur.…”