MEMORY REHABILITATION: INTEGRATING THEORY AND PRACTICE
CONTENTS CHAPTER 1 UNDERSTANDING MEMORY AND MEMORY IMPAIRMENTS WHAT DO WE MEAN BY MEMORY? TIME-DEPENDENT MEMORY THE TYPE OF INFORMATION TO BE REMEMBERED MODALITY-SPECIFIC MEMORY STAGES IN THE PROCESS OF REMEMBERING: ENCODING, STORAGE, AND RETRIEVAL EXPLICIT AND IMPLICIT MEMORY RETROSPECTIVE AND PROSPECTIVE MEMORY RETROGRADE AND ANTEROGRADE MEMORY A BRIEF ACCOUNT OF THE NEUROANATOMY OF MEMORY CHAPTER 2 RECOVERY OF MEMORY FUNCTIONS AFTER BRAIN INJURIES WHAT DO WE MEAN BY RECOVERY? MECHANISMS OF RECOVERY TO WHAT EXTENT DOES MEMORY RECOVER? CAN WE IMPROVE ON NATURAL RECOVERY? CHANGES IN MEMORY FUNCTIONING FOLLOWING INTERVENTION OR REHABILITATION CHAPTER 3 ASSESSMENT FOR REHABILITATION WHAT DO WE MEAN BY ASSESSMENT? WHAT QUESTIONS SHOULD BE ASKED IN ASSESSMENTS FOR REHABILITATION? WHICH ASPECTS OF MEMORY SHOULD BE ASSESSED? BEHAVIORAL ASSESSMENT PROCEDURES FOR IDENTIFYING MEMORY PROBLEMS CHAPTER 4 COMPENSATING FOR MEMORY DEFICITS WITH MEMORY AIDS WITH NARINDER KAPUR TYPOLOGY OF MEMORY AIDS WHICH ARE THE MOST FREQUENTLY USED MEMORY AIDS? HOW EFFECTIVE ARE EXTERNAL MEMORY AIDS? CAN WE PREDICT WHO WILL USE EXTERNAL MEMORY AIDS EFFICIENTLY? WHICH ASSESSMENT PROCEDURES ARE MOST APPROPRIATE WHEN CONSIDERING PATIENTS FOR EXTERNAL MEMORY AIDS? SETTING UP A MEMORY AIDS CLINIC WHICH TYPES OF MEMORY AIDS ARE CURRENTLY AVAILABLE? HOW CAN WE BEST TEACH PEOPLE TO USE EXTERNAL MEMORY AIDS? HOW CAN WE BEST MEASURE THE EFFECTIVENESS OF EXTERNAL MEMORY AIDS? HOW CAN WE BRING ABOUT COMPLIANCE AND GENERALIZATION IN THE USE OF EXTERNAL MEMORY AIDS? HOW WILL ADVANCES IN TECHNOLOGY IMPACT MEMORY AIDS OF THE FUTURE? CHAPTER 5 MNEMONICS AND REHEARSAL STRATEGIES IN REHABILITATION WHAT ARE MNEMONICS? VERBAL MNEMONICS VISUAL MNEMONICS MOTOR MOVEMENTS AS A MEMORY AID HOW SUCCESSFUL ARE MNEMONICS IN MEMORY REHABILITATION? ADVICE WHEN USING MNEMONICS WHAT DO WE MEAN BY REHEARSAL STRATEGIES? STUDIES EVALUATING PQRST WHY DOES PQRST WORK? USING PQRST IN CLINICAL PRACTICE CHAPTER 6 NEW LEARNING IN REHABILITATION: ERRORLESS LEARNING, SPACED RETRIEVAL (EXPANDED REHEARSAL), AND VANISHING CUES WHAT IS ERRORLESS LEARNING? THEORETICAL UNDERPINNINGS OF EL LEARNING EL LEARNING STUDIES WITH MEMORY-IMPAIRED PEOPLE DOES EL LEARNING DEPEND ON IMPLICIT OR EXPLICIT MEMORY? WHAT IS SPACED RETRIEVAL (EXPANDED REHEARSAL)? WHY DOES SPACED RETRIEVAL WORK? SPACED RETRIEVAL COMBINED WITH EL LEARNING SPACED RETRIEVAL ALONE USING SPACED RETRIEVAL IN CLINICAL PRACTICE WHAT DO WE MEAN BY VANISHING CUES? STUDIES EVALUATING VC HOW DOES VC WORK? VC IN CLINICAL PRACTICE TEACHING PROCEDURES OR NEW INFORMATION THROUGH EL LEARNING, SPACED RETRIEVAL, OR VC CHAPTER 7 MEMORY GROUPS WHY RUN MEMORY GROUPS? HOW SHOULD A MEMORY GROUP BE STRUCTURED? STUDIES EVALUATING MEMORY GROUPS SELF-HELP AND SUPPORT GROUPS MEMORY GROUPS IN CLINICAL PRACTICE CHAPTER 8 TREATING THE EMOTIONAL AND MOOD DISORDERS ASSOCIATED WITH MEMORY IMPAIRMENT WHY IS IT IMPORTANT TO TREAT THE EMOTIONAL AND MOOD DISORDERS ASSOCIATED WITH MEMORY IMPAIRMENT? HOW PREVALENT ARE EMOTIONAL AND MOOD DISORDERS AFTER BRAIN INJURY? ASSESSMENT OF EMOTIONAL AND MOOD DISORDERS IN PEOPLE WITH BRAIN INJURY GROUP TREATMENTS FOR EMOTIONAL AND MOOD DISORDERS IN PEOPLE WITH MEMORY IMPAIRMENTS INDIVIDUAL PSYCHOLOGICAL THERAPY FOR EMOTIONAL AND MOOD DISORDERS TREATMENT OF EMOTIONAL AND MOOD DISORDERS IN CLINICAL PRACTICE CHAPTER 9 GOAL SETTING TO PLAN AND EVALUATE MEMORY REHABILITATION WHAT ARE GOALS? WHY USE GOAL SETTING IN MEMORY REHABILITATION? THEORIES OF GOAL SETTING IDENTIFYING AND SETTING GOALS: THE ART OF NEGOTIATION GOAL ATTAINMENT AS AN OUTCOME MEASURE GOAL SETTING IN CLINICAL PRACTICE CHAPTER 10 PUTTING IT ALL TOGETHER BEFORE STARTING A MEMORY REHABILITATION PROGRAM FIRST STEPS IN PLANNING A MEMORY REHABILITATION PROGRAM COMPLEMENTING THE NEUROPSYCHOLOGICAL ASSESSMENT WITH A BEHAVIORAL ASSESSMENT GOAL SETTING SELECTING THE BEST STRATEGIES TO ACHIEVE THE GOALS THE EXAMPLE OF JAY GENERALIZATION OR TRANSFER OF LEARNING A FRAMEWORK FOR PLANNING A REHABILITATION PROGRAM CHAPTER 11 FINAL THOUGHTS AND A GENERAL SUMMARY PRINCIPLES OF GOOD REHABILITATION DOES REHABILITATION IMPROVE QOL? COMBINING THEORY AND PRACTICE SUMMARIES OF INDIVIDUAL CHAPTERS C H A P T E R UNDERSTANDING MEMORY AND MEMORY IMPAIRMENTS WHAT DO WE MEAN BY MEMORY? ONE SIMPLE DEFINITION OF MEMORY THAT MAKES SENSE TO PATIENTS, FAMILIES, AND CAREGIVERS IS “THE ABILITY TO TAKE IN, STORE, AND RETRIEVE INFORMATION” ALTHOUGH PEOPLE TEND TO TALK ABOUT MEMORY AS THOUGH IT WERE ONE SKILL, FUNCTION, OR ABILITY, SAYING, FOR EXAMPLE, “I HAVE A TERRIBLE MEMORY” OR “SHE HAS A PHOTOGRAPHIC MEMORY,” THERE ARE MANY KINDS OF MEMORY AND MANY WAYS IT CAN BREAK DOWN BADDELEY (2004) DISCUSSES THE FRACTION- ATION OF MEMORY AND REMINDS US THAT PEOPLE WITH THE CLASSIC AMNESIC SYNDROME HAVE GREAT DIFFICULTY REMEMBERING AFTER A DELAY OR DISTRACTION BUT HAVE A NORMAL IMMEDIATE MEMORY SPAN, SO AFTER HEARING A STRING OF DIGITS THEY CAN TYPICALLY REPEAT BACK FIVE, SIX, OR SEVEN OF THESE IN THE CORRECT ORDER OTHER PEOPLE HAVE GREAT DIFFICULTY REPEATING TWO OR MORE DIGITS BUT HAVE MUCH LESS OF A PROBLEM AFTER A DELAY OR DISTRACTION THUS, A DOUBLE DISSOCIATION CAN BE FOUND BETWEEN PEOPLE WITH A CLASSIC AMNESIC SYNDROME AND THOSE WITH AN IMPAIRED SHORT-TERM (IMMEDIATE) MEMORY STORE MEMORY, THEN, IS NOT ONE SKILL OR FUNCTION BUT RATHER A “COMPLEX COMBINATION OF MEMORY SUBSYSTEMS” (BADDELEY, 1992, P 5) WE CAN CON- SIDER MEMORY IN TERMS OF THE LENGTH OF TIME FOR WHICH MEMORIES ARE STORED, THE TYPE OF INFORMATION TO BE REMEMBERED, THE MODALITY THE INFORMATION IS IN, THE STAGES IN THE PROCESS OF REMEMBERING, EXPLICIT OR IMPLICIT MEMORY, WHETHER RECALL OR RECOGNITION IS REQUIRED, WHETHER THE MEMORY IS RETROSPECTIVE (FOR THINGS THAT HAVE ALREADY OCCURRED) OR PRO- SPECTIVE (REMEMBERING WHAT HAS TO BE DONE), AND WHETHER THE MEMORY DATES FROM BEFORE OR AFTER THE INJURY OR ILLNESS (CLARE & WILSON, 1997) THIS CHAPTER ADDRESSES EACH OF THESE TOPICS AND PROVIDES A BRIEF CONSID- ERATION OF THE NEUROANATOMY OF MEMORY TIME-DEPENDENT MEMORY BADDELEY AND HITCH (1974), INFLUENCED BY ATKINSON AND SHRIFFIN (1971), SUGGESTED THAT MEMORY CAN BE DIVIDED INTO THREE CATEGORIES BROADLY BASED ON THE LENGTH OF TIME INFORMATION CAN BE STORED: SENSORY MEMORY, WHICH STORES INFORMATION FOR LESS THAN A QUARTER OF A SECOND (250 MSS); SHORT-TERM STORE, WHICH HOLDS INFORMATION FOR A FEW SECONDS; AND LONG-TERM STORE, WHICH HOLDS INFORMATION FOR ANYTHING FROM MINUTES TO YEARS (FIG- URE 11) THE FIRST, SENSORY MEMORY, IS THE SYSTEM WE USE WHEN WE GO TO THE CINEMA AND PERCEIVE WHAT APPEARS TO BE A MOVING FILM IN FACT, WE ARE SEEING A SERIES OF STILL SHOTS BUT THE SHOTS ARE HELD IN THE BRIEF SENSORY FIGURE 11 THE WORKING MEMORY MODEL AFTER BADDELEY AND HITCH (1974) SENSORY MEMORY ICONIC ECHOIC LONG-TERM MEMORY VISUAL VERSUS VERBAL SEMANTIC VERSUS EPISODIC EXPLICIT VERSUS IMPLICIT WORKING MEMORY PHONOLOGICAL LOOP CENTRAL EXECUTIVE VISUO- SPATIAL SKETCHPAD MEMORY REHABILITATION