Transcript Long-Term Memory Problems in Children and Adolescents

Evidence-Based Long-Term Memory
Strategies that Help Students Remember
Milton J. Dehn, Ed.D., NCSP
Schoolhouse Educational Services
Fall, 2012
Notice of Copyright, 2012
This PowerPoint and accompanying materials
are copyrighted by Milton J. Dehn and
Schoolhouse Educational Services, LLC. All
rights reserved. No photocopying, electronic
display, or electronic dissemination of these
materials is allowed without written
permission. For permission, contact
[email protected]
Workshop Information Sources
• References in handout packet
• Books by Dehn: Working Memory and
Academic Learning (2008); Long-Term
Memory Problems in Children and Adolescents
(2010); Helping Students Remember (2011).
• Presenter Email: [email protected]
• www.workingmemoryonline.com
Workshop Overview
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Memory systems and processes
The neuroanatomy of memory
Tier I: Screening and effective instruction
Tier II: Evidence-based interventions
1. Working memory exercises
2. Long-term memory strategies
5. Tier III: Interventions for severe problems
Need for Memory Interventions
1. Under-identified in children & adolescents
2. 10% have a WM impairment-Alloway
3. About 6% of average children have LTM
deficits (UK research)
4. Half of LD have a memory deficit (Dehn)
5. LTM impairments are a growing problem,
e.g, juvenile diabetes and concussions
6. Intervention expertise is lacking; example
Memory Systems
Three main systems
Auditory
Short-Term
Memory
Attention
Verbal
Long-Term
Memory
Retrieval
Working
Memory
Visual ShortTerm Memory
Visual
Long-Term
Memory
WM versus STM
1. STM part of WM construct but separable
neurologically
2. STM is storage; WM is storage + processing
3. Effortful rehearsal and retrieval is WM
4. “WM: the limited capacity to retain
information while simultaneously
manipulating the same or other information
for a short period of time”
5. WM is one of the executive functions
WM Capacity
1. STM adult span of 7; WM limit of 4 chunks
1. Case examples
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Focus of attention: might be one chunk
Processing and storage use same resource
Concurrent processing lowers span
Strategies increase span
Duration affected by processing speed,
content, and amount of interference
7. Human limitations
Cognitive Load Theory
1. WM is a combination of processing & storage
2. Processing & storage both draw on WM
capacity
3. Learner can only focus attention on one
aspect at a time
4. The greater the processing demands, the less
that can be retained in WM/STM (linear)
5. “Cognitive Load” is the processing portion
Retention as a Function of Cognitive
Load
Task Switching (Time Sharing)
1. To retain info. in WM, one must frequently switch
from processing to refreshing the info.
2. If the processing (cognitive load) is demanding,
there will be less switching and more info. will be
lost
3. Theoretically, when cognitive load consumes all of
WM; all info. is lost (Barrouillet, 2011)
4. Switching is difficult for young children
5. Example: remember steps while completing an
online task
Cognitive Load
1. Switching and amount of info. increase the
time to complete the processing
2. Environmental distractions add to cog. load
3. Irrelevant thoughts adds to cognitive load
4. Cognitive load is the main determinant of
storage in WM (and STM)
5. In experiments with very high load, children
can typically retain one item of information
STM/WM vs LTM
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STM
Very limited capacity
Retention for seconds
Conscious access to all content
Depends on attention
Immediate retrieval only
Forgetting is immediate
Amenable to simple strategies
Easy to assess
Less susceptible to brain injury
Frontal & parietal lobes
Electrical activity
LTM
Extensive capacity
Retention for minutes to years
Limited conscious access
Less dependent on attention
Retrieval can be extended
Forgetting is gradual
Amenable to elaborate strategies
Difficult to assess
Very susceptible to injury
Medial temporal lobe
Neuronal and synaptic changes
LTM Memory Systems
1. Explicit/declarative
Link
1. Episodic---episodes, events, autobiographical
1. Organized by scripts
2. Semantic---factual, knowledge, academic
1. Organized by schemas
2. Implicit/nondeclarative
1. Priming---unconscious associations (example)
2. Procedural learning--- “how to” learning
3. Classical conditioning---e.g., phobias
3. Prospective Memory (not really a separate memory
system)
Explicit vs Implicit
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Explicit
Conscious
Knowledge
Flexible expression
Hippocampus-dependent
Recollection expresses
Cognitive only
Effortful retrieval also
Develops until adulthood
Vulnerable to injury
Implicit
Unconscious
Skills
Rigid expression
Non-hippocampus
Performance expresses
Non-cognitive also
Automatic retrieval only
Developed by age 3
Resistant to injury
Episodic vs Semantic
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Episodic
Memory for events
Remembering
Context dependent
Subjective focus
Vulnerable to pathology
Develops later
Known source
Mostly visuospatial
Unintentional encoding
Chronological
Organized spatiotemporally
Subject to rapid forgetting
Few demands on WM
Semantic
Memory for facts
Knowing
Context free
Objective focus
Resistant to pathology
Develops first
Unknown source
Mostly verbal
More intentional
Categorical
Organized by meaning
Less rapid forgetting
Requires WM
Episodic-Semantic Interactions
1. Semantic slowly accrues from episodic
2. School learning is initially episodic but
eventually semantic
3. Episodic helps build the semantic
4. Semantic provides the schemas and scripts for
the episodic
5. Episodic provides context cues for semantic
6. Memory tests are episodic
Encoding
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Requires attention
Associated with learning
All other LT memory depends on
Enhanced by strategies
Hippocampus dependent
STM and WM deficits reduce encoding
opportunities
Learning
1. Mainly refers to initial learning, encoding,
and short-term recall
2. Learning curve---improves rapidly then
plateaus
3. What is difficult to learn is difficult to
remember and vice versa
4. Can be different from retention and recall,
given same degree of learning
Consolidation
1. Memories become more stable and resistant
to interference over time
2. Memories are forgotten because they are not
consolidated
3. LT memories are initially and temporarily
stored in the hippocampus and adjoining
medial temporal lobe structures
4. Over time they are transferred to the cortex
for more “permanent” storage
Consolidation Details
1. Neuroscience construct; not cognitive psych.
2. Evidence from TBI and amnesia
1. Ribot gradient
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Takes time: hours to several days
Unconscious mostly
Much of it occurs during sleep
Especially important for semantic memory
Reactivations improve consolidation
Sleep and Consolidation
1. Mainly during non-REM sleep
2. Hippocampus “replays” experiences/learning
1. “Organizes” information; Strengthens connections
2. “Moves” information to cortical areas
3. Sleep also reduces interference
4. Sleep accounts for 69% of next day
improvement in procedural tasks
5. Immediate sleep: 81% recall; delayed: 66%
Organization and Storage of Memories
1. The connections more important than the cells
2. Memory traces (pathways): synapses
1. New memories: new synapses or changes in strength
3. In networks of interconnected neurons, with
associated items linked more closely
1. Logical linking at the neurological level may
result from thinking about two things at the
same time (associations) (“fire together; wire
together”)
4. Memories end up being stored in same areas
that sensed, perceived, and processed info
Retrieval
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Mostly automatic; strengthens memories
WM involved in effortful retrieval
We know more than we can retrieve
Hippocampus reintegrates information
Reasoning involved in reconstruction
During assessment, compare with
recognition to determine whether it is a
retrieval or a storage problem
Recognition
1. Should be better than uncued retrieval
2. If not, there is a storage problem
3. When significantly better, there is a retrieval
problem
1. Slow retrieval
2. Ineffective retrieval
4. If retrieval problems, cued testing (MC, TF,
Matching) are appropriate modifications
Forgetting
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Lost from storage; not a retrieval problem
Lack of consolidation
Fast at first, then reaches asymptote
20 to 80% forgotten within 24 hours
Some retain well within 30 minutes or first
day but then have very poor retention
afterwards (poor consolidation)
6. Is it lost or not retrievable at moment?
Forgetting
1. Forgetting is necessary/adaptive
1. E.g., forget old address; remember new one
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Facilitates retention of important info
Retrieval causes forgetting of other info
Memories that are not retrieved, decay
Retrieval type of forgetting: cues don’t match
or one cue has multiple associations
Interference
1. Proactive---previous learning interferes with
current learning
2. Retroactive---current learning interferences
with previous learning
3. Related info. is the most interfering
4. Controlled somewhat through inhibition
5. Spread out instruction; different material
1. Block scheduling?
Interference
1. The primary cause of forgetting
2. Memory improves when interference
reduced
3. Amnesic individuals benefit from delaying
interference (dark room example)
4. “Every time I learn something new, it pushes
some old stuff out of my brain” Homer
Simpson
Executive Aspect: Metamemory
1. Understanding memory functions
2. Self-awareness of strengths/weaknesses
3. Knowing what you know
1. Judgments of learning
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Regulating/controlling memory
Strategy knowledge and monitoring
Conditional knowledge (why it works)
Metamemory development is an absolutely
essential intervention piece
Memory Strategies
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Simple strategy use by age 3
From simple to complex to integrated
After age 6, account for LTM improvement
Strategy use and recall (r = .81)
Use depends on metamemory (r = .41) and
knowledge of efficacy
6. Development spurred by academic
requirements
LTM Memory Development
1. Memory structures fully developed by age 6
except those related to exec. functions
2. Consistent improvements in retention
1. Due to expanded background knowledge
2. Due to growth of effective strategies
3. Retained episodic memories by age 3
4. Semantic before episodic (infantile amnesia)
5. Implicit before explicit
Neuroanatomy
LTM and the Brain Lobes
1. Temporal lobes---encoding, retrieval,
consolidation, temporary storage of longterm episodic memories
2. Frontal lobes---memory strategies for
encoding and retrieval (no actual storage of
memories)
3. Parietal---auditory and spatial storage
4. Occipital---visuospatial storage
The Hippocampus
The Hippocampus
1. Horseshoe shape in temporal lobe
2. Necessary for STM-LTM transfer
3. Encodes, consolidates, retrieves and reintegrates
4. May hold some episodic permanently
5. Explicit memory only
6. Sensitive to injury, glucose, oxygen, &
cortisol levels
The Hippocampus
1. Responsible for transferring memories to
cortex
1. Active during sleep
2. Spatial memory depends on (perhaps more
than verbal memory)
1. London’s taxi drivers
3. Large EEG signals
4. High levels of glucocorticoid receptors
The Hippocampus
1. Hippocampus cells can grow back
2. New neurons can be created from stem cells;
up to six weeks to mature
3. Rats given Prozac had a 70 percent increase
in hippocampi cells after three weeks
4. Humans who recover from depression have
more hippocampal volume than those who
are chronically depressed
What the Hippocampus Needs
1. Oxygen
2. Glucose
3. Sleep
4. No cortisol
5. No impact
6. No electricity
See YouTube Video: “Hippocampus Damage”
At-Risk Conditions, Disorders
• Risk of damage to hippocampus
• Some present at birth or early infancy; others
acquired later
• Some temporary with recovery, some stable,
some progressively worse
• Sometimes, damage to prefrontal cortex
See Chart
Will review details after interventions
TBI
• .25% of youth acquire a TBI each year
• Severe TBI: 36 – 53% have ongoing impairments in
LTM
• Implicit more resistant to injury
• More verbal problems than visuospatial
• Most mild cases recover within a month
– But some can have persistent problems
• Most moderate cases within 1-2 years
• Metamemory when frontal lobes involved
Post-Concussion Syndrome
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19% chance for school athletes per year
Likely memory problems: few days/weeks
Loss of consciousness, orientation, increases risk
Possibility of persistent LTM problems should be
considered
• Athletes will deny so they can play again
• Pre-season baseline testing important (IMPACT)
• Example: Soccer player
Tier I: WM Screening for
Young Children
1. Verbal: Digits Forward; Letter Span; Memory
for Words; Memory for Sentences
2. Visual-spatial: Picture Recognition, Spatial
Span, Recall of Designs
3. Executive WM: Digits Backward; LetterNumber
4. WM levels are very predictive of later
academic performance; need for LD
Tier I: LT Memory Screening
1. Phonological STM: Digits Forward and
Memory for Words
2. Executive WM: Digits Backward
3. Learning: Visual-Auditory Learning or Word
List learning
4. Verbal LTM: Verbal Delayed Recall
5. Retrieval: Rapid Automatic Naming and
Retrieval Fluency
Tier I: Cognitive Load in the Classroom
1. Instruction easily overloads WM
1. By the nature of the material
2. By the manner it is presented
2. Focus on designing instruction that reduces
cognitive load
3. Typical classroom learning activities easily
overload WM
Classroom Overload Exs.
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Long, complex, inconsistent verbalization
Requiring two processes simultaneously
No time for processing or rehearsal
No external memory aids
Noisy learning environment
No or limited scaffolding/support
Disorganized presentations
Too many concurrent demands
High Cognitive Load Examples
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Excessive length
Unfamiliar and not meaningful content
Demanding mental activities
Need to integrate information
Keeping track of steps while doing task
Tasks that require a lot of switching of
attention
Cognitive Load Reduction
1. Well designed instruction reduces load
1. Leaves capacity for retention & encoding of info.
2. Or, allow processing without need to
remember; e.g. facts in writing are available
3. Or, processing reminders are available
4. Teach students to alternate between
processing and refreshing
5. Students learn under low load conditions
Reducing Cognitive Load
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Only one step, process at a time
Allow time for processing and rehearsal
Allow self-paced processing
Provide external memory aids
Quite learning environment
Organized materials and presentations
Worked, partially-completed examples
1. Keep adding more for student to complete
Reducing Cognitive Load
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Sequence material from simple to complex
Present material in an integrated way
Include visual presentation
Side by side information (being able to see as
all the information in an integrated fashion)
better than stacked information (e.g. computers)
5. Avoid load that is not related or necessary to
the learning (extraneous load)
General Skills to Teach Student
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Ask for help and repetition
Take notes
Be organized
Don’t self-overload; one task/step at a time
Learn to use memory aids
Tier I: WM and Automaticity
1. Mastery or fluency frees up WM resources
1. Reading decoding and reading comprehension
2. Math problem solving
3. Written language
1. Organization and coordination
4. Long-term structures free up WM
5. Automaticity equals faster processing
Rehearsal Strategies (STM)
1. Most have by age 10; 1st graders can learn
2. Serial and cumulative repetitive process
3. Repeat first word until next delivered then add
next word to the repetition
4. First aloud, then subvocal
5. Good maintenance if overlearned
6. Increase length of list
7. More effective than elaborate strategies?
Tier I LTM: The Mnemonic Classroom
1. Focus on methods that support
consolidation, storage, and retrieval, not just
encoding
2. Educates students about memory
3. Teaches memory strategies/mnemonics
4. Conveys message that you can improve your
memory
5. Mnemonic instruction improves academic
learning
Dual Encoding
1. Instructors should make it both verbal and
visual or give students time to recode
2. Instruct students to visualize verbal info.
3. Instruction students to name/describe visualspatial info.
4. Increases the number of pathways available
for retrieval
5. Spelling example
Verbal Memory Strategy: Elaboration
1. Relate new info. with previous
2. Facilitates encoding and LTM organization,
consolidation, retrieval
3. Teachers should provide for young child
4. In-depth versus superficial processing
5. Ties info. with appropriate schema
6. Example: Asking and answering the “Why
does this make sense” question
Distributed/Spaced Practice
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More efficient than massed/daily review
Strengthens neural pathways
Increases learning by 15%
Builds on remembered information
Supports consolidation & semantic memory
Information must actually be retrieved; best when
effortful retrieval needed
7. Review should be about the time information is
beginning to decay
1. E.g., 1, 2, 4 days, 1, 2, 4 week intervals
Periodic Testing
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Extremely effective
Works because retrieval is required
Can be self-testing
First quiz immediately or within a day
Expanding intervals like periodic review
Not limited to items actually tested
Encoding specificity principle
PQRST
1. Preview and skim the passage
2. Generate at least four questions that need
answers, such as who, what, when, and
where
3. Actively read the passage while seeking
answers to the questions
4. Study the information
5. Self-test answers to the questions
6. Dehn’s option: Insert the “why” question
Context Cues
1. Within the first week or so, retrieval of info is
from episodic memory, not semantic
2. Episodic cues facilitate recall: smell, objects,
colors, feelings, etc.
3. Testing in an environment other than the
actual learning environment lowers test
scores by as much as 30%
4. Teach students to recall the environment
when they are tested elsewhere
Tier II: WM Interventions & the Brain
1. These are exercises, not strategies
2. Brain plasticity should apply to WM
3. To effect the brain, training must have sufficient
difficulty (at the limits of capacity) and
intensity; and be repetitive and daily
4. Klingberg claims working memory capacity can
be increased in The Overflowing Brain
5. Cogmed: See Video
6. Methylphenidate (dopamine) improves WM
7. Physical exercise
N-Back Task (Exec. WM)
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Challenging task but easily administered
Shown to improve WM capacity
Remember stimulus n-items back
Do it repetitively
Deck of cards ideal; prevents practice effects
Parents and children can practice at home
n-back task
What strategy would you teach the child for
succeeding at this?
N-Back Procedures
1. Display cards one at a time for 1-2 seconds
2. Start over after 1st error
3. Should get 10 consecutive correct 3 times
before going to next N
4. 10-15 minutes of daily practice for 4 weeks
5. More challenging: A double n-back
6. Establish baseline
7. Encourage strategy use
WM Training Impact on Brain
1. Takeuchi et al. (2010)
2. Adaptive training with 2 N-Back visual tasks
3. Increase in white matter correlated with
amount of training & improved performance
4. Mainly adjacent to the corpus callosum and
in white matter parietal region
5. Increased transfer of info, at the dorsolateral
prefrontal cortex, location of executive WM
Start With Metamemory
1. Teach child how memory works and its
limitations
2. Teach child self-awareness
3. Inform child of personal strengths and
weaknesses
4. Teach about how we can control memory
5. Have child keep a journal during intervention
Video I
Convincing Students of the Efficacy of
Interventions
1. Memorize word list versus memorize list
while visualizing the object
2. Organizational strategy
1. Memorize random words
2. Memorize words arranged in categories
3. Dramatic improvement is convincing
3. Important for maintenance I
II
4. Other ways of documenting progress?
Mnemonics
• Visual mnemonics link information to
something already known that will not be
forgotten
– Act as a scaffold or bridge
• Verbal not effective with verbal learning
disabilities; info lost of mnemonic lost & might
not remember what letters represent
Visual Mnemonics
1. For students with low verbal WM
2. Link info to something already known that will not
be forgotten; Act as a scaffold or bridge
3. Creates associations and meaning
4. Best when student creates images
5. Interactive images best
6. Ideal for those with verbal WM deficit
7. Basic visualization without a mnemonic is also
beneficial
Keyword
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Highly effective
Combines auditory and visual
First, the acoustical link (keyword)
Then, image of linked items interacting
To retrieve, think of keyword first
LD do better when keyword and image
provided
Link
Video
Keyword Practice
• Use keywords for Denver, Colorado
• Use keyword for these Spanish words:
• Vaca = cow
• Carta = letter
• Escalera = ladder
Make the images unique, interactive, but
focused on the keyword and meaning
Loci
• Visual pairing of items with well known
objects, e.g. household furniture
• Can be in order
• See video
• Loci practice with items in student’s bedroom:
Boston settlers in sequence: Native
Americans, Vikings, Pilgrims, Italians
Discussion
• Pick an intervention that is new to you
– Review the information
– Explain to your peers
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Why you like this method
Who you would use it with
How you intend to use it, e.g., which subjects
The challenges involved in its use
• Discuss how you will demonstrate to students
the efficacy of this intervention
Tier III Interventions
Compared with Tier II, they are:
• Longer
• More practice
• More individualized
Also:
• Data-driven
• Linked with academic deficiencies
Errorless Learning
1. Especially for amnesic cases
2. Prevent learning of errors; unlearning of
errors is difficult
3. Prevent guessing; supply most of the answer
at first
4. Allows learning through implicit system
5. Learners may not recall having learned but
they can learn skills
Self-Imaging
• Imagining yourself in the scene, viewing things
as if you were actually there
– Imagine details and feelings
– For literature, social studies
• Works because the personal aspects of
episodic memory are usually intact
External Memory Aids
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Diaries or journals
Memory books or memory notebooks Link
Alarms and timers
Reminders provided by computers
Schedules and assignment calendars
Checklists with step-by-step procedures
Folders for organizing notes and materials
Lists of activities that need to be completed
Step-by-step instructions for using a strategy
LTM College Case Study
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Cancerous brain tumors at age 16
Affected vision and memory
Originally an A-B student, now failing
Both episodic memory & semantic probs.
Prospective memory problems
Metamemory not realistic
After first semester 2.5 gpa;
1. After third semester 3.5 gpa
8. His plan at end of training Link
Case Study Intervention
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PDA/Assignment calendar for everything
Memory notebook
Memory spot at home
Study schedule (tied to review schedule)
Shorthand for taking notes
Update notes immediately following class
Highlight notes and make review sheet
Case Study Intervention
8. Reading/studying text
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Preview
Elaborative thinking
Highlight
Answer “why” question
Make review sheet
9. Review schedule
10. Self-testing
Case Study Intervention
11. How to recall during tests
12. For WM, N-back
Sessions via Skype
Subject adhered to plan well
Learned how to modify and combine strategies
Parent observed training and took notes
High School Memory Intervention
• Results: Student’s Reflections on what was
learned and how to use it
Link