Dunn, Josephine; (2003) Learning of face-name associations using errorless and effortful processes for people with dementia. Doctoral thesis (D.Clin.Psy), UCL (University College London).

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Abstract

Recent studies have shown the effectiveness of errorless learning principles in memory rehabilitation for people with dementia, whilst studies with people with Korsakoff's Syndrome support effortful methods. However, some effortful methods may elicit errors, so there may be a trade-off relationship between effort and error. The present study compares, in a within-subjects design, the efficacy of four different learning techniques that vary in the extent to which errors are minimised and the degree to which effort is required. The techniques (vanishing cues, forward cues, target selection, paired associate) were used to teach both previously familiar and novel face-name associations to ten people with a diagnosis of early-stage dementia. Best results were achieved in the procedures that elicited most errors whilst learning (forward cues, target selection). It was argued that these procedures also incurred more cognitive effort, thus leading to deeper levels of processing, compared to more passive or shallow processing involved in paired associations and vanishing cues. Recall was also better following cued recall and recognition tasks compared to free recall, which suggested that learning in dementia is facilitated with support at encoding and retrieval. There has also been much debate in current literature as to whether implicit or explicit memory, or both, facilitates interventions using errorless learning. This study aimed to explore this by assessing both implicit and explicit memory for the stimulus items. There was no correlation between recall using implicit and explicit memory tasks, which suggested success on explicit memory tasks might not be due to implicit memory, but this interpretation was challenged. Multiple single case analyses also highlighted the heterogeneity of learning in dementia and emphasised the importance of integrating interpersonal and social factors when developing successful individually-based cognitive rehabilitation techniques.

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