The Spaced-Retrieval Technique: Research Findings & Clinical Implications

The Spaced-Retrieval The Spaced-Retrieval Technique: Research Technique: Research

Findings & Findings & Clinical ImplicationsClinical Implications

Megan L. Malone, M.A. CCC-SLPMegan L. Malone, M.A. CCC-SLPMyers Research Institute, Myers Research Institute,

Beachwood, OHBeachwood, OH

Jenny Loehr, M.A. CCC-SLPJenny Loehr, M.A. CCC-SLPArden Courts,Arden Courts,

Austin, TexasAustin, Texas

About Myers Research About Myers Research Institute…Institute…

Fourteen full-time research staff Three Ph.D. researchers Multiple part-time staff

Funding provided by both federal and private sources NIA, NIMH, National Alzheimer’s Association,

Retirement Research Foundation, HCR Manor Care Foundation, etc.

MissionTo developing practical interventions for dementia and other disabling conditions

associated with aging

About Arden Courts…About Arden Courts…

HCR Manor CareHCR Manor Care Alzheimer’s assisted living facilityAlzheimer’s assisted living facility 60 residents (Min. to moderately independent)60 residents (Min. to moderately independent) ST, OT and PT offered five days per weekST, OT and PT offered five days per week

Mission:Mission:

To assist each resident in maintaining the To assist each resident in maintaining the highest possible level of functional highest possible level of functional

independence appropriate for the assisted independence appropriate for the assisted living environment.living environment.

Seminar ObjectivesSeminar Objectives

Define the Spaced-Retrieval (SR) technique Define the Spaced-Retrieval (SR) technique and its application to cognitively-impaired and its application to cognitively-impaired individuals.individuals.

Provide 2 examples of how SR can be applied Provide 2 examples of how SR can be applied to patients with cognitive impairment.to patients with cognitive impairment.

Identify 2 current research findings on the Identify 2 current research findings on the use of SR in rehabilitative settings.use of SR in rehabilitative settings.

The Spaced-Retrieval The Spaced-Retrieval TechniqueTechnique

Spaced-Retrieval is a memory intervention that Spaced-Retrieval is a memory intervention that gives individuals practice at successfully recalling gives individuals practice at successfully recalling information over progressively longer intervals of information over progressively longer intervals of time. time.

The goal of SR:The goal of SR: To enable individuals to To enable individuals to remember information for long periods (days, remember information for long periods (days, weeks, months, years) so that they can achieve weeks, months, years) so that they can achieve long-term treatment goals.long-term treatment goals.

Therapists teach clients strategies that compensate Therapists teach clients strategies that compensate for memory impairments, using procedural for memory impairments, using procedural memory, including reading and repetitive priming.memory, including reading and repetitive priming.

In addition, SR uses In addition, SR uses external aidsexternal aids to compensate to compensate for memoryfor memory


Capitalizes upon the strengths of an individual with dementia

PROCEDURAL MEMORY READING SKILLS

MemoryMemory (Squire, 1994)(Squire, 1994)

DeclarativeMemory

ProceduralMemory

Facts Events

WorldKnowledge

VocabularySimpleClassical

ConditioningPriming

HabitsSkills


Begin with a prompt question for the Begin with a prompt question for the target behavior and train the client to target behavior and train the client to recall the correct answerrecall the correct answer

When retrieval is successful, the interval When retrieval is successful, the interval preceding the next recall test is increased.preceding the next recall test is increased.

If a recall failure occurs, the participant is If a recall failure occurs, the participant is told the correct response and asked to told the correct response and asked to repeat itrepeat it

The following interval length returns to the The following interval length returns to the last one at which recall was successful.last one at which recall was successful.

SR ExampleSR Example

SR Goal: SR Goal: ‘R’ will learn location of room to ‘R’ will learn location of room to decrease wandering into unsafe areas by decrease wandering into unsafe areas by correctly recalling room number at the correctly recalling room number at the beginning of 3 consecutive therapy beginning of 3 consecutive therapy sessions using SR.sessions using SR.

Information to be :Information to be : Facility room number Facility room number SR Prompt :SR Prompt : What is your room number? What is your room number? SR Response:SR Response: 208 208

SR ExampleSR Example Trial 1 (0 Seconds):Trial 1 (0 Seconds): Client Client

Responds Responds CORRECTLYCORRECTLY Trial 2 (10 Seconds):Trial 2 (10 Seconds): Client Client



Responds Responds INCORRECTLYINCORRECTLY Therapist provides client with Therapist provides client with

correct response (“208”), asks correct response (“208”), asks the client the prompt question the client the prompt question again, allows the client to again, allows the client to respond, and returns to the respond, and returns to the interval at which the client was interval at which the client was last successful.last successful.

Trial 5 (30 Seconds):Trial 5 (30 Seconds): Client Client Responds Responds CORRECTLYCORRECTLY

Trial 6 (60 Seconds):Trial 6 (60 Seconds): Client Client Responds Responds CORRECTLYCORRECTLY

0

10

20

30

40

50

60

Seconds

1 2 3 4 5 6

Trials

SR Therapy Session

SR Case StudiesSR Case Studies

90 year-old female; Diagnosis: dementia; 90 year-old female; Diagnosis: dementia; residing on SCUresiding on SCU

MMSE: 12/30MMSE: 12/30 Anomia, disengagement, executive dysfunctionAnomia, disengagement, executive dysfunction

SR Goal:SR Goal: ‘R’ will recall and demonstrate ‘R’ will recall and demonstrate strategy of describing items in order to better strategy of describing items in order to better communicate wants & needs during 80% of communicate wants & needs during 80% of trials.trials. Prompt Question:Prompt Question: “If you don’t know the “If you don’t know the

name of something, what should you do?”name of something, what should you do?” Target Answer:Target Answer: “Describe it.”“Describe it.”

SR Session Video ExampleSR Session Video Example

SR Case StudySR Case Study

82 year-old male; Diagnosis: dementia; 82 year-old male; Diagnosis: dementia; residing on a sub-acute unit of a LTC facilityresiding on a sub-acute unit of a LTC facility

MMSE: 8/30MMSE: 8/30 Loss of ability to perform ADLs Loss of ability to perform ADLs

independentlyindependently

SR Goal:SR Goal: ‘R’ will consistently respond to ‘R’ will consistently respond to cue during meals in order to maintain focus cue during meals in order to maintain focus on self-feeding during 80% of trials. on self-feeding during 80% of trials. SR Prompt :SR Prompt : “E., your food is here.”“E., your food is here.” SR Response:SR Response: E. looking down at tray of E. looking down at tray of

food and independently feeding himselffood and independently feeding himself

SR Session Video ExampleSR Session Video Example

SR ScreenSR Screen The SR screen evaluates client’s ability to correctly recall The SR screen evaluates client’s ability to correctly recall

a target name for a person in a photograph over 3 a target name for a person in a photograph over 3 different time intervals or Steps (Step 1 - immediately different time intervals or Steps (Step 1 - immediately after presentation; Step 2 - after a 10 second interval; after presentation; Step 2 - after a 10 second interval; and Step 3 - after a 15 to 20 second interval). and Step 3 - after a 15 to 20 second interval).

At each Step the client is offered three trials.At each Step the client is offered three trials.

Three trials per step.Three trials per step.

Only advance to next step if successful at previous step.Only advance to next step if successful at previous step.

Exit if not successful at Trial 3 of Step 1 or Step 2.Exit if not successful at Trial 3 of Step 1 or Step 2.

Consider offering the client a visual cue.Consider offering the client a visual cue.

SR ScreenSR Screen

SR Goal ExamplesSR Goal Examples

DisorientationDisorientation ““Where do you live?” (Answer: Name of Where do you live?” (Answer: Name of

Facility)Facility) ““What is your room number?” (Answer: What is your room number?” (Answer:

Room #)Room #) ““What is your address?” (Answer: What is your address?” (Answer:

Client’s address)Client’s address)

Repetitive QuestioningRepetitive Questioning Dependent upon question being askedDependent upon question being asked

SR Goal ExamplesSR Goal Examples

NamingNaming ““If you don’t know the name of something, what should If you don’t know the name of something, what should

you do?” (Answer: “Describe It”)you do?” (Answer: “Describe It”) What is your husband/wife/son’s name? (Answer: Target What is your husband/wife/son’s name? (Answer: Target

name)name) Who runs the activities here? (Answer: Staff member’s Who runs the activities here? (Answer: Staff member’s

name)name)

DisengagementDisengagement What can you read to remind you of your family? (Answer: What can you read to remind you of your family? (Answer:

“Read my memory book”)“Read my memory book”) What can you check to see what is planned for the day? What can you check to see what is planned for the day?

(Answer: “Activity Schedule”)(Answer: “Activity Schedule”) What can you look at to find something to do? (Answer: What can you look at to find something to do? (Answer:

“My list of activities”)“My list of activities”)

National Institute on Aging National Institute on Aging SR StudySR Study

Funded by the National Institute on Aging• R01 AG17908 • R01 AG17908S1

Cameron J. Camp, Ph.D. Principal Investigator

Michelle S. Bourgeois, Ph.D.Collaborative Researcher

SR Research: SR Research: R01 AG17908

To determine to what extent use of Spaced-To determine to what extent use of Spaced-Retrieval (SR) increases the effectiveness of Retrieval (SR) increases the effectiveness of treatment for communication problems in treatment for communication problems in persons with dementia during the course of persons with dementia during the course of standard speech therapy sessionsstandard speech therapy sessions

To assess to what extent use of SR To assess to what extent use of SR enhances the effectiveness of goals enhances the effectiveness of goals achieved during therapyachieved during therapy

Data taken at 2 different sites (Ohio & Data taken at 2 different sites (Ohio & Florida)Florida)

SR ResearchSR Research

Screen for appropriateness of SR as a Screen for appropriateness of SR as a treatment modality for each clienttreatment modality for each client

Client assessment, collection of medical Client assessment, collection of medical information, interview of a caregiverinformation, interview of a caregiver• BaselineBaseline• One week after therapy has concludedOne week after therapy has concluded• Four months after therapy has concludedFour months after therapy has concluded

Selection of goals for therapySelection of goals for therapy Data taken on each therapy sessionData taken on each therapy session

SR Research ResultsSR Research Results

Persons with dementia can master a wide Persons with dementia can master a wide variety of clinically relevant goals in therapy variety of clinically relevant goals in therapy delivered by Speech-Language Pathologists.delivered by Speech-Language Pathologists.

In this study, SR was more effective in In this study, SR was more effective in allowing persons with dementia to master allowing persons with dementia to master goals than BP (67% of goals attempted were goals than BP (67% of goals attempted were mastered for SR vs. 57% for BP; BP=Best mastered for SR vs. 57% for BP; BP=Best Practice)Practice)

Training materials and protocols for Training materials and protocols for implementing SR have been developed that implementing SR have been developed that can allow dissemination of this therapy can allow dissemination of this therapy technique on a large scale.technique on a large scale.

SR Research: SR Research: R01 AG17908S1

A 1-year research project designed to:A 1-year research project designed to: Train staff at HCR centers in the Train staff at HCR centers in the

application of Spaced Retrieval (SR) using application of Spaced Retrieval (SR) using the train-the-trainer modelthe train-the-trainer model

Assess the effects that the training has on Assess the effects that the training has on various outcome measures for dementia various outcome measures for dementia residents at each centerresidents at each center

Examine the impact that SR training has Examine the impact that SR training has on the existing system/infrastructure of on the existing system/infrastructure of participating centers.participating centers.

SR ResearchSR Research

Baseline data was collected from each facility Baseline data was collected from each facility examining the speech therapy caseload over a 6 examining the speech therapy caseload over a 6 month period. month period. Data collected for baseline included demographic Data collected for baseline included demographic

information (age, diagnoses, medications), and MDS information (age, diagnoses, medications), and MDS information.information.

Outcome data was collected from each facility Outcome data was collected from each facility examining possible changes in the speech therapy examining possible changes in the speech therapy caseload over a six-month period as a result of SR caseload over a six-month period as a result of SR trainingtraining Data collected included demographic information, Data collected included demographic information,

therapy goals attempted using SR, if the SR goals therapy goals attempted using SR, if the SR goals attempted were mastered, and if SR goals were attempted were mastered, and if SR goals were maintained at a one-month post-test.maintained at a one-month post-test.

Number of Participants: 14Mean Age of Participants:

75.93

SR ResearchSR Research After implementation of the SR training, ST caseload included After implementation of the SR training, ST caseload included

residents withresidents with more cognitive impairment more cognitive impairment than those than those seen prior to implementation. seen prior to implementation.

42 goals were attempted and 32 (76%) were mastered; at 42 goals were attempted and 32 (76%) were mastered; at one-month posttest, mastery was one-month posttest, mastery was maintained for 71% of maintained for 71% of goalsgoals mastered previously. mastered previously.

Data from two facilities over a six-month period indicated Data from two facilities over a six-month period indicated that the number of long-term residents receiving speech that the number of long-term residents receiving speech therapy therapy increased increased after implementation of the programafter implementation of the program

Speech therapy caseload included a Speech therapy caseload included a higher percentagehigher percentage of of long-term residents with dementia. long-term residents with dementia.

At one facility, MDS-based Cognitive Performance Scale At one facility, MDS-based Cognitive Performance Scale scores of speech therapy clients were significantly lower after scores of speech therapy clients were significantly lower after implementation of the program, indicating therapy was now implementation of the program, indicating therapy was now being provided to residents with more severe impairment. being provided to residents with more severe impairment.

We also found therapists starting to use SR successfully for We also found therapists starting to use SR successfully for clients who clients who did notdid not have dementia. have dementia.

Arden Courts Short Term Arden Courts Short Term StudyStudy

Data collection from April 2004 to April Data collection from April 2004 to April 20052005

20 residents selected who received 20 residents selected who received therapy servicestherapy services

13/20 residents received SR training13/20 residents received SR training All 13 residents increased overall LOS All 13 residents increased overall LOS

(from 2 weeks to 12 months)(from 2 weeks to 12 months) Of the residents that no longer met AL Of the residents that no longer met AL

requirements, the LOS increased by an requirements, the LOS increased by an average of 5 months.average of 5 months.


84 year old male; Diagnosis: Alzheimer’s 84 year old male; Diagnosis: Alzheimer’s dementia. Residing in AL facility.dementia. Residing in AL facility.

Needs assistive device to ambulate (i.e. Needs assistive device to ambulate (i.e. rolling walker)rolling walker)

SR GoalSR Goal: Teach Mr. L. to remember to : Teach Mr. L. to remember to use the walkeruse the walker

SR PromptSR Prompt: “When you walk, what : “When you walk, what should you take with you?”should you take with you?”

SR ResponseSR Response: “My walker-talker”: “My walker-talker”

SR Case StudySR Case Study 89 year old male; Diagnosis: Alzheimer’s 89 year old male; Diagnosis: Alzheimer’s

disease, Parkinson’s disease, and mild to disease, Parkinson’s disease, and mild to moderate pharyngeal dysphagia (etiology moderate pharyngeal dysphagia (etiology unknown).unknown).

MBS indicated need for resident to use MBS indicated need for resident to use chin tuck as a safe swallow strategychin tuck as a safe swallow strategy

SR GoalSR Goal: Dr. M. needs to learn to use a : Dr. M. needs to learn to use a chin tuckchin tuck

SR PromptSR Prompt: “When you swallow, what : “When you swallow, what should you do?”should you do?”

SR ResponseSR Response: “Look at my lap”.: “Look at my lap”.


80 year old male; Diagnosis: Alzheimer’s 80 year old male; Diagnosis: Alzheimer’s dementia.dementia.

Loss of ability to remember certain Loss of ability to remember certain appropriate social behaviorsappropriate social behaviors

SR GoalSR Goal: Eliminate excessive spitting in : Eliminate excessive spitting in common areascommon areas

SR PromptSR Prompt: “When you feel you need t : “When you feel you need t spit, what should you use?”spit, what should you use?”

SR ResponseSR Response: “My hankie”.: “My hankie”.

SR & DocumentationSR & Documentation

Goal possibilities are endlessGoal possibilities are endless SR goals are NOT written any differently SR goals are NOT written any differently

than other goals.than other goals.

FUNCTIONAL GOAL = SR GOALFUNCTIONAL GOAL = SR GOAL


Measurement of goal attainment can be by percentage Measurement of goal attainment can be by percentage (“80% of time”) or by recalling and demonstrating (“80% of time”) or by recalling and demonstrating target response for a set number of sessions (3 target response for a set number of sessions (3 sessions recommended) depending on the type of goal.sessions recommended) depending on the type of goal.

““Client will recall strategy of inhaling prior to Client will recall strategy of inhaling prior to speaking in order to demonstrate appropriate vocal speaking in order to demonstrate appropriate vocal volume during 80% of structured sentence volume during 80% of structured sentence production”production”

OROR “ “Client will demonstrate strategy of locking wheel Client will demonstrate strategy of locking wheel

chair brakes prior to standing to increase safety at chair brakes prior to standing to increase safety at the beginning of 3 consecutive therapy sessions the beginning of 3 consecutive therapy sessions using SR”using SR”


SR is considered to be a MODALITY or SR is considered to be a MODALITY or APPROACH that therapists may use to help APPROACH that therapists may use to help clients reach their goals.clients reach their goals.

SR does not fit one particular diagnosis SR does not fit one particular diagnosis categorycategory Use the ICD 9 Code that corresponds to Use the ICD 9 Code that corresponds to

the goal area you are addressingthe goal area you are addressing

Use SR to teach compensatory swallowing Use SR to teach compensatory swallowing strategies = Use the ICD 9 code for strategies = Use the ICD 9 code for

DysphagiaDysphagia

ConclusionConclusion SR can enable many persons with dementia to reach specific SR can enable many persons with dementia to reach specific

therapeutic goals and maintain the goals longer than some traditional therapeutic goals and maintain the goals longer than some traditional therapy methods.therapy methods.

Use of SR in rehab treatment may account for longer length of stay in Use of SR in rehab treatment may account for longer length of stay in

dementia patients.dementia patients.

After SR training, SLP’s tend to see more lower functioning clients in After SR training, SLP’s tend to see more lower functioning clients in treatment.treatment.

The success of SR depends on many factors, including appropriate The success of SR depends on many factors, including appropriate screening; selection of appropriate goals; empathy, attitude, and screening; selection of appropriate goals; empathy, attitude, and clinical skills of the therapist; and, appropriate application of SR clinical skills of the therapist; and, appropriate application of SR procedures. procedures.

It is our hope that this information will enable therapists to think It is our hope that this information will enable therapists to think differently about the potential of persons with dementia to learn new differently about the potential of persons with dementia to learn new information and encourage therapists to use SR for clients with information and encourage therapists to use SR for clients with dementia and other forms of memory impairments.dementia and other forms of memory impairments.

ReferencesReferences 1.1. Abrahams, J. P., & Camp, C. J. (1993). Maintenance and Abrahams, J. P., & Camp, C. J. (1993). Maintenance and

generalization of object naming training in anomia associated generalization of object naming training in anomia associated with degenerative dementia. with degenerative dementia. Clinical GerontologistClinical Gerontologist, , 1212, 57‑72., 57‑72.

2.2. Brush, J. A., & Camp, C. J. (1998). Using spaced retrieval Brush, J. A., & Camp, C. J. (1998). Using spaced retrieval as an intervention during speech-language therapy. as an intervention during speech-language therapy. Clinical Clinical Gerontologist, 19,Gerontologist, 19, 51-64. 51-64.

3.3. Brush, J. A., & Camp, C. J. (1998). Using spaced retrieval Brush, J. A., & Camp, C. J. (1998). Using spaced retrieval to treat dysphagia in a long-term care resident with dementia. to treat dysphagia in a long-term care resident with dementia. Clinical Gerontologist, 19 (2),Clinical Gerontologist, 19 (2), 96-99. 96-99.

4. 4. Brush, J. A., & Camp, C. J. (1999). Brush, J. A., & Camp, C. J. (1999). A therapy technique A therapy technique for improving memory: Spaced Retrievalfor improving memory: Spaced Retrieval. Beachwood, OH: . Beachwood, OH: Menorah Park Center for Senior Living.Menorah Park Center for Senior Living.

5. Squire, L.R. (1994). Declarative and nondeclarative memory: 5. Squire, L.R. (1994). Declarative and nondeclarative memory: multiple brain system supporting learning in memory. In D.L. multiple brain system supporting learning in memory. In D.L. Schacter & E. Tulving (Eds.) Schacter & E. Tulving (Eds.) Memory systems. Cambridge, MA: Memory systems. Cambridge, MA: The MIT Press, 203-232The MIT Press, 203-232..

ReferencesReferences 5.5. Brush, J. A., & Camp, C. J. (1999). Effective Brush, J. A., & Camp, C. J. (1999). Effective

interventions for persons with dementia: Using spaced interventions for persons with dementia: Using spaced retrieval and Montessori techniques. retrieval and Montessori techniques. Neurophysiology Neurophysiology and Neurogenic Speech andand Neurogenic Speech and Language Disorders, 9(4),Language Disorders, 9(4), 27-32.27-32.

6.6. Camp, C. J. (1989). Facilitation of new learning in Camp, C. J. (1989). Facilitation of new learning in Alzheimer's Disease. In G. Gilmore, P. Whitehouse, & M. Alzheimer's Disease. In G. Gilmore, P. Whitehouse, & M. Wykle (Eds.), Wykle (Eds.), Memory, aging, and dementia: Theory, Memory, aging, and dementia: Theory, assessment, and treatmentassessment, and treatment (pp. 212-225). N.Y., N.Y.: (pp. 212-225). N.Y., N.Y.: Springer. Springer.

7.7. Camp, C. J., Bird, M. J., & Cherry, K. E. (2000). Camp, C. J., Bird, M. J., & Cherry, K. E. (2000). Retrieval strategies as a rehabilitation aid for cognitive Retrieval strategies as a rehabilitation aid for cognitive loss in pathological aging. In R. D. Hill, L. Bäckman, & A. loss in pathological aging. In R. D. Hill, L. Bäckman, & A. S. Neely (Eds.), S. Neely (Eds.), CognitiveCognitive rehabilitation in old agerehabilitation in old age (pp. (pp. 224-248). New York: Oxford University Press.224-248). New York: Oxford University Press.

ReferencesReferences 8.8. Camp, C. J., Foss, J. W., Stevens, A. B., & O'Hanlon, A. M. Camp, C. J., Foss, J. W., Stevens, A. B., & O'Hanlon, A. M.

(1996). Improving prospective memory task performance in (1996). Improving prospective memory task performance in Alzheimer's disease. In M. A. Brandimonte, G. O. Einstein, & M. A. Alzheimer's disease. In M. A. Brandimonte, G. O. Einstein, & M. A. McDaniel (Eds.) McDaniel (Eds.) Prospective memory: Theory and applications Prospective memory: Theory and applications (pp. (pp. 351‑367). Mahwah, NJ: Lawrence Erlbaum & Assoc.351‑367). Mahwah, NJ: Lawrence Erlbaum & Assoc.

9.9. Camp, C. J., & Schaller, J. R. (1989). Epilogue: Camp, C. J., & Schaller, J. R. (1989). Epilogue: Spaced‑retrieval memory training in an adult day care center. Spaced‑retrieval memory training in an adult day care center. Educational GerontologyEducational Gerontology, , 1515, 641-648., 641-648.

10.10. Camp, C. J., & Stevens, A. B. (1990). Spaced retrieval: A Camp, C. J., & Stevens, A. B. (1990). Spaced retrieval: A memory intervention for Dementia of the Alzheimer’s Type (DAT). memory intervention for Dementia of the Alzheimer’s Type (DAT). Clinical GerontologistClinical Gerontologist, , 1010, 58‑61. , 58‑61.

11.11. Cherry, K. E., Simmons, S. S., & Camp, C. J. (1999). Spaced-Cherry, K. E., Simmons, S. S., & Camp, C. J. (1999). Spaced-retrieval enhances memory in older adults with probable Alzheimer’s retrieval enhances memory in older adults with probable Alzheimer’s disease. disease. Journal of Clinical Geropsychology, 5, Journal of Clinical Geropsychology, 5, 159-175.159-175.

12.12. Hayden, C. M., & Camp, C. J. (1995). Spaced‑retrieval: A Hayden, C. M., & Camp, C. J. (1995). Spaced‑retrieval: A memory intervention for dementia in Parkinson's disease. memory intervention for dementia in Parkinson's disease. Clinical Clinical Gerontologist, 16(2),Gerontologist, 16(2), 80‑82. 80‑82.

ReferencesReferences 13.13. McKitrick, L. A., Camp, C. J., & Black, W. (1992). McKitrick, L. A., Camp, C. J., & Black, W. (1992).

Prospective memory intervention in Alzheimer’s Prospective memory intervention in Alzheimer’s Disease. Disease. The Journal of Gerontology: Psychological The Journal of Gerontology: Psychological SciencesSciences, , 4747, P337‑P343., P337‑P343.

14.14. Stevens, A. B., O'Hanlon, A. M., & Camp, C. J. Stevens, A. B., O'Hanlon, A. M., & Camp, C. J. (1993). Strategy training in Alzheimer’s Disease: A (1993). Strategy training in Alzheimer’s Disease: A case study. case study. Clinical GerontologistClinical Gerontologist, , 1313, 106‑109., 106‑109.

15. Neundorfer, M.M., Camp, C.J., Lee, M.M., Skrajner, 15. Neundorfer, M.M., Camp, C.J., Lee, M.M., Skrajner, M.J., Malone, M. L., & Carr, J. R, (2004). Compensating M.J., Malone, M. L., & Carr, J. R, (2004). Compensating for Cognitive Deficits in Persons Aged 50 and Over with for Cognitive Deficits in Persons Aged 50 and Over with HIV/AIDS: A Pilot Study of a Cognitive Intervention. HIV/AIDS: A Pilot Study of a Cognitive Intervention. Journal of HIV/AIDS & Social ServicesJournal of HIV/AIDS & Social Services, 3, 79-97., 3, 79-97.

16. Bourgeois, M., Camp, C., Rose, M., White, B., 16. Bourgeois, M., Camp, C., Rose, M., White, B., Malone, M., Carr, J., & Rovine, M. (2003). A Malone, M., Carr, J., & Rovine, M. (2003). A Comparison of Training Strategies to Enhance Use of Comparison of Training Strategies to Enhance Use of External Aids by Persons with Dementia. External Aids by Persons with Dementia. Journal of Journal of Communication DisordersCommunication Disorders, 36, 361-379., 36, 361-379.

Thank You!Thank You!

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The Spaced-Retrieval Technique: Research Findings & Clinical Implications

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