Spaced Retrieval Therapy
This is a treatment that can work for clients with Dementia and Aphasia. Memory is not a single system, so it’s important to evaluate which types of memory are most impaired. By using a relatively spared type of memory to access the weaker type of memory, we can effectively teach new strategies using a “back door” of sorts. Of course it will depend on the nature and severity of the memory impairment, as well as the type of information, but effective rehabilitation may be possible. There is declarative memory, which refers to explicit memories that can be consciously recalled, such as facts (semantic memory), and personal events (episodic memory), and non-declarative memory, which is the type of implicit memory that enables us to carry out commonly learned tasks without consciously thinking about them. It is our “how to” knowledge, like how to ride a bike, tie a shoe, or wash dishes. Spaced retrieval (SR) is an evidence-based memory technique that uses procedural memory to help people recall information over progressively longer intervals of time. Anyone can use this technique, but it has been proven especially effective in helping people with Alzheimer’s disease, Parkinson’s disease, traumatic brain injury, and aphasia. It can be done anywhere with simple tools by anyone familiar with the procedure, but it is not meant to be done alone by the person with the memory impairment. It’s important to choose memory targets that are personal, functional, and perhaps most importantly, won’t change. Imagine taking the time to teach someone that bowling night is Tuesday, only to have bowling night change to Wednesday. Start with one or two targets to see how the person responds to the treatment. During spaced retrieval, make sure that the client understands the response/strategy being targeted. Take time during the initial spaced retrieval therapy session to review the prompt question and response with the client. The clinician should take time to educate the client about the goal and why it is being targeted in order to support the client’s motivation for learning it. It is important to remember, spaced retrieval does not cure dementia or memory impairments. It cannot prevent loss of neurons or prevent the progression of disease. However, spaced retrieval can enable many people with memory impairments to maximize their independence and reach important therapeutic goals.