Errorless Learning Techniques Research Articles

Canine scent detection of sinonasal-inverted papilloma in blood plasma and nasal secretions

Sinonasal-inverted papilloma (SNIP) is a rare, benign tumor of the sinonasal tract. Although these tumors are inherently benign, they are prone to malignant transformation and are associated with an unusually high rate of recurrence, even after complete surgical resection. As such, these patients must be followed long-term to monitor for recurrence or the presence of cancer. Unfortunately, there are currently no standards for long-term surveillance, and protocols usually require routine radiography and/or nasal endoscopy, which are not highly sensitive or specific, are time consuming, expensive, and confer morbidity to the patient. There is evidence that suggests that SNIP is associated with a uniquely detectable volatile metabolite signature. This study investigates the ability of four privately owned dogs to learn to identify the presence of SNIP in patients based on blood plasma samples. This type of medical detection is currently being used to create early diagnostic tools for other disease processes, which suggests promising results for the outcome of this study. Blood/plasma and nasal secretions were collected from both patients with SNIP, and healthy age-, sex-, and smoking-status-matched controls. Training was conducted twice weekly using errorless learning techniques that allowed the dogs to utilize odor concentration to guide their understanding of the target odor. After further training, a subsequent double-blind testing phase was conducted, in which the dogs' ability to expand recognition of the target odor from blood plasma samples to nasal secretion samples was assessed. Analysis of recorded training sessions revealed that the dogs exhibited successful odor discrimination between SNIP-positive plasma samples and SNIP-negative controls. Their pattern of behavior change also suggested similarity between SNIP odor in plasma and nasal secretions.

Kinect Project: People with dementia or mild cognitive impairment learning to play group motion-based games

IntroductionMotion-based technologies (MBTs) could provide nonpharmacologic interventions for people with cognitive impairment (PCI; e.g., dementia or mild cognitive impairment). This study examined the use of errorless learning techniques to empower PCI to use MBT. MethodsThirty-eight PCI were recruited to a 10-week (20 × 1-hour sessions) Xbox Kinect bowling group. Video recorded data from first, middle, and final sessions were coded to track (1) number of prompts per turn, (2) independent turn completion, and (3) duration of turns. These values were compared using repeated measures analysis of variance. ResultsLearning and improvement over time was demonstrated in 23 participants who were available for final analysis by significant decreases in number of prompts per turn and turn duration and significant increases in turns completed independently. DiscussionErrorless learning supported PCI to learn MBT and improve over time as evidenced by their need for fewer prompts, shorter turns, and more turns completed independently, confirming the potential of MBT to provide leisure activities for PCI.

Memory Rehabilitation for Amnesic with Acquired Brain Injury

Two theoretical frameworks based on cognitive rehabilitation principles are recommended for the rehabilitation of memory impaired individuals. The first is improving memory function by the remediation of brain plasticity, known as remediation-oriented rehabilitation, and second is the compensation of memory function through the use of external memory aids, environmental modifications, and intact cognitive functions to overcome limitations in daily life. In rehabilitation of episodic memory impaired individuals, it has been recognized that the effortful active retrieval technique is more effective than the memorization technique. In contrast, the errorless learning technique with high-effort conditions and the active participation of patients has been recognized to be particularly effective in directly improving impaired episodic memory systems. More recently, another mnemonic strategy called the spaced retrieval technique has gained support. The theoretical components of spaced retrieval consist of classical conditioning, priming, the spacing effect, and errorless learning by taking advantage of the implicit memory system, which is preserved in many people with memory loss.

Can Technology-Assisted Toilets Improve Quality of Life for Rehabilitating Stroke Patients? A Pilot Cohort Study

intraparenchymal hemorrhage. The patient was noted to have impairments in visual perception, memory, language and balance. The patient was diagnosed with Balint’s Syndrome, characterized by simultagnosia, occulomotor apraxia and optic ataxia. The patient required acute inpatient rehabilitation to address this unique set of impairments. Interventions: An interdisciplinary approach was utilized focusing on task-based training to improve his cognitive and physical functioning. The patient benefited from errorless learning techniques, a low stimulation environment, and proprioceptive input to improve balance and coordination. Main Outcome Measure(s): O-LOG, FIM, Berg Balance Test, and a specialized protocol for spaced retrieval of orientation information. Results: The patient demonstrated improvement in orientation (8/30 to 20/30 on O-LOG), balance (0/56 to 17/56 on Berg Balance Test), basic communication skills, and self-care activities over four weeks. Conclusions: These unique interventions led to functional improvement in this patient with Balint’s Syndrome as measured by objective scales. This case report demonstrates the necessity of an interdisciplinary rehabilitation approach for a patient with complex functional impairments. Limited clinical research exists regarding established approaches and additional studies are needed to validate an effective clinical approach for this unique syndrome.

Errorless learning of prospective memory tasks: An experimental investigation in people with memory disorders

The term prospective memory (PM) refers to memory for future intentions. PM problems are frequent in people with cognitive impairment and, because they are central to the realisation of many everyday goals, are important in rehabilitation. Event-based PM tasks (EBPM) are environmentally-cued and have primarily mnemonic demands, whereas time-based PM tasks (TBPM) require self-initiated retrieval, and have greater executive demands. Errorless learning (EL) is an encoding method that results in superior retrospective memory compared with “errorful” learning (EF). As this EL advantage (ELA) likely stems from its reduced explicit memory demands, and there is no such advantage for executive tasks, a greater ELA for EBPM than TBPM was predicted. Fourteen adults with neurological memory impairment completed PM tasks under four counterbalanced conditions: EL of EBPM, EL of TBPM, EF of EBPM, and EF of TBPM. A significant ELA was observed for EBPM (d = .63), but not TBPM (d = –.01). These results extend the evidence for EL within cognitive rehabilitation, by showing for the first time that the method can benefit future action in addition to retrospective memory. The clinical implications are also clear: errorless learning techniques may be usefully employed to support completion of day-to-day EBPM tasks.

Errorless Learning and Spaced Retrieval Training for Clients with Alzheimer's Dementia

ABSTRACTClients with Alzheimer's dementia (AD) may experience limitations in completing activities of daily living (ADL) due to impairments in cognition, memory, and problem-solving. These clients are often referred to occupational therapy (OT) services in order to maximize independence in ADL and decrease caregiver burden. Occupational therapists may be challenged when developing treatment interventions for clients with AD due to client deficits in memory and learning. This article explores evidence-based learning strategies—errorless learning (EL) and spaced retrieval (SR)—to improve learning and memory and OT outcomes for clients with AD. The roles of memory and learning are discussed, and EL and SR strategies are explored for clients with AD. OT intervention ideas are identified, and strategies for integrating EL and SR techniques into the OT plan of care (POC) are also discussed. Future research implications are explored for expanding evidence for EL and SR as part of the OT POC.

Improving word learning in children using an errorless technique

The current experiment examined the relative advantage of an errorless learning technique over an errorful one in the acquisition of novel names for unfamiliar objects in typically developing children aged between 7 and 9years. Errorless learning led to significantly better learning than did errorful learning. Processing speed and vocabulary predicted unique significant variance in errorful learning but not errorless learning, suggesting a possible locus for the errorless advantage. Errorless methods may provide a suitable basis not only for improving language learning but also for improving classroom learning and identifying children who will benefit from this technique.

A direct comparison of errorless and errorful therapy for object name relearning in Alzheimer's disease

Developing rehabilitation techniques to combat cognitive decline is a key goal of healthcare strategies aimed at promoting increased longevity and better quality of life for individuals with Alzheimer's disease (AD). In AD, problems with episodic memory and word-finding greatly affect everyday life and, as such, these symptoms provide a clear clinical target for therapeutic interventions. Errorless learning (EL) has been proposed as a particularly effective technique for relearning in individuals with memory dysfunction, including AD. However, EL learning has rarely been directly contrasted with other more traditional trial-and-error techniques (errorful learning or EF) in individuals with AD, especially in the context of alleviating word-finding problems. In the current study, we directly contrasted the therapeutic gains of an EL learning paradigm (consisting of reading/repetition of object names) with an EF learning technique (comprised of phonemic/orthographic cueing) in eight mild to moderate AD patients with pronounced anomia. Both techniques were administered concurrently in sessions run twice a week over a five-week period. Therapeutic gains were assessed at one week and five weeks post-intervention using confrontation naming. Our results suggest that, both at the group and individual patient level, EL and EF techniques were equally effective. Correlational analyses of overall therapy gains and background assessments of patient neuropsychology revealed that individuals with better scores on measures of semantic memory, pre-intervention naming, and recognition memory demonstrated larger therapy gains. No individual patient showed a significant advantage for EL over EF learning, however, for patients that showed a numerical advantage in this direction. These results suggest that either EL or EF therapy can be used to alleviate word-finding problems in AD.

Benefits and limitations of errorless learning after surviving pediatric brain tumors: A case study

Survivors of childhood brain tumors often acquire complex cognitive difficulties including impairments in attention, processing speed, and different aspects of memory function. These impairments can affect their learning in the real world and in the classroom. However, the efficacy of memory rehabilitation techniques post treatment has not yet been assessed in these patients. We present the case of a 15-year-old boy, C.J., who acquired a profound episodic memory impairment due to a metastatic germ cell tumor and subsequent treatment. The focus of this study was the application of an errorless learning technique to a verbal learning task. We were interested to test whether C.J. would benefit from errorless learning as compared to errorful learning. Results of an experiment and a follow-up study indicated that C.J.'s learning was more efficient under errorless conditions, although access to the information from long-term memory remained cue dependent. Implications for learning with or without the support of episodic memory are discussed, and future directions for memory rehabilitation of brain tumor survivors are outlined.

Errorless learning and elaborative self-generation in healthy older adults and individuals with amnestic mild cognitive impairment: Mnemonic benefits and mechanisms

Errorless learning is an intervention that benefits memory performance in healthy older adults and a variety of clinical populations. A limitation of the errorless learning technique is that it is passive and does not involve elaborative processing. We report two studies investigating the added benefits of elaborative, self-generated learning to the errorless learning advantage. We also explored the mnemonic mechanisms of the errorless learning advantage. In both studies, older adults and individuals with amnestic mild cognitive impairment (aMCI) completed four encoding conditions representing the crossing of errorless/errorful learning and self-generated/experimenter-provided learning. Self-generation enhanced the errorless learning benefit in cued recall and cued recognition, but not in free recall or item recognition. An errorless learning advantage was observed for priming of target words, and this effect was amplified for participants with aMCI after self-generated learning. Moreover, the aMCI group showed significant priming of prior self-generated errors. These results demonstrate that self-generation enhances the errorless learning advantage when study and test conditions match. The data also support the argument that errorless learning eliminates the misleading implicit influence of prior errors, as well as the need for explicit memory processes to distinguish targets from errors.

Making errorless learning more active: Self-generation in an error free learning context is superior to standard errorless learning of face–name associations in people with Alzheimer's disease

Errorless learning (EL) principles have been shown to enable people with memory impairments to acquire various types of information (Grandmaison & Simard, 2003; Wilson, 2005). However, the effects of EL, based on simple repetition only, tend to be limited with regards to their size and longevity. The present study investigated whether EL could be improved by actively engaging people with Alzheimer's disease in the learning process. Patients learned the names of famous faces over 10 training sessions, treated either with a non-learning control, a simple repetition EL procedure, or an EL condition in which responses had to be self-generated. Cued recall rates after the final training session were significantly greater for the names treated with the self-generated EL technique compared to the control and the repetition EL conditions. In addition, there was evidence that patients with less severe general cognitive impairment benefit more from active generation than more severely impaired patients. The implications of this research for individualised memory rehabilitation programmes are discussed.

Errorless learning and memory performance in schizophrenia

There is evidence that patients with schizophrenia have impaired explicit memory and intact implicit memory. The present study sought to replicate and extend that of O'Carroll et al. [O'Carroll, R.E., Russell, H.H., Lawrie, S.M. and Johnstone, E.C., 1999. Errorless learning and the cognitive rehabilitation of memory-impaired schizophrenic patients. Psychological Medicine 29, 105–112.] which reported that for memory-impaired patients with schizophrenia performance on a (cued) word recall task is enhanced using errorless learning techniques (in which errors are prevented during learning) compared to errorful learning (the traditional trial-and-error approach). Thirty patients with a DSM-IV diagnosis of schizophrenia and fifteen healthy controls (HC) participated. The Rivermead Behavioural Memory Test was administered and from their scores, the schizophrenic patients were classified as either memory-impaired (MIS), or memory-unimpaired (MUS). During the training phase two lists of words were learned separately, one using the errorless learning approach and the other using an errorful approach. Subjects were then tested for their recall of the words using cued recall. After errorful learning training, performance on word recall for the MIS group was impaired compared to the MUS and HC groups. However, after errorless learning training, no significant differences in performance were found between the three groups. Errorless learning may play an important role in remediation of cognitive deficits for patients with schizophrenia.

Evaluation of the Errorless Learning Technique in Children With Traumatic Brain Injury

Landis J, Hanten G, Levin HS, Li X, Ewing-Cobbs L, Duron J, High WM Jr. Evaluation of the errorless learning technique in children with traumatic brain injury. Objective To compare errorless learning with trial-and-error (T&E) learning of declarative facts in children with memory disorders secondary to traumatic brain injury (TBI). Design Retrospective within-subjects concurrent treatment design. Setting Participants’ school or home. Participants Thirty-four children, ages 6 to 18 years, with mild, moderate, or severe postacute TBI who met criteria for memory impairment. Intervention Conditions consisted of an errorless learning method and a T&E method. Within a session, half the items were taught with the errorless learning method and half with the T&E method. Each child received two 1-hour sessions a week for 7 weeks. Main Outcome Measures Relative effectiveness of errorless learning and T&E methods for (1) initial learning and (2) retention over time for learned items. Results There was an advantage for T&E on initial learning. In children with mild, but not moderate or severe TBI, 2-day retention was better with the errorless learning technique; 7-day retention was better with errorless learning in young children with mild TBI. Seventy-seven-day retention revealed an advantage for errorless learning in younger children with severe TBI. Conclusions Findings did not support errorless learning as a generalized intervention for learning difficulties after TBI or identify specific age- or injury-severity groups that benefited from this technique.

Two case studies in the application of errorless learning techniques in memory impaired patients with additional executive deficits

Primary objective: The purpose of the present study was to examine in what extent errorless learning can be applied to amnesic patients with additional executive dysfunction.Research design: Two case studies were used in which two patients with severe closed head-injury were compared according to their different neuropsychological profiles.Methods and procedures: Patients were taught complex semantic information about their therapists and cognitive procedures needed to programme an electronic organizer.Main outcomes and results: Both semantic and procedural results suggest that the errorless method can be very helpful for teaching complex new knowledge to amnesic patients with mild executive impairment, whereas the presence of a dysexecutive syndrome may hamper the success of this form of memory rehabilitation.Conclusions: The present study puts forward that executive deficits should be taken into account when neuropsychologists are planning to use errorless techniques.

Implicit motor learning of a balancing task

This study examined the implicit learning of a balancing task. Three treatment conditions were constructed using different motor learning strategies. In two of the treatment conditions, explicit learning of the balancing task was impeded by using either an analogy or an errorless learning technique. In the third treatment condition, participants learnt the task by discovery learning, which typically results in explicit knowledge. It was hypothesised that in the analogy and errorless learning conditions, learning of the balancing task would be implicit in character. Three criteria of implicit learning were used to test this hypothesis; the accumulation of few explicit rules, robustness under secondary task loading and durability over time. Although the discovery learners acquired more explicit rules, all groups appear to have acquired the skill implicitly, in that all groups were robust to imposition of a concurrent task load and over time. Indeed, balance performance with a concurrent verbal task was better than balance performance alone. Discussion focuses on the contribution of verbal and non-verbal processes to balancing.

Implicit Learning in Memory Rehabilitation: A Meta-Analysis on Errorless Learning and Vanishing Cues Methods

The objective of this study was to present a quantitative review on the treatment effects of memory rehabilitation techniques based on intact implicit learning capacity in amnesic patients, that is, errorless learning and the method of vanishing cues. English-language journal articles focusing on these rehabilitation techniques were examined using MedLine (1966-2002) or PsychInfo (1887-2002), as well as additional papers listed in the references of these articles. Studies had to meet the following inclusion criteria: (1) original data were reported, (2) memory rehabilitation was studied in memory-impaired patients, (3) a control intervention was included, (4) exact scores were listed for both intervention conditions, or the exact statistics were presented. Studies were classified on the basis of the to-be-learned material and the method of intervention (errorless learning, vanishing cues, control intervention), patient characteristics were determined, and the tasks that were used were taken into account. Effect sizes and variances were computed for each individual study compared to control treatment using within-group statistics. A “large” and statistically significant ES was found for errorless learning treatment, but no significant ES was demonstrated for the vanishing cues method. The results of the present study show that the errorless learning technique is effective in amnesic patients. The effects on the vanishing cues method are only small (and nonsignificant).

An investigation of errorless learning in memory-impaired patients: improving the technique and clarifying theory

In rehabilitating individuals who demonstrate severe memory impairment, errorless learning techniques have proven particularly effective. Prevention of errors during acquisition of information leads to better memory than does learning under errorful conditions. This paper presents results of a study investigating errorless learning in three patient groups: those demonstrating mild, moderate, and severe memory impairments. The first goal of the study was to trial a new version of errorless learning, one encouraging more active participation in learning by patients via the use of elaboration and self-generation. This technique led to significantly better memory performance than seen under standard errorless conditions. This finding highlights the value of encouraging active and meaningful involvement by patients in errorless learning, to build upon the benefits flowing from error prevention. A second goal of the study was to clarify the mechanisms underlying errorless learning. Memory performance under errorless and errorful conditions was compared within and across each group of patients, to facilitate theoretical insight into the memory processes underlying performance. The pattern of results observed was equivocal. The data most strongly supported the hypothesis that the benefits seen under errorless learning reflect the operation of residual explicit memory processes, however a concurrent role for implicit memory processes was not ruled out.

UNLEARNING JOHN MAJOR: THE USE OF ERRORLESS LEARNING IN THE REACQUISITION OF PROPER NAMES FOLLOWING HERPES SIMPLEX ENCEPHALITIS

In this study we examined the value of errorless learning as a means of restoring memory for proper names in an individual who had becomedysnomic following herpes simplex encephalitis. In Experiment 1 the errorless learning technique was used to teach the subject (PM) the names of eightpoliticians thathe had forgotten. In evaluating thetechnique, we also examined whether there was any generalisation to the naming of untrained politicians' names that he had also forgotten and whether the technique had any effect on politicians' names he was able to produce at the outset of training. Training was successful in that PM reached criterion on naming the trained faces but there was no recovery of untrained names. Moreover, we also observed inhibition of politicians' name he was able to produce at the outset of the study. Experiment 2 used a similar procedure to teach PM the names of personal friends that he could not remember. However, the technique was modified so as to include a “refresh” trial at the end of each training session for those friends' names he was already able to produce. Errorless learning again facilitated the reacquisition of names but there was no inhibition of names available at the outset. These data illustrate that errorless learning can be used as a means of restoring lost vocabulary but demonstrate how retrieval inhibition is an important element in evaluating overall effectiveness. In addition, the data are discussed in relation to recent theories of memory restoration.

Errorless learning of novel associations in amnesia

In two experiments involving verbal association learning by people with memory impairments, the effectiveness of errorless learning (EL) was compared with errorful learning (EF). Experiment 1 examined the effectiveness of both methods in learning remotely linked word pairs. There was an advantage for items learned by EL at immediate test which was not sustained over a delay of 1 hr. Learning appeared to be stable over this delay in the EF condition. Analysis of responses at delayed cued recall showed more evidence of spontaneous recovery in EF than in EL. Elimination of these items from analysis resulted in a similar pattern of forgetting in both methods. Experiment 2 examined the effectiveness of EL and EF in teaching novel associations, and showed an advantage for EL at immediate and delayed test. Forgetting was apparently observed following EL, but not EF. As in Experiment 1, this discrepancy was attributed to recovered responses at delayed test in EF. Eliminating these responses showed a similar pattern of forgetting in both methods for items correctly recalled at immediate test. The study shows an advantage for EL techniques in learning novel associations. The two methods also differ in that learning via EF is associated with more spontaneous recovery.