Using testing to improve learning after severe traumatic brain injury

Buildup and release from proactive interference: The forward testing effect in children's spatial memory

Previous work has indicated that testing can enhance memory for subsequently studied new information by reducing proactive interference from previously studied information. Here, we examined this forward testing effect in children's spatial memory. Kindergartners (5-6 years) and younger (7-8 years) and older (9-10 years) elementary school children studied four successively presented 3 × 3 arrays, each composed of the same 9 objects. The children were asked to memorize the locations of the objects that differed across the four arrays. Following presentation of each of the first three arrays, memory for the object locations of the respective array was tested (testing condition) or the array was re-presented for additional study (restudy condition). Results revealed that testing Arrays 1 to 3 enhanced children's object location memory for Array 4 relative to restudying. Moreover, children in the testing condition were less likely to confuse Array 4 locations with previous locations, suggesting that testing reduces the buildup of proactive interference. Both effects were found regardless of age. Thus, the current findings indicate that testing is an effective means to resolve proactive interference and, in this way, to enhance children's learning and remembering of spatial information even before the time of school entry.

The Forward Effect of Delayed Judgments of Learning Is Influenced by Difficulty in Memory and Category Learning

Delayed judgment of learning (JOL) is a widely used metacognitive monitoring strategy that can also enhance learning outcomes. However, the potential benefits of delayed JOL on subsequent learning of new material, known as the forward effect of delayed JOL, and its stability and underlying mechanisms have yet to be fully explored. In this study, we investigated the forward effect of delayed JOL using previously unexamined word pair materials and explored the boundary conditions of this effect by manipulating the difficulty of the materials. We also examined this effect within the context of category learning. Our findings demonstrate that delayed JOL significantly enhanced the retention of new information (Experiment 1A), while the forward effect of the delayed JOL occurred only for material with a certain degree of difficulty rather than for easy material (Experiment 1B). These findings were extended and replicated using category learning (Experiment 2). These results suggest that delayed JOL can be used as a preparation strategy for subsequent learning, particularly when faced with challenging materials. Our study provides novel insights into the potential benefits and limitations of delayed JOL and contributes to our understanding of the underlying mechanisms that govern metacognitive monitoring and learning strategies.

How retrieval practice and semantic generation affect subsequently studied material: an analysis of item-level effects

The forward testing effect (FTE) refers to the finding that retrieval practice of previously studied material can facilitate recall of newly studied (critical) material. Such interim retrieval practice can also lead to a differential FTE, i.e., a more pronounced FTE for items at early than later serial positions in the critical material. The present study examined whether this differential FTE also holds with interim semantic generation of extra-list items, and whether it is influenced by study material. Consistent with prior work, the results of two experiments showed that both interim retrieval practice and interim semantic generation induce the general (list-level) FTE when unrelated study lists are applied, whereas retrieval practice only creates the effect with categorised study lists. Critically, however, the differential FTE was present in response to retrieval practice but absent in response to semantic generation. This pattern held regardless of which material was studied, thus experimentally dissociating the general (list-level) from the differential (item-level) FTE. The findings may suggest that retrieval practice, but not semantic generation, induces a reset of the encoding process which promotes attentional encoding such that a more pronounced FTE arises for early than middle and late serial positions in the critical list.

The Effects of Interspersed Retrieval Practice in Multiple-List Learning on Initially Studied Material

The forward testing effect (FTE) refers to the finding that retrieval practice of previously studied material can facilitate retention of newly studied material more than does restudy of the material. The goal of the present study was to examine how such retrieval practice affects initially studied, unpracticed material. To this end, we used two commonly applied versions of the FTE task, consisting of either three (Experiment 1) or five (Experiment 2) study lists. While study of list 1 was always followed by an unrelated distractor activity, study of list 2 (3-list version) or lists 2, 3, and 4 (5-list version) was followed by either interim restudy or retrieval practice of the immediately preceding list. After studying all lists, participants were either asked to recall the first or last study list. Results showed that, for both the three-list and five-list versions, interim retrieval practice led to a typical FTE, irrespective of whether unrelated or categorized study lists were used. Going beyond the prior work, interim retrieval practice was found to have no effect on initially studied, unpracticed material, regardless of the type of study material. The findings suggest that using interim retrieval practice as a study method can improve recall of the last studied list without incurring a cost for the initially studied material. Our results are difficult to align with the view that retrieval practice induces context change, but are consistent with the idea that retrieval practice can lead participants to employ superior encoding strategies.

Abrufeffekte im Gedächtnis: Ein Überblick zur aktuellen Grundlagenforschung

Zusammenfassung. Der Frage, wie Erinnern das Gedächtnis formt, wurde in der Kognitiven Psychologie in letzter Zeit große Aufmerksamkeit gewidmet. Testungseffekte, die in einer durch Gedächtnisabruf in der Folge verbesserten Zugänglichkeit von Gedächtniseinträgen bestehen, wurden in diesem Zusammenhang insbesondere auch hinsichtlich ihres pädagogischen Potentials diskutiert. Neben erleichterter Zugänglichkeit kann Gedächtnisabruf allerdings auch Vergessen nicht abgerufener Information verursachen. Der aktuelle Stand der Grundlagenforschung zu Abrufeffekten wird in diesem Überblicksartikel dargestellt und eine integrative Betrachtung unterschiedlicher Arten von Abrufeffekten unter Berücksichtigung wichtiger Moderatorvariablen versucht.

The Effect of Forward Testing as a Function of Test Occasions and Study Material

It has long been known that one of the most effective study techniques is to be tested on the to-be-remembered material, a phenomenon known as the testing effect. Recent research has also shown that testing of previous materials promotes the learning of new materials, a phenomenon known as the forward testing effect. In this paper, as of yet unexplored aspects of the forward testing effect related to face-name learning are examined; continuous and initial testing are compared to restudying, the effects of an initial test on subsequent learning, and whether an initial change of domain (change from one topic to another) regarding study material affects the robustness of the effect. An experiment (N = 94) was performed according to a 2 (Material: word pairs/face-name pairs in Block 1) × 3 (Test occasions: Blocks 1–4/Blocks 1 and 4/Block 4) complex between-groups design. The results showed that no difference between testing and repetition could be observed regarding the recall of faces and names. The restudy groups incorrectly recalled more names from previous lists in the last interim test compared to the tested groups, which supports the theory that interim tests reduce proactive interference. The results also suggest that the number of test occasions correlates with the number of incorrect recalls from previous lists. These results, in contrast to previous studies, highlight a potential uncertainty about the forward testing effect linked to the robustness of the phenomenon, the specificity in execution, and generalizability.

Retrieval Practice in Memory- and Language-Impaired Populations: A Systematic Review

OBJECTIVE

Neurological conditions, such as multiple sclerosis and stroke, may impair memory and language. A technique called retrieval practice (RP) may improve memory and language outcomes in such clinical populations. The RP effect refers to the finding that retrieving information from memory leads to better long-term retention than restudying the same information. Although the benefits of RP have been repeatedly observed in healthy populations, less is known about its potential applications in cognitive rehabilitation in clinical populations. Here we review the RP literature in populations with acquired memory and language impairments.

METHOD

Systematic searches for studies published before January 2020 were conducted on Elsevier, PsycARTICLES, PsycINFO, Pubmed, Web of Science, and Wiley Online Library, with the terms "retrieval practice"/"testing effect" and "cognitive rehabilitation". In addition, backward and forward snowballing were used to allow the identification of important publications missed by the initial search. Studies were included if they were peer-reviewed, empirical work in which memory or language outcome measures were compared between an RP condition and a re-exposure-control condition in patients with acquired memory or language impairments.

RESULTS

Sixteen articles fulfilled the inclusion criteria. Studies from memory-impaired samples were relatively homogeneous with respect to experimental protocols and materials and favored RP over control conditions. The results were mostly positive despite short retention intervals and predominantly single-session designs. Similarly, studies from language-impaired samples focused on naming impairments in patients with aphasia and also favored RP over name repetition.

CONCLUSION

The results indicate that RP is a viable technique for cognitive rehabilitation.

The Forward Testing Effect is Immune to Acute Psychosocial Encoding/Retrieval Stress

The forward testing effect (FTE) refers to the finding that testing of previously studied information enhances memory for subsequently studied other information. Previous research demonstrated that the FTE is a robust phenomenon that generalizes across different materials and populations. The present study examined whether the FTE is robust under acute psychosocial encoding/retrieval stress. In each of two experimental conditions, participants studied three item lists in anticipation of final cumulative recall testing. In the testing condition, participants were tested immediately on lists 1 and 2, whereas in the restudy condition, they restudied lists 1 and 2. In both conditions, participants were tested immediately on list 3. Acute psychosocial stress was induced in participants prior to the encoding of item lists using the Trier social stress test for groups protocol. No stress was induced in a control group. Salivary cortisol, alpha amylase, and subjective stress were measured repeatedly to capture the biopsychological stress response. The results showed a significant FTE on list 3 recall, that is, testing of lists 1 and 2 enhanced the recall of list 3. No significant effect of stress on the FTE was observed, suggesting that the FTE is robust under acute psychosocial encoding/retrieval stress. The discussion provides suggestions for future research directions.

The Forward Testing Effect is Reliable and Independent of Learners' Working Memory Capacity

The forward testing effect refers to the finding that retrieval practice of previously studied information enhances learning and retention of subsequently studied other information. While most of the previous research on the forward testing effect examined group differences, the present study took an individual differences approach to investigate this effect. Experiment 1 examined whether the forward effect has test-retest reliability between two experimental sessions. Experiment 2 investigated whether the effect is related to participants' working memory capacity. In both experiments (and each session of Experiment 1), participants studied three lists of items in anticipation of a final cumulative recall test. In the testing condition, participants were tested immediately on lists 1 and 2, whereas in the restudy condition, they restudied lists 1 and 2. In both conditions, participants were tested immediately on list 3. On the group level, the results of both experiments demonstrated a forward testing effect, with interim testing of lists 1 and 2 enhancing immediate recall of list 3. On the individual level, the results of Experiment 1 showed that the forward effect on list 3 recall has moderate test-retest reliability between two experimental sessions. In addition, the results of Experiment 2 showed that the forward effect on list 3 recall does not depend on participants' working memory capacity. These findings suggest that the forward testing effect is reliable at the individual level and affects learners at a wide range of working memory capacities alike. The theoretical and practical implications of the findings are discussed.

Retrieval practice and spacing effects in multi-session treatment of naming impairment in aphasia

Retrieval practice and spacing are two factors shown to enhance learning in basic psychological research. The present study investigated the clinical applicability of these factors to naming treatment in aphasia. Prior studies have shown that naming treatment that provides retrieval practice (i.e., practice retrieving names for objects from semantic memory) improves later naming performance in people with aphasia (PWA) more so than repetition training. Repetition training is a common form of naming treatment that can support errorless production of names for objects, but it does not provide retrieval practice. Prior work has also demonstrated enhanced naming treatment benefit in PWA when an item's training trials are separated by multiple intervening trials (i.e., spacing) compared to only one intervening trial (i.e., massing). However, in those studies, items were only trained in one session. Also, the effects of the learning factors were probed after one day and one week. The goal of the present study was to examine the effects of retrieval practice and spacing in a more clinically-inspired schedule of delivery and to assess the effects of the learning factors at retention intervals of greater functional significance. Matched sets of errorful items for each of four PWA were presented for multiple trials of retrieval practice or repetition in a spaced or massed schedule in each of multiple training sessions. Mixed regression analyses revealed that retrieval practice outperformed repetition, and spacing outperformed massing, at an initial post-treatment test administered after one week. Furthermore, the advantage for retrieval practice over repetition persisted at a follow-up test administered after one month. The potential clinical relevance of retrieval practice and spacing for multi-session interventions in speech-language treatment is discussed.

Testing enhances motor practice

We investigated how retrieval of a set of newly learned motor sequences influences subsequent learning of another set of motor sequences. In four experiments, retrieval reduced an acceleration of movement execution over subsequent study trials. This relative slowing-down was associated with better recall performance in a final memory test. Explicit retrievability of motor sequences benefited from longer study-trial response times (RTs), suggesting that retrieval caused more attentive encoding. The use of motor sequences requiring overt action during encoding allowed for this demonstration of a twofold forward effect of testing on encoding quality and on recall. Experiment 1 adopted a paradigm used in previous studies with verbal materials. Experiment 2 changed the test format to be less susceptible to interference. Experiments 3 and 4 additionally switched from a between-participants design to a within-participants design. These modifications did not affect the occurrence of the twofold forward effect of testing but enabled detecting a correlation between recall and study-trial performance that had been precluded by the strongly interference-dependent test format of the original paradigm. Our findings demonstrate an immediate learning benefit of testing. It enhances encoding in subsequent study trials.

Desirable Difficulties in Spatial Learning: Testing Enhances Subsequent Learning of Spatial Information

Previous work has shown that testing can enhance learning and retention of subsequently studied new information. The present study investigated this forward testing effect in spatial memory. In two experiments, participants studied four successively presented 3 × 3 arrays, each composed of the same nine objects. They were asked to memorize the locations of the objects which differed across the four arrays. Following presentation of Arrays 1-3, memory for the object locations of the respective array was tested (testing condition), or the array was re-presented for additional study (restudy condition). Thereafter, Array 4 was presented and tested in both the testing and the restudy condition. In Experiment 1, testing was self-paced, whereas in Experiment 2, testing time was controlled by the experimenter. Consistent across the two experiments, testing was found to enhance location memory for Array 4, relative to restudying. Furthermore, testing also reduced the number of confusion errors (i.e., the tendency to misplace objects to locations on which they had appeared previously) made during recall of Array 4, suggesting that testing reduced the interference potential of prior information. The results indicate that testing can enhance subsequent learning of spatial information by reducing the build-up of proactive interference from previously studied information.

Enhancing learning and retrieval of new information: a review of the forward testing effect

In recent years evidence has accumulated showing that interim testing of studied information facilitates learning and retrieval of new information-the forward testing effect. In the current article, we review the empirical evidence and putative mechanisms underlying this effect. The possible negative effects of administering interim tests and how these negative effects can be mitigated are discussed. We also propose some important directions for future research to explore. Finally, we summarize the practical implications for optimizing learning and teaching in educational settings.

A autorregulação, avaliação e promoção da aprendizagem por meio da prática de recuperação da memória

Resumo Este artigo pretende discutir a avaliação como promotora dos processos de aprendizagem em sala de aula, para além do exame. Para isso, traz a discussão sobre “o efeito de teste” como uma metodologia a serviço da consolidação da memória nos processos de ensino e autorregulação do estudo pelos estudantes. Testar com frequência conteúdos aprendidos pode otimizar o ensino e modificar a forma como hoje são conduzidos os processos em sala de aula. O conhecimento de estratégias metacognitivas de aprendizagem leva a um maior empoderamento dos alunos na gestão do aprendizado, consolidando o papel do professor como um mediador do conhecimento.

Retrieval Practice Fails to Insulate Episodic Memories against Interference after Stroke

Recent work in cognitive psychology showed that retrieval practice of previously studied information can insulate this information against retroactive interference from subsequently studied other information in healthy individuals. The present study examined whether this beneficial effect of interference reduction is also present in patients with stroke. Twenty-two patients with stroke, 4.6 months post injury on average, and 22 healthy controls participated in the experiment. In each of two experimental sessions, participants first studied a list of items (list 1) and then underwent a practice phase in which the list 1 items were either restudied or retrieval practiced. Participants then either studied a second list of items (list 2) or fulfilled an unrelated distractor task. Recall of the two lists’ items was assessed in a final criterion test. Results showed that, in healthy controls, additional study of list 2 items impaired final recall of list 1 items in the restudy condition but not in the retrieval practice condition. In contrast, in patients with stroke, list 2 learning impaired final list 1 recall in both conditions. The results indicate that retrieval practice insulated the tested information against retroactive interference in healthy controls, but failed to do so in patients with stroke. Possible implications of the findings for the understanding of long-term memory impairment after stroke are discussed.

Leveraging the test effect to improve maintenance of the gains achieved through cognitive rehabilitation

OBJECTIVE

An important aspect of the rehabilitation of cognitive and linguistic function subsequent to brain injury is the maintenance of learning beyond the time of initial treatment. Such maintenance is often not satisfactorily achieved. Additional practice, or overtraining, may play a key role in long-term maintenance. In particular, the literature on learning in cognitively intact persons has suggested that it is testing, and not studying, that contributes to maintenance of learning. The present study investigates the hypothesis that continuing to test relearned words in persons with anomia will lead to significantly greater maintenance compared with continuing to study relearned words.

METHOD

The current study combines overtraining with the variable of test versus study in examining the effects of overtesting and overstudying on maintenance of word finding in 3 persons with aphasia. First, treatment successfully reestablished the connections between known items and their names. Once the connections were reestablished (i.e., items could be named successfully), each item was placed into 1 of 4 overtraining conditions: test and study, only test, only study, or no longer test or study. Maintenance was probed at 1 month and 4 months following the end of overtraining.

RESULTS

The results are consistent with an advantage of testing compared with studying. All 3 participants showed significantly greater maintenance for words that were overtested than for words that were overstudied. This testing benefit persisted at 1 month and 4 months after completion of the treatment. In fact, there was no clear evidence for any benefit of overstudying.

CONCLUSIONS

The present study demonstrates that overtesting, but not overstudying, leads to lasting maintenance of language rehabilitation gains in patients with anomia. The implications for the design of other treatment protocols are immense. (PsycINFO Database Record

Cognitive Rehabilitation After Traumatic Brain Injury: A Reference for Occupational Therapists

Nearly 1.7 million Americans sustain a traumatic brain injury (TBI) each year. These injuries can result in physical, emotional, and cognitive consequences. While many individuals receive cognitive rehabilitation from occupational therapists (OTs), the interdisciplinary nature of TBI research makes it difficult to remain up-to-date on relevant findings. We conducted a literature review to identify and summarize interdisciplinary evidence-based practice targeting cognitive rehabilitation for civilian adults with TBI. Our review summarizes TBI background, and our cognitive remediation section focuses on the findings from 37 recent (since 2006) empirical articles directly related to cognitive rehabilitation for individuals (i.e., excluding special populations such as veterans or athletes). This manuscript is offered as a tool for OTs engaged in cognitive rehabilitation and as a means to highlight arenas where more empirical, interdisciplinary research is needed.

Testing enhances subsequent learning in older but not in younger elementary school children

In adults, testing can enhance subsequent learning by reducing interference from the tested information. Here, we examined this forward effect of testing in children. Younger and older elementary school children and adult controls studied four lists of items in anticipation of a final cumulative recall test. Following presentation of each of the first three lists, participants were immediately tested on the respective list, or the list was re-presented for additional study. Results revealed that, compared to additional study, immediate testing of Lists 1-3 enhanced memory for the subsequently studied List 4 in adults and older elementary school children, but not in younger elementary school children. The findings indicate that the forward effect of testing is a relatively late-maturing phenomenon that develops over middle childhood and is still inefficient in the early elementary school years. Together with the results of other recent studies, these findings point to a more general problem in young children in combating interference.

Retrieval practice enhances new learning: the forward effect of testing

In the last couple of years, there has been a dramatic increase in laboratory research examining the benefits of recall testing on long-term learning and retention. This work was largely on the backward effect of testing, which shows that retrieval practice on previously studied information, compared to restudy of the same material, renders the information more likely to be remembered in the future. Going beyond this prominent work, more recent laboratory research provided evidence that there is also a forward effect of testing, which shows that recall testing of previously studied information can enhance learning of subsequently presented new information. Here, we provide a review of research on this forward effect of testing. The review shows that the effect is a well replicated phenomenon in laboratory studies that has been observed for both veridical information and misinformation. In particular, the review demonstrates that the effect may be applied to educational and clinical settings, enhancing learning in students and reducing memory deficits in clinical populations. The review discusses current theoretical explanations of the forward effect of testing and provides suggestions for future research directions.