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Child Neuropsychology

A blog by Dr Jonathan Reed

  • I have just created a new game that involves working memory as part of the play.  The game is called Memorise and is available free on iTunes .  Memorise allows you to test your visual spatial working memory and to see if you can improve it over time.

    Working memory is the ability to hold information in mind in the short term and manipulate it.

    The reason I chose to develop a game involving working memory is the increasing body of research that shows that working memory can be improved with training and that improving working memory can have a wealth of other benefits.

    Examples in the research include:

    Working memory training can change brain function – see Olesen, Westerberg and Klingberg 2004

    Improve Fluid Intelligence (IQ) see Jaeggi et al 2008

    Reduce some symptoms in ADHD  see Klingberg et al 2005

    Help improve academic achievement see Holmes and Gathercole 2009

    and help individuals with brain injury see Johansson and Tornmalm 2012

    Developing visual spatial working memory seems to be particularly important and is associated with increased brain activity in Frontal and Parietal areas in childhood and similar brain network in adults

    Working memory training basically involves repeated practice at holding information in mind.  This can be boring but with Memorise I have tried to create a fun and motivating game that also produces benefits.  Memorise has some built in rewards to encourage your brain to carry on playing.  Memorise also adjusts according to your level, which reduces the sort of frustration seen in many similar games.   You can download the training report to monitor your performance over time and to see if you can improve your working memory ability.

    Memorise is a fun way to test your working memory and try and improve.  It is not a medical treatment.  If you have a medical condition and want a more detailed and clinically focused approach I would recommend trying the Cogmed program.

    Have fun and let me know how you get on.

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  • Neuropsychologists have studied memory for a long time.   We have a clear system of memory classification involving declarative memory which includes episodic memory (memory for events) and semantic memory (memory for facts) and non declarative memory which includes more implicit systems such as procedural memory, classical conditioning and priming.  The neurological substrates of this system are understood.  Numerous case studies of individuals with brain injury and memory disturbance have been reported.   The whole enterprise is best summarised by one of the leading researchers Larry Squire in this excellent paper Memory and brain systems 1969-2009 .

    Yet despite all this knowledge I struggle to see the relevance for the many children I see with memory and learning difficulties.  I was therefore fascinated to read a new book Moonwalking with Einstein: The Art and Science of Remembering Everything by Joshua Foer.  Foer’s book is based around a strange group of people who compete in memory championships around the world.  He explains how these competitors memorise the orders of multiple packs of cards, very long strings of digits and long unpublished poems.  The amount of information they can remember is quite remarkable.  Yet Foer shows that these feats are based on some simple memory techniques.  The premise is that human memory evolved to aid survival (finding food and avoiding danger) and therefore is primarily visual and spatial (location based).  He also highlights the way the brain learns and remembers through associations.  The techniques he describes are based on creating an imaginary spatial location (a memory palace) and imagining different visual images which can be associated with what you want to remember in this location.  So for example if you wanted to remember a shopping list you may imagine your home and visualise the first item, which could be milk by imaging someone bathing in milk.  The next item may be fish and you could imagine a singing fish in the kitchen.  The more bizarre the image the better you will recall, hence the title of the book.  By recalling the location and image you can then easily recall the information.   Individuals can create huge memory palaces and remember large amounts of information this way.  Foer believed that these techniques were so powerful that anyone could become a memory champion and he sets out in the book to prove this by entering the US memory championship.  I won’t give away the ending but it is a fascinating read.

    I think that these ideas could have important implications for neuropsychological rehabilitation and teaching.  How many teachers and psychologists know about these techniques and use them?   The techniques would need some adaptation (learning packs of cards, shopping lists and strings of numbers is not that useful) but used properly it could be very helpful for children learning facts about the world or number facts or just developing more effective ways to pass exams.  Is anyone out there using these techniques to help children with learning problems? If so I would love to hear about it.

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  • I have just been reading a very good new book on neuropsychological rehabilitation by Barbara Wilson and colleagues Neuropsychological Rehabilitation: Theory, Models, Therapy and Outcome
    I also heard her give an interesting talk this week on memory rehabilitation. In the book and the talk she discuses proven techniques to help with memory. These are designed for individual with memory problems but they also work really well for anyone wanting to learn and remember information. The methods are backed with experimental evidence. They will work for adults as well as children.

    1. Encourage associations or links when learning- the best way is to use visual or spatial images and associate these with what you are trying to learn. Some of the best learners use an internal picture of a house or journey and imagine what they have to remember placed in different places in the house. This helps with retrieval of information from memory.

    2. Spaced retrieval i.e. gradually extend the recall time. With this you need to initially recall what you have learnt straight away and then over time extend the time gap between learning and retrieval. For example look at a fact to remember, cover and recall immediately, then look again and wait for 15 seconds and try and recall, then 30 seconds and then 1 min etc. This leads to information stored more deeply in memory.

    3. Pace your learning and reduce the amount you are trying to learn at any one time. Learn a few bits of information, have a break and learn a few more. Trying to do too much at once doesn’t work.

    4. Organize the information e.g. if learning a list, group the items together according to meaning. For example for a shopping list put the items of fruit together, drink together etc. If learning facts group together for meaning. The brain likes to store information semantically i.e. according to categories.

    5. Error free learning- this is used to teach others. If the person doesn’t know the answer to the question immediately provide the answer and ask them to repeat. Continue to support until the answer is recalled automatically without any errors. This works for adults with memory problems including those with Alzheimer’s and also for children with learning difficulties. See previous post for more details

    It does take a bit more effort to store information more efficiently in memory when learning but these methods are proven to work. There are other techniques and also the research behind them in the book.

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