Design of a computerised treatment for short-term memory deficits in aphasia

The treatment of auditory-verbal short-term memory (STM) deficits in aphasia is a growing avenue of research (Martin & Reilly, 2012; Murray, 2012). STM treatment requires time precision, which is suited to computerised delivery. We have designed software, which provides STM treatment for aphasia. The treatment is based on matching listening span tasks (Howard & Franklin, 1990), aiming to improve the temporal maintenance of multi-word sequences (Salis, 2012). The person listens to pairs of word-lists that differ in word-order and decides if the pairs are the same or different. This approach does not require speech output and is suitable for persons with aphasia who have limited or no output. We describe the software and how its review from clinicians shaped its design.

Memo test: standardisation of computerised assessment of auditory verbal short-term memory

Short-term memory (STM) impairments are prevalent in adults with acquired brain injuries. While there are several published tests to assess these impairments, the majority require speech production, e.g. digit span (Wechsler, 1987). This feature may make them unsuitable for people with aphasia and motor speech disorders because of word finding difficulties and speech demands respectively. If patients perceive the speech demands of the test to be high, the may not engage with testing. Furthermore, existing STM tests are mainly ‘pen-and-paper’ tests, which can jeopardise accuracy. To address these shortcomings, we designed and standardised a novel computerised test that does not require speech output and because of the computerised delivery it would enable clinicians identify STM impairments with greater precision than current tests. The matching listening span tasks, similar to the non-normed PALPA 13 (Kay, Lesser & Coltheart, 1992) is used to test short-term memory for serial order of spoken items. Sequences of digits are presented in pairs. The person hears the first sequence, followed by the second sequence and s/he decides whether the two sequences are the same or different. In the computerised test, the sequences are presented in live voice recordings on a portable computer through a software application (Molero Martin, Laird, Hwang & Salis 2013). We collected normative data from healthy older adults (N=22-24) using digits, real words (one- and two-syllables) and non-words (one- and two- syllables). Their performance was scored following two systems. The Highest Span system was the highest span length (e.g. 2-8) at which a participant correctly responded to over 7 out of 10 trials at the highest sequence length. Test re-test reliability was also tested in a subgroup of participants. The test will be available as free of charge for clinicians and researchers to use.

Memory operations in rapid serial visual presentation

Short-term memory (STM) has often been considered to be a central resource in cognition. This study addresses its role in rapid serial visual presentation (RSVP) tasks tapping into temporal attention-the attentional blink (AB). Various STM operations are tested for their impact on performance and, in particular, on the AB. Memory tasks were found to exert considerable impact on general performance but the size of the AB was more or less immune to manipulations of STM load. Likewise, the AB was unaffected by manipulating the match between items held in STM and targets or temporally close distractors in the RSVP stream. The emerging picture is that STM resources, or their lack, play no role in the AB. Alternative accounts assuming serial consolidation, selection for action, and distractor-induced task-set interference are discussed.

Short-term memory and the attentional blink: capacity versus content

When people monitor the rapid serial visual presentation (RSVP) of stimuli for two targets (T1 and T2), they often miss T2 if it falls into a time window of about half a second after T1 onset, a phenomenon known as the attentional blink (AB). We found that overall performance in an RSVP task was impaired by a concurrent short-term memory (STM) task and, furthermore, that this effect increased when STM load was higher and when its content was more task relevant. Loading visually defined stimuli and adding articulatory suppression further impaired performance on the RSVP task, but the size of the AB over time (i.e., T1-T2 lag) remained unaffected by load or content. This suggested that at least part of the performance in an RSVP task reflects interference between competing codes within STM, as interference models have held, whereas the AB proper reflects capacity limitations in the transfer to STM, as consolidation models have claimed.

Computerized short-term memory treatment for older adults with aphasia

We report on a software prototype designed to deliver a novel term memory treatment for older adults with aphasia. We conducted a review of the prototype with 14 speech and language therapists, to elicit feedback on the potential usefulness of the ultimate application and, particularly, the prototype in terms of its main design features and use by older adults with aphasia. The clinicians’ feedback highlights a number of design considerations relating to the usability, training methods, and appeal of treatment software, which can help engage patients more fully in computerized treatments and improve treatment outcomes.