Strategies

Smartphone training helps people with serious memory impairment regain independence

April, 2012

A smartphone training program, specifically designed for those with moderate-to-severe memory impairment, was found to significantly improve day-to-day functioning in a small study.

While smartphones and other digital assistants have been found to help people with mild memory impairment, their use by those with greater impairment has been less successful. However, a training program developed at the Baycrest Centre for Geriatric Care has been using the power of implicit memory to help impaired individuals master new skills.

The study involved 10 outpatients, aged 18 to 55 (average age 44), who had moderate-to-severe memory impairment, the result of non-neurodegenerative conditions including ruptured aneurysm, stroke, tumor, epilepsy, closed-head injury, or anoxia after a heart attack. They all reported difficulty in day-to-day functioning.

Participants were trained in the basic functions of either a smartphone or another personal digital assistant (PDA) device, using an errorless training method that tapped into their preserved implicit /procedural memory. In this method, cues are progressively faded in such a way as to ensure there is enough information to prompt the correct response. The fading of the cues was based on the trainer’s observation of the patient’s behavior.

Participants were given several one-hour training sessions to learn calendaring skills such as inputting appointments and reminders. Each application was broken down into its component steps, and each step was given its own score in terms of how much support was needed. Support could either comprise a full explanation and demonstration; full explanation plus pointing to the next step; simply pointing to the next step; simply confirming a correct query; no support. The hour-long sessions occurred twice a week (with one exception, who only received one session a week). Training continued until the individual reached criterion-level performance (98% correct over a single session). On average, this took about 8 sessions, but as a general rule, those with relatively focal impairment tended to be substantially quicker than those with more extensive cognitive impairment.

After this first training phase, participants took their devices home, where they extended their use of the device through new applications mastered using the same protocol. These new tasks were carefully scaffolded to enable progressively more difficult tasks to be learned.

To assess performance, participants were given a schedule of 10 phone calls to complete over a two-week period at different times of the day. Additionally, family members kept a log of whether real-life tasks were successfully completed or not, and both participants and family members completed several questionnaires: one rating a list of common memory mistakes on a frequency-of-occurrence scale, another measuring confidence in dealing with various memory-demanding scenarios, and a third examining the participant's ability to use the device.

All 10 individuals showed improvement in day-to-day memory functioning after taking the training, and this improvement continued when the patients were followed up three to eight months later. Specifically, prospective memory (memory for future events) improved, and patient confidence in dealing with memory-demanding situations increased. Some patients also reported broadening their use of their device to include non-prospective memory tasks (e.g. entering names and/or photos of new acquaintances, or entering details of conversations).

It should be noted that these patients were some time past their injury, which was on average some 3 ½ years earlier (ranging from 10 months to over 25 years). Accordingly, they had all been through standard rehabilitation training, and already used many memory strategies. Questioning about strategy use prior to the training revealed that six participants used more memory strategies than they had before their injury, three hadn’t changed their strategy use, and one used fewer. Strategies included: calendars, lists, reminders from others, notebooks, day planner, placing items in prominent places, writing a note, relying on routines, alarms, organizing information, saying something out loud in order to remember it, mental elaboration, concentrating hard, mental retracing, computer software, spaced repetition, creating acronyms, alphabetic retrieval search.

The purpose of this small study, which built on an earlier study involving only two patients, was to demonstrate the generalizability of the training method to a larger number of individuals with moderate-to-severe memory impairment. Hopefully, it will also reassure such individuals, who tend not to use electronic memory aids, that these are a useful tool that they can, with the right training, learn to use successfully.

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Video game training benefits cognition in some older adults

April, 2012

A study has found that playing a cognitively complex video game improved cognitive performance in some older adults, particularly those with initially poorer cognitive scores.

A number of studies have found evidence that older adults can benefit from cognitive training. However, neural plasticity is thought to decline with age, and because of this, it’s thought that the younger-old, and/or the higher-functioning, may benefit more than the older-old, or the lower-functioning. On the other hand, because their performance may already be as good as it can be, higher-functioning seniors may be less likely to benefit. You can find evidence for both of these views.

In a new study, 19 of 39 older adults (aged 60-77) were given training in a multiplayer online video game called World of Warcraft (the other 20 formed a control group). This game was chosen because it involves multitasking and switching between various cognitive abilities. It was theorized that the demands of the game would improve both spatial orientation and attentional control, and that the multiple tasks might produce more improvement in those with lower initial ability compared to those with higher ability.

WoW participants were given a 2-hour training session, involving a 1-hour lecture and demonstration, and one hour of practice. They were then expected to play the game at home for around 14 hours over the next two weeks. There was no intervention for the control group. All participants were given several cognitive tests at the beginning and end of the two week period: Mental Rotation Test; Stroop Test; Object Perspective Test; Progressive Matrices; Shipley Vocabulary Test; Everyday Cognition Battery; Digit Symbol Substitution Test.

As a group, the WoW group improved significantly more on the Stroop test (a measure of attentional control) compared to the control group. There was no change in the other tests. However, those in the WoW group who had performed more poorly on the Object Perspective Test (measuring spatial orientation) improved significantly. Similarly, on the Mental Rotation Test, ECB, and Progressive Matrices, those who performed more poorly at the beginning tended to improve after two weeks of training. There was no change on the Digit Symbol test.

The finding that only those whose performance was initially poor benefited from cognitive training is consistent with other studies suggesting that training only benefits those who are operating below par. This is not really surprising, but there are a few points that should be made.

First of all, it should be noted that this was a group of relatively high-functioning young-old adults — poorer performance in this case could be (relatively) better performance in another context. What it comes down to is whether you are operating at a level below which you are capable of — and this applies broadly, for example, experiments show that spatial training benefits females but not males (because males tend to already have practiced enough).

Given that, in expertise research, training has an on-going, apparently limitless, effect on performance, it seems likely that the limited benefits shown in this and other studies is because of the extremely limited scope of the training. Fourteen hours is not enough to improve people who are already performing adequately — but that doesn’t mean that they wouldn’t improve with more hours. I have yet to see any interventions with older adults that give them the amount of cognitive training you would expect them to need to achieve some level of mastery.

My third and final point is the specific nature of the improvements. This has also been shown in other studies, and sometimes appears quite arbitrary — for example, one 3-D puzzle game apparently improved mental rotation, while a different 3-D puzzle game had no effect. The point being that we still don’t understand the precise attributes needed to improve different skills (although the researchers advocate the use of a tool called cognitive task analysis for revealing the underlying qualities of an activity) — but we do understand that it is a matter of precise attributes, which is definitely a step in the right direction.

The main thing, then, that you should take away from this is the idea that different activities involve specific cognitive tasks, and these, and only these, will be the ones that benefit from practicing the activities. You therefore need to think about what tasks you want to improve before deciding on the activities to practice.

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Scent of rosemary may help cognition

March, 2012

Rosemary is a herb long associated with memory. A small study now provides some support for the association, and for the possible benefits of aromatherapy. And a rat study indicates that your attitude to work might change how stimulants affect you.

A small study involving 20 people has found that those who were exposed to 1,8-cineole, one of the main chemical components of rosemary essential oil, performed better on mental arithmetic tasks. Moreover, there was a dose-dependent relationship — higher blood concentrations of the chemical were associated with greater speed and accuracy.

Participants were given two types of test: serial subtraction and rapid visual information processing. These tests took place in a cubicle smelling of rosemary. Participants sat in the cubicle for either 4, 6, 8, or 10 minutes before taking the tests (this was in order to get a range of blood concentrations). Mood was assessed both before and after, and blood was tested at the end of the session.

While blood levels of the chemical correlated with accuracy and speed on both tasks, the effects were significant only for the mental arithmetic task.

Participants didn’t know that the scent was part of the study, and those who asked about it were told it was left over from a previous study.

There was no clear evidence that the chemical improved attention, but there was a significant association with one aspect of mood, with higher levels of the scent correlating with greater contentment. Contentment was the only aspect of mood that showed such a link.

It’s suggested that this chemical compound may affect learning through its inhibiting effect on acetylcholinesterase (an important enzyme in the development of Alzheimer's disease). Most Alzheimer’s drugs are cholinesterase inhibitors.

While this is very interesting (although obviously a larger study needs to confirm the findings), what I would like to see is the effects on more prolonged mental efforts. It’s also a little baffling to find the effect being limited to only one of these tasks, given that both involve attention and working memory. I would also like to see the rosemary-infused cubicle compared to some other pleasant smell.

Interestingly, a very recent study also suggests the importance of individual differences. A rat study compared the effects of amphetamines and caffeine on cognitive effort. First of all, giving the rats the choice of easy or hard visuospatial discriminations revealed that, as with humans, individuals could be divided into those who tended to choose difficult trials (“workers”) and those who preferred easy ones (“slackers”). (Easy trials took less effort, but earned commensurately smaller reward.)

Amphetamine, it was found, made the slackers worked harder, but made the workers take it easier. Caffeine, too, made the workers slack off, but had no effect on slackers.

The extent to which this applies to humans is of course unknown, but the idea that your attitude to cognitive effort might change how stimulants affect you is an intriguing one. And of course this is a more general reminder that factors, whatever they are, have varying effects on individuals. This is why it’s so important to have a large sample size, and why, as an individual, you can’t automatically assume that something will benefit you, whatever the research says.

But in the case of rosemary oil, I can’t see any downside! Try it out; maybe it will help.

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Music and sports training help spatial skills differently for men and women

March, 2012

While sports training benefits the spatial skills of both men and women, music training closes the gender gap by only helping women.

I talked recently about how the well-established difference in spatial ability between men and women apparently has a lot to do with confidence. I also mentioned in passing that previous research has shown that training can close the gender gap. A recent study suggests that this training may not have to be specific to spatial skills.

In the German study, 120 students were given a processing speed test and a standard mental rotation test. The students were evenly divided into three groups: musicians, athletes, and education students who didn’t participate in either sports or music.

While the expected gender gap was found among the education students, the gap was smaller among the sports students, and non-existent in the music students.

Among the education students, men got twice as many rotation problems correct as women. Among the sports students, both men and women did better than their peers in education, but since they were both about equally advantaged, a gender gap was still maintained. However, among the musicians, it was only women who benefited, bringing them up to the level of the men.

Thus, for males, athletes did best on mental rotation; for females, musicians did best.

Although it may be that those who went into music or sports had relevant “natural abilities”, the amount of training in sports/music did have a significant effect. Indeed, analysis found that the advantage of sports and music students disappeared when hours of practice and years of practicing were included.

Interestingly, too, there was an effect of processing speed. Although overall the three groups didn’t differ in processing speed, male musicians had a lower processing speed than female musicians, or male athletes (neither of which groups were significantly different from each other).

It is intriguing that music training should only benefit females’ spatial abilities. However, I’m reminded that in research showing how a few hours of video game training can help females close the gender gap, females benefited from the training far more than men. The obvious conclusion is that the males already had sufficient experience, and a few more hours were neither here nor there. Perhaps the question should rather be: why does sports practice benefit males’ spatial skills? A question that seems to point to the benefits for processing speed, but then we have to ask why sports didn’t have the same effect on women. One possible answer here is that the women had engaged in sports for a significantly shorter time (an average of 10.6 years vs 17.55), meaning that the males tended to begin their sports training at a much younger age. There was no such difference among the musicians.

(For more on spatial memory, see the aggregated news reports)

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Pietsch, S., & Jansen, P. (2012). Different mental rotation performance in students of music, sport and education. Learning and Individual Differences, 22(1), 159-163. Elsevier Inc. doi:10.1016/j.lindif.2011.11.012

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Group settings hurt expressions of intelligence, especially in women

March, 2012

Comparing performance on an IQ test when it is given under normal conditions and when it is given in a group situation reveals that IQ drops in a group setting, and for some (mostly women) it drops dramatically.

This is another demonstration of stereotype threat, which is also a nice demonstration of the contextual nature of intelligence. The study involved 70 volunteers (average age 25; range 18-49), who were put in groups of 5. Participants were given a baseline IQ test, on which they were given no feedback. The group then participated in a group IQ test, in which 92 multi-choice questions were presented on a monitor (both individual and group tests were taken from Cattell’s culture fair intelligence test). Each question appeared to each person at the same time, for a pre-determined time. After each question, they were provided with feedback in the form of their own relative rank within the group, and the rank of one other group member. Ranking was based on performance on the last 10 questions. Two of each group had their brain activity monitored.

Here’s the remarkable thing. If you gather together individuals on the basis of similar baseline IQ, then you can watch their IQ diverge over the course of the group IQ task, with some dropping dramatically (e.g., 17 points from a mean IQ of 126). Moreover, even those little affected still dropped some (8 points from a mean IQ of 126).

Data from the 27 brain scans (one had to be omitted for technical reasons) suggest that everyone was initially hindered by the group setting, but ‘high performers’ (those who ended up scoring above the median) managed to largely recover, while ‘low performers’ (those who ended up scoring below the median) never did.

Personality tests carried out after the group task found no significant personality differences between high and low performers, but gender was a significant variable: 10/13 high performers were male, while 11/14 low performers were female (remember, there was no difference in baseline IQ — this is not a case of men being smarter!).

There were significant differences between the high and low performers in activity in the amygdala and the right lateral prefrontal cortex. Specifically, all participants had an initial increase in amygdala activation and diminished activity in the prefrontal cortex, but by the end of the task, the high-performing group showed decreased amygdala activation and increased prefrontal cortex activation, while the low performers didn’t change. This may reflect the high performers’ greater ability to reduce their anxiety. Activity in the nucleus accumbens was similar in both groups, and consistent with the idea that the students had expectations about the relative ranking they were about to receive.

It should be pointed out that the specific feedback given — the relative ranking — was not a factor. What’s important is that it was being given at all, and the high performers were those who became less anxious as time went on, regardless of their specific ranking.

There are three big lessons here. One is that social pressure significantly depresses talent (meetings make you stupid?), and this seems to be worse when individuals perceive themselves to have a lower social rank. The second is that our ability to regulate our emotions is important, and something we should put more energy into. And the third is that we’ve got to shake ourselves loose from the idea that IQ is something we can measure in isolation. Social context matters.

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Confidence is key to women's spatial skills

March, 2012

A series of experiments has found that confidence fully accounted for women’s poorer performance on a mental rotation task.

One of the few established cognitive differences between men and women lies in spatial ability. But in recent years, this ‘fact’ has been shaken by evidence that training can close the gap between the genders. In this new study, 545 students were given a standard 3D mental rotation task, while at the same time manipulating their confidence levels.

In the first experiment, 70 students were asked to rate their confidence in each answer. They could also choose not to answer. Confidence level was significantly correlated with performance both between and within genders.

On the face of it, these findings could be explained, of course, by the ability of people to be reliable predictors of their own performance. However, the researchers claim that regression analysis shows clearly that when the effect of confidence was taken into account, gender differences were eliminated. Moreover, gender significantly predicted confidence.

But of course this is still just indicative.

In the next experiment, however, the researchers tried to reduce the effect of confidence. One group of 87 students followed the same procedure as in the first experiment (“omission” group), except they were not asked to give confidence ratings. Another group of 87 students was not permitted to miss out any questions (“commission” group). The idea here was that confidence underlay the choice of whether or not to answer a question, so while the first group should perform similarly to those in the first experiment, the second group should be less affected by their confidence level.

This is indeed what was found: men significantly outperformed women in the first condition, but didn’t in the second condition. In other words, it appears that the mere possibility of not answering makes confidence an important factor.

In the third experiment, 148 students replicated the commission condition of the second experiment with the additional benefit of being allowed unlimited time. Half of the students were required to give confidence ratings.

The advantage of unlimited time improved performance overall. More importantly, the results confirmed those produced earlier: confidence ratings produced significant gender differences; there were no gender differences in the absence of such ratings.

In the final experiment, 153 students were required to complete an intentionally difficult line judgment task, which men and women both carried out at near chance levels. They were then randomly informed that their performance had been either above average (‘high confidence’) or below average (‘low confidence’). Having manipulated their confidence, the students were then given the standard mental rotation task (omission version).

As expected (remember this is the omission procedure, where subjects could miss out answers), significant gender differences were found. But there was also a significant difference between the high and low confidence groups. That is, telling people they had performed well (or badly) on the first task affected how well they did on the second. Importantly, women in the high confidence group performed as well as men in the low confidence group.

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Gestures improve language learning

February, 2012

Those learning a new language benefit from making suitable gestures as they repeat new vocabulary, and this can even extend to gestures arbitrarily linked to abstract adverbs.

I always like gesture studies. I think I’m probably right in saying that they started with language learning. Way back in 1980 it was shown that acting out action phrases meant they were remembered better than if the phrases had been only heard or read (the “enactment effect”). Enacted items, it turned out, “popped out” effortlessly in free recall tests — in other words, enactment had made the phrases highly accessible. Subsequent research found that this effect occurred both for both older and younger adults, and in immediate and delayed recall tests — suggesting not only that such items are more accessible but that forgetting is slower.

Following these demonstrations, there have been a few studies that have specifically looked at the effect of gestures on learning foreign languages, which have confirmed the benefits of gestures. But there are various confounding factors that are hard to remove when using natural languages, which is why the present researchers have developed an artificial language (“Vimmi”) to use in their research. In their first study, as in most other studies, the words and phrases used related to actions. In a new study, the findings were extended to more abstract vocabulary.

In this study, 20 German-speakers participated in a six-day language class to study Vimmi. The training material included 32 sentences, each containing a subject, verb, adverb, and object. While the subject nouns were concrete agents (e.g., musician, director), the other words were all abstract. Here’s a couple of sample sentences (translated, obviously): (The) designer frequently shapes (the) style. (The) pilot really enjoys (the) view. The length of the words was controlled: nouns all had 3 syllables; verbs and adverbs all had two.

For 16 of the sentences, participants saw the word in Vimmi and heard it. The translation of the word appeared on the screen fractionally later, while at the same time a video appeared in which woman performed the gesture relating to the word. The audio of the word was replayed, and participants were cued to imitate the gesture as they repeated the word. For the other 16 sentences, a video with a still image of the actress appeared, and the participants were simply cued to repeat the word when the audio was replayed.

While many of the words used gestures similar to their meaning (such as a cutting gesture for the word “cut”), the researchers found that the use of any gesture made a difference as long as it was unique and connected to a specific word. For example, the abstract word “rather” does not have an obvious gesture that would go with it. However, a gesture attached to this word also worked.

Each daily session lasted three hours. From day 2, sessions began with a free recall and a cued recall test. In the free recall test, participants were asked to write as many items as possible in both German and Vimmi. Items had to be perfectly correct to be counted. From day 4, participants were also required to produce new sentences with the words they had learned.

Right from the beginning, free recall of items which had been enacted was superior to those which hadn’t been — in German. However, in Vimmi, significant benefits from enactment occurred only from day 3. The main problem here was not forgetting the items, but correctly spelling them. In the cued recall test (translating from Vimmi to German, or German to Vimmi), again, the superiority of the enactment condition only showed up from day 3.

Perhaps the most interesting result came from the written production test. Here, people reproduced the same number of sentences they had learned on each of the three days of the test, and although enacted words were remembered at a higher rate, that rate didn’t alter, and didn’t reach significance. However, the production of new sentences improved each day, and the benefits of enactment increased each day. These benefits were significant from day 5.

The main question, however, was whether the benefits of enactment depended on word category. As expected, concrete nouns were remembered than verbs, followed by abstract nouns, and finally adverbs. When all the tests were lumped together, there was a significant benefit of enactment for all types of word. However, the situation became a little more nuanced when the data was separately analyzed.

In free recall, for Vimmi, enactment was only of significant benefit for concrete nouns and verbs. In cued recall, for translating German into Vimmi, the enactment benefit was significant for all except concrete nouns (I’m guessing concrete nouns have enough ‘natural’ power not to need gestures in this situation). For translating Vimmi into German, the benefit was only significant for verbs and abstract nouns. In new sentence production, interestingly, participants used significantly more items of all four categories if they had been enacted. This is perhaps the best evidence that enactment makes items more accessible in memory.

What all this suggests is that acting out new words helps you learn them, but some types of words may benefit more from this strategy than others. But I think we need more research before being sure about such subtleties. The pattern of results make it clear that we really need longer training, and longer delays, to get a better picture of the most effective way to use this strategy.

For example, it may be that adverbs, although they showed the most inconsistent benefits, are potentially the category that stands to gain the most from this strategy — because they are the hardest type of word to remember. Because any embodiment of such an abstract adverb must be arbitrary — symbolic rather than representational — it naturally is going to be harder to learn (yes, some adverbs could be represented, but the ones used in this study, and the ones I am talking about, are of the “rather”, “really”, “otherwise” ilk). But if you persist in learning the association between concept and gesture, you may derive greater benefit from enactment than you would from easier words, which need less help.

Here’s a practical discussion of all this from a language teacher’s perspective.

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Cognitive training for older adults can also change a personality trait

February, 2012

A program designed to improve reasoning ability in older adults also increased their openness to new experiences.

Openness to experience – being flexible and creative, embracing new ideas and taking on challenging intellectual or cultural pursuits – is one of the ‘Big 5’ personality traits. Unlike the other four, it shows some correlation with cognitive abilities. And, like them, openness to experience does tend to decline with age.

However, while there have been many attempts to improve cognitive function in older adults, to date no one has tried to increase openness to experience. Naturally enough, one might think — it’s a personality trait, and we are not inclined to view personality traits as amenable to ‘training’. However, recently there have been some indications that personality traits can be changed, through cognitive interventions or drug treatments. In this new study, a cognitive training program for older adults also produced increases in their openness to experience.

The study involved 183 older adults (aged 60-94; average age 73), who were randomly assigned to a 16-week training program or a waiting-list control group. The program included training in inductive reasoning, and puzzles that relied in part on inductive reasoning. Most of this activity was carried out at home, but there were two 1-hour classroom sessions: one to introduce the inductive reasoning training, and one to discuss strategies for Sudoku and crosswords.

Participants came to the lab each week to hand in materials and pick up the next set. Initially, they were given crossword and Sudoku puzzles with a wide range of difficulty. Subsequently, puzzle sets were matched to each participant’s skill level (assessed from the previous week’s performance). Over the training period, the puzzles became progressively more difficult, with the steps tailored to each individual.

The inductive reasoning training involved learning to recognize novel patterns and use them to solve problems. In ‘basic series problems’, the problems required inference from a serial pattern of words, letters, or numbers. ‘Everyday serial problems’ included problems such as completing a mail order form and answering questions about a bus schedule. Again, the difficulty of the problems increased steadily over the training period.

Participants were asked to spend at least 10 hours a week on program activities, and according to the daily logs they filled in, they spent an average of 11.4 hours a week. In addition to the hopefully inherent enjoyment of the activities, those who recorded 10 hours were recognized on a bulletin board tally sheet and entered into a raffle for a prize.

Cognitive and personality testing took place 4-5 weeks prior to the program starting, and 4-5 weeks after program end. Two smaller assessments also took place during the program, at week 6 and week 12.

At the end of the program, those who had participated had significantly improved their pattern-recognition and problem-solving skills. This improvement went along with a moderate but significant increase in openness. Analysis suggested that this increase in openness occurred independently of improvement in inductive reasoning.

The benefits were specific to inductive reasoning and openness, with no significant effects on divergent thinking, processing speed, verbal ability, or the other Big 5 traits.

The researchers suggest that the carefully stepped training program was important in leading to increased openness, allowing the building of a growing confidence in their reasoning abilities. Openness to experience contributes to engagement and enjoyment in stimulating activity, and has also been linked to better health and decreased mortality risk. It seems likely, then, that increases in openness can be part of a positive feedback cycle, leading to greater and more sustained engagement in mentally stimulating activities.

The corollary is that decreases in openness may lead to declines in cognitive engagement, and then to poorer cognitive function. Indeed it has been previously suggested that openness to experience plays a role in cognitive aging.

Clearly, more research is needed to tease out how far these findings extend to other activities, and the importance of scaffolding (carefully designing cognitive activities on an individualized basis to support learning), but this work reveals an overlooked aspect to the issue of mental stimulation for preventing age-related cognitive decline.

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Teaching those with ASD to 'talk things through' may help them plan

February, 2012

A study showing that those with ASD are less likely to use inner speech when planning their actions, a failure linked to their communication ability, has implications for us all.

I’ve reported before on evidence that young children do better on motor tasks when they talk to themselves out loud, and learn better when they explain things to themselves or (even better) their mother. A new study extends those findings to children with autism.

In the study, 15 high-functioning adults with Autism Spectrum Disorder and 16 controls (age and IQ matched) completed the Tower of London task, used to measure planning ability. This task requires you to move five colored disks on three pegs from one arrangement to another in as few moves as possible. Participants did the task under normal conditions as well as under an 'articulatory suppression' condition whereby they had to repeat out loud a certain word ('Tuesday' or 'Thursday') throughout the task, preventing them from using inner speech.

Those with ASD did significantly worse than the controls in the normal condition (although the difference wasn’t large), but they did significantly better in the suppression condition — not because their performance changed, but because the controls were significantly badly affected by having their inner speech disrupted.

On an individual basis, nearly 90% of the control participants did significantly worse on the Tower of London task when inner speech was prevented, compared to only a third of those with ASD. Moreover, the size of the effect among those with ASD was correlated with measures of communication ability (but not with verbal IQ).

A previous experiment had confirmed that these neurotypical and autistic adults both showed similar patterns of serial recall for labeled pictures. Half the pictures had phonologically similar labels (bat, cat, hat, mat, map, rat, tap, cap), and the other nine had phonologically dissimilar labels (drum, shoe, fork, bell, leaf, bird, lock, fox). Both groups were significantly affected by phonological similarity, and both groups were significantly affected when inner speech was prevented.

In other words, this group of ASD adults were perfectly capable of inner speech, but they were much less inclined to use it when planning their actions.

It seems likely that, rather than using inner speech, they were relying on their visuospatial abilities, which tend to be higher in individuals with ASD. Supporting this, visuospatial ability (measured by the block design subtest of the WAIS) was highly correlated with performance on the Tower of London test. Which may not seem surprising, but the association was minimal in control participants.

Complex planning is said to be a problem for many with ASD. It’s also suggested that the relative lack of inner speech use might contribute to some of the repetitive behaviors common in people with autism.

It may be that strategies targeted at encouraging inner speech may help those with ASD develop such skills. Such strategies include encouraging children to describe their actions out loud, and providing “parallel talk”, whereby an observer plays alongside the child while verbalizing their actions.

It is also suggested that children with ASD could benefit from verbal learning of their daily schedule at school rather than using visual timetables as is currently a common approach. This could occur in stages, moving from pictures to symbols, symbols with words, before finally being restricted to words only.

ASD is estimated to occur in 1% of the population, but perhaps this problem could be considered more widely. Rather than seeing this as an issue limited to those with ASD, we should see this as a pointer to the usefulness of inner speech, and its correlation with communication skills. As one of the researchers said: "These results show that inner speech has its roots in interpersonal communication with others early in life, and it demonstrates that people who are poor at communicating with others will generally be poor at communicating with themselves.”

One final comment: a distinction has been made between “dialogic” and “monologic” inner speech, where dialogic speech refers to a kind of conversation between different perspectives on reality, and monologic speech is simply a commentary to oneself about the state of affairs. It may be that it is specifically dialogic inner speech that is so helpful for problem-solving. It has been suggested that ASD is marked by a reduction in this kind of inner speech only, and the present researchers suggest further that it is this form of speech that may have inherently social origins and require training or experience in communicating with others.

The corollary to this is that it is only in those situations where dialogic inner speech is useful in achieving a task, that such differences between individuals will matter.

Clearly there is a need for much more research in this area, but it certainly provides food for thought.

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Music training protects against aging-related hearing loss

February, 2012

More evidence that music training protects older adults from age-related impairment in understanding speech, adding to the potential benefits of music training in preventing dementia.

I’ve spoken before about the association between hearing loss in old age and dementia risk. Although we don’t currently understand that association, it may be that preventing hearing loss also helps prevent cognitive decline and dementia. I have previously reported on how music training in childhood can help older adults’ ability to hear speech in a noisy environment. A new study adds to this evidence.

The study looked at a specific aspect of understanding speech: auditory brainstem timing. Aging disrupts this timing, degrading the ability to precisely encode sound.

In this study, automatic brain responses to speech sounds were measured in 87 younger and older normal-hearing adults as they watched a captioned video. It was found that older adults who had begun musical training before age 9 and engaged consistently in musical activities through their lives (“musicians”) not only significantly outperformed older adults who had no more than three years of musical training (“non-musicians”), but encoded the sounds as quickly and accurately as the younger non-musicians.

The researchers qualify this finding by saying that it shows only that musical experience selectively affects the timing of sound elements that are important in distinguishing one consonant from another, not necessarily all sound elements. However, it seems probable that it extends more widely, and in any case the ability to understand speech is crucial to social interaction, which may well underlie at least part of the association between hearing loss and dementia.

The burning question for many will be whether the benefits of music training can be accrued later in life. We will have to wait for more research to answer that, but, as music training and enjoyment fit the definition of ‘mentally stimulating activities’, this certainly adds another reason to pursue such a course.

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