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Spaced Retrieval for Adult Speech Therapy

Spaced retrieval is an easy-to-use, evidence-based memory treatment. A single session can improve learning, plus it’s simple enough for caregivers to use. What’s not to love?!

In this post, you’ll find a quick guide to spaced retrieval for adult speech therapy, from step-by-step treatment instructions to sample goals.

Feel free to use any content in this post with your patients. And for ready-made materials, check out the bestselling Adult Speech Therapy Starter Pack!

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Who Should I Use Spaced Retrieval With?

who should i use spaced retrieval with?

The goal of spaced retrieval is to help patients remember information, long-term.

This approach is recommended for those with mild to severe cognitive-communication impairments. Mostly commonly, dementia.

To screen whether a patient is a good candidate, do a mini spaced retrieval session. You can fold it into your assessment, or spend a few minutes teaching a simple piece of information, such as your name or the name of a person in a picture.

Step-By-Step Instructions

step by step instructions for spaced retrieval

The First Spaced Retrieval Session

  1. Ask the question
    • Ask your patient a specific, open-ended target question
    • “Where do you live now?”

  2. Give the correct response
    • “June Fields Retirement Home”

  3. Ask the question again
    • Ask the exact same target question again and wait for an immediate response. The answer should exactly mimic your correct response
    • “June Fields Retirement Home”

  4. If correct, move on to step 5. If incorrect, go back to step 1.

  5. Wait for 15 seconds, then ask the exact same question again
    • Continue to increase the time between asking the question again
    • Start with 15 seconds, then increase to 30 seconds, 1 minute, 2 minutes, 4 minutes, 8 minutes, etc. You may go up to a half-hour or beyond.
    • Remember, the response must be correct to increase the time interval.
    • If incorrect, go back one time interval (or until they’re successful)

All Other Spaced Retrieval Sessions

  1. Ask the target question
    • Without reminders, ask the target question and wait for an immediate response

  2. If correct, wait for 15 seconds then ask the exact same question again (if incorrect, remind patients of the correct response)

  3. Wait, then ask again
    • Continue to increase the time between asking the question again
    • Start with 15 seconds, then increase to 30 seconds, 1 minute, 2 minutes, 4 minutes, 8 minutes, etc. You may go up to a half-hour or beyond.
    • Remember, the response must be correct to increase the time interval.
    • If incorrect, go back one time interval (or until they’re successful)

For more on how to successfully use spaced retrieval, keep scrolling!

What Makes A Good Target Question?

  1. Patient-centered
  2. Short and to the point
  3. Leads to recall
    • What should you do after taking a bite of food? “Take a drink”
  4. Use their own words
    • Point to the call light, memory book, dining room, etc., and ask, “What would you call this?” to hear what they call it in their own words.

As always, lead with patient-centered care. Work with the patient and their caregivers to choose an area of need that matters to them.

As appropriate, choose prompts that you believe are meaningful to your patient. Think safety, daily activities, interests, etc.

Best Frequency & Duration?

duration and frequency of spaced retrieval

Success can be seen in as little as one session per week, although 5 sessions per week is ideal.

The duration of each treatment should be 30 minutes to 1 hour, as appropriate.

Add A Visual Aid

external aid for spaced retrieval

To support learning, add a visual aid to the spaced retrieval process.

This supports errorless learning during treatment. And once learned, it can help patients remember the information for a longer period of time.

  • Size 14+ font
  • Arial or Calibri font (don’t use fonts with curly bits, like Times New Roman)
  • High contrast (black ink on white paper, white ink on blue or kelly green paper)
  • Capital letter at beginning of the sentence (not all caps)
  • During treatment, tent the paper and keep it horizontal on the table
  • If using the aid long-term, laminate and secure it somewhere useful (refrigerator, attached to walker or wheelchair, on the wall, etc.)

When Should I Progress My Patient?

when to discharge spaced retrieval

When your patient can give the correct response on the first try (immediate recall) of 3 consecutive spaced retrieval sessions, then the target information is considered learned! Yay!

Of course, check to make sure that the learning has led to functional change.

For example, let’s say your patient successfully recalls and demonstrates that they should lock their wheelchair before standing, 3 sessions in a row. But the caregiver reports that they don’t consistently do it out in the community.

You may recommend securing a visual aid to their wheelchair. Or have their caregiver ask the target question when out in the community.

Once the information is learned, move on to the next target question. Or add an additional step to the one they just learned.

Spaced Retrieval Goals!

spaced retrieval goals

Below are example spaced retrieval goals to get you started. Free free to copy, edit, or otherwise use them in your speech therapy practice.

Keep in mind that spaced retrieval is a treatment method to help get patients to their goals. You may not even mention spaced retrieval in your goal, which is fine.

For more on goal-writing, see the Goal Bank and How to Write Excellent Goals.

Safety Goals

  1. The patient will recall and demonstrate using the call light when they need to use the restroom at first practice across 3 consecutive sessions.
  2. The patient will demonstrate use of safe swallowing strategies when eating at first practice across 3 consecutive sessions.
  3. The patient will recall that she should call 911 when there is an emergency at first practice across 3 consecutive sessions.
  4. The patient will recall to lock their wheelchair brakes before standing in 80% of opportunities.
  5. The patient will recall to use her cane when she walks in 80% of opportunities.

Daily Activities Goals

  1. The patient will recall how to find the bathroom at first practice across 3 consecutive sessions.
  2. The patient will recall to use a calendar to check daily appointments at first practice across 3 consecutive sessions.
  3. The patient will take their daily medications on time in 80% of opportunities.
  4. The patient will recall and demonstrate where to put their dirty clothes in 80% of opportunities.
  5. The patient will recall her daughter’s name at first practice across 3 consecutive sessions.

Time-Saving Speech Therapy Materials

For everything you need to assess, treat, and document, check out The Adult Speech Therapy Starter Pack!

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References

  1. Benigas, J.E. (n.d.) Spaced retrieval for memory loss part 1: screenings, development, and support. Medbridge.
    https://www.medbridgeeducation.com/courses/details/spaced-retrieval-for-memory-loss-part-1-screenings-development-and-support-jeanette-benigas

  2. Benigas, J.E. (n.d.) Spaced retrieval for memory loss part 2: implementation strategies. Medbridge. https://www.medbridgeeducation.com/courses/details/spaced-retrieval-for-memory-loss-part-1-screenings-development-and-support-jeanette-benigas

  3. Hopper, T., Mahendra, N., Kim, E., Azuma, T., Bayles, K. A., Cleary, S. J., & Tomoeda, C. E. (2005). Evidence-based practice recommendations for working with individuals with dementia: Spaced-retrieval training. Journal of Medical Speech-Language Pathology13(4), xxvii-xxxiv.

  4. Malone, M.L. (2022). The spaced retrieval technique: a how-to for SLPs. Speechpathology.com. https://www.speechpathology.com/articles/spaced-retrieval-technique-to-for-20503#:~:text=There%20is%20a%20very%20simple,15%2D20%20seconds%20after%20that.

  5. Oren S, Willerton C, Small J. Effects of spaced retrieval training on semantic memory in Alzheimer’s disease: a systematic review. J Speech Lang Hear Res. 2014 Feb;57(1):247-70.
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