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 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!

What Is Spaced Retrieval?

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

It’s recommended for patients with mild to severe cognitive-communication impairments. Most commonly, dementia.

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

Spaced Retrieval Step-By-Step

Spaced Retrieval Training: The First Session

1. Ask the question
   
   • Ask your patient a specific, open-ended target question
   • Clinician: “Where do you live now?”
     
2. Give the correct response
   
   • Clinician: “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
   • Patient: “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)

Spaced Retrieval Training: All Other 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.

How Often Should You Do Spaced Retrieval Treatment?

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 To Spaced Retrieval

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

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

• Size 14+ font
• Arial or Calibri font (sans serif fonts)
• High contrast (black ink on white paper, white ink on blue or kelly green paper)
• A capital letter at the 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 your patient can respond correctly on the first try (immediate recall) of 3 consecutive spaced retrieval sessions, then the target information is considered learned!

Of course, check to make sure it has led to functional change.

For example, let’s say your patient successfully recalls and shows you that they should lock their wheelchair before standing, 3 sessions in a row. But, the caregiver says that they don’t consistently do it at home.

You may recommend securing a visual aid to their wheelchair. Or have the caregiver do spaced retrieval with the target question at home.

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

Spaced Retrieval Video

For our visual and auditory learners, SLP and university instructor Alisha Kleindel walks you through the basic steps of spaced retrieval.

Spaced Retrieval Goals!

Below are 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 Adult Speech Therapy Goal Bank and How to Write Excellent Goals.

Safety Spaced Retrieval 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 Spaced Retrieval 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

Visit our shop for print-and-go handouts, assessments, and documentation forms (The Starter Pack).

And for a step-by-step guide to assess, treat, and document all major areas of speech therapy, see The Adult Speech Therapy Roadmap. Eligible for 1.55 ASHA CEUs!

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 Pathology, 13(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.