Errorless Leaning of Face-Name Associations in Early Alzheimer's Disease

Clare, L., Wilson, B.A., Breen, K., & Hodges, J.R. (1999). Errorless learning of face-name associations in early Alzheimer’s disease. Neurocase: The Neutral Basis of Cognition, 5(1), 37-46.

Dementia refers to the loss of memory and other mental abilities that are severe enough to interfere with daily life. Many patients with dementia complain of major problems in face-name recognition. There is evidence that people with Alzheimer’s (a common type of dementia) can learn and retain new information by using strategies such as elaboration of material at encoding and expanding rehearsal. Another effective strategy that has been used with brain injured and learning disabled people is errorless learning. Errorless learning aims to prevent or significantly reduce errors made by the learner during the learning process.

This paper reports a multiple baseline intervention single case study of a 72 year old man (VJ) with Alzheimer’s disease and memory problems for the last three years aimed at improving face-naming. The first phase, initial baseline, involved showing VJ Polaroid pictures of 14 club members and testing which names he already knew. The second phase, the intervention, consisted of teaching the remaining face name associations over 21 sessions in his home. Phase three, generalization, took place at the social club and required VJ to identify individuals in person. In phase four, post intervention baseline, sessions were conducted in which VJ’s ability to name the photographs was tested. Finally, phase 5 included a follow-up at 1,3,6, and 9 months.

Errorless learning principles were applied throughout the phases by instructing VJ to provide a name only if he was sure. If he was unsure of a name, prompts were given. Each name-face association was trained in the same way during the intervention phase. VJ was shown a photograph and told the name. Next a mnemonic was chosen that related the name to a physical feature (example: Caroline with the curl on her forehead). Next, vanishing cues were used during the learning trials. Finally, an expanding rehearsal procedure took place.

The results of the study showed a significant increase in the number of faces VJ correctly named, rising from 22% at baseline to 98% following training with improvements maintained after 3, 6, and 9 months. The results provide some evidence that the errorless learning technique may be useful in learning face-name relationships in individuals with Alzheimer’s. However, mnemonic and vanishing cues may also have contributed to the improvement in VJ’s memory.

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