A comparison of automatic and intentional instructions when using the method of vanishing cues in acquired brain injury

Abstract

Thirty-four participants with acquired brain injury learned word lists under two forms of vanishing cues – one in which the learning trial instructions encouraged intentional retrieval (i.e., explicit memory) and one in which they encouraged automatic retrieval (which encompasses implicit memory). The automatic instructions represented a novel approach in which the cooperation of participants was actively sought to avoid intentional retrieval. Intentional instructions resulted in fewer errors during the learning trials and better performance on immediate and delayed retrieval tests. The advantage of intentional over automatic instructions was generally less for those who had more severe memory and/or executive impairments. Most participants performed better under intentional instructions on both the immediate and the delayed tests. Although those who were more severely impaired in both memory and executive function also did better with intentional instructions on the immediate retrieval test, they were significantly more likely to show an advantage for automatic instructions on the delayed test. It is suggested that this pattern of results may reflect impairments in the consolidation of intentional memories in this group. When using vanishing cues, automatic instructions may be better for those with severe consolidation impairments, but otherwise intentional instructions may be better.

Keywords:

• Cognitive rehabilitation
• Method of vanishing cues
• Implicit memory
• Explicit memory
• Acquired brain injury

Notes

¹Age-adjusted scaled scores (derived from the test manuals) were also considered as the basis for categorising the participants into the executive and memory groups. All participants were classified in the same way whether using raw Tower Test scores or age-adjusted ones, and three participants were differently classified using raw Word List scores compared to age-adjusted ones. When the high-low memory classifications using the age-adjusted scores were used in the analyses instead of those based on the raw scores, there were negligible differences in terms of the outcome of the analysis and the overall pattern of significant/non-significant results was the same.

²Galea et al. (2010) used the concepts of procedural and declarative memory, rather than automatic and intentional memory. However, within a process-oriented approach (Jacoby, 1991), the emphasis is on process rather than content, and the procedural/declarative distinction is subsumed under the broader automatic/intentional framework.