Using recognition testing to support semantic learning in developmental amnesia

Figures & data

Figure 1. Reproduced from Elward and Vargha-Khadem (2018). Data from two studies designed to investigate semantic learning in DA. Recall Learning (top panel): Participants complete six recall tests during learning. The cued recall test (highlighted with a box) indicates that participants did not show good learning with this method. Recognition Learning (bottom panel): Participants complete recognition tests during learning. In this case, performance on the cued recall test (highlighted with a box) was similar to controls.

A comparison of two datasets. The top graph shows data from a recall learning paradigm using written text and audio. The bottom graph shows data from a recognition learning paradigm using videos. The key comparison is highlighted – recognition learning leads to better recall performance after a delay than recall learning.

Table 1. Neuropsychological assessment results of patient H.

Cognitive Domain	Test		Standard Score	Percentile
Intelligence	Wechsler Intelligence Scale for Children
		Full Scale IQ	116	86
		Verbal Comprehension	114	82
		Perceptual Reasoning	121	92
		Working Memory	113	81
		Processing Speed	94	34
Vocabulary	One Word Picture Vocab. Test
		Expressive	124	95
		Receptive	99	49
Attainment	Wechsler Individual Achievement Test 3rd UK Edition
		Word Reading	122	93
		Reading Comprehension	126	96
		Numeracy	114	82
		Mathematical Problem Solving	116	86
		Spelling	107	68
Memory	Children’s Memory Scale
		Visual Immediate	115	84
		Visual Delayed	109	73
		Verbal Immediate	66	1
		Verbal Delayed	54	0.1
		General Memory	80	9
		Attention / Concentration	115	84
		Learning	78	7
		Delayed Recognition	82	12
	Doors and People		Raw Score	Percentile
		People (Recall)	16/36	25
		Doors (Recognition)	16/24	50
		Shapes (Recall)	16/36	25
		Names (Recognition)	20/24	95
	Children’s Auditory Verbal Learning Test (CAVLT-2)
		Immediate Memory	89	23
		Level of Learning	66	1
		Interference	83	13
		Immediate Recall	< 60	< 1
		Delayed Recall Learning Trial 1 Learning Trial 2 Learning Trial 3 Learning Trial 4 Learning Trial 5	< 60 100 85 67 76 65	< 1 50 16 1 5 1

Figure 2. Manual segmentation of the hippocampus. Top: 3T-MRI scan of a 14-year-old male control participant (left) alongside Patient H (right) showing the reduced volume of the subicular complex (in green) and CA-DG region in (orange). Bottom. ICV-corrected hippocampal volumes for Patient H compared with 32 healthy controls (8y – 38y; 16male) indicating a 34% volume atrophy of the hippocampus.

Top: A coronal section of a T1-weighted MRI scan. Manual segmentation of hippocampal subregions highlights reduced volumes in the patient compared to a control. Below Left: Hippocampal volume of a control participant is plotted beside the volume from the patient. Below Right, ICV-corrected volumes of hippocampal subregions are plotted to show reduced volumes in the patient compared to controls.

Table 2. Crawford’s Bayesian test for single case assessment (Crawford & Garthwaite, 2007) to identify significant differences between patient to the controls on IQ and CMS test scores.

Test	Subscale	Patient Score	Z-Score	Control Mean	Control SD	p	CI lower	CI higher
IQ	FSIQ	116	−1.22	126	8.38	0.159	0.000	0.413
	VCI	114	−1.11	120	5.39	0.178	0.001	0.434
	PRI	121	−0.60	128	10.97	0.283	0.088	0.500
CMS	Visual Immediate	115	0.18	113	12.19	0.357	0.173	0.500
	Visual Delayed	109	−0.03	109	7.76	0.366	0.190	0.500
	Verbal Immediate	66	−6.86	127	8.93	0.002**	0.000	0.002
	Verbal Delayed	54	−3.99	117	15.74	0.011*	0.000	0.063
	General Memory	80	−4.55	126	10.06	0.007**	0.000	0.036
	Attention/Concentration	115	−2.22	126	4.95	0.056	0.000	0.241
	Learning	78	−3.00	124	15.31	0.026*	0.000	0.136
	Delayed Recognition	82	−3.80	112	7.95	0.013*	0.000	0.077

*p < 0.05, ** p < 0.01 (one-tailed).

Table 3. Overview of the test procedures over three weeks.

Week 1	Week 2	Week 3
Recall learning of video 1	Delayed test of video 1
Short delay test of video 1
Recognition learning of video 2	Delayed test of video 2
Short delay test of video 2
	Recognition learning of video 3	Delayed test of video 3
	Short delay test of video 3
	Recall learning of video 4	Delayed test of video 4
	Short delay Test of video 4
		Neuropsychological assessment

Figure 3. Schematic of the protocols.

A schematic of the paradigm. The learning phase is split into two sections, recall-based learning and recognition-based learning. Below, the test phase is represented as showing three stages; a free recall test, a cued recall test and a recognition test.

Figure 4. Mean memory performance across the two learning conditions. Error bars indicate 1+/- the standard error of the mean. The outcomes of the case-control statistical tests are indicated with symbols, *p < 0.05, **p < 0.01, ***p < 0.001.

Two line graphs indicating the rate of learning in the recall learning condition and the recognition learning condition.

Figure 5. Memory performance in the 15-Minute Delayed Test following recall learning (left panel) and recognition learning (right panel). The outcomes of the case-control statistical tests are indicated with symbols, *p < 0.05, **p < 0.01, ***p < 0.001.

Two graphs showing performance in the 15-minute delayed test.

Figure 6. Memory performance in the 1-week Delayed Test. The outcomes of the case-control statistical tests are indicated with symbols, *p < 0.05, **p < 0.01, ***p < 0.001.

Two graphs showing performance in the one-week delayed test.

Elward, R. L., & Vargha-Khadem, F. (2018). Semantic memory in developmental amnesia. Neuroscience Letters, 680(October 2017), 23–30. https://doi.org/10.1016/j.neulet.2018.04.040

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Crawford, J. R., & Garthwaite, P. H. (2007). Comparison of a single case to a control or normative sample in neuropsychology: Development of a Bayesian approach. Cognitive Neuropsychology, 24(4), 343–372. https://doi.org/10.1080/02643290701290146

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Data availability

Data and analysis code are available on the Open Science Framework. https://doi.org/10.17605/OSF.IO/KS3MQ.