Abstract
This review considers the origins of the errorless learning (EL) concept, its application in memory rehabilitation, the evidence for its effectiveness, and the theoretical basis for the observed findings. The evidence suggests that EL offers valuable benefits for at least some people with memory impairments when teaching certain types of tasks. However, the benefits are not evident for all groups, some findings are equivocal, and there are some limitations associated with this approach. We discuss methodological issues impacting on these mixed findings, consider which theoretical explanations might account for the findings regarding benefits and limitations of EL, and comment on the implications for rehabilitation practitioners of the current state of evidence in this area.
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Abrahams, J. P., & Camp, C. J. (1993). Maintenance and generalization of object naming training in anomia associated with degenerative dementia. Clinical Gerontologist, 12, 57–72.
Anderson, N., & Craik, F. I. M. (2006). The mnemonic mechanisms of errorless learning. Neuropsychologia, 44, 2806–2813.
Baddeley, A. (2002). The psychology of memory. In A. D. Baddeley, M. D. Kopelman, & B. A. Wilson (Eds.), Handbook of memory disorders. Chichester: Wiley.
Baddeley, A. D., & Wilson, B. A. (1994). When implicit learning fails: Amnesia and the problem of error elimination. Neuropsychologia, 32, 53–68.
Bjork, R. A. (1989). Retrieval inhibition as an adaptive mechanism in human memory. In H. L. Roediger III & F. I. M. Craik (Eds.), Varieties of memory and consciousness: Essays in honour of Endel Tulving. Hillsdale, NJ: Erlbaum.
Bourgeois, M. S., Camp, C. J., Rose, M., White, B., Malone, M., Carr, J., et al. (2003). A comparison of training strategies to enhance use of external aids by persons with dementia. Journal of Communication Disorders, 36, 361–379.
Camp, C. J. (1989). Facilitation of new learning in Alzheimer’s disease. In G. Gilmore, P. Whitehouse, & M. Wykle (Eds.), Memory and aging: Theory, research and practice. New York: Springer.
Camp, C. J., Foss, J. W., O’Hanlon, A. M., & Stevens, A. B. (1996). Memory interventions for persons with dementia. Applied Cognitive Psychology, 10, 193–210.
Camp, C. J., & Stevens, A. B. (1990). Spaced retrieval: A memory intervention for dementia of the Alzheimer’s type (DAT). Clinical Gerontologist, 10, 58–61.
Cherry, K. E., Simmons, S., & Camp, C. J. (1999). Spaced retrieval enhances memory in older adults with probable Alzheimer’s disease. Journal of Clinical Geropsychology, 5, 159–175.
Christensen, H., & Birrell, P. (1991). Explicit and implicit memory in dementia and normal ageing. Psychological Research, 53, 149–161.
Clare, L., McKenna, P. J., Mortimer, A. M., & Baddeley, A. D. (1993). Memory in schizophrenia: What is impaired and what is preserved? Neuropsychologia, 31, 1225–1241.
Clare, L., & Wilson, B. A. (2004). Memory rehabilitation for people with early-stage dementia: A single case comparison of four errorless learning methods. Zeitschrift für Gerontopsychologie und-Psychiatrie, 17, 109–117.
Clare, L., Wilson, B. A., Breen, K., & Hodges, J. R. (1999). Errorless learning of face–name associations in early Alzheimer’s disease. Neurocase, 5, 37–46.
Clare, L., Wilson, B. A., Carter, G., Gosses, A., Breen, K., & Hodges, J. R. (2000). Intervening with everyday memory problems in early Alzheimer’s disease: An errorless learning approach. Journal of Clinical and Experimental Neuropsychology, 22, 132–146.
Clare, L., Wilson, B. A., Carter, G., & Hodges, J. R. (2003). Cognitive rehabilitation as a component of early intervention in dementia: A single case study. Aging and Mental Health, 7, 15–21.
Clare, L., Wilson, B. A., Carter, G., Hodges, J. R., & Adams, M. (2001). Long-term maintenance of treatment gains following a cognitive rehabilitation intervention in early dementia of Alzheimer type: A single case study. Cognitive Rehabilitation in Dementia: A Special Issue of Neuropsychological Rehabilitation, 11, 477–494.
Clare, L., Wilson, B. A., Carter, G., Roth, I., & Hodges, J. (2002). Relearning of face–name associations in early-stage Alzheimer’s disease. Neuropsychology, 16, 538–547.
Duffy, L., & Wishart, J. G. (1987). A comparison of two procedures for teaching discrimination skills to Down’s Syndrome and non-handicapped children. British Journal of Educational Psychology, 57, 265–278.
Dunn, J. (2003). Learning of face–name associations using errorless and effortful processes for people with dementia. DClinPsy thesis, University College London.
Dunn, J., & Clare, L. (2007). Learning face–name associations in early-stage dementia: Comparing the effects of errorless learning and effortful processing. Neuropsychological Rehabilitation, 17 735–754.
Evans, J. J., Wilson, B. A., Schuri, U., Andrade, J., Baddeley, A., Bruna, O., et al. (2000). A comparison of ‘errorless’ and ‘trial and error’ learning methods for teaching individuals with acquired memory deficits. Neuropsychological Rehabilitation, 10, 67–101.
Fillingham, J. K., Hodgson, C., Sage, K., & Ralph, M. A. L. (2003). The application of errorless learning to aphasic disorders: A review of theory and practice. Neuropsychological Rehabilitation, 13(3), 337–363.
Fridriksson, J., Holland, A. L., Beeson, P., & Morrow, L. (2005). Spaced retrieval treatment of anomia. Aphasiology, 19, 99–109.
Glisky, E. (1995). Acquisition and transfer of word processing skill by an amnesic patient. Neuropsychological Rehabilitation, 5, 299–318.
Glisky, E., Schacter, D., & Tulving, E. (1986). Learning and retention of computer-related vocabulary in memory-impaired patients: Method of vanishing cues. Journal of Clinical and Experimental Neuropsychology, 8, 292–312.
Gollin, E. S., & Savoy, P. (1968). Fading procedures and conditional discrimination in children. Journal of the Experimental Analysis of Behavior, 11, 443–451.
Graf, P., & Schacter, D. L. (1985). Implicit and explicit memory for new associations in normal and amnesic subjects. Journal of Experimental Psychology: Learning, Memory, and Cognition, 11, 501–518.
Hamman, S. B., & Squire, L. R. (1995). On the acquisition of new declarative knowledge in amnesia. Behavioral Neuroscience, 109, 1027–1044.
Haslam, C., Gilroy, D., Black, S., & Beesley, T. (2006). How successful is errorless learning in supporting memory for high and low-level knowledge in dementia? Neuropsychological Rehabilitation, 16, 505–536.
Haude, R. H. (1973). Failure to establish errorless discrimination in monkeys. Perceptual and Motor Skills, 37, 299–304.
Hawley, K. S., & Cherry, K. E. (2004). Spaced-retrieval effects on name–face recognition in older adults with probable Alzheimer’s disease. Behavior Modification, 28(2), 276–296.
Hochhalter, A. K., Overmier, J. B., Gasper, S. M., Bakke, B. L., & Holub, R. J. (2005). A comparison of spaced retrieval to other schedules of practice for people with dementia. Experimental Aging Research, 31, 101–118.
Holland, J. G., & Skinner, B. F. (1961). The analysis of behavior: A program for self-instruction. New York: McGraw-Hill.
Hopper, T., Mahendra, N., Kim, E., Azuma, T., Bayles, K. A., Cleary, S. J., et al. (2005). Evidence-based practice recommendations for working with individuals with dementia: Spaced retrieval training. Journal of Medical Speech–Language Pathology, 13, 27–34.
Hunkin, N. M., Squires, E. J., Parkin, A. J., & Tidy, J. A. (1998). Are the benefits of errorless learning dependent on implicit memory? Neuropsychologia, 36, 25–36.
Jones, R. S. P., & Eayrs, C. B. (1992). The use of errorless learning procedures in teaching people with a learning disability: A critical review. Mental Handicap Research, 5(2), 204–212.
Kalla, T., Downes, J. J., & van den Broek, M. (2001). The pre-exposure technique: Enhancing the effects of errorless learning in the association of face–name associations. Neuropsychological Rehabilitation, 11, 1–16.
Kern, R. S., Green, M. F., Mintz, J., & Liberman, R. P. (2003). Does ‘errorless learning’ compensate for neurocognitive impairments in the work rehabilitation of persons with schizophrenia? Psychological Medicine, 33, 433–442.
Kern, R. S., Green, M. F., Mitchell, S., Kopelowicz, A., Mintz, J., & Lieberman, R. P. (2005). Extensions of errorless learning for social problem-solving deficits in schizophrenia. American Journal of Psychiatry, 162, 513–519.
Kern, R. S., Liberman, R. P., Kopelowicz, A., Mintz, J., & Green, M. F. (2002). Applications of errorless learning for improving work performance in persons with schizophrenia. American Journal of Psychiatry, 159, 1921–1926.
Kessels, R. P. C., & de Haan, E. H. F. (2003). Implicit learning in memory rehabilitation: A meta-analysis on errorless learning and vanishing cues methods. Journal of Clinical and Experimental Neuropsychology, 25, 805–814.
Kessels, R. P. C., van Loon, E., & Wester, A. J. (2007). Route learning in amnesia: a comparison of trial-and-error and errorless learning in Korsakoff patients. Clinical Rehabilitation, 21, 905–911.
Kirsch, I., Lynn, S. J., Vigorito, M., & Miller, R. R. (2004). The role of cognition in classical and operant conditioning. Journal of Clinical Psychology, 60, 369–392.
Komatsu, S. -I., Mimura, M., Kato, M., Wakamatsu, N., & Kashima, H. (2000). Errorless and effortful processes involved in the learning of face–name associations by patients with alcoholic Korsakoff’s syndrome. Neuropsychological Rehabilitation, 10, 113–208.
Lancioni, G. E., Hoogeveen, F. R., Smeets, P. M., & Boelens, H. (1989). Errorless discrimination of reversible letters: Superimposition and fading combined with an intervening response. Psychological Record, 39, 373–385.
Landauer, T. K., & Bjork, R. A. (1978). Optimum rehearsal patterns and name learning. In K. M. Gruneberg, P. E. Morris, & R. N. Sykes (Eds.), Practical aspects of memory. New York: Academic.
Lawrence, D. H. (1952). The transfer of a discrimination along a continuum. Journal of Comparative and Physiological Psychology, 45, 511–516.
Llorente, C., & Gaffan, E. A. (1989). Coin identification and relative value: a training program for adults with a mental handicap. Behavioral Psychotherapy, 17, 332–346.
Lovibond, P. F., & Shanks, D. R. (2002). The role of awareness in Pavlovian conditioning: Empirical evidence and theoretical implications. Journal of Experimental Psychology: Animal Behavior Processes, 28, 3–26.
Lowe, C. F. (1979). Determinants of human operant behavior. In M. D. Zeiler & P. Harzem (Eds.), Advances in analysis of behavior: Reinforcement and the organization of behavior (vol. 1, (pp. 159–192)). Chichester, UK: Wiley.
Lowe, C. F., Horne, P. J., & Higson, P. J. (1987). Operant conditioning: The hiatus between theory and practice in clinical psychology. In H. J. Eysenck & I. Martin (Eds.), Theoretical foundations of behavior therapy (pp. 153–165). New York: Plenum.
Luciano, M. C. (1986). Acquisition, maintenance, and generalization of productive intraverbal behavior through transfer of stimulus control procedures. Applied Research in Mental Retardation, 7, 1–20.
McAvinue, L., O’Keefe, F., McMackin, D., & Robertson, I. H. (2005). Impaired sustained attention and error awareness in traumatic brain injury: Implications for insight. Neuropsychological Rehabilitation, 15, 569–587.
McCoy, J. & Pratt, M. E. (1976). Reversal following errorless discrimination learning. Psychological Reports, 38, 971–978.
McKissock, S., & Ward, J. (2007). Do errors matter? Errorless and errorful learning in anomic picture naming. Neuropsychological Rehabilitation, 17, 355–373.
McKitrick, L. A., & Camp, C. J. (1993). Relearning the names of things: The spaced-retrieval intervention implemented by a caregiver. Clinical Gerontologist, 14, 60–62.
Melton, A. K., & Bourgeois, M. S. (2005). Training compensatory memory strategies via the telephone for persons with TBI. Aphasiology, 19, 353–364.
Mitchell, K. J., & Johnson, M. K. (2000). Source monitoring: Attributing mental experiences. In E. Tulving & F. I. M. Craik (Eds.), Handbook of memory. Oxford: Oxford University Press.
Moore, R., & Goldiamond, I. (1964). Errorless establishment of visual discrimination using fading procedures. Journal of the Experimental Analysis of Behavior, 7, 269–272.
Morris, R., & Hannesdottir, K. (2004). Loss of ‘awareness’ in Alzheimer’s disease. In R. Morris & J. Becker (Eds.), Cognitive neuropsychology of Alzheimer’s disease. Oxford: Oxford University Press.
Moscovitch, M. (1989). Confabulation and the frontal systems: Strategic versus associated retrieval in neuropsychological theories of memory. In H. L. Roediger III & F. I. M. Craik (Eds.), Varieties of memory and consciousness: Essays in honour of Endel Tulving. Hillsdale, NJ: Erlbaum.
O’Carroll, R. E., Russell, H. H., Lawrie, S. M., & Johnstone, E. C. (1999). Errorless learning and the cognitive rehabilitation of memory-impaired schizophrenic patients. Psychological Medicine, 29, 105–112.
Page, M., Wilson, B. A., Shiel, A., Carter, G., & Norris, D. (2006). What is the locus of the errorless-learning advantage? Neuropsychologia, 44, 90–100.
Parkin, A. J., Hunkin, N. M., & Squire, E. J. (1998). Unlearning John Major: Tthe use of errorless learning in the reacquisition of proper names following herpes simplex encephalitis. Cognitive Neuropsychology, 15, 361–375.
Reading, J. C., & Ager, A. K. (1990). Teaching age and gender discrimination by the enhancement of criterion-related cues. Behavioral Psychotherapy, 18, 207–219.
Riley, G. A., Sotiriou, D., & Jaspal, S. (2004). Which is more effective in promoting implicit and explicit memory: The method of vanishing cues or errorless learning without fading? Neuropsychological Rehabilitation, 14(3), 257–384.
Rodriguez-Fornells, A., Kofidis, C., & Muente, T. F. (2004). An electrophysiological study of errorless learning. Cognitive Brain Research, 19, 160–173.
Roediger III, H. L., Weldon, M. S., & Challis, B. H. (1989). Explaining dissociations between implicit and explicit measures of retention: a processing account. In H. L. Roediger III & F. I. M. Craik (Eds.), Varieties of memory and consciousness: Essays in honour of Endel Tulving. Hillsdale, NJ: Erlbaum.
Ruis, C., & Kessels, R. P. C. (2005). Effects of errorless and errorful face–name associative learning in moderate to severe dementia. Aging Clinical and Experimental Research, 17, 514–517.
Schacter, D. L., Rich, S. A., & Stampp, M. S. (1985). Remediation of memory disorders: experimental evaluation of the spaced-retrieval technique. Journal of Clinical and Experimental Neuropsychology, 7, 79–96.
Sidman, M., & Rosenberger, P. B. (1967). Several methods for teaching serial position sequences to monkeys. Journal of the Experimental Analysis of Behavior, 10, 467–478.
Sidman, M., & Stoddard, L. T. (1967). The effectiveness of fading in programming a simultaneous form discrimination for retarded children. Journal of the Experimental Analysis of Behavior, 10, 3–15.
Skinner, B. F. (1948). ‘Superstition’ in the pigeon. Journal of Experimental Psychology, 38, 168–172.
Skinner, B. F. (1958). Teaching machines. Science, 128, 137–158.
Skinner, B. F. (1968). Technology of teaching. Engelwood Cliffs, NJ: Prentice Hall.
Skinner, B. F., & Ferster, C. B. (1957). Schedules of reinforcement. New York: Appleton-Century-Crofts.
Sohlberg, M. M., Ehlhardt, L., & Kennedy, M. (2005). Instructional techniques in cognitive rehabilitation: A preliminary report. Seminars in Speech Language Pathology, 26, 268–279.
Spiker, C. C. (1956). The stimulus generalization gradient as a function of the intensity of stimulus lights. Child Development, 27, 85–98.
Spiker, C. C. (1957). The effects of type of stimulus pretraining on discrimination performance in preschool children. Child Development, 28, 79–84.
Squire, L. R., & Knowlton, B. J. (1995). Memory, hippocampus, and brain systems. In M. Gazzaniga (Ed.), The cognitive neurosciences. Boston: MIT.
Squires, E. J., Hunkin, N. M., & Parkin, A. J. (1997). Errorless learning of novel associations in amnesia. Neuropsychologia, 35(8), 1103–1101.
Stark, C., Stark, S., & Gordon, B. (2005). New semantic learning and generalization in a patient with amnesia. Neuropsychology, 19, 139–151.
Stoddard, L. T., & Sidman, M. (1967). The effects of errors on children’s performance on a circle–ellipse discrimination. Journal of the Experimental Analysis of Behavior, 10, 261–270.
Tailby, R., & Haslam, C. (2003). An investigation of errorless learning in memory-impaired patients: improving the technique and clarifying theory. Neuropsychological Rehabilitation, 41(9), 1230–1240.
Terrace, H. S. (1963a). Discrimination learning with and without “errors”. Journal of the Experimental Analysis of Behavior, 6(1), 1–27.
Terrace, H. S. (1963b). Errorless transfer of a discrimination across two continua. Journal of the Experimental Analysis of Behavior, 6, 223–232.
Tulving, E., & Schacter, D. (1990). Priming and human memory. Science, 247, 301–306.
Verfaellie, M., & Keane, M. M. (2002). Impaired and preserved memory processes in amnesia. In L. R. Squire & D. L. Schacter (Eds.), Neuropsychology of memory (3rd ed.). New York: Guilford.
Wagner, A. D. (2002). Cognitive control and episodic memory: contributions from prefrontal cortex. In L. R. Squire & D. L. Schacter (Eds.), Neuropsychology of memory (3rd ed.). New York: Guilford.
Wilson, B. A., Baddeley, A., Evans, J. J., & Shiel, A. (1994). Errorless learning in the rehabilitation of memory impaired people. Neuropsychological Rehabilitation, 4(3), 307–326.
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Clare, L., Jones, R.S.P. Errorless Learning in the Rehabilitation of Memory Impairment: A Critical Review. Neuropsychol Rev 18, 1–23 (2008). https://doi.org/10.1007/s11065-008-9051-4
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DOI: https://doi.org/10.1007/s11065-008-9051-4