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Flashcards in Direct treatment approaches for Dementia Deck (11):

Direct interventions

Direct interventions are those in which the SLP provides individual or group therapy.


Indirect interventions

“Indirect interventions are those in which the physical and/or linguistic environments are modified to support communication...”


Guidelines of direct intervention

- Strengthen the knowledge and processes that have the potential to improve.

- Reduce demands on impaired cognitive systems.

- Increase reliance on spared cognitive systems.

- Provide stimuli that evoke positive fact memory, action, and emotion.


Types of Direct Interventions

- Spaced Retrieval Training (SRT)

- Reminiscence

- Montesorri-based Activities

- Memory Wallets and Books


Spaced Retrieval Training 1

- “Spaced Retrieval Training (SRT) is a shaping procedure in which an individual is asked to recall information over increasingly longer intervals of time.”

- Target, number of trials, and interval length are controlled by the clinician.

- SRT can be done throughout the day by the clinician, caregivers, and family.



- When a patient is able to successfully recall a piece of information, the interval preceding the next recall test is increased.

- If the patient cannot successfully recall information, he or she is given the correct answer, asked to repeat it, and the interval time is decreased.

- SRT relies on spared nondeclarative memory in dementia patients. The patient may not remember the event of learning, but will still be able to learn and recall associations.

- Cueing is discouraged and each interval must end with a correct recall.


Reminiscence therapy

It stimulates recall. When individuals with dementia and healthy adults are presented with pictures, newspaper articles...and props associated with a theme, their personal experiences related to the theme come to mind.”

- It is recommended to use all the senses to trigger memory.

- Good reminiscence therapy sessions require planning. The clinician should take time to choose props or activities that will be relevant to the patient as well as a list of questions to probe for the less obvious recollections.

- Can be done in a group!


Suggested activities for reminiscence therapy

- Holidays

- Personal milestones/events (marriage, retirement, birth of a grandchild, etc.)

- World events

- National or cultural traditions

- Food preparation



- “The defining principles of the Montessori method are: having choices, purposeful experience, multi-sensory experience, action-oriented, and incremental learning.”

- Patients who participate in Montessori-based activities are more attentive than when they participate in passive events like watching an event.

- Montessori-based activities can be used in individual sessions as well as groups of varying size.


Examples of Montessori/Multimodal

- Examples of Montessori-based activities are:

--- Picture sorting by category (animals, colors, facial expressions, etc.)

--- Word sorting

--- Memory bingo


Memory and wallet books

- Sentences with corresponding photographs are printed on index cards or sheets of paper and bound into a booklet.

--- Pages should start with personal identification and end with facts about current life.

----- e.g. “My name is Mary Rockport. I was born in Washington, Pennsylvania on August 24, 1946”

----- “On Saturdays, my son, Henry, visits me.” or “I go to bed at 9:00 p.m.”

- Shown to increase the number of on-topic statements (novel and from the memory aid) per minute during conversations