Recall as a Function of Single Versus Multiple Trials: Implications for Rehabilitation

Objective: To empirically demonstrate that recall based on multiple presentations of material (i.e., "learning") is statistically distinct from recall based on singular presentations of material (i.e., "memory"). Participants: Two hundred ninety-one individuals referred to an outpatient neuropsychology laboratory, including 199 with a primary diagnosis of traumatic brain injury, 13 who experienced a cerebral vascular accident, 3 with progressive dementia, and 76 with an unknown etiology. Main Outcome Measures: Raw-standard scores from the Wechsler Memory Scale-Revised Logical Memory and Visual Reproduction subtests, the Rey Auditory Verbal Learning Test (RAVLT), the Tactual Performance Test (TPT), the Category Test, and indices of "learning" based on difference scores: RAVLT Trial 5 minus Trial 1; TPT Trial 3 minus Trial 1. Results: A promax factor analysis of 291 participants with cognitive dysfunction revealed a 4-factor solution (verbal memory, spatial memory, verbal learning, and tactile-motor learning), supporting the distinction between learning and memory constructs. Conclusions: Recall based on multiple presentations of information should be evaluated to provide the most functionally relevant assessments.