Recall as a function of single versus multiple trials: Implications for rehabilitation

Objective: To empirically demonstrate that recall based on multiple present ations 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 neuropsychol ogy laboratory, including 199 with a primary diagnosis of traumatic brain i njury, 13 who experienced a cerebral vascular accident, 3 with progressive dementia, and 76 with an unknown etiology. Main Outcome Measures: Raw-stand ard 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 minu s Trial 1. Results: A promax factor analysis of 291 participants with cogni tive dysfunction revealed a 4-factor solution (verbal memory, spatial memor y, verbal learning, and tactile-motor learning), supporting the distinction between learning and memory constructs. Conclusions: Recall based on multi ple presentations of information should be evaluated to provide the most fu nctionally relevant assessments.