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Integration of Working Memory Training

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Integration of Working Memory Training Working memory has been a growing topic of interest in the field of Speech Language Pathology. It affects all aspects of children’s development, including speech, language, reading, and classroom success. Working memory deficits are prevalent in people with schizophrenia, attention deficit hyperactivity disorder (ADHD), traumatic brain injuries, learning disabilities, specific language impairment (SLI), and intellectual disabilities (Van der Molen, Van Luit, Van der Molen, Klugkist, & Jongmans, 2010). With the rising awareness of how working memory deficits can effect children’s development, the question of whether speech language pathologists should assess and treat these deficits has been asked more and more. Assessing and treating working memory deficits are key and can help many different populations improve in their speech and language development. Assessment for working memory deficits and working memory training should be standard and included into the normal regime. The following paper will touch on what working memory is. As well as how a deficit in working memory can effect children’s development, whether they are typically developing children, or children with other disorders. Some assessment options and then training techniques of working memory will be introduced as well.
What is Working Memory?
Working memory requires the ability to attend to new information, retain incoming information, and manipulate the new information (Riccio, Cash, & Cohen, 2007). It requires information to be maintained and processed simultaneously while performing cognitive tasks (Van der Molen et al., 2010). Children use working memory on a daily basis while at school. Following multiple step directions, doing mental math, and counting forward or backwards by a set increment are all just a few examples of tasks that require working memory (Boudreau & Costanza-Smith, 2011). With poor working memory skills, it is easy for children to fall behind and perform poorly while in the classroom (St. Clair, Stevens, Hunt, & Bolder, 2010).
There are three components to working memory. The central executive system is responsible for attention control and controls the cognitive processes (Montgomery, Magimairaj, & Finney, 2010; Schuchardt, Maehler, & Hasselhorn, 2008). It also regulates information flow (Montgomery, 2002). The central executive system is then broken down into two subsets, the phonological loop and the visual-spatial sketchpad (Schuchardt et al., 2008). The phonological loop, which is split even further into the phonological store and the sub vocal rehearsal process, is responsible for the maintenance of auditory information (Schuchardt et al., 2008; St. Clair et al., 2010). The visual-spatial sketchpad is responsible for remembering and processing visual and spatial information (Schuchardt, Gebhardt, & Maehler, 2010). Working memory is highly involved in children’s scholastic success. It is key to fluid intelligence and the development of arithmetic and reading (Van der Molen et al., 2010). Working memory can also be a predictor in children’s literacy, math, and comprehension skills (St. Clair et al., 2010). Their working memory abilities at school entry can also predict their overall academic attainment through adolescence (Boudreau & Costanza-Smith, 2011). It has been shown that poor performance on working memory assessments translates into poor performance on curriculum assessments (St. Clair et al., 2010). Children with poor WM tend to do poorly in their curriculum activities because the activities have high memory demands. Mistakes are usually made in errors with following directions, remembering instructions, and keeping track with multilevel tasks (St. Clair et al., 2010). Working memory deficits can be found in regularly developing children and children with co occurring disorders as well (Schuchardt et al., 2008; Van der Molen et al., 2010). Co occurring language deficits and working memory deficits are usually found in children with disabilities such as specific learning disabilities and ADHD (Archibald, Joanisse, & Edmunds, 2011; St. Clair et al., 2010). In the inattention dimension of ADHD, research has shown a strong association with working memory deficits (Martinussen & Tannock, 2006). Working memory has shown to play a critical role in children’s ability to control attention (Martinussen & Tannock, 2006). From problems with controlling attention in children with ADHD, working memory also affects children with reading disabilities who were found to have deficits in phonological processing, storage, and executive functioning (Maehler & Schuchardt, 2009). The central executive is also impaired in children with arithmetic learning disabilities as well (Maehler & Schuchardt, 2009). For children with SLI, ADHD, and different specific learning disabilities, working memory deficits play a key role. In order for these children to have the best chance at overcoming these deficits, early detection is key. The best way to detect these deficits early is by adding an assessment of working memory to the battery of tests given in screenings.
Assessment of Working Memory
Assessment of any kind is necessary for the earliest detection of any disorders or abnormalities. Due to the significant role working memory plays in language acquisition and learning, Speech Language Pathologists should add working memory assessments to their battery of tests (Boudreau & Costanza-Smith, 2011). One of the best ways to accurately test working memory is with the use of standardized tests. A standardized test that can be used to assess working memory is the Automated Working Memory Assessment (AWMA) (Alloway, Gathercole, Susan, Kirkwood, Hannah, Elliott, & Julian, 2008). This standardized test is an easy - to - use computer based test given to children from the ages of 4 to 22 years of age to screen for possible working memory deficits (Alloway, 2008). There are three parts to this test. The first section is the AWMA Screener section, which is made up of two tests and screens those who are suspected of having working memory deficits (Pearson, 2012). The second section is the AWMA Short Form, which is made up of four tests and is for those who are suspected of having memory problems, but the exact area of difficulty is unknown (Pearson, 2012). The third section is the AWMA Long Form, which is made up of 12 tests and is designed to give confirmation of a working memory deficit for the individuals who have been identified (usually by the teacher) as having working memory problems (Pearson, 2012). Another test that can be used to screen for working memory problems is the Working Memory Rating Scale (WMRS) (Alloway et al., 2008 as cited in Montgomery et al., 2010). The WMRS is a behavioral rating scale aimed at identifying children with working memory problems (Alloway, 2008). It can be used for children 5 to 11 years of age (Alloway, 2008). The WMRS contains 20 behavioral descriptions that are characteristic of children with working memory deficits (Alloway et al., 2008). Some of theses characteristics include the child raising their hand to answer a question but then forgetting their response when they are called upon, losing their place in tasks with multiple steps, difficulty remaining on task, etc (Alloway et al., 2008). The observer is asked to rate how typical each characteristic is on a four-point scale from not typical, to occasionally, to fairly typical, to very typical (Alloway et al., 2008). These two assessments have no constraints and can be used for a large population of children.
More specifically, certain assessments can be used for certain populations or disorders. A phonological short - term memory assessment can be used with children presenting with vocabulary and literacy (decoding or spelling) problems (Boudreau & Costanza-Smith, 2011). This type of assessment uses non-word repetition tasks. Some examples of non-word repetition tests are the Children’s Test of Non-word Repetition (CNrep; Gathercole &Baddeley, 1996 as cited in Boudreau & Costanza-Smith, 2011), and the Non-word Repetition Task (NRT; Dollaghan & Campbell, 1998 as cited in Boudreau & Costanza-Smith, 2011). These tests ask the child to repeat lists of non-words that vary in number of words and number of syllables in each word (Boudreau & Costanza-Smith, 2011). The use of non-words helps to assure that the child cannot pull from their learned knowledge (Boudreau & Costanza-Smith, 2011). Non-word repetition tasks can help to assess phonological short-term memory because repeating non–words requires maintaining a phonological representation of the information in memory (Boudreau & Costanza-Smith, 2011). The scores on a phonological short - term memory test can also be helpful in deciphering between children who are typically developing and those who may be disordered (Dollaghan et al., 1997; Engel, Santos, & Gathercole, 2008 as cited in Boudreau & Costanza-Smith, 2011). Another assessment is a functional working memory assessment. The functional working memory assessment can be used with children who have shown to have problems in the classroom such as following directions, reading comprehension, oral comprehension, or completing tasks mentally (Boudreau & Costanza-Smith, 2011). Functional working memory assessments evaluate how much information can be maintained in storage while performing processing operations (Baddeley & Hitch, 2000; Hitch, Towse, & Hutton, 2001 as cited in Boudreau & Costanza-Smith, 2011). Working memory is tested by the use of dual tasks (Boudreau & Costanza-Smith, 2011). Dual tasks are tasks that draw from both storage and processing at the same time (Boudreau & Costanza-Smith, 2011). The storage of a dual task may be accessed through a task such as remembering a work list or number list, while the processing side may be accessed through tasks such as reading comprehension, word classes, or mathematical operations (Boudreau & Costanza-Smith, 2011). The way in which the child coordinates both storage and processing functions manifests in how well they do on the assessment (Boudreau & Costanza-Smith, 2011). Once an assessment is done and the child is diagnosed with a working memory deficit, memory training is needed to help remediate the working memory problems.
Working Memory Training There are several approaches to training working memory. Those approaches would be the direct approach where you work on rehearsal strategies, the classroom approach where you focus on the dynamics and delivery of information in the classroom, and the indirect approach where you train in phonological awareness to in turn remediate working memory (Boudreau & Costanza-Smith, 2011; van Kleeck, Gillam, & Hoffman, 2009).
Direct Approach
The direct approach involves more child specific strategies (Boudreau & Costanza-Smith, 2011). Some of these strategies include rehearsing, visualizing, and working on study and organizational skills (Boudreau & Costanza-Smith, 2011; Gill, Klecan-Aker, Roberts, & Fredenburg, 2003). The innate use of rehearsing does not appear in children until about the age of seven (Gill et al., 2003). With the rehearsal strategy training (RST), the Speech Language Pathologist teaches the children rehearsal techniques that can be used in the classroom (Gill et al., 2003). For example, if the teacher were to give the child a set of instructions, the child would then immediately repeat the instructions (rehearse) out loud several times. The child would then proceed to carry out the instructions, continuing to repeat (rehearse) the instructions to themselves until their task is complete (Gill et al., 2003). This assures that the child has followed every step and has met all the criteria to finish the assignment correctly.
The visualization technique uses a combination of both the rehearsal technique and a visualization technique. The Speech Language Pathologist would teach the child to visualize the task they are asked to complete before actually completing the task (Gill et al., 2003). For example, if the child is asked to draw a house with two trees, color the picture, and hang it up on the bulletin board, the child should first rehearse the set of instructions given to them out loud. They then would visualize themselves completing each step before drawing, coloring, and hanging up their artwork (Gill et al., 2003).
Due to the fact that many children with working memory deficits have problems with the organization of information, teaching them study and organization skills would be key (Boudreau & Costanza-Smith, 2011). The Speech Language Pathologist would teach study skills such as self made visual aides, written notes cards, picture representations, etc. (Boudreau & Costanza-Smith, 2011).

Classroom Approach The classroom approach deals with both the teacher and the child. The Speech Language Pathologist takes a look at how instructions are given in the classroom, the language of the instructions, and the form of the instructions (Boudreau & Costanza-Smith, 2011). Since children with working memory problems have difficulty with following directions, instructions in the classroom should be given in small portions (Boudreau & Costanza-Smith, 2011). Breaking down the instructions into step - by - step directions makes it easier for the child to process the information (Boudreau & Costanza-Smith, 2011). Instead of asking the class to draw a house with two trees, color the picture, and hang it up on the bulletin board all at once, the instructions should be given one portion at a time. Along with the shortened delivery of any instructions, the language of the instructions is very important. The instructions should be in a lexicon that the child is familiar and comfortable with (Boudreau & Costanza-Smith, 2011). Lastly, the form in which the instructions are given can be changed to better suit children with working memory deficits. To help lower the amount of information the child is expected to remember, the instructions can be written on the board. Pre - typing and handing out the instructions to the students would allow for them to have a reference to refer back to while completing their task (Boudreau & Costanza-Smith, 2011). All of these strategies would help prevent information overload and would raise the chance of children with working memory deficits being successful within the classroom setting.

Indirect Approach The indirect approach can be considered the time saving approach. With session times limited and so many goals to accomplish, using the indirect approach can save time and still allow goals to be met. With the indirect approach, the Speech Language Pathologist focuses on training phonological awareness to remediate working memory (van Kleeck et al., 2009). Like working memory, phonological awareness can be a key factor in children’s learning to read (Gibbs, 2004). Both phonological awareness and working memory share similar components with co – occurring deficits. Due to this fact, van Kleeck et al. found that it is possible to work on phonological awareness in therapy and inadvertently remediate working memory.
Conclusion
Working memory is a very integrated portion of speech, language. It involves the ability to take in, retain, and manipulate new and incoming information. Working memory deficits are seen in populations such as children with SLI, ADHD, and learning disabilities. Standardized tests such as the AWMA, behavioral rating scales such as the WMRS, phonological short - term memory assessments, and functional working memory assessments are needed for early detection of working memory deficits in children. Once working memory problems are detected, children can get started on working memory training. Using working memory training techniques such as visualization, rehearsing, and organization and study skills would not only help improve the child’s scholastic success, but those skills can carry over to real life applications as well. More needs to be done in assessing for and training to remediate working memory. With the use of these strategies, training and remediation in working memory can be done with many different populations and disorders.

References
Alloway, T. (2008, September 18). Working memory tests (Web log post). Retrieved from http://tracyalloway.com/index.php/research-projects/working-memory-tests/
Alloway T., Gathercole S., Susan , Kirkwood H., Hannah, Elliott, & Julian. (2008). The working wemory rating scale: A classroom-based behavioral assessment of working memory. Educational Psychology, 28 (7), 725-734. Retrieved from http://dx.doi.org/10.1080/01443410802243828
Archibald, L., Joanisse, M., & Edmunds, A. (2011). Specific language or working memory impairments: A small scale observational study. Child Language Teaching & Therapy, 27(3), 294-312. doi:10.1177/0265659010396779
Boudreau, D., & Costanza-Smith, A. (2011). Assessment and treatment of working memory deficits in school-age children: The role of the speech-language pathologist. Language, Speech & Hearing Services In Schools, 42(2), 152-166. doi:10.1044/0161-1461(2010/09-0088)
Gibbs, S. (2004). Phonological awareness: An investigation into the developmental role of vocabulary and short-term memory. Educational Psychology, 24(1), 13-26. Retrieved from http://www.tandf.co.uk/journals/alphalist.html
Gill, C. B., Klecan-Aker, J., Roberts, T., & Fredenburg, K. A. (2003). Following directions: Rehearsal and visualization strategies for children with specific language impairment. Child Language Teaching & Therapy, 19(1), 85-103. Retrieved from http://clt.sagepub.com/
Maehler, C., & Schuchardt, K. (2009). Working memory functioning in children with learning disabilities: Does intelligence make a difference? Journal Of Intellectual Disability Research, 53(1), 3-10. doi:10.1111/j.1365-2788.2008.01105.x
Martinussen, R., & Tannock, R. (2006). Working memory impairments in children with attention-deficit hyperactivity disorder with and without comorbid language learning disorders. Journal Of Clinical & Experimental Neuropsychology, 28(7), 1073-1094. doi:10.1080/13803390500205700
Montgomery, J. W. (2002). Understanding the language difficulties of children with specific language impairments: Does verbal working memory matter? American Journal of Speech-Language Pathology, 11, 77-91. doi:10.1044/1058-0360(2002/009)
Montgomery, J., Magimairaj, B., & Finney, M. (2010). Working memory and specific language impairment: An update on the relation and perspectives on assessment and treatment. American Journal of Speech-Language Pathology, 19(1), 78-94. doi:10.1044/1058-0360(2009/09-0028) Pearson (2012). Automated working memory assessment. Retrieved from http://www.pearsonclinical.co.uk/
Riccio, C., Cash, D., & Cohen, M. (2007). Learning and memory performance of children with specific language impairment (SLI). Applied Neuropsychology, 14, 255-261.
Schuchardt, K., Gebhardt, M., & Maehler, C. (2010). Working memory functions in children with different degrees of intellectual disability. Journal Of Intellectual Disability Research, 54(4), 346-353. doi:10.1111/j.1365-2788.2010.01265.x
Schuchardt, K., Maehler, C., & Hasselhorn, M. (2008). Working memory deficits in children with specific learning disorders. Journal Of Learning Disabilities, 41(6), 514-523. Retrieved from http://www.sagepubs.com.
St. Clair, H., Stevens, R., Hunt, A., & Bolder, E. (2010). Improving children’s working memory and classroom performance. Educational Psychology, 30 (2), 203-210. doi: 10.1080/01443410903509259.
Van der Molen, M., Van Luit, J., Van der Molen, M., Klugkist, I., & Jongmans, M. (2010). Effectiveness of a computerised working memory training in adolescents with mild to borderline intellectual disabilities. Journal of Intellectual Disability Research, 54(5), 433-447. doi:10.1111/j.1365-2788.2010.01285.x
Van Kleeck, A., Gillam, R., & Hoffman, L. (2009). Training in phonological awareness generalizes to phonological working memory: A preliminary investigation preliminary investigation. Journal of Speech and Language Pathology and Applied behavior Analysis, 1 (3), 58 – 74.

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...3.0 TESTING There are many types of testing such as inspection, walkthrough, desk checking, unit test, integration test, stub test and system test. Inspection, walkthrough and desk checking was implemented by development team. Each module of system is test alone in attempt to discover errors in code. By using several of test, the potential error is revealed and action being taken to improve the performance of the system. The objectives of test planning are: • Record, organize, and guide testing activities • Schedule testing activities according to the test strategy and project deadlines • Provide a basis for re-testing during system maintenance • Provide a basis for evaluating and improving testing process The testing process required in implementation phase being began from planning phase which are determining part of system needs to be tested and also collecting test data. After that, come to analysis phase, testing requirements are list out by relating it with system requirements. HL Northern Enterprise development team used several types of testing toward system that consists of manual and computer conduct. Inspection being executed by team and subtle errors are being examined with the checklist. The information of errors occurred is investigated and documented to avoid making same types errors in future work. In addition, the automated inspection software is being implemented for detecting the routine error and content mistake....

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