Target Working Memory: See Our Three N-cluded N-Back Tasks

Working Memory (WM) is critical to the functions of daily living. It is the ability to hold information in your mind and do something with that information. Here are some great tasks you can share with your patients.

Let’s examine some instances when you use working memory in your daily life – for example, grocery shopping. As you walk down the aisles, you might be mentally crossing items off of your shopping list. You notice that there’s a sale where if you buy three boxes of cereal, they are 15% off.  At checkout, the cashier tells you the total sum, and you calculate in your head how much change you will receive.

As you walk to your car, you think about what errands you have left and calculate which one to do next based on the amount of time you have and how far away it is. All of these things occur in your working memory.

Constant Therapy has many tasks that work on working memory, including N-Back tasks. Below, we will highlight three types of N-Back tasks for your patients.  

You may be familiar with our Remember pictures in order (N-back) task, already included in the Constant Therapy app. N-Back tasks target a process of working memory (WM) called updating.  Updating is when your brain holds onto information while simultaneously replacing old pieces of information with new, updated information. These tasks are widely used for assessing and treating WM in the field of neuroscience, and are a staple in the toolbox of many speech-language pathologists.  

Technically speaking, N-Back exercises are continuous recognition tasks where the patient is presented with a sequence of stimuli and must indicate when the current stimulus matches the one from n steps earlier in the sequence. The load factor n can be adjusted to make the task more or less difficult (e.g., remembering the item presented 1 item ago vs. remembering the item that was presented 3 items ago).

There is a Significant Amount of Research on the Effectiveness of the N-Back Exercises

A series of studies looked the effects of various kinds of N-back mental training exercises on more than 200 young adults and children. Results showed that practicing N-Back tasks for about 20 minutes each day for 20 days significantly improved performance on a standard test of fluid intelligence (the ability to reason and solve new problems). And this improvement lasted for up to three months.

According to lead researcher, Dr. John Jonides:

“The N-back task taps into a crucial brain function known as working memory, which is the ability to maintain information in an active, easily retrieved state, especially under conditions of distraction or interference. Working memory goes beyond mere storage to include processing information.”

N-back tasks have been examined in other studies with individuals with neurological impairments including traumatic brain injury and stroke.  

Research Conducted Using N-Back Tasks with Stroke

Participants with aphasia practiced 2 computerized tasks: Remember pictures in order (N-back) and Remember spoken word order (N-back), 4 times per week for 4 weeks. All participants showed improvement on at least one measure of spoken sentence comprehension and everyday memory activities. The authors of this study suggest that working memory “can be improved through computerized training in chronic aphasia and this can transfer to spoken sentence comprehension and functional communication in some individuals” (Zakarias et al., 2017).

Three N-Back Tasks in Constant Therapy

The N-Back Tasks are comprised of pictures, spoken words, or written words.

The user is presented with a series of items. They must remember the order of these items and tap when the items in the sequence match the instructions. For example, in Level 1, you will tap when the item is the same as one item ago, and in Level 3, you must tap when the item is the same as three items ago. 

Let’s take a peek at the three tasks in the program.  For a video tutorial, click the links below:

Remember spoken word order       (N-back)	Remember written words in order  (N-back)	Remember pictures in order            (N-back)

An important part of therapy, our three N-Back Tasks provide you with some of the best tools to help your patients make N-roads in their cognitive recovery.

References:

• Jaeggi, S., Buschkuehl, M., and Jonides, J. (2008). Improving fluid intelligence with training on working memory, Proceedings of the National Academy of Sciences, 6829-6833.
• Zakarias, L., Salis, C., & Wartenburger, I. (2017). Transfer effects on spoken sentence comprehension and functional communication after working memory training in stroke aphasia. Journal of Neurolinguistics, 2-17.
• Klingberg, T. (2010). Training and plasticity of working memory. Trends in Cognitive Sciences, 317-24.
• Cicerone, K. (2002). Remediation of ‘working attention’ in mild traumatic brain injury. Brain Injury, 185-95.