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Mrs B: a woman with particular difficulties in visual memory functioning

Mrs B was a 60-year-old woman who suffered a right-hemisphere stroke 18 months prior to the assessment. She had been working as a librarian at the time. At the time of the assessment she reported ongoing problems with memory. On Version 1 of the RBMT-3 she showed mild problems with several of the RBMT-3 subtests, but her scores on the Picture Recognition - Delayed Recognition subtest, Face Recognition - Delayed Recognition subtest, Route subtests (Immediate and Delayed Recall), and the Novel Task subtests (Immediate and Delayed Recall) were particularly low. On the Route - Immediate Recall, she only managed to score 2 points and remembered nothing after a delay. She failed to score on the Face Recognition - Delayed Recognition, saying that she had not seen any of the faces before. She was unable to learn the Novel Task (see Figure 1).

On a number of verbal and prospective tasks (Story - Immediate and Delayed Recall; Names - Delayed Recall; Belongings - Delayed Recall; Appointments - Delayed Recall), Mrs B’s scores were in the low average range (see Figure 1). Her General Memory Index was below the 2nd percentile.

Figure 1

RBMT3 record form

Given her relative strengths on the verbal subtests, rehabilitation focused on utilizing these strengths, i.e. visual tasks were turned into verbal tasks as far as possible. Compensatory strategies also emphasized verbal rather than visual skills. For learning new tasks errorless learning and spaced retrieval were used. Mrs B’s poor visual memory was probably comprised of perceptual difficulties and a degree of unilateral neglect. Strategies for reducing neglect and improving perceptual functioning should be used in conjunction with the memory rehabilitation strategies.

Further case studies describing the clinical application of the tool are described in the RBMT-3 manual.

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