Using Spaced Retrieval/Delayed Imitation to Foster Learning in Pediatric SLP

If you're a geriatric/adults SLP, you're probably familiar with the concept of "spaced retrieval". Even as pediatric SLPs, however, we sometimes use this technique (most often unconsciously) to develop a child's ability to independently respond to questions. Most frequently, it just looks like drill or repetition of a concept:

Ex.:
SLP: "Where is the frog swimming?"
Child: No response.
SLP: "In the water!"
Child: "In the water."
SLP: "Where is he swimming?"
Child: "In the water."

So the child is exposed to the question and then answer, after which they are typically able to answer "independently", although the truth is they are answering in delayed imitation. Which is fine, totally great! I wanted to explain how I used the technique of spaced retrieval/delayed imitation for a 3-year old today who has been unable to name objects on command for quite awhile, despite the fact that she responds appropriately to directions to interact with said items and her imitation skills are intact. It's almost as if her short-term memory or retrieval abilities are somewhat delayed. Typically, or previously, our verbal interactions looked like this:

Me: "What's this?"
Child: "What's this?"
Me: "Cow."
Child: "Cow."
Me: "What's this?"
Child: "What's this?"

Working on vocabulary development with animal friends.

As you can see, this interaction is different from above in that she was not able to hold onto the semantic content long enough to respond appropriately to my question. I should note I'm making this assumption based on the fact that she is not "echolalic" in the true sense or in any other context as well as the fact that I know her comprehension skills are much higher than her expressive language abilities. Today, I utilized the technique of spaced retrieval/delayed imitation. Essentially, we repeat the question/answer format 2-3 times, quickly. Any significant pausing will impact her ability to respond correctly in delayed imitation.

Me: "What's this? (quickly) Cow (stressed). What's this?"
Child: "What's this?"
Me: "Cow."
Me: (quickly) "What's this?"
Child: *thinking* "Cow!"
Me: "Cow!" (pat on the back, visual excitement/verbal reinforcement).

We did this exchange for the majority of our noun targets today. I found that as time went on, we only had to go through the question/answer sequence about 2 times, and at this point, I started using more spaced retrieval to encourage her to hold the word longer in her short term memory. It looked like this:

Me: "Cow. (stressed) What's this? (quickly)"
Child: "Cow."
Me: pause 1-2 seconds..."What's this?"
Child: *thinking* "Cow!"
Me: "Cow!" (pat on the back, visual excitement/verbal reinforcement).

My hope is that the longer we continue using this spaced retrieval format, I will not have to go through the question/answers more than 1X (as in the example at the top) and can gradually add time to my second prompt to increase her semantic memory until finally she *learns* the name of the object and is able to label independently or following a WH- question.

Tell me: do you see delayed imitation skills as part of the learning hierachy for vocabulary? Have you used "spaced retrieval" with kids on your caseload recently? Chime in in the comments below.

Until next time,
L.L.