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Effects of errorless skill learning in people with mild-to-moderate or severe dementia: a randomized controlled pilot study


Kessels, Roy P. C., Hensken, Linda M. G. Olde


Neurorehabilitation, Volume: 25, No.: 4, Pages.: 307-312

Year of Publication



This pilot study examines whether learning without errors is advantageous compared to trial-and-error learning in people with dementia using a procedural task and a randomized case-control design. A sample of 60 people was recruited, consisting of 20 patients with severe dementia, 20 patients with mild-to-moderate dementia and 20 participants without dementia. The participants had to acquire a novel procedural problem-solving task with the help of cues (errorless learning) or with cues only given in case an error was made (trial-and-error learning). The number of steps completed without assistance immediately after errorless or trial-and-error learning and after a delay of 1-3 days was recorded. Overall performance was better after errorless learning compared to trial-and-error learning (p=0.012), with effect sizes being largest in the mild-to-moderate dementia group after delayed testing (d=1.61). The effects of errorless learning were larger after delayed testing. We conclude that errorless learning of a procedural task results in a better performance than learning with errors. This study is the first to use a controlled group design to show such a benefit in patients with dementia. These findings can be extended to the acquisition of tasks that are relevant for everyday-life functioning, having important implications for dementia care.;


aged, aged, 80 and over, association learning, classification, dementia, double-blind method, errorless, female, geriatric assessment, humans, learning, male, middle aged, motor skills, neuropsychological tests, performance, physiology, physiopathology, pilot projects, rehabilitation, severity of illness index, task

Countries of Study


Types of Dementia

Dementia (general / unspecified)

Types of Study

Randomised Controlled Trial

Type of Outcomes

Other, Other carer outcomes (e.g. financial burden and more)

Type of Interventions

Non-pharmacological Treatment

Non-Pharmaceutical Interventions

Occupational Therapy, Other