Working memory is the ability to hold information in mind and manipulate it for a few seconds to guide behaviour, for example, when understanding a sentence, following instructions, or solving a problem. It is particularly relevant in neuropsychology because it helps explain common functional difficulties and is intricately linked to attentional and executive performance (Budson & Price, 2005; Chai et al., 2018).
From a clinical perspective, it is important to distinguish working memory from related concepts:
- Short-term memory: focuses on the temporary storage of information.
- Working memory also involves manipulation and control (comparing, reorganising, and updating information).
- Executive attention: refers to the system that regulates which information remains relevant and which is inhibited.
As demands increase, that is, when more items need to be manipulated within a shorter time frame or when there are more distractions, effort increases and performance declines.
- Low cognitive load: smooth performance with few errors.
- Moderate cognitive load: slower performance and occasional memory lapses.
- High cognitive load: losing track, interference, and needing repetition.
What Is Working Memory?
There are several memory systems. The classic working memory model proposed by Baddeley and Hitch (1974) describes working memory as a limited-capacity system comprising several subsystems: the phonological loop (verbal storage), the visuospatial sketchpad (visual storage), and the central executive, which is responsible for coordinating and updating relevant information according to task demands. Baddeley (2000) subsequently introduced the ‘episodic buffer’, a multimodal component that integrates information from the subsystems and long-term memory into unified representations, facilitating integration and conscious access to information.
In summary, working memory is currently conceptualised as an active system that combines temporary verbal and visual storage with executive control and integration mechanisms, allowing flexible manipulation of information relevant to complex cognition.
Examples of Working Memory
A typical example of working memory in clinical practice involves the ability to retain and manipulate information relevant to the task at hand, such as following a sequence of instructions:
- Following a sequence of instructions: ‘Pick up the prescription, underline the dose and write down the date.’
- Mental arithmetic: holding numbers in mind and performing calculations without external aids.
- Reading comprehension: integrating information from different parts of a text to derive meaning while suppressing irrelevant information.
- Conversation with distractions: keeping track of the conversation and preparing a response while ignoring distracting stimuli.
When working memory is impaired, disorganisation, interference-related errors, losing track, and cognitive fatigue are commonly observed, particularly in situations involving multitasking or high cognitive demands.
Working Memory Activities in Neuropsychology
Working memory activities involving updating, manipulation, dual-task performance, controlled interference, and transfer to everyday life reflect the key components targeted in current cognitive intervention programmes.
Clinical exercises (with progressive difficulty):
- Updating: recalling only the last 2–3 items in a sequence, progressively introducing distractors.
- Manipulation: repeating numbers backwards; arranging letters in order; grouping lists into categories.
- Dual-task performance: maintaining a simple rule while performing another task.
- Controlled interference: Stroop-type tasks with changing rules. These tasks are specifically used to train inhibition and interference control, while varying the rules increases executive demands.
- Transfer to everyday life: planning a shopping trip with one or two constraints (e.g. budget or ingredients) or following a simple set of step-by-step instructions (with supervision where appropriate).
Key clinical considerations:
- Define which component is being trained (updating, manipulation, inhibition).
- Adjust difficulty by varying cognitive load, time, or interference.
- Record errors and completion times to objectively measure changes.
Transfer to broader abilities (far transfer) is limited and depends on the type of training and the patient’s profile. In clinical practice, functional transfer and monitoring using objective measures are generally prioritised.
How Is Working Memory Assessed?
When selecting tests to assess working memory, it is important to distinguish not only how much information is retained, but also how it is maintained, manipulated, and updated under conditions of interference or cognitive load. Current evidence shows that different assessment paradigms (simple span, complex span, updating, and visuospatial tasks) capture partially independent cognitive processes.
Therefore, using a diverse battery of tasks is recommended for a comprehensive assessment. In neuropsychological practice, this typically involves tasks such as the following:
|
Task type |
Specific example |
Clinical considerations |
|
Simple span |
Digit Span Forward (recalling digits in the same order) |
Useful for initial assessment; reflects short-term retention; less sensitive to interference and manipulation |
|
Complex span |
Operation Span (recalling words while solving mathematical problems) |
Assesses simultaneous retention and processing; more sensitive to executive demands and multitasking |
|
Reading Span (recalling words while reading sentences) |
Recommended for profiles involving impaired verbal comprehension and manipulation |
|
|
Symmetry Span (recalling positions while judging the symmetry of shapes) |
Indicated for profiles involving visuospatial impairment; useful in cases of parietal damage or mild cognitive impairment |
|
|
Updating |
N-back (identifying whether the current stimulus matches one presented a specified number of positions earlier) |
Measures updating capacity and interference control; useful in executive function disorders and for differentiating cognitive profiles |
|
Visuospatial tasks |
Corsi Block-Tapping Test (repeating a sequence of blocks in the same order) |
Specific to visuospatial working memory; recommended in cases of parietal damage, dementia, or mild cognitive impairment |
In addition to accuracy, response times, interference-related errors, and variability should be recorded whenever possible, as they provide information about cognitive efficiency and executive control. For further information, you can consult the neuropsychological assessment tests.
Working Memory Tests
A clinically useful working memory test should provide:
- Standardisation: a consistent procedure that ensures the reproducibility and comparability of results.
- Norms for interpreting results: normative data adjusted for age, educational level, and population characteristics, allowing impairments to be identified relative to the expected average.
- Measures beyond accuracy: reaction times, interference-related errors, and intra-individual variability, as these parameters provide information about cognitive efficiency, executive control, and performance stability, aspects that may go unnoticed if only the number of correct responses is recorded.
In this regard, particularly when the aim is to make assessments more representative of real-world demands, it may be useful to complement traditional assessment methods with digital tools and more ecologically valid environments. Tests administered digitally or in immersive environments (such as virtual reality) can improve the ecological validity of assessments by simulating conditions closer to the demands of everyday life and enabling the automatic recording of response times, errors, and variability. For example, within the range of assessment tools available, you can consult the memory test for professionals (designed for memory assessment).
When a more precise assessment is required under conditions of cognitive load and controlled distractions, Nesplora Memory Suite provides a tool to support neuropsychological assessment. This virtual reality test enables the assessment of different components of memory: episodic memory, working memory, prospective memory, and recognition memory, in controlled everyday scenarios, such as a furniture store where the individual being assessed must remember and organize information while following specific instructions. Thanks to its immersive design, it offers conditions of greater ecological validity, allowing performance to be observed in situations that simulate real-life demands. In addition, virtual reality technology facilitates the recording of additional variables, such as response times, visual exploration patterns, and motor data, enriching clinical interpretation and enabling the detection of subtle impairments that might go unnoticed in traditional assessments.
References
- Baddeley, A. D., & Hitch, G. J. (1974). Working Memory. Psychology of Learning and Motivation, 8, 47–89. https://doi.org/10.1016/S0079-7421(08)60452-1
- Baddeley, A. D. (2000). The episodic buffer: a new component of working memory? Trends in Cognitive Sciences, 4(11), 417–423. https://doi.org/10.1016/S1364-6613(00)01538-2
- Budson, A. E., & Price, B. H. (2005). Memory dysfunction. The New England Journal of Medicine, 352(7), 692-699. https://doi.org/10.1056/NEJMra041071
- Chai, W. J., Abd Hamid, A. I., & Abdullah, J. M. (2018). Working memory from the psychological and neurosciences perspectives: A review. Frontiers in Psychology, 9, 401. https://doi.org/10.3389/fpsyg.2018.00401
- Engle, R. W. (2002). Working memory capacity as executive attention. Current Directions in Psychological Science, 11(1), 19–23. https://doi.org/10.1111/1467-8721.00160
- Miyake, A., Friedman, N. P., Emerson, M. J., Witzki, A. H., Howerter, A., & Wager, T. D. (2000). The unity and diversity of executive functions and their contributions to complex “Frontal Lobe” tasks: A latent variable analysis. Cognitive Psychology, 41(1), 49–100. https://doi.org/10.1006/cogp.1999.0734
- Conway, A. R. A., Kane, M. J., Bunting, M. F., Hambrick, D. Z., Wilhelm, O., & Engle, R. W. (2005). Working memory span tasks: A methodological review and user’s guide. Psychonomic Bulletin & Review, 12(5), 769–786. https://doi.org/10.3758/BF03196772