practice schedules
Imagine two ways to practise three skills — buttoning, pouring, and writing. You could do all the buttoning, then all the pouring, then all the writing (neat and orderly), or you could jumble them up, switching constantly (messy and harder). Surprisingly, the messy way usually leads to better long-term learning, even though the neat way looks better during the session. How you arrange practice — not just how much you do — strongly shapes what sticks.
Two main dials matter. The first is blocked versus random practice: blocked means repeating one task many times before the next; random means interleaving several tasks in a mixed order. Blocked practice looks impressive in the moment because performance climbs quickly, but random practice, though messier and slower-looking that day, produces stronger retention and better carry-over to new situations — a famous effect called the contextual interference effect. The second dial is massed versus distributed practice: massed means long sessions packed close together; distributed means shorter sessions spread out with rest. Distributed practice generally beats cramming for durable learning, and rest also matters for fatigue and safety.
These choices are practical tools, not trivia. A therapist might deliberately interleave standing-up, reaching, and turning rather than drilling each alone, accepting messier sessions for better real-world gains. The crucial honest caveat: the best schedule depends on the learner and the stage. A patient deep in the cognitive stage, or with significant cognitive or attention problems, may be overwhelmed by random practice and may genuinely need blocked, simpler practice first. Performance during practice is a poor guide; what counts is retention and transfer, tested later.
Instead of 30 repetitions of sit-to-stand in a row, a therapist mixes sit-to-stand, reaching to a shelf, and stepping over a line in shuffled order; the patient looks more error-prone that day but holds onto the skills better a week later.
Random practice can look worse in the session yet teach better — judge by later retention.
Random and distributed practice are not universally superior. Early in learning, or with cognitive impairment, learners can be overwhelmed and may need blocked practice first; the schedule should fit the person and stage.