More than flashcards: Using SAFMEDS to help ABA Staff

How do people achieve fluency, or true mastery with content area knowledge? For example, subjects like biology, statistics, physics, and history all possess their own vocabulary and concepts. Mastering abstract information such as the Linnaean Taxonomy (biology), probability (statistics), velocity (physics), or the branches of the government (American history) pose challenges to all students.

Many self-study methods exist which help students, or anyone, learn content. Researchers surveyed college students and discovered 11 different study strategies. After (1) rereading notes or the textbook and (2) engaging with practice problems, students used (3) flashcards (Karpicke, Buttler, & Roediger, 2009).

Many studies examine flashcards and their benefits. For instance, flashcards have helped young children learn to read better, aided medical students acquisition of terms, increased university students psychology exam scores, and even heightened patients understanding of diabetes and medication adherence.

Flashcards continue to attract the interest of researchers and practitioners due to their effectiveness, adaptability, and portability. Yet even with the previously stated benefits and popularity of flashcards, several factors limit their potential.

  1. Almost all flashcard practice trials have no set timed practice interval. In other words, students will practice in an untimed manner.
  2. No uniform performance goals exist. Students may practice to any accuracy criteria (e.g., 80%, 90%, or 100%).
  3. Flashcards lack instructional design. Creating flashcards comes with no set of rules and each deck may contain widely discrepant methods for presenting target content.

The previously stated limitations make flashcards less effective. Students using the popular instructional tool may not learn content as effectively or efficiently as they like. Furthermore, retaining information and moving forward with more complicated content may occur at slower place or not at all. Fortunately, a method exists that addresses the flashcard limitations and has research demonstrating accelerated performance gains and learning.

Flashcards Morph into SAFMEDS

In 1978 Ogden Lindsley and Steve Graf pioneered a practice and assessment procedure called SAFMEDS (Potts, Eshleman, & Cooper, 1993). SAFMEDS stands for Say All Fast, a Minute Every Day, Shuffled. In other words, learners would:

  • See the front of the card and Say the answer.
  • Practice with the entire set or All of the content in the deck
  • Go through the content Fast instead of slow to produce steeper celerations (faster learning).
  • Practice with timed units such as a Minute or other consistent interval (e.g., 20 seconds).
  • Assess progress and practice content Every Day instead of weekly or some other protracted time interval.
  • Shuffle the deck instead of practicing the cards in order.

A host of studies demonstrate the superiority of SAFMEDS over flashcards and other self-study practices. Research indicates that SAFMEDS form an effective instructional and assessment method in many domains (View some examples under Resources at the bottom of this article).

A study conducted by your friendly blog author demonstrates how SAFMEDS can help behavior change agents improve understanding of important Precision Teaching concepts such as movement cycles.

SAFMEDS and Movement Cycles Study

Staff who work with people with disabilities such as autism, intellectual disabilities, and learning disabilities can employ Precision Teaching to enhance measurement, decision making, and communication of data among team members and stakeholders. Precision Teaching has four steps:Pinpoint, Record, Change, Try Again.

The first step consists of creating a pinpoint. And at the core of the pinpoint exists a movement cycle. Movement cycles contain two parts, an observable action described by an active verb and the object involved with the action.

The essence of every behavior originates in a movement cycle. Composing an essay would translate to “writes essay” (action verb + object involved with the action). “Aggression” could include several movement cycles: hits staff, slaps face, or scratches arm. And complex behavior such as “joint attention” may encompass aims gaze, points finger, or follows gaze.

Behavior change agents can profit from Precision Teaching knowledge such as movement cycles. A study, for example, demonstrated a 94% difference in detection accuracy when comparing movement cycles with operational definitions (i.e., 35% detection accuracy for operational definitions and 68% for movement cycles). Another experiment examined how behavior analysts and special education teachers working with students with autism would learn movement cycles with SAFMEDS.

In the Kubina, Yurich, Durica, & Healy (2016) study, the experimenters crafted two SAFMEDS decks with pictures depicting students behaving. The picture on the front of the card had a corresponding movement cycle (i.e., two words = active verb in the simple present tense + object receiving action) on the back of the card.

Figure 1 came from one of the decks. The student had a specific behavior participants needed to translate into a movement cycle. In the picture circles and arrows focused precision and indicated movement. The larger circle showed a hand while the smaller circle centered on two fingers. The arrow portrayed downward motion. Therefore, if the participant said “presses toy” the experimenters would score the response as correct.

Figure 1

Figure 1. A picture of a card taken from a movement cycle deck.

The participants made many competing, incorrect responses to the SAFMEDS cards at the beginning of the study. Participants might say the incorrect active verb (push instead of press), use the incorrect verb tense (pressing – present progressive tense – instead of presses – simple present tense), choose an incorrect object receiving the action (piano instead of key), or not use the proper format of action + object involved with the action (saying “He is hitting the doll”)

Additionally, the participants initially performed the assessment task slowly, with hesitations, or skipped answers outright. The following clip came from one participant’s baseline. The X’s in the video represent incorrect responses.

Across time the participants increased their frequency. The students practiced saying their answers and self-correcting their responses. The participants also practiced on the whole deck each day and shuffled it before a practice trial.

Figure 2 illustrates skill progress. In baseline, all of the participants made more incorrect (x) than correct (dot) answers. Furthermore, incorrect responses accelerated in baseline, a worsening condition for saying movement cycles.

Figure 2. A multiple baseline design for group 2 using Deck A movement cycles.

The experimenters applied the SAFMEDS intervention and the same learning pictures emerged: correct responses grew rapidly while incorrect responses decelerated quickly.

The transformation appeared remarkable. The following video captures one of the performances of a participant toward the end of the SAFMEDS intervention. The dots on the video mark each instance of a correct response made in time.

The SAFMEDS study had several important findings:

  1. SAFMEDS offers a reliable method to help adult learners quickly gain competency with the targeted content (e.g., movement cycles);
  2. Participants retained information across time;
  3. SAFMEDS facilitates extension of content to novel content (i.e., Participants performed very well on a novel deck demonstrating transfer of learning);
  4. A performance criterion or frequency aim can signal how fast and accurate participants must respond in order to achieve their goal; and
  5. Analyzing performance results on a Standard Celeration Chart provides a wealth of visual and statistical information.


SAFMEDS supports the learning of simple and complex content for young and older learners. SAFMEDS also gives rise to important learning outcomes such as long-term retention and maintenance, application or extension of content to novel material, and social validity seen in meaningful participant behavior change and stakeholder satisfaction (see references below and in article).

Rick Kubina, Ph.D., BCBA-D

Director of Research, CentralReach

Professor of Special Education, The Pennsylvania State University


Karpicke, J. D., Butler, A. C., & Roediger III, H. L.(2009). Metacognitive strategies in student learning: Do students practice retrieval when they study on their own? Memory, 17, 471-479.

Kubina, R. M., Yurich, K. L., Durica, K. C., & Healy, N. M. (2016). Developing behavioral fluency with movement cycles using SAFMEDS. Journal of Behavioral Education, 25, 120-141.

Potts, L., Eshleman, J. W., & Cooper, J. O. (1993). Ogden R. Lindsley and the historical development of precision teaching. The Behavior Analyst, 16(2),177-189.


Branch, A., Hastings, R. P., Beverley, M. & Hughes, J. C. (2018). Increasing support staff fluency with the content of behaviour support plans: An application of precision teachingJournal of Intellectual & Developmental Disability, 43, 213-222.

Chapman, S. S., Ewing, C. B., & Mozzoni, M. P. (2005). Precision teaching and fluency training across cognitive, physical, and academic tasks in children with traumatic brain injury: A multiple baseline studyBehavioral Interventions, 20, 37-49.

Mason, L. L., Rivera, C. J., & Arriaga, A. (2018). The effects of an avoidance contingency on postsecondary student SAFMEDS performanceEuropean Journal of Behavior Analysis, 19, 62-71.

Peladeau, N., Forget, J., & Gagne, F. (2003). Effect of paced and unpaced practice on skill application and retention: How much is enoughAmerican Educational Research Journal, 40, 769-801.