Assessment & Research

An Evaluation of Multiple SAFMEDS Procedures

Quigley et al. (2021) · Behavior Analysis in Practice 2021
★ The Verdict

Add error correction and bigger card sets to SAFMEDS drills for quicker mastery of new symbols.

✓ Read this if BCBAs running fluency programs or staff training with flash cards.
✗ Skip if Practitioners who only run vocal mand training or discrete-trial drills.

01Research in Context

01

What this study did

Quigley et al. (2021) tested five ways to run SAFMEDS flash-card drills. College students had to learn odd Korean symbols. Each student tried all five methods in random order across days.

The basic method was simple: see the card, say the answer, check it. The four extras added error correction, bigger card sets, longer timings, or both bigger sets and longer timings.

02

What they found

Every extra feature beat the basic drill. Students scored more correct responses per minute when any add-on was in place. Bigger sets plus longer timings worked best.

Error correction alone also helped, but the combo of larger sets and longer timings gave the biggest jump in fluency.

03

How this fits with other research

Wu et al. (2019) also taught foreign symbols to college students. They compared mand, tact, and intraverbal training. Both studies show that the way you drill matters more than just drilling.

Thompson et al. (1974) used the same alternating-treatments trick. They added student essays to plain behavior management and saw lunchroom disruption drop. Quigley’s team added pieces to flash cards and saw learning speed rise. Same design, same lesson: extras can turn a weak procedure into a strong one.

Abuin et al. (2026) warn that rapid, unsignaled switches in alternating designs can hide true effects. Quigley’s team switched daily, not minute-by-minute, so their gains are easier to trust.

04

Why it matters

If you use SAFMEDS for staff training or student fluency goals, stop running the bare-bones version. Drop in error correction first—it’s easy. Then try larger card sets and longer timings. You should see cleaner, faster responding within a week.

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Add a simple error-correction step: after an error, have the learner repeat the correct answer twice before moving on.

02At a glance

Intervention
precision teaching
Design
alternating treatments
Population
neurotypical
Finding
positive
Magnitude
medium

03Original abstract

Lindsley developed the “say all fast minute every day shuffled” (SAFMEDS) procedure in the late 1970s to enhance the typical use of flash cards (Graf & Auman, 2005). The acronym specifically guides the learner’s behavior when using flash cards. A review of SAFMEDS research indicates its successful use with children, college students, and older adults with and without disabilities. The literature also indicates that SAFMEDS procedures are not well documented and have multiple variations, limiting practitioners’ ability to know what procedures to use and when. The purpose of this study was to evaluate the effects of a basic SAFMEDS procedure and four supplementary SAFMEDS procedures on the rates of correct and incorrect responding to unfamiliar Russian words and Chinese characters in college students. The results of the study suggest that the basic SAFMEDS procedure produced some learning (i.e., increases in correct responding and decreases in incorrect responding), but all of the supplementary procedures led to greater increases in the number of correct responses per 1-min timing. Further research evaluating differences in performance across the supplementary procedures is warranted.

Behavior Analysis in Practice, 2021 · doi:10.1007/s40617-020-00527-7