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Issues in cognitive rehabilitation.

Cognitive training has been an accepted therapeutic intervention in the areas of psycholinguistics and special education for learning disability in children and adults for several decades. 1 Current controversy revolves around the questions of "faddism," the potential to effect meaningful change in a neurologically stable individual, and the use of the computer as synonymous with cognitive rehabilitation. A cognitive impairment is a consequence of a structural lesion that may be measured. Neuropsychologic testing enables us to identify that specific impairment that is a consequence of the structural deficit. Brain injury results in impaired function of localized higher-order sensory and motor function corresponding to these well-defined anatomic structures, but it also results in a variety of functions that are not clearly localized, such as the abilities to abstract and to reason. The first step in the process of rehabilitation is to identify the specific deficits. Cognitive retraining is a systematic attempt