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The Elemental Driving Simulator (EDS) is a PC-based software and hardware system for advising people with known or suspected cognitive impairment. It is elemental in its simplicity and in its simulation of the elements of driving-related cognitive abilities. The EDS explicitly addresses metacognition and quantitatively relates it to performance. A neuropsychological case example, with an EDS Personal Report, is complemented by statistical findings from (1) workingage drivers (norms), (2) patients with central nervous system impairment seeking driver rehabilitation, and (3) a large sample of older drivers. The EDS proved to be a challenging procedure that all the normals completed more consistently, efficiently, and accurately than the other groups. Clinically, it discriminated extreme cases and, for those who fell in between, it helped focus the issues for further assessment and intervention. The discussion addresses how much realism is necessary, as well as the psychometric limitations of on-road testing.

Grouped and ungrouped lists were presented for free recall. Temporal grouping increased recall of only items presented at the end of the list, i.e., shortterm storage. Contrary to expectations, grouping did not improve long-term storage. The fact that grouping produced a stereotypic order of recall focused on recall order as a crucial factor in determining short-term recall.Grouping is interesting not only because it is used frequently as a mnemonic technique but also because it is intimately involved in speech in the form of intonation. Intonational groupings (created by pausing or accenting) play an important role in processing and remembering verbal stimuli (O'Connell, Turner, & Onuska, 1968). The purpose of the present series of studies was to elucidate the role of grouping in remembering words by using single-trial free recall. The U-shaped serial position curve obtained with free recall is viewed as a composite with recall for items from the end of the list being determined primarily by the state of the short-term store (STS) and recall for other items being determined by the long-term store (LTS) (Atkinson & Shiffrin, 1968;Glanzer, 1968;Waugh & Norman, 1965).Previous studies of rhythmic or temporal grouping have involved fixed-order recall of items such as numbers, letters, and nonsense syllables. Ryan (1967) reviewed these studies. However, fixed-order recall is in two ways a more complex task than free recall: (a) It requires order information; and (b) it requires a fixed order in recalling words. These factors make it 1 The author thanks both her sponsor, Murray Glanzer, and Doris Aaronson for extensive guidance and encouragement. Reinhilde Nelson was most helpful in testing 5s. This paper is based on a dissertation submitted in partial fulfillment of the requirements for the PhD degree at New York University. While conducting this research the author was a National Institutes of Health predoctoral fellow (5 F01 MH40050).

In its first decade cognitive rehabilitation has emerged from infancy with the energy and much of the turmoil of youth. It has become an established speciality in brain-injury rehabilitation and has inspired many neuropsychologists to broaden their expertise beyond diagnosis and address their efforts to intervention. Restoration, although controversial, is an important and valid goal at the outset of cognitive rehabilitation, whereas the substitution of other means of goal achievement and environmental redesign are significant components of a comprehensive neuro-rehabilitative treatment programme. Efficacy is being demonstrated in many ways, ranging from increased patterns of use to controlled empirical studies. Few continue to raise the naive issue of whether there is any scientific basis for this neuropsychological speciality; instead, questions have become more focused on understanding the process of change to best serve human needs. In the next decade the refinement of current approaches can be anticipated, as well as the breaking of new ground. Neuropsychologists specializing in cognitive rehabilitation are likely to be turning their attention to underserved populations, such as those emerging from protracted coma, individuals suffering from 'progressive' neurological conditions, and persons whose brains were injured early in development. Scientific (theoretical, methodological and empirical) developments in cognitive psychology will help to delve more precisely into the underlying basic processes, including the sensory substrate. We will be challenged to address specific applications, such as advising people with known or suspected cognitive deficits who wish to drive.

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