Empirically proven mnemonic techniques from the literature were assembled into a comprehensive treatment program for brain injured clients. Twenty head injured subjects with mild to moderate neuropsychological impairments were matched on the variables of age, sex, years of formal premorbid education, and elapsed time since insult. These patients were then randomly assigned to either the control or experimental remediation group. Both groups attended a six-week program and were blind as to what type of treatment they were receiving. Each followed identical daily schedules where the experimental group received the formal memory remediation and the controls received treatment focusing on psychosocial issues. Both groups improved on the neuropsychological memory measures over the course of the study. The experimental group did not improve significantly more than did the control group; however, once the groups were subdivided according to the severity of neuropsychological functioning at intake, significant treatment effects were observed. More specifically, only those patients with mild residual impairments seemed to benefit from rehabilitative efforts, and those with more moderate deficits did not respond to treatment. Clinical implications and future research are discussed.

The present study examined the ability of traditional neuropsychological measures to predict successful vocational training in a severely neurologically impaired population. Eighty head trauma patients were evaluated prior to pre-vocational training which involved cognitive remediation and psychosocially-based intervention. Subjects were approximately 2 years post-injury. Results showed that of the total population studies, 73.8% participated in vocational evaluations, 23.8% did not, and 2.4% of the sample returned to work or college. Neuropsychological assessments were over 77% accurate in predicting whether subjects would successfully complete this vocational evaluation. The most significant predictors were reading comprehension, immediate and delayed verbal memory, level of depression, and dysphasic symptomatology. Issues relating to generalizability of cognitive retraining to the vocational evaluation and/or vocational training setting are discussed. Future considerations for both clinical practice and research include the use of ecologically valid measures.

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