Contributions and limitations of the cognitive neuropsychological approach to treatment: Illustrations from studies of reading and spelling therapy

Background : Cognitive neuropsychological research is focused on improving the understanding of cognitive processes and representations underlying normal tasks such as reading and spelling, on the basis of impaired performance of these tasks after brain damage. Functional architectures of cognitive tasks developed through this approach have often assisted speech-language pathologists and other therapists in understanding the task to be treated, and in identifying the impaired and spared components of the task to be treated in each individual with brain damage. Aims : To review the benefits and limitations of this approach, focusing on illustrations from treatment of reading and spelling, and to provide ideas about how the limitations might be addressed. Contributions : We provide examples that demonstrate how disruption of particular cognitive functions in the process of reading or spelling might be identified and rationally treated. Additionally, we provide some illustrations of how limitations of this approach might be addressed by considering evidence from cognitive neuroscience regarding neural mechanisms of recovery and learning. Conclusions : Insights from cognitive neuropsychology should be integrated with insights from neuroscience in developing rehabilitation strategies.