Expected and actual behavioural capacity after diffuse reduction in cerebral cortex: a review and suggestions for rehabilitative techniques with the mentally handicapped and head injured.

Expectations of residual function (and of potential therapeutic outcome) after brain damage are important factors in the selection of rehabilitation programmes. Drawing upon reports of what we call here association learning and memory in humans and animals, it is shown that this type of learning remains intact and may be mediated by subcortical brain structures, despite the often severe cognitive blunting which accompanies diffuse cortical brain damage. In retarded humans the application of association learning-based behaviour modification techniques may lead to the development of an adequate behavioural base-line on which to develop cognitive rehabilitation programmes. The implications of potentially valid neuropsychological extrapolations from animals to man are discussed. Finally suggestions are made concerning the interaction between association learning and more cognitive information-processing strategies, and the implications for behaviour modifications with retarded and head injured are considered.