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Author's Response Normalisation and Statistical Procedures, Should Turn out to Be Any More Transparent Response/ Shallice: Neuropsychology difference lies. Essentially, the emphasis in single case studies is 1. The focus of the book on dissociations; however, what is not properly recognized is that group studies are typically concerned with associations and Many felt that the empirical base was too narrow (An- relationships. Shallice is at pains to argue that the value of single drews, Butter & Laeng, Cowan, Grodzinsky, and cases lies in the information they give concerning dissociation of Smith). Where my discussion of theories of particular deficits; he argues consistently against using associations in functions (e.g., memory [Smith] and executive functions developing theory (pp. 35; 61; 207). The essential argument [Butter & Laeng]) ignored evidence from other neu- given is that an association is not of value because it may later be robiological disciplines I consider the criticism justified. contradicted by a dissociation, whereas the converse does not hold for a dissociation. The problem, however, is that this is a With respect to Butter & Laeng's stress on the general very general argument. The same logical point was made by importance of lesion localisation in neuropsychology, Hume (1789) concerning any causal analysis: however, I would agree with Frith that the traditional Even when experience has informed us of the constant conjunction of neuropsychological approach seems much less helpful two objects it is impossible for us to satisfy ourselves by our reason with functional syndromes analysed by single-case study why we should extend that experience beyond those particular methods because of the difficulty of localising the func- instances which have fallen under our observation, (p. 648) tional lesion adequately (see section 9.4; for a concrete Shallice's argument thus applies to any observed relationship or example - the short-term memory syndrome - see the association. It is quite true that single cases are a poor and discussion in Shallice & Vallar 1990). unreliable source of information concerning relationships. This Andrews in particular sees the book as being primarily is a well-recognized problem with single cases and one of the main reasons for studying groups of patients. If one looks at the about the general theory of mental organisation, hence far questions posed by studies of groups of patients they typically too limited in what information it considers. The book I concern relationships not dissociations. Common questions are should have written he argues, would have paid more the relationship of cognitive impairment to other aspects of attention to developmental and cross-cultural data on psychological impairment and to underlying brain damage. The localisation and recovery of function and to evidence from methodology adopted in conducting and analyzing group stud- populations with structural limitations (e.g., the deaf) and ies is typically designed to answer such questions. special characteristics (e.g., idiot savants) using PET, Single cases have always provided an important source of SPECT, evoked responses, and so on. neuropsychological evidence and will continue to do so. The Had I been attempting to write a work in the spirit of strength of the single-case approach is in revealing functional Fodor's (1983) on modularity, I would agree with An- dissociations; but it is a poor guide to associations. On the other hand, group studies are of particular value in investigating drews . It is implicit in his view, however, that findings relationships and associations. Seen in this light, Shallice's view derived by the methods he advocates are theoretically that neuropsychological evidence should be restricted to dis- transparent and convergent, applicable without detailed sociations is unsatisfactory. It is unconvincing that there will be specialized knowledge. As Cowan points out, however, long-term progress in a science which does not seek information "the full set of tools . falls beyond any single investiga- concerning relationships. The future for cognitive neuropsy- tor's expertise." These diverse data appear on the surface chology must surely lie with study of both groups and to point in many different directions (see Neuropsychol- individuals. ogy p. 5). Hence there is a very real danger of "confir- matory bias" in interpreting them from a preexisting theoretical framework derived from another speciality. Smith in fact accuses me of such a bias in my limited use of localisation evidence with respect to executive and mem- ory functions. I see no reason why studies using a tech- nique like PET scanning, which involves very complex Author's Response normalisation and statistical procedures, should turn out to be any more transparent. For example, in the very interesting PET scanning study of Peterson et al. (1988), How neuropsychology helps us understand certain semantic processing is held to be frontally lo- normal cognitiwe function calised, whereas neuropsychological evidence points to a fairly posterior temporal lobe localisation (e.g., Cappa et Tim Shallice al. 1981). How can one assess such a clash of evidence Department of Psychology, University College London, London WC1E 6BT, without a detailed knowledge of both methodologies? England Neuropsychology is accordingly concerned with gener- Electronic mall: [email protected] al theoretical questions, but on the (one hopes secure) The commentators on From neuropsychology to mental base of one primary methodology (cognitive neuropsy- structure (henceforth Neuropsychology) have in general chology), which is examined in depth and compared with been gracious in their criticism. The negative parts of a second one (cognitive psychology) that is presumed to their critiques, however, when combined, make a formi- be generally better understood. The book is therefore dable assault on the set of positions I advocated. There more in the spirit of Posner's (1978) work on mental were criticisms of the detailed neuropsychological meth- chronometry than Fodor's (1983) on modularity. odology, the general theoretical perspective, and specific A consequence of this more restricted view is that views on short-term memory, amnesia, attention and its Neuropsychology does not provide a very good starting disorders, and executive functions and consciousness. All point for answering Jerison's provocative questions about these are discussed in turn, but first I would like to make evolution. My opinions (e.g., about language) are much two general points: The first concerns what the book is the same as his, but most of the methods of neuropsychol- about. ogy discussed are applicable only to humans. Indeed, for BEHAVIORAL AND BRAIN SCIENCES (1991) 14:3 457 Response/ Shallice: Neuropsychology Chapters 3-7 the underlying functional architecture is group studies, but In fact I defend them (see Chapter 9) if assumed to be specific to humans. The topics treated in with some reservations (see In particular p. 212). In Chapters 13-16 are, of course, also approachable by addition, it seems bizarre to hold that the selection of general neuroscientific procedures, and in these I have "clinically defined" groups requires no methods or exper- made the standard assumption of a qualitative similarity tise different from what is needed to select student in functional architecture between humans and the high- subjects In normal human experimental psychology. 1 er mammals. As Jerison points out with respect to blind- confess to some difficulty in understanding Grodzlnky's. sight and split-brain studies, my treatment In these chap- objections. ters tends to omit relevant animal studies that were Both Hunt and Wilson make a more subtle criticism. historically Important In the development of neuro- They argue that, despite my theoretical position support- psychology. Ing group studies, I In practice emphasise the Importance of single-case studies and that this confidence in single- case methodology may be unjustified. In particular, both 2. Criticisms of accounts of particular areas commentators make the point that single-case meth- odology routinely assumes qualitative equivalence In 2.1. Criticisms of specific theories applied to the neuro- functional architecture across patients and that, for some psych®flogical ewidence* Neuropsychology has two main tasks at least, there Is evidence that Individuals differ empirical sections. The substantive arguments of four of qualitatively In the underlying processes used to carry the more speculative later chapters (11-16) were crit- them out. In my view It remains an open question icised in detail. By contrast, only one of the six earlier whether further work on Individual differences In normal empirical chapters (3-8) - on short-term memory - was- subjects will merely converge theoretically with neuro- substantively criticised; the chief criticism of these chap- psychologicai single-case methodology, as seems to be ters was that the theorising was insufficiently detailed. occurring for reading by sight and by sound, or whether it Thus In nearly all the fields In which I argued that will undermine it. In any case, I do not see the basis for cognitive neuropsychology methodology should be Wilson's claim that the evidence of qualitative individual judged, the specific arguments presented were not con- differences makes group studies more useful, although I tested. The disputes over methodology, to which I now strongly agree that the multiple single-case Is an impor- turn, were not reflected in a rejection of the specific tant design (see Shallice
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