In 1991 Dr Kevin Walsh, the founding President of ASSBI, presented an invited address entitled “Some gnomes worth knowing” in which he discussed examples of common errors and difficulties in neuropsychological test interpretation in the form of “gnomes” or aphorisms from prominent clinicians. His paper was aimed at demonstrating “the need for improvement in the education of all psychologists who are likely to be faced with essentially neuropsychological problems”. The current paper will examine the extent to which such improvement has occurred over the past eight years and will consider directions for the future. The major areas of concern outlined by Dr Walsh will be reviewed in terms of current clinical practice. Additional areas of controversy and concern which have emerged more recently, such as the assessment of mild head injury, the assessment of malingering and the impact of neurochemical changes in certain psychiatric conditions, will also be considered. The importance of considering the client in a more holistic manner, which takes into account a range of issues that may impact upon test scores, is emphasised. It is hoped that this presentation will assist in formulating more clearly the challenges facing all those involved in research, assessment and treatment of brain disorders as we approach a new millennium.

Following severe traumatic brain injury, difficulty with behavioural adjustment and community reintegration is common. A potential contributor to this difficulty is a sense of personal identity that is inconsistent with the restrictions on activity and need for effortful compensation imposed by persistent impairment. We summarise an information processing framework within which the impact of schematic mental models of self is explained and present intervention procedures designed to help individuals with traumatic brain injury reconstruct an organised and positive sense of personal identity. We conclude the paper with three instructive case illustrations.

Children with acquired brain injury (ABI) experience deficits in attentional skills such as, sustained attention, distractability and impulsivity, which have the potential to influence all aspects of their functioning. The use of central nervous system (CNS) stimulants is gaining increasing popularity in adult ABI literature. CNS stimulants have been successfully utilised in the management of attentional problems in attention deficit-hyperactivity disorder and are believed to have their therapeutic effect by modulating neurotransmitter function in the neocortex, an area of the brain implicated in the neurobehavioural sequelae of ABI. Research into the use of CNS stimulants in paediatric ABI reports contradictory findings. We present the case of LI a 7-year-old boy with a history of ABI who underwent a trial of stimulant medication for management of attentional deficits. The case is discussed with regard to the efficacy of the pharmacological intervention and the design of objective protocols for stimulant trials.