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To the Editor: The article by Dr Salazar and colleagues¹ on cognitive rehabilitation for traumatic brain injury (TBI) leads to inaccurate conclusions because they fail to place their findings and methods in the appropriate scientific context.

First, Salazar et al state that they compared an in-hospital cognitive rehabilitation program modeled after my own milieu-oriented approach with a limited home-rehabilitation program in a prospective randomized controlled design. I have repeatedly emphasized, however, that my neuropsychological rehabilitation program was intended for postacute patients with TBI who fail to return to work after undergoing traditional rehabilitation procedures.² Typically, patients were enrolled in this program 1 to 2 years after their injury. In contrast, the patients in the study by Salazar et al were enrolled a mean of 38 days beyond their TBI—hardly a group of patients in the postacute stage of injury.

Second, in conducting milieu-oriented neuropsychological rehabilitation programs for patients with moderate-to-severe . . . [Full Text of this Article]

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Cognitive Rehabilitation for Traumatic Brain Injury: A Randomized Trial
Andres M. Salazar, Deborah L. Warden, Karen Schwab, Jack Spector, Steven Braverman, Joan Walter, Reginald Cole, Mary M. Rosner, Elisabeth M. Martin, James Ecklund, Richard G. Ellenbogen, and for the Defense and Veterans Head Injury Program Study Group
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