Given the largely prefrontostriatal neuropathogenesis of HIV-associated neurobehavioral deficits, it is often presumed that HIV infection leads to greater impairment on letter versus category fluency. A meta-analysis of the HIV verbal fluency literature was conducted (k = 37, n = 7110) to assess this hypothesis and revealed generally small effect sizes for both letter and category fluency, which increased in magnitude with advancing HIV disease severity. Across all studies, the mean effect size of category fluency was slightly larger than that of letter fluency. However, the discrepancy between category and letter fluency dissipated in a more conservative analysis of only those studies that included both tests. Thus, HIV-associated impairments in letter and category fluency are of similar magnitude, suggesting that mild word generation deficits are evident in HIV, regardless of whether traditional letter or semantic cues are used to guide the word search and retrieval process (JINS, 2007, 13, 183–189.)

Fluent Aphasia, by Susan Edwards. 2006. New York: Cambridge University Press. 230 pp., $75.00 (HB).

The 21st-century aphasiologist may be surprised to find a new book with such a title as Fluent Aphasia. Three decades of cognitive neuropsychology advances would seem sufficient to relegate a fuzzy concept like “fluent aphasia” as a relic of the past, or, at best, restrict it to the realm of shorthand descriptions meant to facilitate daily communication among clinicians. Even among those accustomed to strict collaboration, a concept like “fluent aphasia” may cause misunderstanding. I personally learned about aphasia directly from the Boston school. Yet, when I speak with my Italian colleagues from Milan, whom I have known for most of my professional life, and with whom I have written quite a few papers on aphasia, I am often unsure about what they mean when they label an aphasic patient as “fluent.” I still remember Harold Goodglass telling me, in almost the same words Susan Edwards quotes from him, how “fluency is best rated in terms of the longest occasional uninterrupted strings of words that are produced.” My own understanding of his teaching included the concept that the presence of phonetic problems and/or abnormal articulation effort was not so essential in drawing the fluency-non fluency distinction: according to his rule of thumb, fluent aphasia should be diagnosed when a patient can produce at least five connected words. This rule derived from observations made in Goodglass, Quadfasel, and Timberlake's (1964) study on phrase length and type of aphasia, whereby it was shown that aphasics can be dichotomized on the basis of the number of words that they can typically utter as an uninterrupted string. Edwards reports that other people entertain different beliefs about what is fluent aphasia. Surely several, heterogeneous criteria such as phrase length, verbal agility, melodic line, amount of articulation effort, and grammatical form are differently weighted by different aphasiologists as they consider their diagnosis.

Mental Retardation and Developmental Delay: Genetic and Epigenetic Factors, by Moyra Smith. 2006. New York: Oxford University Press, 344 pp., $49.95 (HB).

Most of us have had the experience of evaluating a child who looks just like other children, whose MRI scan is read as normal, and whose test performance results in a diagnosis of mental retardation. Such children cause us to ponder the question, “How can a brain look so normal, yet work so abnormally?” As the results are presented, parents ponder a different question. They want to know why this has happened to their child. What makes the question a hard one to respond to is that we ask ourselves the same question but often do not have an answer. The neuropsychological conceptualization of mental retardation starts with skill patterns and works backwards through neural networks looking for cause. Mental Retardation and Developmental Delay: Genetic and Epigenetic Factors begins with the inner workings of the cell, examining genes, gene products, and cell metabolism as the basis for the observed disruption of learning and memory.

Sports Neuropsychology: Assessment and Management of Traumatic Brain Injury. Ruben J. Echemendía (Ed.). 2006. New York: The Guilford Press, 324 pp., $45.00 (HB).

Sports Neuropsychology: Assessment and Management of Traumatic Brain Injury, edited by Ruben J. Echemendía, brings together a variety of experts in the area of sports concussion, in an effort to introduce psychologists and neuropsychologists to the rapidly developing area of sports neuropsychology. The book is organized into five parts. Part I, Sports Neuropsychology in Context, outlines the historical context for the development of sports neuropsychology as a professional endeavor. Chapter 1 (Barth, Broshek, and Freeman), introduces the readers to a number of important definitions that are used throughout the book, including concussion, post-concussion syndrome, second-impact syndrome, and the system of grading concussion severity. Importantly, Barth, a pioneer in the study of sports-related concussion, describes his early efforts at the University of Virginia using pre- and posttrauma assessment with the Sports as a Laboratory Assessment Model (SLAM)—a method of examining concussion in a controlled environment, which has become a standard for current practice. Chapter 2 (Zillmer, Schneider, Tinker, and Kamineris) provides a fascinating historical account of sports-related injuries, dating from the 8th century B.C. (ancient Olympic games) to the present. Their account chronicles the medical and behavioral assessment of head trauma (beginning with Hippocrates, who wrote extensively about head injury), to the modern-day three-tiered grading system introduced by Cantu (1986) and the American Academy of Neurology (1997), and provides a unique perspective on how neuropsychologists have come to play such a critical role in sports medicine. Chapter 3 (Echemendía) takes on the important task of highlighting the potential pitfalls inherent in consulting with athletes, including those at the collegiate and professional levels. Echemendía directly confronts the different “rules” associated with athletic consultation (e.g., flexibility of scheduling, dealing with the media) and challenges psychologists to examine their motivation for pursuing this type of specialty practice (i.e., the need to be around “celebrities”). The chapter even describes the down side of sports neuropsychology practice, including not being treated with the same level of professional respect that they are accustomed to receiving from their clients.