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COGNITIVE NEUROPSYCHOLOGY, 2006, 23 (1), 3 – 12

Cognitive Neuropsychology twenty years on

Alfonso Caramazza
Cognitive Neuropsychology Laboratory, Harvard University, Cambridge, MA, USA

Max Coltheart
Macquarie Centre for Cognitive Science, Macquarie University, Sydney, NSW, Australia

Cognitive neuropsychology began in the second behaviourism at the beginning of the twentieth
half of the nineteenth century when neurologists century, saw cognitive neuropsychology practically
such as Lichtheim, Wernicke, Bastian, and vanish from the scientific scene for the first half of
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others began to make inferences about the cogni- the twentieth century.
tive architecture of the intact language-processing However, after the advent of the so-called
system from studying the different ways in which “Cognitive Revolution” in the middle of the twen-
spoken or written language abilities broke down tieth century (Broadbent, 1956; Chomsky, 1959;
after brain damage. They even began to express Miller, Galanter, & Pribram, 1960), cognitive
their proposals about this architecture by means neuropsychology awoke from its slumbers,
of explicit box-and-arrow diagrams: hence the aroused by seminal papers from Marshall and
term “the diagram-makers” that was applied to Newcombe (1966, 1973) on the cognitive neurop-
them. sychology of reading and from Shallice and
These cognitive neuropsychologists were also Warrington (1970) on the cognitive neuropsycho-
cognitive neuroscientists: They were interested logy of memory. Also important were developments
not only in the functional architecture of cogni- in the area of sentence processing in aphasia where
tion, but also in how the components of such linguistic and psycholinguistic theory played a
an architecture were localized in the brain. Their crucial role in guiding the analysis of aphasic
cognitive neuropsychology was successful (their symptoms (Caramazza & Zurif, 1976; Marin,
diagrams of the language-processing system are Saffran, & Schwartz, 1976). The first conference
simplified versions of diagrams that enjoy contem- solely devoted to cognitive neuropsychology was
porary support; see Coltheart, Rastle, Perry, held at Oxford in 1979 (the conference was on
Langdon, & Ziegler, 2001, for examples) but deep dyslexia, one of the three forms of acquired
their cognitive neuroscience was not. They did dyslexia defined by Marshall & Newcombe,
not succeed in localizing in the brain any of the 1973), and its proceedings were published as a
hypothesized components of a functional architec- book in the following year (Coltheart, Patterson,
ture of cognition, and this failure exposed the & Marshall, 1980). The field was burgeoning
whole enterprise to damning criticisms from rapidly; it needed its own journal, and Cognitive
noncognitively-oriented neurologists such as Neuropsychology began publication in 1984.
Head (1926). This, plus the demise of cognitive The field also needed an undergraduate text,
psychology itself consequent upon of the rise of and Human Cognitive Neuropsychology (Ellis &

Correspondence should be addressed to Alfonso Caramazza, Cognitive Neuropsychology Laboratory, Harvard University,
Cambridge, MA 02138, USA (Email: caramazz@fas.harvard.edu).

# 2006 Psychology Press Ltd 3


http://www.psypress.com/cogneuropsychology DOI:10.1080/02643290500443250
CARAMAZZA AND COLTHEART

Young, 1986) was published shortly after the relevant to claims about the functional organiz-
journal first appeared. Shortly after that, an ation of the brain. Hence cognitive neuropsychol-
advanced text (Shallice, 1988) appeared. ogy may also be considered to be a branch of
The 20th birthday of the journal was celebrated cognitive neuroscience. However, depending
by a symposium at the 22nd European Workshop on the particular proclivities of individual
on Cognitive Neuropsychology at Bressanone, cognitive neuropsychologists, there is considerable
Italy, in February 2004, and from that symposium variation in the specific weight given by any one
came the papers collected together here. investigator to the cognitive or the neural part of
the brain/cognition equation” (Caramazza, 1992,
pp. 80 –81).
Cognitive neuropsychology and cognitive
The distinction between cognitive neuroscience
neuroscience
and cognitive neuropsychology is an important
It is useful, if one wants to make some remarks one, but it is sometimes overlooked or neglected.
about the past twenty years of cognitive neuropsy- There seem to be several reasons for this.
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chology, to begin by discussing the distinction, First, cognitive neuropsychologists are usually
already alluded to above, between cognitive studying people with brain disorders (even
neuropsychology and cognitive neuroscience. though not studying those disorders).
Cognitive neuroscience is the study of those Second, some cognitive neuropsychologists are
neural systems of the brain that subserve cognition, also cognitive neuroscientists (just as some mathe-
and so it is a branch of neuroscience. Cognitive maticians are also physicists, and some psycholo-
neuropsychology is the use of investigations of gists are also economists) whereas others are
people with impairments of cognition (acquired not. For example, the papers in this collection
or developmental) to learn more about normal by Rapp and Goldrick, Martin, Coltheart,
cognitive processes, and so it is a branch of cogni- and Miceli and Capasso are solely cognitive-
tive psychology, just as Rapp and Goldrick neuropsychological; they have nothing at all to
(2006) say. This view of cognitive neuropsychology say about the brain system subserving cognition.
as a branch of cognitive psychology and as distinct In contrast the papers by Caramazza and Mahon,
from cognitive neuroscience is widely accepted: Humphreys and Riddoch, Buxbaum, Vallar, and
“The term cognitive neuropsychology often con- Schwartz are not only cognitive-neuropsychological
notes a purely functional approach to patients (seeking to reach conclusions about the nature of
with cognitive deficits that does not make use of, normal cognitive mechanisms from studying
or encourage interest in, evidence and ideas about people in whom these mechanisms have broken
brain systems and processes” (Schacter, 1992, down) but also cognitive-neuroscientific (seeking
p. 560); or for a more nuanced position: to reach conclusions about the neural organization
“Cognitive Neuropsychology’s domain of inquiry of those mechanisms).
concerns the structure of normal perceptual, Third, there often seem to be (generally
motor, and cognitive processes. As such, it consti- unstated) assumptions that conclusions about
tutes a branch of cognitive science. What the functional architecture of cognition have
distinguishes cognitive neuropsychology from implications for what the brain must be like, and
other branches of cognitive science is the type of conclusions about what the brain is like have
observations that it uses in developing and evaluat- implications for theories of the functional archi-
ing theories of normal cognition. The data used in tecture of cognition (see Caramazza, 1992, for
cognitive neuropsychology are the patterns of discussion of this issue). If these assumptions
performance produced by brain-damaged subjects. were correct, then anyone doing cognitive neurop-
Because the basic data used in cognitive neuropsy- sychology would also ipso facto be doing cognitive
chology are the result of a biological manipu- neuroscience. But are these assumptions correct?
lation—a brain lesion—these data will be directly Do facts about the mind constrain possible

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COGNITIVE NEUROPSYCHOLOGY TWENTY YEARS ON

theories about what the brain could be like? One (Goodale, Milner, Jakobson, & Carey, 1991)
of the present authors has expressed doubts have been used to distinguish between the percep-
about that (Coltheart, 1982, 2004, in press), and tion of form within the object recognition process
so did one of the papers in the very first issue of and the “perception” of form used to guide motor
Cognitive Neuropsychology (Mehler, Morton, & behaviour. However, this work has also led to the
Jusczyk, 1984). Consider, for example, such proposal that a specific part of lateral occipital
claims about cognitive architecture as those made cortex is crucial for a perceptual process tied to
in Figure 5 of Rapp and Goldrick (2006, which the conscious recognition of form but that these
depicts a detailed model of how speech production processes are not needed for guiding motor beha-
is achieved), Figure 3 of Coltheart (2006, which viour (see Humphreys & Riddoch, 2006, for
depicts a detailed model of how visual word recog- further discussion of these issues).
nition and reading aloud are achieved), or Figure 5
of Miceli and Capasso (2006, which depicts a
detailed model of the structure of the orthographic
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Syndromes, symptoms, and single case


representations used in spelling). Here we have
studies: The patient as a snowflake
strong, explicit, and detailed claims about certain
cognitive architectures. Suppose we were con- It is deeply characteristic of cognitive neuropsy-
vinced that the claims were true in all three chology that it studies symptoms rather than
cases; would anything about the brain follow, syndromes and carries out single case studies
and, if so, what? And what do we currently rather than group studies. These issues surface in
know about the brain that importantly constrains many of the papers collected here; For example,
theories about cognitive architecture? It is clear it is precisely these issues that underlie the
that many people do believe that there are such comment, made in relation to hemispatial
constraints in both directions—for example, neglect by Buxbaum (2006), who observes that
“because I believe that neural constraints can be “nearly every possible fractionation of the disorder
important for cognitive theorizing, I use the has been reported, raising the possibility that each
term cognitive neuroscience rather than cognitive patient may be as unique as a snowflake”.
neuropsychology” (Schacter, 1992, p. 560). This is not true just of neglect: It is true of every
However, whether there are actually such con- disorder that has been studied in any detail by cog-
straints is currently still a matter of controversy: nitive neuropsychologists. Broca’s aphasia is a
See, for example, the symposium on “What has classic example, as is very clearly documented by
cognitive neuroimaging told us about the mind Martin (2006). Early work (Caramazza & Zurif,
(so far)?” in the journal Cortex this year (see 1976) began with a hypothesis that attributed
Coltheart, in press, and the commentaries upon this disorder to a single cause: a defect of a syntac-
that paper). So there is no general agreement as tic processing system that is used both for under-
to how cognitive neuropsychology is related to standing sentences and for constructing them.
cognitive neuroscience. Soon, however, it became clear that agrammatic
Nonetheless, as already noted, it is equally clear comprehension and agrammatic production do
that neuropsychological data are by their very not always co-occur; indeed, they doubly dissociate
nature function – brain pairings, and therefore (see, e.g., Caramazza & Berndt, 1985). Given
they offer a potential window into the neural this double dissociation, the disorder of language
organization of cognitive systems (Caramazza, seen in Broca’s aphasia cannot always be ascribed
1992). Neuropsychological data have been used to damage to a single syntactic system used
to formulate hypotheses about the relationship for both sentence comprehension and sentence
between particular brain areas and processing construction. Distinct explanations are thus
components in cognitive theories. For example, needed for agrammatic sentence comprehension
the elegant and detailed studies of patient DF and agrammatic sentence construction, and so it

COGNITIVE NEUROPSYCHOLOGY, 2006, 23 (1) 5


CARAMAZZA AND COLTHEART

cannot be right to seek the explanation of the morphology is quite small, which makes the
syndrome of Broca’s aphasia. prospect of group studies of snowflake mor-
But perhaps a more restricted aphasic syn- phology an impractical one. Marshall (1984),
drome—agrammatic sentence construction, say— Coltheart (1984), and Howard and Franklin
might be a suitable subject of scientific study? (1988) make exactly the same point about the
This soon turned out not to be so either, because impracticality of group studies in cognitive neu-
the various symptoms of even this more restricted ropsychology. Suppose the model of some cogni-
syndrome doubly dissociate too, to a remarkably tive domain that one wishes to investigate
refined degree. For example, some patients with contains n processing components and m path-
agrammatic sentence constructions are impaired ways of communication between them. If each
at the use of function words but not at the use component or pathway can be independently
of affixes, whereas others show the opposite impaired by brain damage, then the number of
dissociation (Berndt, 1987; Miceli, Silveri, different patterns of impairment of the system
Romani, & Caramazza, 1989; Parisi, 1987). that can arise is 2(mþn). The values of m and n
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This is one reason why cognitive neuropsy- do not have to be very large for 2(mþn) to
chologists study symptoms, not syndromes. become astronomically large. Since the prob-
What, they might say here, can we infer about ability of seeing two consecutive patients with
the architecture of the sentence construction the same pattern of impairment (which is the
system from the fact that it can be damaged in only justification for treating them as a group) is
such a way that function words suffer but affixes 1/2(mþn), this probability is infinitesimal for
do not, and also can be damaged in such a way values of m and n that are typical of current
that function words do not suffer but affixes do? models of cognition. That is why it is appropriate
Which theories about this architecture are ruled to think of patients as being as unique as
out by this double dissociation, and which are snowflakes.
compatible with it? Questions like this can be If, for practical purposes, every patient is
asked if the data from which inferences are unique, how can we amass knowledge that gener-
to be drawn are data about single symptoms. alizes across people? This requires what
Such questions cannot be asked if the data are Caramazza (1986) referred to as the “universality
data about syndromes such as Broca’s aphasia assumption”: the assumption that there is no
(Caramazza, 1984). qualitative variation across neurologically intact
The focus on studying single symptoms rather people in the architecture of the cognitive system
than syndromes (groups of symptoms) goes that these people use to perform in a certain
hand-in-hand with the strategy of carrying out cognitive domain. This allows us to infer that,
single case studies rather than group studies. It is although patient X and patient Y currently
easy to collect together a group of people all diag- have very different systems as a consequence
nosed as exhibiting Broca’s aphasia; it is very unli- of their brain damage, they had the same
kely that one could collect together a group of system premorbidly, and it is about that system
people with intact sentence comprehension and that we want to make inferences from studying
impaired ability to generate affixes correctly but patients X and Y. Cognitive neuropsychology
otherwise intact sentence construction (including cannot be practised unless this universality
intact use of function words). assumption is made, but nor can cognitive
To pursue Buxbaum’s (2006) analogy, that psychology. This is how, even though every
would be like trying to collect together a group patient is essentially unique, we can seek general-
of snowflakes that all had exactly the same izable knowledge from studying them
morphology. The number of possible different (Caramazza, 1986).
shapes for snowflakes is so large that the likeli- The same is true for snowflakes. There is a
hood of obtaining two snowflakes with the same falsifiable theory of snowflake generation that

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COGNITIVE NEUROPSYCHOLOGY TWENTY YEARS ON

makes the following predictions (and no doubt that is taken. The one exception is the work on
many others): the cognitive neuropsychology of everyday action
discussed by Myrna Schwartz. She discusses
1. All snowflakes are snow crystals, or are com-
explicitly the use of group studies. However, the
posed of snow crystals.
aim of the research that she discusses is not to
2. Any snow crystal can have 3 or 6 or 12 sides,
infer something about the cognitive architecture
but none can have 4 or 5 or 8 sides.
of the intact action-planning system from studying
Just as a single patient can refute some hypothesis people with acquired deficits of action planning:
about cognitive architecture by yielding a pattern It is to investigate “hypotheses about brain –
of data that according to that hypothesis could behaviour or deficit – behaviour correlations”
never occur, so a single snow crystal can refute (Schwartz, 2006).
this theory of snowflake generation—a crystal
with 4 or 5 or 8 sides is all that is needed (see
Modularity
Caramazza, 1986, for detailed discussion).
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None of this is meant to be a claim that syn- With his The Modularity of Mind (1983), Jerry
dromes and group studies have no role to play at Fodor did cognitive neuropsychology a great
all in cognitive neuropsychology. Indeed, the first service by elucidating a concept that has played
studies of the cognitive neuropsychology of an important role in the development of the
reading in the modern era were studies of syn- subject—namely, modularity. It should be no sur-
dromes of acquired dyslexia: surface dyslexia, prise, then, to find an extended review of Fodor’s
deep dyslexia, and visual dyslexia (Marshall & book in the first issue of the journal (Schwartz &
Newcombe, 1966, 1973). What this work Schwartz, 1984).
showed us was that there are subtypes of acquired Some cognitive neuropsychologists (e.g.,
dyslexia (Castles & Coltheart, 1993, did the same Coltheart, 1999) are completely committed to
thing with reference to developmental dyslexia). the view that the mind is modular (in the
That allowed work on dyslexia to focus on the sub- Fodorian sense). Others (e.g., Caramazza, 1992)
types rather than on some undifferentiated entity assume only a weak form of modularity—that is,
“acquired dyslexia”. Work on each subtype then that the mind is componentially structured (in
revealed subtypes of the subtypes: different the sense used by Simon, 1969, and Marr, 1982).
subtypes of deep dyslexia and different subtypes In all the papers in this volume, theories about
of surface dyslexia, for example. So the data the architecture of a cognitive system are postu-
compelled finer and finer fractionations of the lated in which that system is considered to be
syndromes, until eventually what is being studied composed of information-processing components
is not a small group of symptoms (a small each responsible for one of the information-
syndrome) but a single symptom. processing jobs that need doing if cognition is to
The moral is clear: In any field of cognition run smoothly. It is this property of cognitive
where cognitive neuropsychology is underdeve- systems that makes them amenable to neuropsy-
loped, starting with small group studies of chological investigation. In other words, it is
symptom collections (syndromes) might prove to because cognitive systems are composed of rela-
be a useful ground-clearing exercise. Mature tively autonomous processing components that
development of the cognitive neuropsychology of “local” brain damage can result in dissociation of
that domain of cognition is signalled by the repla- functions.
cement of this approach in favour of research in That we do not need the strong modularity
which inferences about the intact cognitive assumption in order to make progress in cognitive
system are made on the basis of data from neuropsychology is well illustrated by the case
studies of individual symptoms. In all bar one of of belief formation. On a Fodorian account of
the papers in this volume, this is the approach modularity, belief formation is supported by

COGNITIVE NEUROPSYCHOLOGY, 2006, 23 (1) 7


CARAMAZZA AND COLTHEART

nonmodular central cognitive processes, and The papers in this volume show that compu-
Fodor claims that these nonmodular central tational modelling is rapidly becoming important
processes are not amenable to scientific study. in cognitive neuropsychology. If the theory of
Yet the cognitive neuropsychology of belief which the model is an instantiation is correct,
formation actually seems to be progressing rather that theory ought to be able to offer an explanation
well (see, e.g., Coltheart, 2005; Coltheart & of abnormal as well as of normal cognition:
Davies, 2000). When the theory has been translated into compu-
tational terms, it should be possible to “lesion” the
computational model so that it shows symptoms
Computational cognitive neuropsychology that are also shown by patients. Whenever this is
achieved, further support for the underlying
A computational model of cognition is a computer
theory has been obtained. This is computational
program that is capable of performing the cogni-
cognitive neuropsychology; and this kind of work
tive task in question and, more importantly,
is reported in a number of the papers in this
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performs the task in exactly the same way as,


volume.
according to the theory that is instantiated by
A widely used model of speech productions is
the model, people perform that task. There are
that of Gary Dell and his associates (see, e.g.,
major virtues associated with computational
Dell, 1986). This has been used not only to
modelling:
offer an account of normal speech production,
1. Attempting to implement any theory of cogni- but also to model speech production in aphasia
tion as a working computer program always (Dell, Schwartz, Martin, Saffran, & Gagnon,
identifies a host of hitherto unsuspected ways 1997), and data from aphasia have been essential
in which the theory was underspecified or in development of the model. Rapp and Goldrick
incomplete—problems that have to be fixed if (2006) discuss in detail the implications of data
the theory is to claim viability. from aphasic speech production for fundamental
2. Once the theory has been made “fully com- computational properties of the speech pro-
plete”, and the program is executable, one can duction system such as whether there is feedback
see immediately whether the theory does in the system and whether processing is cascaded
in fact offer an adequate account of this or thresholded. Coltheart (2006) argues in his
domain of cognition: Can the program actually chapter that data from acquired dyslexia have
do the task? played a crucial role in evaluating competing
3. Theory testing can be done with great rigour: Is computational models of reading. Schwartz
the behaviour of the programs affected by all (2006) discusses in detail in her chapter acquired
and only those stimulus properties that affect disorders of action and how they can be
human performance in this cognitive domain, accounted for in relation to an explicit compu-
and in the same way? tational model of everyday action and planning,
4. Even if the answer to the question above is the CS model, and in the chapter by Miceli
“Yes” in relation to a particular computational and Capasso (2006) we see data on acquired
model, there may be other computational dysgraphia beginning to exert constraints on an
models in that cognitive domain, implemen- explicit computational model of spelling.
tations of competing theories, which are Although it is indisputable that computational
equally successful in simulating the relevant modelling provides an especially useful extra
facts. So theory adjudication is needed. It is tool in the toolbox of cognitive neuropsycholo-
much easier to discover experimental outcomes gists, this is not to say that the interpretation of
about which competing theories make different modelling results is any less problematic than
predictions if these theories are expressed as the interpretation of other experimental results.
computer programs. Thus, for example, there are open and difficult

8 COGNITIVE NEUROPSYCHOLOGY, 2006, 23 (1)


COGNITIVE NEUROPSYCHOLOGY TWENTY YEARS ON

issues concerning how one determines whether Some theorists (e.g., Shallice, 1988) have
a computational model can generate the patterns suggested that cognitive neuropsychological data
of results seen in brain-damaged subjects. are too “noisy” for use beyond the level of
Some theorists are content with a general quali- functional architecture. Others (McCloskey &
tative fit of the data (e.g., Dell et al., 1997) Caramazza, 1991) have argued instead that
while others consider it crucial that the fit be there is no a priori restriction on the usefulness
quantitatively appropriate (e.g., Coltheart et al., of such data for the purpose of developing cogni-
2001; Ruml & Caramazza, 2000; Ruml, tive theory at any arbitrary level of detail. They
Caramazza, Capasso, & Miceli, 2005). Thus, offered as existence proof for this position the
for example, Ruml et al. (2005) have argued case of spelling, where significant progress has
that the strongly interactive model of lexical been made in characterizing the structure of the
access proposed by Dell and colleagues is orthographic representations computed at
undermined by the fact that it fails to account various levels of the spelling process. Crucially,
for the detailed distribution of naming error McCloskey and Caramazza noted that the kind
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types in aphasic patients. Independently of how of data that were used for the latter purpose
this issue is resolved, the important point here consisted of the detailed analyses of error
is that increasingly precise theoretical proposals distributions and not simply the patterns of
are possible in the context of computational dissociations across tasks (the more common
models. type of data reported in neuropsychological inves-
tigations). Caramazza and Miceli (1990) reported
that there were precise constraints on the occur-
rence and distribution of error types in the
From boxes and arrows to the structure of
spelling performance of their dysgraphic subject,
representations
LB. For example, they noted that LB’s letter
Much of the early development in modern cogni- substitution and transposition errors were strictly
tive neuropsychology was concerned with the constrained by their consonant –vowel (CV)
articulation of the functional architecture of status: Consonants were exchanged/transposed
specific cognitive systems (e.g., the spelling only with consonants, and vowels were
system). These theories were formulated in terms exchanged/transposed only with vowels. This
of the components of processing implicated in a constraint, together with other converging
task and their organization—the so-called box- evidence, was taken as indicating that the ortho-
and-arrow models. Although often denigrated graphic representation used at the level of the
for their relatively general nature, these models graphemic buffer specified not only the identity
played (and continue to play) an important role and order of graphemes but also their CV struc-
in formulating hypotheses about the general archi- ture. This conclusion has since received wide
tecture of cognitive systems (see Coltheart et al., confirmation (for review, see Miceli & Capasso,
2001). In fact, such cognitive architectures are 2006; Tainturier & Rapp, 2001), validating the
inescapable features of all cognitive theories claim that cognitive neuropsychological data can
(even of those proposed by denigrators of the so- be used to constrain theories beyond the level of
called box-and-arrow theories) for the simple functional architecture to inform the types of
reason that any nontrivial aspect of cognition will representation used at various levels of processing.
involve a number of processing components and Indeed, there is a growing body of literature
their associated representations. Be this as it focusing on the implications for the structure
may, the crucial question is whether cognitive and content of cognitive representations from
neuropsychological data can be used to inform the patterns of deficits in brain-damaged individ-
cognitive theory beyond the general level of uals (see, e.g., Nickels, 2001; Rapp & Goldrick,
functional architecture. 2006).

COGNITIVE NEUROPSYCHOLOGY, 2006, 23 (1) 9


CARAMAZZA AND COLTHEART

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Cognitive Neuropsychology twenty years on


a b
Alfonso Caramazza & Max Coltheart
a
Cognitive Neuropsychology Laboratory, Harvard University, Cambridge,
MA, USA
b
Macquarie Centre for Cognitive Science, Macquarie University, Sydney,
NSW, Australia
Available online: 05 Jan 2007

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