Objective:To determine the effects of stimulus modality on the verbal learning of patients with closed head injury (CHI) and to compare the performance of the patients with CHI to matched normal subjects.Patients:Twenty-four randomly selected subjects with moderate to severe CHI were matched in age, sex, education, and handedness to 16 normal volunteers.Main outcome measure:A multitrial free recall paradigm incorporating three modalities (auditory, visual, and auditory plus visual) was used to measure the number of words learned per trial.Results:Subjects with CHI learned new information at a significantly slower rate compared with normal subjects. Patients with CHI learned more words presented visually (with or without auditory presentation of names) during free recall and recognition.Conclusions:Visual therapy methods that incorporate pictures may enhance verbal learning in patients with moderate to severe CHI.