Occupational therapists use both adaptive and remedial approaches to perceptual retraining in adults with head injury. This experimental treatment outcome study compared the effects of adaptive and remedial treatments for constructional deficits on meal preparation competence and on constructional abilities in adult men with head injury. Forty-five subjects, 18 to 52 years of age, in long-term rehabilitation programs were randomly assigned to one of two treatment groups. A remedial group (n = 22) received individual training with parquetry block assembly, and an adaptive group (n = 23) received individual training in food preparation activities. Both groups received training for three 30-min sessions per week for 6 weeks, in addition to their regular rehabilitation programs. Results of analyses of variance and paired t tests on perceptual and functional test scores showed task-specific learning in both groups and suggested that training in functional activities may be the better way to improve performance in such activities in this population.