Cognitive rehabilitation: A neuropsychological speciality comes of age

Abstract

In its first decade cognitive rehabilitation has emerged from infancy with the energy and much of the turmoil of youth. It has become an established speciality in brain-injury rehabilitation and has inspired many neuropsychologists to broaden their expertise beyond diagnosis and address their efforts to intervention. Restoration, although controversial, is an important and valid goal at the outset of cognitive rehabilitation, whereas the substitution of other means of goal achievement and environmental redesign are significant components of a comprehensive neuro-rehabilitative treatment programme. Efficacy is being demonstrated in many ways, ranging from increased patterns of use to controlled empirical studies. Few continue to raise the naive issue of whether there is any scientific basis for this neuropsychological speciality; instead, questions have become more focused on understanding the process of change to best serve human needs. In the next decade the refinement of current approaches can be anticipated, as well as the breaking of new ground. Neuropsychologists specializing in cognitive rehabilitation are likely to be turning their attention to underserved populations, such as those emerging from protracted coma, individuals suffering from 'progressive' neurological conditions, and persons whose brains were injured early in development. Scientific (theoretical, methodological and empirical) developments in cognitive psychology will help to delve more precisely into the underlying basic processes, including the sensory substrate. We will be challenged to address specific applications, such as advising people with known or suspected cognitive deficits who wish to drive.

Dynamic instability during obstacle crossing following traumatic brain injury

“…Therefore, the ability to identify any functional impairment that may affect safety after a TBI is critical to prevention of re-injury. The utility of neuropsychometric testing in evaluating cognitive impairment resulting from TBI is well established [2][3][4][5][6]. However, comparatively little information is available on the performance of dynamic motor tasks following TBI.…”

Cognitive rehabilitation groups: A thematic analysis of feasibility and perceived benefits for clients with moderate to severe traumatic brain injury living in the Western Cape

“…The result is frequently a decrease, or loss, of income and earning potential, resulting in increased financial strain for the individual, and his or her family, over a lifetime (Khan et al 2003; Sarajuuri et al 2005). The consequences of TBI are social, emotional, and cognitive, affecting both the individual and his or her family (Gianutsos 1991). …”

Traumatic Brain Injury Rehabilitation: An Overview

“…However, there is no doubt that such techniques, whilst not influencing memory impairment, can certainly reduce the effects of such impairment and have positive benefits in terms of disability and handicap [22]. Similar approaches have been taken to the remediation of problem solving deficits, attention deficits and perceptual problems [23] Fortunately, very few individuals remain in prolonged coma or prolonged vegetative state following brain injury. One study [24] found that 0.6% of all brain-injured individuals admitted to a neurosurgical unit remained in prolonged coma (of more than two weeks' duration).…”