Rehabilitation of neuropsychological deficits: Compensatory approaches.

Abstract

This chapter provides a summary of relevant and recent literature on evidence-based compensatory approaches to neurorehabilitation. The benefits of compensation, including how they can help address the needs and challenges faced by patients and their families, are also addressed. A primary focus of the chapter is on current assessment methods and literature on compensatory skills training, including strengths and weaknesses of currently practiced methods. This chapter concludes with recommendations for designing and evaluating compensatory strategies (particularly technology-based solutions) and treatment interventions. Overall, research supports the importance of compensatory-based interventions to improve everyday functioning and reduce caregiver burden. Importantly, individuals with mild to moderate cognitive impairment have the capacity to learn and apply new strategies, and there is evidence of continued strategy use following intervention withdrawal, making compensation approaches to neurorehabilitation, particularly external strategies and assistive technology, a reliable practice standard. It is suggested that future work focus on matching compensatory strategies with the area of impairment or other factors that may affect use (e.g., age). Along these lines, continued identification of mediating and moderating factors that influence compensation use is vital. In order to assess the impact of interventions, reliable and ecologically valid assessment measures that support evaluation of compensation clinically are warranted. Further, evidence suggests that compensatory training may work synergistically with other treatment strategies, yet it is suggested that therapeutic effect of each component be evaluated both separately and together.