The Rehabilitation of Cognitive Disabilities
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1 The Rehabilitation of Cognitive Disabilities
2 The Rehabilitation of Cognitive Disabilities Edited by J. Michael Williams Center for Applied Psychological Research Memphis State University Memphis, Tennessee and Charles J. Long Center for Applied Psychological Research Memphis State University and Neuropsychology Laboratory University of Tennessee Center for the Health Sciences Memphis, Tennessee PLENUM PRESS NEW YORK AND LONDON
3 Library of Congress Cataloging in Publication Data Mid-South Conference of Human Neuropsychology on the Rehabilitation of Cognitive Disabilities (4th: 1986: Memphis, Tenn.) The rehabilitation of cognitive disabilities. "Proceedings of the Fourth Mid-South Conference of Human Neuropsychology on the Rehabilitation of Cognitive Disabilities, held May 29-30, 1986, in Memphis, Tennessee" - T. p. verso. Includes bibliographies and index. 1. Cognition disorders - Patients - Rehabilitation - Congresses. 1. Williams, J. Michael, II. Long, CharlesJ., III. Title. [DNLM: 1. Brain Injuries-rehabilitation - congresses. 2. Cognition Disorders - rehabilitation - congresses. W3 MI286 4th 1986r 1 WL 354 M r] RC394.C64M ISBN-13: e-isbn-13: DOl: / Proceedings of the Fourth Mid-South Conference of Human Neuropsychology on the Rehabilitation of Cognitive Disabilities, held May 29-30, 1986, in Memphis, Tennessee 1987 Plenum Press, New York Softcover reprint of the hardcover 1 st edition 1987 A Division of Plenum Publishing Corporation 233 Spring Street, New York, N.Y All rights reserved No part of this book may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, microfilming, recording, or otherwise, without written permission from the Publisher
4 Contributors Gerald Bennett, Spain Rehabilitation Center, University of Alabama at Binningham, Binningham, AL Thomas Bergquist, Spain Rehabilitation Center, University of Alabama at Birmingham, Binningham, AL Tina Brown, Department of Psychology, Memphis State University, Memphis, TN Marian B. Danse, Department of Preventive, Family, and Rehabilitation Medicine, Monroe Community Hospital, University of Rochester, Rochester, NY. Raymond S. Dean, Neuropsychology Laboratory, TC-521, Ball State University, Muncie, IN Kathleen Fitzhugh-Bell, Department of Neurology, Indiana University Medical Center, Indianapolis, IN Wm. Drew Gouvier, Department of Psychology, Lousiana State University, Baton Rouge, LA Gregory Harter, Department of Psychology, Memphis State University, Memphis, TN Donna L. Hartley, Spain Rehabilitation Center, University of Alabama at Binningham, Binningham, AL Aleida K. Inglis, Department of Reading, Language, and Learning Disabilities, Harvard University, Cambridge, MA Marsha M. Little, Department of Psychology, Memphis State University, Memphis, TN Charles J. Long, Department of Psychology, Memphis State University, Memphis, TN Kurt A. Moehle, Department of Psychology, Purdue University at Indianapolis, Indianapolis, IN Sam B.Morgan, Department of Psychology, Memphis State University, Memphis, TN Thomas A. Novak, Spain Rehabilitation Center, University of Alabama at Birmingham, Binningham, AL Randolph W. Parks, Department of Psychiatry, Massachusetts Mental Health Center, Harvard Medical School, Cambridge, MA v
5 vi Contributors George Prigatano, Department of Neuropsychology, St. Joseph Hospital and Medical Center, Phoenix, AZ Jeffrey L. Rassmussen, Department of Psychology, Purdue University at Indianapolis, Indianapolis, IN Gurmal Rattan, Indiana University of Pennsylvania, Indiana, PA Robert Sbordone, University of California at Irvine School of Medicine and Orange County Neuropsychology Group, Fountain Valley, CA Cathy Telzrow, Cuyahoga Special Education, Service Center, Granger Road, Maple Heights,OH Mark, T. Wagner, Department of Preventive, Family, and Rehabilitation Medicine, Monroe Community Hospital, University of Rochester, Rochester, NY Mark S. Warner, Department of Psychology, Lousiana State University, Baton Rouge, LA 1. Michael Williams, Department of Psychology, Memphis State University, Memphis, TN Lisa A. Wolfe, Department of Psychology and Social Relations, Harvard University, Cambridge, MA
6 Preface The rehabilitation of intellectual impairment resulting from brain injury has become a major professional activity of clinical neuropsychologists. In recent years, neuropsychology has developed from a professional role stressing assessment and diagnosis to one that now includes treatment and rehabilitation activities. Such trends are also manifested in two new research interests of neuropsychologists: the study of the generalizability of neuropsychological test findings to everyday abilities, often referred to as the "ecological validity" of tests, and outcome studies of cognitive retraining treatments. Discovering the relationships between traditional neuropsychological tests and everyday behavior is important because the referral questions posed to neuropsychologists have changed. Now, the neuropsychologist is asked to comment on the patient's functional intellectual abilities as they relate to the everyday demands of home, work and educational settings. Of course, the development of cognitive retraining theory and procedures allows neuropsychologists to intervene in the treatment of the cognitive problems that the neuropsychological evaluation has documented. Since these approaches are still in their formative stages, they have been the subject of clinical lore, great controversy and little systematic research. This situation prompted one of our presenters to lament, "Either you believe Cognitive Retraining is divinly inspired, or the work of the devil." There is apparently little middle ground. Given this state of affairs, the program committee of the Mid-South Conference on Human Neuropsychology decided to focus on the role of neuropsychologists in rehabilitation. Such a conference would allow us to mull over all of the new problems inherent in developing new research and clinical programs. We also decided to include presentations on intervention approaches used to remediate learning disabilities. This area is also in its formative stages and shares many of the retraining techniques and controversies present in the rehabilitation of brain injuries. The following chapters represent the proceedings of the fourth May conference on human neuropsychology. The chapters cover a broad area and we are not sure we have achieved a significant new synthesis of ideas in this volume. We can certainly claim that the present chapters are excellent current reviews of the major topics. As such, we certainly hope this book will bring some clarity to the study of cognitive rehabilitation. J. Michael Williams and Charles J. Long Memphis, Tennessee vii
7 Contents Part One: General Theories of Cognitive Rehabilitation 1. A Conceptual Model of Neuropsychologically-Based Cognitive Rehabilitation... ' 3 Robert J. Sbordone 2. Neuropsychological Rehabilitation After Brain Injury: Some Further Reflections George P. Prigatano 3. The Role of Cognitive Retraining in Comprehensive Rehabilitation J. Michael Williams 4. Neuropsychological Theories and Cognitive Rehabilitation......, 57 Kurt A. Moehle, Jeffrey Lee Rasmussen and Kathleen B. Fitzhugh-Bell Part Two: The Practice of Cognitive Rehabilitation 5. The Current Status of Computer-Assisted Cognitive Rehabilitation Charles J. Long 6. Methodological Issues in Cognitive Retraining Research Gregory W. Harter 7. Treatment of Visual Imperception and Related Disorders Wm. Drew Gouvier and Mark S. Warner 8. The Remediation of Everyday Memory Deficits Marsha M. Little ix
8 x Contents 9. Cognitive Rehabilitation: Psychosocial Issues MarkT. WagnerandMarianB.Danse 10. Cognitive Stimulation in the Home Environment Thomas A. Novack, Thomas F. Bergquist, Gerald Bennett, and Donna Hartley Part Three: Pediatric Cognitive Rehabilitation 11. The Neuropsychology of Children's Learning Disorders Gurmal Rattan and Raymond S. Dean 12. The "So What?" Question: Intervention with Learning Disabled Children Cathy F. Telzrow 13. Learning Disabilities and Hyperactivity: Implications for Research and Clinical Assessment Lisa A. Wolfe, Aleida K. Inglis, and Randolph W. Parks 14. Cognitive Training with Brain-Injured Children: General Issues and Approaches Tina L. Brown and Sam B. Morgan Subject Index
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