ISSN:0269-9052    

DOI:10.3109/02699059109008106

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

In a prospective study 76 children were divided into three groups on the basis of severity of head injury as defined by the Glasgow Coma Scale and duration of increased intracranial pressure. The children were administered a neuropsychological test battery and behavioural ratings were made by parents and teachers at three intervals: time of hospital discharge and 3 and 9 months post-initial testing. There were cognitive deficits related to severity of injury with the greatest difference in abilities observed between the severe and the other two groups. The greatest differences in skills were on the Performance IQ and timed tests of visual-motor speed and co-ordination. The greatest improvement in skills occurred in the first 3 months post-injury. Several children in coma for up to 4 weeks were able to obtain normal IQ scores. In the mild and moderate injury groups very few had behavioural change while in the severe group approximately 90% had one learning or adjustment difficulty and 40% had three or more problems.

ISSN:0269-9052    

DOI:10.3109/02699059109008107

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

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 processes 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.Assessment of non-compliance has been discussed. This included exploration of reinforcement contingencies, age appropriateness, cultural background and social background. Several perspectives on this have been addressed. Memory deficits are also critical when assessing non-compliance. Specifically, when the TBI person has severe memory deficits. Consequence management and antecedent control techniques have shown to be highly effective in promoting participation. Additionally, non-compliance should not necessarily be viewed as non-desirable, in fact, the client may be communicating preferred and non-preferred interests. It is important to recognize individual talents, interests and preferences. This is a signicant point when you consider that TBI survivors had pre-injury lifestyles, i.e. full-time employment, a working social network, and preferred interests and activities.

ISSN:0269-9052    

DOI:10.3109/02699059109008108

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Assessment of non-compliance has been discussed. This included exploration of reinforcement contingencies, age appropriateness, cultural background and social background. Several perspectives on this have been addressed. Memory deficits are also critical when assessing non-compliance. Specifically, when the TBI person has severe memory deficits. Consequence management and antecedent control techniques have shown to be highly effective in promoting participation. Additionally, non-compliance should not necessarily be viewed as non-desirable, in fact, the client may be communicating preferred and non-preferred interests. It is important to recognize individual talents, interests and preferences. This is a signicant point when you consider that TBI survivors had pre-injury lifestyles, i.e. full-time employment, a working social network, and preferred interests and activities.

ISSN:0269-9052    

DOI:10.3109/02699059109008109

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The current study evaluated under double-blind placebo-controlled conditions, the safety and efficacy of 400 mg pramiracetam sulphate TID in treating memory and other cognitive problems of males who have sustained brain injuries. The results of the study indicate that subject performance in measures of memory, especially delayed recall, evidenced clinically significant improvements after the administration of pramiracetam sulphate as compared to placebo. This improvement was maintained during an 18-month open-trial period on the medication as well as during a 1-month follow-up period after the pramiracetam was discontinued.

ISSN:0269-9052    

DOI:10.3109/02699059109008110

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Higher level traumatically brain-injured (TBI) adults often present a challenge in assessment as well as in the measurement of recovery. Traditional clinical measures of language abilities have not been adequate to identify and describe precisely what is deviant about their communication. Assessment has generally consisted of aphasia tests and measures of general cognitive abilities. Although such measures may be sensitive to deficits in lower level TBI patients or those in the early stages of recovery, their usefulness with higher functioning patients is questionable due to the often subtle nature of their residual communication problems. An overview of discourse analyses is presented and recent applications of these procedures with TBI patients reviewed.

ISSN:0269-9052    

DOI:10.3109/02699059109008111

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

Patients diagnosed as being in prolonged coma (vegetative state) in this hospital are routinely treated according to a sensory stimulation protocol. This paper reports an evaluation of the efficacy of this procedure using the comparison of behavioural measures taken immediately prior to and post-stimulation. Four single cases produced significant behavioural changes suggesting increased arousal as a result of stimulation. The results and implications for further evaluation studies are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059109008112

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The practice of coma arousal and sensory stimulation is becoming the focus of heated debate. There is no theory on which patients may benefit, at what time in their recovery, or how the 'arousal' or 'stimulation' procedures should be applied. This paper considers some of the information processing mechanisms that are important mediators of arousal and awareness, pointing to some of the weaknesses in current practices and suggesting alternative approaches. Recommendations for a conceptual model of sensory stimulation are given that might provide a more scientific perspective to those who use such methods.

ISSN:0269-9052    

DOI:10.3109/02699059109008113

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

This study was conducted to examine functional status, costs of treatment, and how function and costs are related to the referral process of persons with traumatic head injury (THI). The study attempted to answer questions such as: what portion of the THI population is not referred on for subsequent treatment? Is referral dependent upon level of function at time of discharge from acute care? What are the costs associated with different levels of treatment by different facilities? Information was gathered from medical record reviews. Data were gathered from 101 persons with traumatic head injury (PWTHI) using a survey form, a functional assessment inventory, and a performance status scale. Per subject cost statements were obtained from the treatment/service facilities. Results indicate that the factors in the referral process for further treatment and rehabilitation do not appear to be consistent. Acute care referral at discharge is dependent upon severity of residual dysfunction including other factors than THI, while referral at discharge from a rehabilitation centre is dependent upon less obvious factors; one of which may be age at time of injury. Acute care and rehabilitation centre per patient average costs are quite similar and significantly higher than average per client costs.

ISSN:0269-9052    

DOI:10.3109/02699059109008114

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor

摘要:

The severely brain-injured patient may demonstrate a limited repertoire of responses. Anecdotal accounts suggest that stimuli of personal relevance, or of an unusual or innovatory nature, may sometimes elicit more meaningful responses. Two cases of severe acquired brain injury are described, in whom overall levels of responsiveness had been very low since coma ended. The use of stimuli with personal relevance provoked strong responses and presaged further behavioural change. The implications are discussed.

ISSN:0269-9052    

DOI:10.3109/02699059109008115

出版商:Taylor&Francis    

年代:1991

数据来源: Taylor