Early Neuropsych Evaluation Helps Formulate Rehab Plan
Results from a neurospychological exam conducted soon after a TBI will help formulate the rehabilitiation plan.
In an ideal world--I'd like to live in an ideal world--if you can get a neuropsychological assessment early on after an injury, it kind of gives you a baseline of where you're starting from in the rehabilitation process. It informs you, in terms of where the deficits are, where the problems really are coming from. Much of the cognition and behaviors that we engage in are kind of an endpoint of a very long thinking process and mechanical, electrical process within our brain. So what you see is the result of a lot of stuff happening in your brain. If we can figure out where the breakdown is and what is happening with your brain, we can more efficiently direct where the intervention needs to be. Going in and trying to intervene, for example, with a memory problem without knowing is it an encoding problem, is it an attribution problem, is it a retrieval problem, is it a storage problem--without knowing where exactly the breakdown is, there are some strategies you can use to improve it just generally, but you can be much more efficient if you can pinpoint where exactly the breakdown in that whole process is. So early on, in particular, in terms of formulating the treatment plan, the neuropsychologist is very helpful, in terms of being able to determine what exactly is going on and where can we intervene. As the team continues to work with an individual, a neuropsychologist very often takes on a consultative role, in terms of monitoring improvement, monitoring progress, tweaking the treatment plan, helping people when they run into glitches and get stuck. It's not unusual, particularly working with people with brain injuries because it's such a complex disorder, that some of the traditional stuff that we do for this doesn't seem to be working. So to help tweak some of those interventions and to say, "Well, let's approach it this way." "Let's present information in this way. This person needs this level of repetition and practice," those kinds of things, act in a kind of consultative role as they go along. Also working some with family and others involved with the person to help them understand what's going on and why their loved one is suddenly such a different person.
Posted on BrainLine February 7, 2011.
Dr. Celeste Campbell is a neuropsychologist in the Polytrauma Program at the Washington, DC Veterans Administration Medical Center. She has a long history of providing cognitive psychotherapy and developing residential behavioral management programs for children and adults.
Produced by Victoria Tilney McDonough and Brian King, BrainLine.