The Ecological Validity Of Neuropsychological Assessment and Remediation

Memory assessment in neuropsychology: Theoretical considerations and practical utility

“…Two aspects of this shift, one more theoretical and one largely applied, are seen. Presently, there has been a theoretical shift toward integration with cognitive psychology and analysis of cognitive "components," although localization is still of importance, and an applied shift toward rehabilitation involving the analysis of more pragmatic behavioral "components" (Hart & Hayden, 1986). However, when performing an evaluation of cognitive functioning, the neuropsychologist must first ensure that the tests employed genuinely assess the cognitive operations of interest in order to 341 MEMORY ASSESSMENT avoid making erroneous conclusions regarding the behavioral sequelae associated with brain pathology.…”

Evaluation of cognitive rehabilitation as a treatment paradigm

“…Most assume that the cognitive deficits require intensive intervention. Hence the treatment plans tend to be relatively complex, staging therapies for the defective cognitive processes in several content areas [36,39], including simulations and/or in vivo training of job, social, daily living and community skills required for post-discharge adaptation [19]. Many of these programmes also attempt to create a transdisciplinary 'united front' in which multiple therapists jointly address key deficits as soon as they become fully amenable to training (the 'zone of proximal development' [40,41]) by the use of a shared behavioural intervention protocol [42].…”

“…First, strategies are introduced didactically, anchored in clearly defined central concepts. Then they are applied to a varied set of training tasks, which are progressed to higher levels of difficulty and complexity as they are mastered [26,39]. They are next 'bridged' to other therapy sessions and activities and assigned for use in the real world as homework, often with the collaborative assistance of family members [7,14,24].…”

“…The milieu therapy component, initially modelled on therapeutic communities for drug and alcohol addiction [30], is a unique feature not found in programmes for physical rehabilitation. The rationale for its use is that trainees need to be optimally engaged, motivated and taught self-discipline and this is best accomplished through (1) a programme philosophy that places the responsibility for recovery on the patient, (2) strong group cohesion and identification and (3) the use of confrontative (as well as supportive) peer feedback as a primary vehicle for establishing insight [7,39]. In some ways, this model is even more effective than its original application in substance abuse, in that the trainees are brought face-to-face with their deficits many times every day and required to make commitments to anticipate and recognize the deficits and use the recommended processing strategies.…”

Memory Problems

“…Although everyday problems and questions about treatment are best answered through behavioural assessment or direct observation, it is possible to make standardised tests more relevant to real-life situations (Hart & Hayden, 1986). For example, one can make standardised tests more like real-life tasks.…”