Addressing a continuum of recovery after acquired brain injury

Abstract

In their dialogue published in JINS, Wilson (1997) and Prigatano (1997) have eloquently and concisely presented the challenges facing neuropsychology with respect to cognitive rehabilitation. However, both authors neglect two important issues that must be addressed if people with cognitive disorders are to be effectively treated. First, cognitive impairment must be treated during the acute stages of recovery; as to ignore cognitive deficits until patients are more fully recovered may bypass an opportune time for intervention. Evidence is mounting that the injured brain adapts to the losses sustained and that the adaptation will be enhanced by increasing interaction with the environment, as compared to more passive states (Johansson & Ohlsson, 1996; Stein et al., 1995). Given such information, it is difficult to justify withholding cognitive stimulation and remediation from people during acute stages of recovery and instead awaiting a point when spontaneous recovery (presumably) will be complete.