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Science is the search for generalizable processes— clinicians solve complex problems: A reply to Wilson on the importance of not confusing these two things

Published online by Cambridge University Press:  01 July 2005

IAN H. ROBERTSON
IAN H. ROBERTSON
Affiliation:
University of Dublin Trinity College, Dublin, Ireland
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Extract

Barbara Wilson is a creative and influential clinician–scientist who has dedicated her working life to finding ways to rehabilitate brain-damaged people in all the confusing complexity of their damaged brains and lives. Her behavioral training at the Institute of Psychiatry in London inspired her to apply the powerful methods of applied behavior analysis to shape functionally relevant behaviors in the real-life contexts in which these people have to learn new ways of living. I, on the other hand, have chosen to work with people who have specific cognitive deficits such as unilateral neglect (Robertson et al., 1998), impaired sustained attention (Robertson et al., 1997) or goal-neglect-type executive deficits (e.g., Manly et al., 2002). I have specifically avoided trying to carry out research on people with complex problems, specifically because I tried to understand how these strange interchanges we call rehabilitation actually work (Robertson, 2002; Robertson & Murre, 1999). In my research (not, I hasten to add, in my clinical practice), I try to identify relatively pure processes that can be replicated anywhere in the world—not to solve the pressing problems of a particular, unique and complex life.

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DIALOGUE
Information
Journal of the International Neuropsychological Society , Volume 11 , Issue 4 , July 2005 , pp. 494 - 497
Copyright
© 2005 The International Neuropsychological Society

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References

REFERENCES

Ball, K., Berch, D.B., Helmers, K.F., Jobe, J.B., Leveck, M.D., Marsiske, M., Morris, J.N., Rebok, G.W., Smith, D.M., Tennstedt, S.L., Unverzagt, F.W., & Willis, S.L. (2002). Effects of cognitive training interventions with older adults: A randomised controlled trial. Journal of the American Medical Association, 13, 2271–2281.CrossRefGoogle Scholar
Crerar, M.A., Ellis, A.W., & Dean, E.C. (1996). Remediation of sentence processing deficits in aphasia using a computer-based microworld. Brain and Language, 52, 229–275.Google Scholar
Frassinetti, F., Angeli, V., Meneghello, F., Avanzi, S., & Ladavas, E. (2002). Long-lasting amelioration of visuospatial neglect by prism adaptation. Brain, 125, 608–623.CrossRefGoogle Scholar
Gray, J.M., Robertson, I.H., Pentland, B., & Anderson, S.I. (1992). Microcomputer based cognitive rehabilitation for brain damage: A randomised group controlled trial. Neuropsychological Rehabilitation, 2, 97–116.CrossRefGoogle Scholar
Kalra, L., Perez, I., Gupta, S., & Wittink, M. (1997). The influence of visual neglect on stroke rehabilitation. Stroke, 28, 1386–1391.CrossRefGoogle Scholar
Kaschel, R., Sala, S.D., Cantagallo, A., Fahlbock, A., Laaksonen, R., & Kazen, M. (2002). Imagery mnemonics for the rehabilitation of memory: A randomised group controlled trial. Neuropsychological Rehabilitation, 12, 127–153.CrossRefGoogle Scholar
Kerkhoff, G. (1999). Restorative and compensatory therapy approaches in cerebral blindness: A review. Restorative Neurology and Neuroscience, 15, 255–271.Google Scholar
Levine, B., Robertson, I., Clare, L., Carter, G., Hong, J., & Wilson, B.A. (2000). Rehabilitation of executive functioning: An experimental-clinical validation of Goal Management Training. Journal of the International Neuropsychological Society, 6, 299–312.Google Scholar
Manly, T., Hawkins, K., Evans, J., Woldt, K., & Robertson, I.H. (2002). Rehabilitation of executive function: Facilitation of effective goal management on complex tasks using periodic auditory alerts. Neuropsychologia, 40, 271–281.CrossRefGoogle Scholar
Miltner, W.H., Bauder, H., Sommer, M., Dettmers, C., & Taub, E. (1999). Effects of constraint-induced movement therapy on patients with chronic motor deficits after stroke: A replication. Stroke, 30, 586–592.CrossRefGoogle Scholar
O'Connor, C., Manly, T., Robertson, I.H., Hevenor, S.J., & Levine, B. (2004). An fMRI study of sustained attention with endogenous and exogenous engagement. Brain and Cognition, 54, 133–135.Google Scholar
Robertson, I., Gray, J., Pentland, B., & Waite, L. (1990). A randomised controlled trial of computerised cognitive rehabilitation for unilateral left neglect. Archives of Physical Medicine and Rehabilitation, 71, 663–668.Google Scholar
Robertson, I.H. (2002). Cognitive neuroscience and brain rehabilitation: A promise kept (Editorial). Journal of Neurology, Neurosurgery and Psychiatry, 73, 357.CrossRefGoogle Scholar
Robertson, I.H., Manly, T., Andrade, J., Baddeley, B.T., & Yiend, J. (1997). Oops!: Performance correlates of everyday attentional failures in traumatic brain injured and normal subjects: The Sustained Attention to Response Task (SART). Neuropsychologia, 35, 747–758.CrossRefGoogle Scholar
Robertson, I.H., Mattingley, J.B., Rorden, C., & Driver, J. (1998). Phasic alerting of neglect patients overcomes their spatial deficit in visual awareness. Nature, 395, 169–172.CrossRefGoogle Scholar
Robertson, I.H., McMillan, T.M., MacLeod, E., & Brock, D. (2002). Rehabilitation by Limb Activation Training (LAT) reduces impairment in unilateral neglect patients: A single-blind randomised control trial. Neuropsychological Rehabilitation, 12, 439–454.Google Scholar
Robertson, I.H. & Murre, J.M.J. (1999). Rehabilitation of brain damage: Brain plasticity and principles of guided recovery. Psychological Bulletin, 125, 544–575.CrossRefGoogle Scholar
Robertson, I.H. & North, N. (1992). Spatio–motor cueing in unilateral neglect: The role of hemispace, hand and motor activation. Neuropsychologia, 30, 553–563.CrossRefGoogle Scholar
Robertson, I.H. & North, N. (1994). One hand is better than two: Motor extinction of left hand advantage in unilateral neglect. Neuropsychologia, 32, 1–11.Google Scholar
Robertson, I.H., North, N., & Geggie, C. (1992). Spatio-motor cueing in unilateral neglect: Three single case studies of its therapeutic effectiveness. Journal of Neurology, Neurosurgery and Psychiatry, 55, 799–805.CrossRefGoogle Scholar
Robertson, I.H., Tegner, R., Tham, K., Lo, A., Nimmo-Smith, I. (1995). Sustained attention training for unilateral neglect: theoretical and rehabilitation implications. Journal of Clinical and Experimental Neuropsychology, 17, 416–430.Google Scholar
Rossetti, Y., Rode, G., Pisella, L., Farne, A., Li, L., & Boisson, D. (1998). Prism adaptation to a rightward optical deviation rehabilitates left hemispatial neglect. Nature, 395, 166–169.CrossRefGoogle Scholar
Samuel, C., Louis-Dreyfus, A., Kaschel, R., Makiela, E., Troubat, M., & Aselmi, N. (2000). Rehabilitation of very severe unilateral neglect by visuo-spatial cueing: Two single case studies. Neuropsychological Rehabilitation, 10, 385–399.Google Scholar
Schindler, I., Kerkhoff, G., Karnath, H.-O., Keller, I., & Goldenberg, G. (2002). Neck muscle vibration induces lasting recovery in unilateral neglect. Journal of Neurology, Neurosurgery and Psychiatry, 73, 412–419.CrossRefGoogle Scholar
Seki, K., Yajima, M., & Sugishita, M. (1995). The efficacy of kinaesthetic reading treatments for pure alexia. Neuropsychologia, 33, 595–609.Google Scholar
Seze, M.D., Wiart, L., & Bon-Saint-Come, A. (2001). Rehabilitation of postural disturbances of hemiplegic patients by using trunk control retraining during exploratory exercises. Archives of Physical Medicine and Rehabilitation, 82, 793–800.Google Scholar
Stigsdotter-Neely, A. & Bäckman, L. (1993). Long-term maintenance of gains from memory training in older adults: Two 3 1/2 year follow-up studies. Journal of Gerontology, 48, 233–237.CrossRefGoogle Scholar
Sturm, W., Longonia, F., Weisa, S., Specht, K., Herzog, H., & Vohna, R. (2004). Functional reorganisation in patients with right-hemisphere stroke after training of alertness: A longitudinal PET and fMRI study in eight cases. Neuropsychologia, 42, 434–450.CrossRefGoogle Scholar
Tallal, P., Miller, S.L., Bedi, G., Byma, G., Wang, X.Q., & Nagarajan, S.S. (1996). Language comprehension in language-learning impaired children improved with acoustically modified speech. Science, 271, 81–84.CrossRefGoogle Scholar
Taub, E. & Wolf, S.L. (1997). Constraint induced movement techniques to facilitate upper extremity use in stroke patients. Topics in Stroke Rehabilitation, 3, 38–61.Google Scholar
Wilson, B.A. (1988). Remediation of apraxia following an anaesthetic accident. In J. West & P. Spinks (Eds.), Clinical psychology in action (pp. 178–183). London: John Wright & Sons.
Wilson, B.A., Baddeley, A.D., Evans, J.J., & Shiel, A. (1994). Errorless learning in the rehabilitation of memory impaired people. Neuropsychological Rehabilitation, 4, 307–326.CrossRefGoogle Scholar
Wilson, B.A., Emslie, H.C., Quirk, K., & Evans, J.J. (2001). Reducing everyday memory and planning problems by means of a paging system: A randomised control crossover study. Journal of Neurology, Neurosurgery and Psychiatry, 70, 477–482.Google Scholar
Wilson, F.A.W., Scalaidhe, S.P.O., & Goldman-Rakic, P.S. (1993). Dissociation of object and spatial processing domains in primate prefrontal cortex. Science, 260, 1955–1958.CrossRefGoogle Scholar