Neuropsychological Rehabilitation Principles and Applications

List of contributors ix

1 Neuropsychological Rehabilitation: Need and Scope 1

J. Rajeswaran, C.N. Bennett and E.A. Shereena

 The Miracle of the Human Brain—The Basis for

Neuropsychological Rehabilitation 1

Definition and Introduction 2

the Development of a Sound Neuropsychological 

Rehabilitation Program 2

Theories of Neuropsychological Intervention 3

 The Role of Neuronal Plasticity 3

 The Role of Restitution, Substitution, and Compensation 4

 The Role of Diaschisis and the Unmasking of Latent Neural Pathways 4

 Major Influences and Recent Advances in the Development 

of Rehabilitative Neuropsychology 4

Methods of Neuropsychological Rehabilitation 5

Need for Intervention 6

Vital Issues and Current Trends 6

 Caregiver Burden: Giving Till It Hurts 6

 Rehabilitation of Pediatric Populations 7

 Static Versus Progressive Conditions 8

 Medico-Legal Cases 8

 Setting Up a Rehabilitation Center 8

Conclusion 8

2 Computerized Cognitive Retraining Programs for 

Patients Afflicted with Traumatic Brain Injury and 

Other Brain Disorders 11

C.R. Mukundan

Introduction 11

Neuroplasticity and Neurogenesis 13

 Neuropsychological Impairment in Traumatic Brain 

Injury in Asian Countries 15

Cognitive Retraining for Restoring Brain Function 15

Effectiveness of Cognitive Retraining 17
The BFT Program Modules 17
Findings with BFT-Based Cognitive Retraining 19
 Retraining for Restoration of Attention 19
 Retraining of Working Memory 21
 Visuospatial Analysis and Synthesis 22
 Response Inhibition Ability 23
Conclusions 27

3 Neuropsychological Rehabilitation: Healing 

the Wounded Brain Through a Holistic Approach 33
J. Rajeswaran, D. Sadana and H. Kashyap
Cognitive Tasks and Mediation 35
 Cognitive Tasks 35
 Mediation 36
Psychological Services 38
 Psychosocial Factors 38
 Psychotherapy 38
 Financial and Employment Issues 40
 Family Therapy 42
Other Professional Services 46
 Neuropsychological Assessment and Rehabilitation 48
 Counseling and Therapy 51
Conclusions 52

4 EEG Neurofeedback Training in Clinical Conditions 57

J. Rajeswaran, C.N. Bennett, S. Thomas and K. Rajakumari
Alcohol Dependence Syndrome 59
Cognitive Impairment in ADS 60
Traumatic Brain Injury 63
 Cognitive Impairment in TBI 64
 Neurofeedback Training in TBI 65
Stroke 70
 Cognitive Deficits in Stroke 70
 EEG Neurofeedback Training in Stroke 70
Conclusion 73

5 Applications of Cognitive Behavioral Principles in

Neuropsychological Rehabilitation 79
P.M. Sudhir
Introduction 79
Components of Applied Behavioral Analysis 81
Models for Assessment 82
 Application of Reinforcement Principles in
Neuropsychological Rehabilitation 83
Social Skills Training 85Contents vii
Other Behavior Therapy Procedures in TBI
Biofeedback and Neuropsychological Rehabilitation 87
 Applications of Behavioral and Cognitive Behavioral
Programs in Self- and Emotion Regulation 87
 Applications of Cognitive Behavioral Therapy
to Emotional Distress in TBI 90
Applications to Schizophrenia 90
The Role of Family 92
Case Illustrations 92
Conclusions 95

6 Neuropsychological Rehabilitation in Neurological 

Conditions: A Circuitry Approach 103
J. Keshav Kumar
Neuropsychological Rehabilitation 104
 Attention Rehabilitation 104
 Memory Rehabilitation 104
 Executive Functions Training 105
 Multimodal Interventions 105
Neuropsychological Rehabilitation in India 105
Theories of Executive Functions 108
Neural Circuitry Mediating Executive Functions 110
 Attention Training 112
 Neuropsychological Rehabilitation Based on Neural 
Circuitry: Case Studies 115
Conclusion 119

7 Cognitive Remediation of Neurocognitive Deficits in Schizophrenia 123

S. Hegde, S.L. Rao, A. Raguram and B.N. Gangadhar
Neurocognitive Deficits in Schizophrenia 124
 Cognitive Remediation: A Treatment Method to Ameliorate
Cognitive Deficits 126
Cognitive Remediation in Schizophrenia 127
 Cognitive Remediation Using the Integrated Psychological
Intervention Program: A Case Illustration 130
 Preintervention Assessment of the Patient 133
 Preintervention Assessment of the Caregiver 133
The Cognitive Remediation Program 134
 Attention 134
 Focused Attention 135
 Verbal Fluency 136
 Information Processing 136
 Response Inhibition 137
 Working Memory 138
 Visual Working Memory 138
Set Shifting 138
 Motor Set-Shifting Tasks 139
 Planning 140
Postintervention Assessment 142
 2-Month Follow-Up Assessment 142
 Global Functioning of the Patient at Postintervention
and at 2-Month Follow-Up Period 142
 Postintervention Assessment of the Caregiver 142
 Summary 143
Cognitive Remediation in the Early Phase of the Illness 144
Summary and Future Directions 146

8 Neuropsychological Intervention for Specific Learning 

Disorder: An Innovative Approach 155
A. Sadasivan
Specific Reading Disorder 157
 Phonological Awareness in the Indian Context 158
Specific Mathematical Disorder 159
Disorders of Written Expression 160
 Specific Learning Disorder in the Indian Context 161
 The School System in India 161
 Prevalence of Learning Disorder in India 162
 Interventions for Specific Learning Disorder in India 163
 Issues Pertinent to the Indian Context 166
Conclusion 172

9 Neuropsychological Rehabilitation: Critical Analysis 177

A. Nehra, D. Sadana and J. Rajeswaran
Approaches to Cognitive Rehabilitation 179
Ideal Duration 179
Is Improvement and Generalization Just a Game of Numbers? 181
Economic Costs 182
Ill-Defined Outcome Measures 183
Frames of Reference 184
Dearth of Published Material 184
Future Directions 185
 Research in Neuropsychological Rehabilitation 185
 Ethical Issues 187
 Special Populations 187
 Expanding Horizons 187
 Educational Perspective 188
 Prevention 189
 Culture-Fair Therapy 1