NeuroRehabilitation - Volume 7, issue 1

Authors: Kreutzer, Jeffrey S.

Article Type: Introduction

DOI: 10.3233/NRE-1996-7101

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 1-1, 1996

Authors: Sherrod Taylora, J.

Article Type: Research Article

Abstract: Neurological injuries result from a variety of traumatic events which may become the subject of civil litigation. The emerging field of medical jurisprudence known as neurolaw deals specifically with traumatic brain injury and spinal cord injury in the legal setting. This article reviews the myriad ramifications of neurolaw and provides practical suggestions to neurorehabilitation professionals who serve as expert witnesses in civil actions.

Keywords: Neurolaw, Traumatic brain injury, Spinal cord injury, Litigation literacy

DOI: 10.3233/NRE-1996-7102

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 3-14, 1996

Authors: Sbordone, Robert J. | Purisch, Arnold D.

Article Type: Research Article

Abstract: Neuropsychological testing has frequently been perceived by many health care and rehabilitation professionals as simply the administration and scoring of standardized neuropsychological tests followed by a comparison of the patient's scores to normative standards for the purposes of determining the patient's cognitive strengths and deficits, and whether or not the patient has sustained brain damage. Unfortunately, this simplistic model often results in inaccurate and misleading assessments of the patient's cognitive and behavioral functioning, erroneous diagnoses, and improper treatment. The issue of whether or not a patient has actually sustained a traumatic brain injury, or what specific cognitive and behavioral functions …are impaired and to what degree, particularly in reference to a specific accident or event, cannot be determined solely by examining the patient's test data. Such data are frequently confounded by numerous factors which necessitate that the neuropsychologist proceed with caution and avoid arriving at any diagnostic impressions without a full appreciation of the impact of these factors, which may contribute significantly to the patient's neuropsychological test performance. This paper examines numerous potential confounds to test performance and discusses how the neuropsychologist can utilize a vector analysis approach to address the issue of the ecological validity of the neuropsychological test data. Show more

Keywords: Neuropsychological testing, Brain damage, Ecological validity, Pain

DOI: 10.3233/NRE-1996-7103

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 15-26, 1996

Authors: Hart, Tessa | Nagele, Drew

Article Type: Research Article

Abstract: Professionals who evaluate and treat persons with traumatic brain injury are often called upon to assess competency, yet few clinical guidelines exist for this purpose. This article discusses some issues relevant to both legal and clinical conceptualizations of competency and reviews methods of evaluation. A recommended model for competency assessment in TBI is outlined. This includes attention to common sequelae of TBI that can elude formal assessment: consistency, complex memory, self-monitoring, initiation and interpersonal factors. Given the subtle nature of some of these factors and the contribution of changes over time, a team evaluation embedded in treatment is ideal for …the assessment of competency in TBI. Show more

Keywords: Traumatic brain injury, Competence, Functional assessment

DOI: 10.3233/NRE-1996-7104

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 27-38, 1996

Authors: Ruff, Ronald M. | Mueller, Jonathan | Jurica, Paul

Article Type: Research Article

Abstract: Estimation of premorbid functioning in patients with traumatic brain injury (TBI) is a difficult but necessary step both in the assessment of neurological impairment and in planning treatment. Because the estimation process is almost always retrospective, its reliability is questionable. The use of multiple sources of information improves the likelihood of an accurate estimate. The effects of TBI cross a number of domains in the victim's life. Thus, premorbid functioning must be estimated in the physical, cognitive, emotional, social, financial and vocational spheres. Knowledge of baseline or premorbid functioning levels allows the clinician to appreciate the severity of injury, provide …a prognosis, and shape treatment goals that are specific to the individual. In this article, we present the key questions to be addressed, suggest sources of information to obtain the answers, describe the processes through which answers should be obtained, and outline the uses for this important information in working with victims of TBI. Show more

Keywords: Premorbid functioning, Traumatic brain injury, Neurological impairment, Treatment planning

DOI: 10.3233/NRE-1996-7105

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 39-53, 1996

Authors: Millis, Scott R. | Putnam, Steven H.

Article Type: Research Article

Abstract: The evaluation of malingering in the neuropsychological examination of mild head injury is a multiple method diagnostic process that takes into consideration injury severity, typical neuropsychological test performance patterns, differential diagnosis of other medical and psychiatric disorders, and the use of neuropsychological indicators of suboptimal effort. Current methods and trends in the evaluation of malingering are reviewed, including the use of specialized tests of effort and motivation and the application of conventional neuropsychological tests. Symptom validity techniques and tests with a multiple-choice format along with statistically-derived univariate and multivariate formulas appear to considerable merit in the detection of suboptimal effort …or malingering. Show more

Keywords: Malingering, Mild head injury, Neuropsychological assessment

DOI: 10.3233/NRE-1996-7106

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 55-65, 1996

Authors: Binder, Laurence M. | Burton, Brent T.

Article Type: Research Article

Abstract: Guidelines for providing competent and fair medicolegal reports and testimony are provided. Among them are (1) remaining within one's area of clinical competence when performing medicolegal work, (2) obtaining board certification from a legitimate specialty board, (3) considering the patients' claims and diagnoses from the opposing medicolegal viewpoint, and (4) Performing differential diagnosis in each case. Experts are asked to strive for honesty, fairness, thoroughness, and accuracy while avoiding the attempts at persuasion which sometimes are made by legal referral sources.

Keywords: Medicolegal testimony, Report writing, Competency

DOI: 10.3233/NRE-1996-7107

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 67-71, 1996

Article Type: Correction

DOI: 10.3233/NRE-1996-7108

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 73-73, 1996

Article Type: Announcement

DOI: 10.3233/NRE-1996-7109

Citation: NeuroRehabilitation, vol. 7, no. 1, pp. 75-75, 1996