Cross-Cultural Neuropsychological Assessment: Theory and Practice

By Victor Nell | Go to book overview

Chapter 6
A Behavioral Frame: Neuropsychology as a Transferable Technology

The professional core of clinical neuropsychology is its highly differentiated ability to describe the behavior of brain-damaged persons. However, the reader of current neuropsychology handbooks and journals is likely to arrive at two incorrect conclusions about the nature of current neuropsychological practice.


THE PREPONDERANCE OF DIFFUSE INJURIES

The first error is to believe that most of the cases brought to a neuropsychologist's attention are discrete focal injuries, and can be described in terms such as "infarct of the inferior left angular gyrus" or "left frontal orbitobasal contusion." This is certainly true for neuropsychologists in tertiary acute care settings. But the picture is very different for forensic, rehabilitation, and private practice neuropsychologists who work outside neurology-neurosurgery settings, for isolated psychologists, and for most psychologists in the developing countries. The clinical consequence of the epidemiology of brain damage (reviewed in greater detail at the beginning of chap. 7) is that the overwhelming majority of individuals requiring neuropsychological diagnosis and treatment are the survivors of motor vehicle accidents, assaults, and falls. The violent forces that these events unleash in the brain cause extensive diffuse damage that cannot be accommodated within the correlational neuroanatomy of classical neuropsychology. These are not discrete focal injuries that give rise to such marvelously bizarre syndromes as unilateral neglect, pure alexia, or mistaking

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