14 - Lorna: applying models of language, calculation and learning within holistic rehabilitation: from dysphasia and dyscalculia to independent cooking and travel

Summary

Introduction

In Chapter 1 we presented a model of rehabilitation that highlights the range of theories that may be drawn upon to support the identification and development of interventions for the many consequences of brain injury or illness. The case presented here highlights in practice how cognitive neuropsychological intervention (as defined by Coltheart (2005)) can be integrated into neuropsychological rehabilitation, with a specific emphasis on communication and numeracy. The importance of learning method is also raised both in terms of learning specific skills or information as well as functional generalization.

We describe our work with Lorna as a further example of our interdisciplinary approach, in which team members worked in an integrated way with the client towards shared functional goals. Significantly, Lorna's level of communication was initially considered a potential barrier to her ability to benefit from the groups and participate fully in the therapeutic milieu process. Subsequently these concerns appeared largely unfounded.

Once again a formulation-based approach provided a means of integrating assessment results, developing a collaborative understanding regarding the client's needs and building a basis upon which to address these across the team. The case highlights specific and successful interventions for naming and numeracy difficulties, as well as development of compensatory strategies, together applied to increase participation in meaningful activities as part of the integrated rehabilitation programme.

History of injury

Lorna suffered a brain injury in May 1999 whilst living and working abroad.