Clinical Management of Right Hemisphere Dysfunction.

Halper AS, Cherney LR, Burns MS. Gaithersburg, MD 20878, Aspen Publishers Inc, 1996, hardback, 137 pp, $56.

Clinical Management of Right Hemisphere Dysfunction was designed as a practical manual for the evaluation and treatment of cognitive and communicative problems. This second edition includes updated information on hemispheric specialization, a revised and standardized communication evaluation, and specific treatment goals with measurable objectives.

The first three chapters present the current understanding of the principal functions of the right and left hemispheres, including anatomical and biochemical differences. Clinical syndromes associated with right hemisphere lesions are detailed. Visuoperceptual, emotional, memory, and neuropsychiatric disorders are thoroughly discussed with clear clinical examples. The interrelationships among cognitive processes are emphasized.

Chapter 4 provides the statistical background of the Rehabilitation Institute of Chicago Evaluation of Communication Problems in Right Hemisphere Dysfunction--Revised (RICE--R). The actual tool is included in Appendix A, and the administration manual is found in Appendix B.

The fifth chapter is an annotated list of formal standardized tests. In current health care situations, the speech-language pathologist must prioritize certain cognitive-communicative areas for assessment. The annotated list indicates processes each test, such as attention, memory, perception, and orientation. The authors point out that determination of priorities also requires considerations of premorbid status, discharge placement, and patient/family goals.

The last chapter covers treatment for cognitive-communicative disorders. Long-term clinical objectives are listed and then divided into short-term objectives, procedures, and methods of measurement. All objectives are stated in functional terms, and procedures include interventions that all health care professionals and family members can provide. One example of an activity to facilitate perceptions of nonverbal cues in a conversation is to present a patient with a photograph and ask the patient to identify distinctive features and expressions.

The stated purpose of this book is to provide rehabilitation clinicians information that is helpful in daily practice. Although the book covers assessments specifically administered by speech-language pathologists, there is a wealth of information also applicable to physical therapy practitioners. The subject is well researched and formatted in an easy-to-read manner. Many tables and exhibits are provided, outlining strategies to reinforce restorative and compensatory techniques for communication with the person who has right hemisphere involvement. Physical therapists and physical therapist assistants who work with persons,with brain injury would find this book a useful audition to their libraries.

Bonnie Bauer Swafford, PT University of Kansas Medical Center Kansas City, Kan

Ms Swafford is Director of the Physical Therapy Department, whose services include inpatient acute care, outpatient clinics, and an accredited general and traumatic brain injury rehabilitation unit.