Perception, Interaction, and Language: Interaction of Daily Living, the Root of Development.

Affolter FD. New York, NY 10010, Springer-Verlag New York Inc, 1991, hardback, 306 pp, illus, $39.50.

The author has translated this book from her German work, entitled Wahrnehmung, Wirklichkeit und Sprache. The first chapter poetically describes tactile-kinesthetic explorations of infants and young children and the relationships between tactile-kinesthetic experiences and cognitive, emotional, and social development. Beautiful photographs and vignettes of children's interactions with their environments illustrate a developmental sequence of tactile-kinesthetic exploration through which normally developing children are said to come to know the "Wirklichkeit." This is a term that the author defines in the glossary as "a German concept [that] derives from "wirken," meaning "to act, to operate, to influence, to work, to do, to have an effect."

The second chapter concerns children and adults who do not know the Wirklichkeit and have perceptual disorders that result in aberrant behaviors of varying degrees. As in the first chapter, photographs and vignettes are used effectively to describe many- carefully observed behaviors. The behavioral characteristics of children who are described as having perceptual disorders have much in common with characteristics that many clinicians will consider as indicative of sensory-integrative dysfunction. These include such behaviors as excessive or too little movement, motor planning, bilateral integration, sequencing, coordination, delayed speech and language, withdrawal from touch, and aggressiveness. The author describes similar behaviors in adults following brain injury, behaviors that she attributes to a search for visual, auditory, or tactile-kinesthetic information. Many examples of atypical behaviors of children and adults with perceptual disorders are described within the context of their associated sensory dysfunction. Although there are a few examples of behaviors resulting from visual and auditory dysfunction, t are associated with inadequate tactfle-kinesthetic information, which the author believes is a primary problem of adults and children with perceptual disorders.

The third chapter begins with a summary of the author's research, which concluded that the development of children with perceptual disorders is different from that of normally developing, blind, or deaf children, whose development is similar. The results of her research have led to a model in which tactile-kinesthetic problem-solving experiences within daily living contexts form the basis for normal development. Much of the rest of the chapter is devoted to an engaging and potentially valuable discussion of intervention in which movements are guided during functional daily activities to promote adequate tactfle-kinesthetic experiences.

This book is beautifully written and produced and is both thoughtful and thought-provoking. The author presents many ideas that are congruent with current physical therapy and occupational therapy concepts and practices in this country, but there are interesting differences that could stimulate new ways to interpret assessment information and develop intervention strategies. The emphasis on assessment and intervention in naturalistic, daily living contexts is especially appealing. This is a book that is not easily absorbed on the first reading. its greatest value is likely to be found after repeated reading and thoughtful study. I highly recommend it to physical therapy practitioners with pediatric or adult rehabilitation experience. It could also serve as a text for specialized post-entry-level graduate courses and as supplementary reading for entry-level physical therapy and occupational therapy students.

Irene R McEwen, PhD, PT

Univ of Oklahoma Health Sciences Center

Oklahoma City, Okla