Treating Neurodevelopmental Disabilities: Clinical Research and Practice.

Treating Neurodevelopmental Disabilities: Clinical Research and Practice Farmer JE, Donders J, Warschausky S, eds. New York, NY 10012, The Guilford Press, 2006, hardcover, 336 pp, illus, ISBN: 1-59385-2460, $48.

The purpose of this text is to synthesize information about the psychosocial aspects of selected acquired and congenital neurodevelopmental disorders, including clinical strategies for examining and treating children with these disorders. The title of the text can fool the reader into believing that this is a text for practitioners who treat movement disorders. This text, however, was written for neuropsychologists, clinical and school psychologists, rehabilitation specialists (psychologists), and others who work with children with disabilities. The contributing authors all hold PhDs in the areas of neuropsychology, neurobehavioral sciences, or educational psychology, and one contributing author holds an MD.

The book is divided into 3 parts. The first part introduces the reader to the authors' definition of childhood disability, which extends beyond medical impairments and special educational challenges. The first chapter contains an overview of the psychosocial aspects of function that are routinely addressed. In part I, the authors effectively describe the multidimensional classification system of function as proposed by the World Health Organization (WHO). The International Classification of Function, Disability and Health (ICF) is a classification system that not only looks at impairments, but includes indicators of capacity, performance, and opportunity for participation in psychosocial roles. The text is based on the philosophy that assessing and treating the psychosocial aspect of the disability will help reduce the disability and promote adaptive functioning.

Part II, "Psychological and Social Aspects of Childhood Disability," includes chapters on various diagnoses and their impact on psychosocial outcomes. The chapters use a general format of diagnosis description, epidemiology, and basic pathophysiology, followed by the common outcome profiles in the areas of behavior, emotional/ social outcomes, academic outcomes, and family functioning outcomes. The chapters also present clinical implications and future research directions concerning the neuropsychological and psychosocial aspects of adjustment within the child's environment.

Traumatic brain injury, spinal cord injury, hearing impairments, and visual impairments are each addressed in separate chapters. The other 3 chapters in this part, "Early Medical Risks and Disability," Physical Impairments and Disability," and "Chronic Illness and Neurodevelopmental Disability," cover a variety of diagnoses. The chapter on early medical risks, for example, primarily covers conditions resulting from prematurity (and "free from major handicaps") and focuses on the cognitive, neuropsychological, and behavioral outcomes. The chapter describing physical impairments includes cerebral palsy (with and without seizure disorders) and spina bifida, whereas the chapter on chronic illness refers to those diseases that can be classified by one of the following: having a protracted course, persisting more than 3 months in 1 year, being considered chronic, and requiting ongoing care from a health care provider. Some of the diseases in this category include, but are not limited to, insulin-dependent diabetes mellitus, burns, acquired heart defects, sickle cell disease, hemophilia, cancers, and orthopedic trauma.

Part III, "Innovative Treatment Strategies," proved to be more valuable than expected at first glance. The chapter on family-focused care discusses the core elements and principles of family-centered rehabilitation. A table of measures that have been used in the literature to document the effects of family-centered care on services, child rehabilitation outcomes, and parent learning outcomes is presented. This table helps the reader understand the variety of services available. This chapter presents a well-grounded discussion of the barriers to implementation of the family-centered approach, which is applicable to all members of the team. The chapters "Cognitive and Behavioral Rehabilitation" and "Students with Acquired Brain Injury" provide the reader with information and research-based instructional strategies (in relation to specific characteristics of the brain injury) that can be utilized in physical therapist practice to enhance the effectiveness of intervention.

The last chapter explores the effects of cultural differences on our rehabilitation efforts by reviewing evidence-based, culturally sensitive approaches. The editors promote awareness of the multicultural forces that affect rehabilitation and add complexity to the process but also can maximize patient outcomes.

Overall, the text is well organized and meets its objective of providing synthesized information about the psychosocial aspects of selected acquired and congenital neurodevelopmental disorders, and includes clinical strategies (psychosocial) for examining and treating children with these disorders. Although Treating Neurodevelopmental Disabilities is not specifically written for the physical therapist, there are suggested strategies that, if implemented with the total child/family/environment in mind, will augment our intervention outcomes. There are no illustrations, but none are necessary for this subject matter. The text utilizes up-to-date research as a foundation for most of the material. This text is not a book that would be used in a physical therapy curriculum; however, it does have value as a resource for the physical therapist working closely with family and other team members in pediatric service delivery.

Jennifer L Lander, PT, EdD

Armstrong Atlantic State University 

Savannah, Ga

Lander is an Associate Professor in the Department of Physical Therapy and provides consultation, examination, evaluation, and intervention services for "Babies Can't Wait," an early intervention, Part C program.