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Excerpt
The third edition of Rehabilitation of the Adult and Child with Traumatic Brain Injury maintains the status of this volume as the premier textbook in traumatic brain injury (TBI) rehabilitation. This edition is the clear choice of a single book that comprehensively reviews the mainstream of TBI rehabilitation from a multidisciplinary perspective as it is being practiced at the end of the twentieth century. Virtually every generally accepted approach to rehabilitation evaluation and treatment for persons with TBI is elucidated in this text. Nonetheless, this is a mainstream textbook. Speculative, alternative, and experimental approaches and treatments are not reviewed.
The first two sections of this book on acute aspects of brain injury and specialized assessment techniques for adults provide an excellent foundation for any professional who is entering the world of TBI rehabilitation. Traumatic brain injury professionals whose knowledge of the field is largely limited to the paradigms of their individual discipline will also find in these sections a more comprehensive understanding of the field from a multidisciplinary perspective. Readers may be a little disappointed in the variation in accessibility to the general reader among and within the chapters. Some portions include clear explanations of discipline-specific terms and jargon, and are written in language that can be easily understood by almost any rehabilitation professional. Other portions, however, seem to be written only for those with a strong background in the discipline of the authors, reducing the value of the text as a general source for TBI professionals.
Providing a foundation textbook, rather than a more speculative, futuristic look at TBI rehabilitation was clearly the intention of the editors. The seasoned professional will find some of the foundation chapters of high value as relatively comprehensive literature reviews of the topic area. However, other chapters primarily offer information on the basis of the authors' expertise, with limited and parochial referencing. Extensive, if not comprehensive, referencing of the current literature in all chapters would increase the value of this text for the more experienced professional. The seasoned TBI professional who has stayed reasonably abreast of the literature will find little new in the foundation sections but will find state-of-the-art treatment of specific topics, such as pharmacology, substance use, and care of the minimally conscious patient, in the final section.
The conservative nature of this book is also apparent in the dates of references. The majority of references in most chapters predate 1990. Reflecting the unfortunate delay between submission and publication of any text, virtually no references postdate 1996. Another indicator of the book's conservative bent is the deference paid to the Rancho scale throughout the adult sections. Some chapters that reference this quasi-ordinal scale as a guide for intervention compress it, reflecting the nonordinal and often irrelevant character of several Rancho levels. The compressed version describes the three levels of recovery from brain injury that have become very familiar in the research literature and clinical experience: a period of reduced responsiveness with inferred reduced consciousness (Rancho Levels I–III), a period of increased responsiveness and interaction with severe amnesia (Rancho Levels (IV–VI), and a period with some recovery of memory but with persistent sequelae of moderate to minimal severity (Rancho Levels VII–VIII). A more progressive text would develop such inferences for the reader. (In fairness, Katz and Black do offer an alternative approach to conceptualizing recovery from TBI that, unfortunately, is not discussed or debated by other chapter authors.
