Letters to the Editor

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Excerpt

I appreciate the opportunity to respond to the concerns raised by Drs Donders, Hanks, Morgan, Ricker and Sweet, hereafter referred to as Donders et al. Given their prominence, leadership roles, and clinical and research acumen in the fields of neuropsychology and rehabilitation psychology, an exchange of letters in the Journal of Head Trauma Rehabilitation (JHTR) offers an excellent forum for public interchange of issues they have raised. I hope my letter elicits more public dialogue on forensic neuropsychology and traumatic brain injury (TBI).
I was the organizer and topical issue editor for the JHTR issue titled “Forensic Neuropsychology” [JHTR, 2009, 24(2)]. The issue had 6 articles on forensic neuropsychology and TBI, the last article being my request of Dr Ron Ruff to summarize the other articles in the form of “guidelines” articulated from a “best practice” perspective. Hence, Ruff's article titled “Best Practice Guidelines for Forensic Neuropsychological Examinations of Patients With Traumatic Brain Injury,”1 hereafter referred to as the “Ruff article,” was the concluding article of the topical issue. It was meant as a summary of previous articles, interwoven with threads of experience by a seasoned clinical neuropsychologist who had extensive expertise in TBI. The Ruff article was definitely not intended to be or become a position or “white” paper of a professional organization. To be absolutely clear, the content of Dr Ruff's article was based on his personal, professional, and research experience spanning more than 30 years of clinical practice. Dr Ruff's abstract plainly states that the last section of his article “... provides guidelines based on the introductory article by Bigler and Brooks, as well as a synopsis of the main conclusions offered by the contributors in this journal issue.”1(p131)
Donders et al object to inclusion of the words “Best Practice Guidelines” in the title, considering such wording “presumptuous” or “misleading.” In my view, terms such as “best practice” and “guidelines,” even when used together, are not restricted terms that are never to be used unless sanctioned by an organization. Similarly, use of such terms by a single author does not presuppose that they signify the official position of a professional society or organization, unless explicitly identified as such. The reader will not find an explicit logo, official statement, declaration, or endorsement of a professional society or organization in Ruff's title or text. At the time this response was written, the National Library of Medicine (http://www.nlm.nih.gov), covering a multitude of specialties, listed thousands of articles that used the term “guidelines” and/or “best practices” as searchable terms. These terms, even when used in titles, generally represent commentary by individuals. In fact, JHTR has published in earlier issues several articles representative of authors' opinions using these terms in their title and/or as key words (see References 2–7). The terms in Dr Ruff's title were used in the spirit of author opinion and commentary and that is unmistakable when the entire article is read.
The opening article by Bigler and Brooks8 clearly states that the “... current issue of JHTR will hopefully offer some general principles that should assist the field in developing standards.”(p77) Bigler and Brooks further state: “The article by Ruff provides a practical commentary and summary regarding a best-practices approach to forensic neuropsychology as the concluding article of this special topical issue of JHTR.”(p85) No professional society sponsorship of Ruff's material is indicated or promised. When an organization does make a position statement, explicit identification is typical.
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