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Reducing Level of Handicap in Traumatic Brain Injury: An Environmentally Based Model of Treatment

Hayden, Mary Ellen PhD, ABPP; Moreault, Anne-Marie PhD; LeBlanc, Jeanne PhD; Plenger, Patrick M. PhD, ABPP

Journal of Head Trauma Rehabilitation: August 2000 - Volume 15 - Issue 4 - p 1000–1021
Ecological Validity in Traumatic Brain Injury

A treatment model is described that has as its primary focus reducing the level of handicap of individuals with traumatic brain injury (TBI) by addressing the interaction between critical environmental variables and areas of deficit. The model focuses on two primary environmental variables—degree of distraction tolerated and degree of structure required by each individual to function optimally. These variables are systematically addressed in treatment through environmental simulations within the clinic. An outcome measurement system (Pate Environmentally Relevant Program Outcome System [PERPOS]) is presented that quantifies the level of handicap throughout treatment and at discharge as a function of the interplay between deficit and environment. Data are provided that validate the PERPOS scores through comparison with qualitative descriptors of day-to-day functioning in several domains. Outcome data indicate the participants in this treatment model made significant gains with regard to reduction of handicap.

Diplomate in Clinical Neuropsychology, American Board of Professional Psychology, Clinical Director, Pate Rehabilitation (Hayden)

Director of Assessment, Pate Rehabilitaion (Moreault)

Program Director, Marshall Youth Services, Sabine Valley Center, Marshall, Texas (LeBlanc)

Diplomate in Clinical Neuropsychology, American Board of Professional Psychology, Associate Clinical Director, Pate Rehabilitation, Dallas, Texas (Plenger)

We would like to acknowledge gratefully the generous support and contribution of Henry S. Irving.

© 2000 Lippincott Williams & Wilkins, Inc.