Concluding Comments

Abstract

Time has passed between the early years of the Wichita program and the completion of this book. Still, little progress has been made in regard to its topic. A work originally written by Luria (1948/1963) has gained in popularity, and a book on the role of neuropsychology in relation to rehabilitation has been published (Golden, 1978). Diller and his colleagues at NYU are continuing their impressive work with stroke and head-injured patients and publishing their findings (Diller & Gordon, 1981). To the best of our knowledge, no other major contributions have been made to our understanding of how to rehabilitate brain-damaged adults, nor have there been major advances with regard to techniques or technologies. However, in our perception, there has been an increased public and professional demand for such rehabilitation efforts. Perhaps the aura of pessimism has been lifted to some extent, and people are beginning to seek active treatment for various brain disorders. Perhaps this movement is largely attributable to changes in health care philosophy, particularly in regard to the developing belief that patients should no longer be indefinitely, and perhaps permanently, institutionalized because there is no medical cure for their illness. It is now mandatory in accredited treatment facilities to have a treatment plan for each patient and to comment on each patient’ s rehabilitation potential. Indeed, an assessment of rehabilitation potential must be made even for patients with terminal illnesses. Additionally, the relatively positive experience with de-institutionalization of psychiatric patients may ultimately have had an influence on the ways in which we deal with brain-damaged patients.