Dynamic Assessment and Multicontext Treatment of Unilateral Neglect

Abstract

Although common after right hemisphere strokes, the clinical presentation of unilateral neglect is complex and multifaceted. Literature reports a strong relationship between neglect and poor rehabilitation outcome. This article discusses various assessment approaches, including a dynamic interactional assessment approach. Functional treatment approaches are presented along with an overview of Toglia’s (1998a) multicontext approach. The multicontext approach to treating neglect requires careful analysis of the patient’s awareness, strategy use, and response to varied task parameters to design an intervention program that actively addresses the issues of generalization and self-monitoring. A case illustration using the multicontext approach is included.

Keywords:

• attention
• evaluation
• occupational therapy
• perceptual disorders
• rehabilitation
• stroke