Functional outcome assessment of adults with right hemisphere brain damage

Abstract

This article addresses functional outcome assessment of adults with cognitive-communicative disorders due to relatively focal right hemisphere brain damage (RBD). Our discussion observes the World Health Organization's orientation on the multidimensional consequences of health conditions. The WHO framework distinguishes specific deficits (impairments) from their functional consequences: disabilities, or restrictions in daily life activities and handicaps, or broader changes in life role participation. Although there is little evidence about the functional aftermath of RBD, especially in relation to cognitive-communicative disorders, we summarize the data and observations that are available and hypothesize about relationships among outcomes at different levels. We also describe some tools and procedures that may be useful for measuring functional outcomes after RBD, along with relevant caveats, and end with a discussion of research needs and future directions, emphasizing gaps that span the range from basic investigation to treatment research to instrument and procedure development.