Assessment	<<< about CNS

While we provide a transdisiplinary approach to comprehensive neurorehabilitation, the focus of our program is on neuropsychological or cognitive aspects of neurobehavioral disorders. This makes our program unique from many neurorehabilitation settings. Following physician referral, neuropsychology is usually the primary focus at the point of entry and provides a triage of all symptoms presented. The assessment process may include evaluations from any or all disciplines. In the case of direct referral to a specific discipline, neuropsychology may not be involved.

The following points summarize the typical decision making process regarding recommended assessments:

• Neuropsychology is the point of entry, and appropriate neuropsychological evaluation will be recommended. Neuropsychological assessment also includes psychological assessment and development of a treatment plan for psychological services.
• Neurology referral is made if:
  • Client has not been evaluated by neurology or
  • Client is reporting symptoms of pain, sleep disorder, and/or depression that are not being followed by another physician
• Speech - language pathology referral is made if:
  • Client reports significant problems with word-finding, language comprehension, language expression or oral motor skills
  • Client is a student
• Occupational therapy referral is made if:
  • Client reports difficulties with vision, perception, balance, and/or fine motor skills and coordination (physical therapy and occupational therapy coordinate closely on care plans).
  • Client experiences significant difficulties in functional activities of daily living (including home, community, and work).
  • Adaptive equipment training for home, community, work, and mobility (including driving).
• Physical therapy referral is made if:
  • Problems are reported with respect to mobility, walking, strength, range of motion, and/or conditioning
  • Client reports post-traumatic headaches
  • Clients reports physical pain secondary to musculoskeletal injuries
• Music therapy referral is made if:
  • Client experiences difficulties with timing, coordination, or endurance in motor movements, including gait
  • Client reports difficulty with memory, executive functioning, or attention skills
  • Client experiences significant communication difficulty
• Vocational re-entry referral is made whenever there are issues related to return-to work. (Occupational therapy also addresses return-to-work and work environment modification issues).
• School re-entry referral is made whenever there are difficulties regarding return-to-school or modifying the classroom environment or academic demands to accommodate a student’s cognitive problems.
• Social work/case management is included when the client requires assistance in identifying/obtaining resources, housing, and/or benefits. Family/support system education is provided individually and in groups.

Following completion of the initial assessments, an individualized treatment plan is developed on the basis of needs identified in the initial evaluations. Projections are made for number and frequency of therapy sessions for each discipline until discharge. The treatment plan will include both long-term and short-term measurable functional goals. Monthly or bimonthly progress reports are provided which discuss progress to date and treatment goals for the next treatment interval. Treatment plans and progress reports are signed, as orders, by the referring physician. Family members and significant others are included in the assessment and overall process of helping the client achieve maximum recovery through rehabilitation.