Perceptual retraining for adults with diffuse brain injury.

Occupational therapy for adults with perceptual dysfunction secondary to diffuse acquired brain injury from trauma or anoxia often includes remedial retraining with treatment tasks, like construction of puzzles, to provide clients with practice in deficit perceptual skills. Therapists using this approach assume that adults with brain injury learn specific perceptual skills from retraining exercises and can transfer those skills across all activities (including self-care and community living activities) that require those skills. This review of outcome studies about remedial perceptual retraining for adults with diffuse acquired brain injury suggests that those learning assumptions hold true only for clients with localized lesions and preserved abstract reasoning who have been explicitly taught to transfer learning across a variety of treatment activities. Recommendations about ways to assess clients' learning potential and appropriateness for remedial retraining include keeping track of the number of repetitions clients need to relearn functional tasks and systematically varying functional tasks during training to see how easily clients can transfer learning across variations of the same task.