Making It Right? Some Thoughts about the Future of Treatment for Right Hemisphere Cognitive-Communication Disorders

This article reflects on the future of intervention for language and communication disorders that follow unilateral damage to the right cerebral hemisphere. The author first introduces some of the challenges inherent in this task: a very small and preliminary evidence base and a limited number of investigators conducting treatment research for most of the consequences of these disorders, more general difficulties of translating evidence to practice, and limited graduate training in the area. The article then addresses some predictions and hopes for the future. The author foresees progress in defining the disorders and in clinicians' knowledge of the heterogeneity of the population, the multifaceted nature of complex impairments, and the expanding range of well-justified treatment options. The article next discusses the potential of noninvasive brain stimulation techniques, virtual reality-based approaches to intervention, and the promise of telerehabilitation. Finally, the author voices a concern that undeniably important new trends in health care, such as emphases on patient-reported outcomes and patient satisfaction measures, could penalize the subset of the client population that lacks awareness of or minimizes their deficits, and calls for vigilant clinician advocates in such cases.