The World Health Organization estimates that approximately 90 million people, or 1.5% of the world population, are in need of rehabilitation services at any given point in time (WHO, 2003). Many of these individuals are at risk for long-term disability due to brain injury and disease. They range from the young, who increasingly survive early brain insults, to older adults, whose independence and every day functioning may be threatened by the onset of neurologic impairments. As medical advances improve survival rates and longevity, the number of those in need of cognitive and behavioral rehabilitation services to enhance functioning is likely to grow. This situation raises pressing questions, such as, who will get better with what rehabilitation treatment, and why?

Dr. Ponsford's edited book is a scholarly effort to lay the groundwork for neuropsychologists, rehabilitation psychologists, and other health professionals to answer such questions. The book aims to integrate advances in the neurosciences with research on the clinical care of people with brain dysfunction. It is built on the premise that rehabilitation interventions may improve if they are more closely linked to emerging principles of neuronal organization and recovery processes and to theoretical models from neuropsychology and cognitive neuroscience. The contributors posit that research based on this expanded paradigm may lead to important discoveries about how to enhance human functioning following brain insult. This approach has been spurred forward by the development of interventions such as constraint-induced movement therapy (Taub & Uswatte, 2000).

The book is well organized, beginning with two chapters on brain functioning that provide a strong foundation for the remainder of the book. Kolb and Coie present an engaging overview of basic concepts underlying brain-behavior relationships, physiological events associated with brain injury, reparative processes, and variables that moderate recovery (e.g., age, type of injury). In chapter 2, Kolb adds a clear discussion of recent findings about plasticity in both the intact and injured brain. This chapter concludes with a brief review of implications for rehabilitation, such as the idea that early intervention may be needed to promote beneficial reorganization of plastic morphological structures and to achieve adaptive rather than maladaptive functioning.

The next six chapters take the reader into the heart of what is unique about this book, an in-depth exploration of the relationship between basic research/theory and treatments for specific cognitive and behavioral domains that are affected by brain injury and disease in adults. The cognitive domains include nonspatial attention, memory, language, spatial orientation/unilateral neglect, and executive functioning and self-awareness. The authors of these chapters are experts who demonstrate breadth and depth of knowledge across diverse literatures. For example, in the chapter on memory disorders, Glisky reviews recent conceptualizations of memory as a set of overlapping systems, describes what is known about the underlying neuroanatomical substrates of these systems, presents a short discussion of the neurophysiology and neurochemistry of normal memory functions, discusses findings from studies on the treatment of memory dysfunction, and notes ways that basic research may help to refine future treatment strategies. The book illustrates findings with examples from common brain disorders such as traumatic brain injury and stroke.

In all of the chapters there is a valiant effort to integrate cross-discipline theory and research and to note where basic science informs practice. Sometimes, this reveals explanatory mechanisms for what is generally observed in rehabilitation settings (e.g., recovery is worse with more severe injury due to specific limits in reparative processes following extensive brain damage). In other cases, promising treatment approaches are identified, such as selecting the type of memory intervention strategy based on brain lesion location and the memory systems affected. The book falls somewhat short of its goal to bridge the gap between the neurosciences and clinical practice, but this is due to the size of the chasm between these fields and the immature state of these brain-related scientific disciplines.

Without a doubt, the book is thought provoking and raises key questions that must be answered to advance cognitive and behavioral rehabilitation in persons with brain insults. It is likely to spark lively debate about the degree to which underlying neurobiology is relevant to any specific individual's recovery process, given the complexities involved in real world intervention and the number of variables that contribute to personal outcomes. Although there are other books available on current rehabilitation practices and on basic brain and cognitive research, this is the one to read to gain a glimpse of how these fields may merge and grow to benefit persons with brain dysfunction.