Abstract

A 15-year-old boy had severe persisting behavioural and cognitive deficits after herpes simplex encephalitis in 1980 despite 18 months of early inpatient rehabilitation, two and a half years at home and 16 months' inpatient treatment in a behavioural unit. Following discharge from the behavioural unit in 1987, a behavioural programme was continued in the home using an untrained daytime care worker under the supervision of a community psychologist. This was associated with significant and continuing functional recovery in many areas including continence, wandering, washing and dressing. Possible reasons for the success of this inexpensive novel programme and the implications for long-term rehabilitation of brain-injured patients are discussed.

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