ABSTRACT

The concept of neurobehavioural disability developed from early pioneering efforts to find better ways of understanding and treating the more debilitating and chronic behavioural consequences of serious brain injury. Key figures in an approach that would develop into neurobehavioural rehabilitation were Kurt Goldstein and Alexander Luria, both of whom recognised the importance of the frontal lobes in the regulation of human social behaviour. A neurobehavioural paradigm for brain injury rehabilitation evolved out of this behaviour management approach. The neurobehavioural paradigm recognised that even the hospital environment itself can be counter-productive for rehabilitation. The organisational constraints on delivering neurobehavioural rehabilitation in its pure form led to the subsequent development of a stand-alone service in 1985 at Grafton Manor, a few miles from St Andrews Hospital, by several of the original Kemsley Unit pioneers. Neurobehavioural interventions have evolved both theoretically and practically, keeping pace with a changing healthcare system.