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Neuropsychology for the attorney
Amhti ofClinicd Neump~hola~, W. F’rbted in Ihe USA. All tightsraavcd.
0887-617ll92 $500 + .OLl Copyright 0 1992 National Academy of
7. pp. 557-559.1992
Neuropsychology
Book and Test Reviews Arthur MacNeill
Horton, Jr., Associate Editor
Psych Associates, Towson, MD
Neuropsychology for the Attorney, By Robert J. Sbordone. Orlando, Florida:
Paul M. Deutsch Press, Inc., 1991,373
pp.
(hardbound).
Criminal and personal injury courts frequently rely upon neuropsychological testimony to make crucial decisions regarding persons with neurobehavioral problems. Neuropsychologists end up as expert witnesses whether they intend it or not. The attorneys involved need to understand the various experts they encounter. An attorney’s knowledge of an expert’s profession is critical to effective case development and representation. Attorneys often burn the midnight oil gaining a working knowledge of a profession. A superficial knowledge is acceptable in some cases, but in other cases a thorough understanding is essential. This is the first book specifically written to introduce neuropsychology to attorneys. Until this book, attorneys were on their own to find information about professional clinical neuropsychology. They now have a book written specifically for them by a highly experienced and respected specialist in forensic clinical neuropsychology. The scope of the book is broad. There are 17 chapters. The chapters discuss important topics for attorneys. These include: a definition of neuropsychology, the education and training of a neuropsychologist, neuroanatomy, neuropathology, neuropsychological assessment, testing, test scoring and analysis, test interpretation, determining conclusions, prognosis, treatment, sample neuropsychological reports, how to select a neuropsychological expert and use the services, how to depose a neuropsychologist, and malingering. The appendix includes a list of diplomates of the American Board of Clinical Neuropsychology, current at the time of publication, a glossary of neurological and neuropsychological terms, and a bibliography. Most of these topics could till books of their own! The major strength of the book is its emphasis upon selecting a well trained, experienced, and board certified neuropsychologist. Dr. Sbordone emphasizes the need for competent experts. This is consistent with the guidelines given by 557
558
Book and Test Reviews
the International Neuropsychological Society and Division 40 of the American Psychological Association (1987) for training, education, and credentialing, and the Executive Committee of Division 40’s definition of a clinical neuropsychologist (1989) . An example of his sound advice is the following:
...Attomeys should seek out neuropsychologists whose competence has been established by a formal examining board and who have been granted certification based on a rigorous examination of their training, background, and competence. The attorney should review the curriculum vitae of the prospective expert to determine if the prospective neuropsychological expert has the necessary training, publications, background, and expertise to qualify as an expert in the field of neuropsychology. The attorney should also determine if the prospective neuropsychologist has expertise in a specific area (e.g., postconcussive syndrome, anoxic encephalopathy, etc.), by carefully questioning his or her training, background, and experience.... (p. 265)
There are examples of reports. Dr. Sbordone presents and critiques examples of both good and bad neuropsychological reports. These examples offer useful guidance to determine the quality of the expert’s services. A neuropsychologist’s report reveals competency. The fundamental weakness of the book is the sacrifice of depth for breadth. The chapters are short and often barely brush the topics. A glaring example is mild head trauma - less than a page! Since this is a very common presentation in personal injury litigation, attorneys need indepth knowledge. Not only is the topic superficially discussed, there are few references. Key works are not listed in the references (Levin, Eisenberg, & Benton, 1989; Levin, Mattis, Ruff, Eisenberg, Marshall, & Tabaddor, 1987; Levin, Benton, & Grossman, 1982). The discussion of toxic related neurobehavioral problems is a short paragraph and never mentions Hartman’s unrivaled book (1988). In a discussion with Dr. Sbordone about the brevity of topics and lack of references, he pointed out that the intent of the book is an introduction. It is an overview and a guide to select a qualified expert, and not an exhaustive discourse. He believes that if a good expert is selected, the expert can lead the attorney to greater depths of knowledge. This is a valid point, but the book would have been stronger with more references. The references could be added to the ends of chapters and organized by topic. This would allow the attorney the choice of deeper study rather than bobbing around on the surface. The book is missing important information. It does not mention the criticisms aimed at neuropsychology in the court room. No guidance is offered on how to effectively fend off these potshots. The critics are not even referenced (Ziskin & Faust, 1988). There is no mention of the issues involved in applying neuropsychology to criminal cases. This is inexcusable for a book titled Neuropsychology for the Attorney. Which attorney? Which legal situation?
Book
and TestReviews
559
Plaintiff or defense counsel? What type of case? The title is misleading. Given the limitations of the book and its plaintiff orientation, it is better titled An Overview of Neuropsychology for the Personal Injury PlaintifSAttomey. Despite the limitations of the book, it is a significant contribution to the legal and neuropsychological professions. It is highly recommended to both attorneys and neuropsychologists. For attorneys it is the only book available on this topic. It begins to till a gap in knowledge, although it does not completely bridge it. If, as Dr. Sbordone recommends, good neuropsychological experts are selected, additional gaps can be filled. Complementing the book with a more indepth book like Lezak’s work (1983) will fill further gaps. For neuropsychologists it is an opportunity to see how and what a very well qualified colleague with exceptional experience in personal injury litigation consultation thinks about our profession in this complex arena. Your thinking will be stimulated and challenged. You probably will improve your legal consultation. Some may be inspired to write on this topic. Dr. Sbordone is to be commended for this creative contribution. It is much needed. This seminal work has the potential of growing into a mature treatise. Hopefully, future editions will nurture and expand this promising beginning.
REFERENCES The Clinical Neuropsychologist, 3(I), 22. Hartman, D. E. (1988). Neuropsychological toxicology: Identijication and assessment of human neurotoxic syndromes. Elmsford. NY: Pergamon Press. Levin, H. S., Eisenberg, H. M.. & Benton, A. L. (1989). Mild head injury. New York: Oxford
Executive Committee of Division 40 (1989). Definition of a clinical neuropsychologist.
University Press. Levin, H. S., Mattis, S., Ruff, R. M., Eisenberg, H. M., Marshall, L. F., & Tabaddor, K. (1987). Neurobehavioral outcome of minor head injury: A three center study. Journal of Neurosurgery, 66,234-243.
Levin, H. S., Benton. A. L., & Grossman, R G. (1982). Neurobehavioral consequences of closed head injury. New York: Oxford University Press. Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press. Reports of the INS-Division 40 Task Force on Education, Accreditation, and Credentialing (1987). Guidelines for doctoral training programs in clinical neuropsychology. The Clinical Neuropsychologist, 1.29-34.
Ziin, J. KcFaust, D. (1988). Coping with psychiatric andpsychological testimony (Vols. 1 & 2, 4th ed). Marina Del Rey, CA: Law and Psychology Press.
Lloyd I. Cripe, PhD Private Practice, Seattle, Washington
0887-617ll92 $500 + .OLl Copyright 0 1992 National Academy of
7. pp. 557-559.1992
Neuropsychology
Book and Test Reviews Arthur MacNeill
Horton, Jr., Associate Editor
Psych Associates, Towson, MD
Neuropsychology for the Attorney, By Robert J. Sbordone. Orlando, Florida:
Paul M. Deutsch Press, Inc., 1991,373
pp.
(hardbound).
Criminal and personal injury courts frequently rely upon neuropsychological testimony to make crucial decisions regarding persons with neurobehavioral problems. Neuropsychologists end up as expert witnesses whether they intend it or not. The attorneys involved need to understand the various experts they encounter. An attorney’s knowledge of an expert’s profession is critical to effective case development and representation. Attorneys often burn the midnight oil gaining a working knowledge of a profession. A superficial knowledge is acceptable in some cases, but in other cases a thorough understanding is essential. This is the first book specifically written to introduce neuropsychology to attorneys. Until this book, attorneys were on their own to find information about professional clinical neuropsychology. They now have a book written specifically for them by a highly experienced and respected specialist in forensic clinical neuropsychology. The scope of the book is broad. There are 17 chapters. The chapters discuss important topics for attorneys. These include: a definition of neuropsychology, the education and training of a neuropsychologist, neuroanatomy, neuropathology, neuropsychological assessment, testing, test scoring and analysis, test interpretation, determining conclusions, prognosis, treatment, sample neuropsychological reports, how to select a neuropsychological expert and use the services, how to depose a neuropsychologist, and malingering. The appendix includes a list of diplomates of the American Board of Clinical Neuropsychology, current at the time of publication, a glossary of neurological and neuropsychological terms, and a bibliography. Most of these topics could till books of their own! The major strength of the book is its emphasis upon selecting a well trained, experienced, and board certified neuropsychologist. Dr. Sbordone emphasizes the need for competent experts. This is consistent with the guidelines given by 557
558
Book and Test Reviews
the International Neuropsychological Society and Division 40 of the American Psychological Association (1987) for training, education, and credentialing, and the Executive Committee of Division 40’s definition of a clinical neuropsychologist (1989) . An example of his sound advice is the following:
...Attomeys should seek out neuropsychologists whose competence has been established by a formal examining board and who have been granted certification based on a rigorous examination of their training, background, and competence. The attorney should review the curriculum vitae of the prospective expert to determine if the prospective neuropsychological expert has the necessary training, publications, background, and expertise to qualify as an expert in the field of neuropsychology. The attorney should also determine if the prospective neuropsychologist has expertise in a specific area (e.g., postconcussive syndrome, anoxic encephalopathy, etc.), by carefully questioning his or her training, background, and experience.... (p. 265)
There are examples of reports. Dr. Sbordone presents and critiques examples of both good and bad neuropsychological reports. These examples offer useful guidance to determine the quality of the expert’s services. A neuropsychologist’s report reveals competency. The fundamental weakness of the book is the sacrifice of depth for breadth. The chapters are short and often barely brush the topics. A glaring example is mild head trauma - less than a page! Since this is a very common presentation in personal injury litigation, attorneys need indepth knowledge. Not only is the topic superficially discussed, there are few references. Key works are not listed in the references (Levin, Eisenberg, & Benton, 1989; Levin, Mattis, Ruff, Eisenberg, Marshall, & Tabaddor, 1987; Levin, Benton, & Grossman, 1982). The discussion of toxic related neurobehavioral problems is a short paragraph and never mentions Hartman’s unrivaled book (1988). In a discussion with Dr. Sbordone about the brevity of topics and lack of references, he pointed out that the intent of the book is an introduction. It is an overview and a guide to select a qualified expert, and not an exhaustive discourse. He believes that if a good expert is selected, the expert can lead the attorney to greater depths of knowledge. This is a valid point, but the book would have been stronger with more references. The references could be added to the ends of chapters and organized by topic. This would allow the attorney the choice of deeper study rather than bobbing around on the surface. The book is missing important information. It does not mention the criticisms aimed at neuropsychology in the court room. No guidance is offered on how to effectively fend off these potshots. The critics are not even referenced (Ziskin & Faust, 1988). There is no mention of the issues involved in applying neuropsychology to criminal cases. This is inexcusable for a book titled Neuropsychology for the Attorney. Which attorney? Which legal situation?
Book
and TestReviews
559
Plaintiff or defense counsel? What type of case? The title is misleading. Given the limitations of the book and its plaintiff orientation, it is better titled An Overview of Neuropsychology for the Personal Injury PlaintifSAttomey. Despite the limitations of the book, it is a significant contribution to the legal and neuropsychological professions. It is highly recommended to both attorneys and neuropsychologists. For attorneys it is the only book available on this topic. It begins to till a gap in knowledge, although it does not completely bridge it. If, as Dr. Sbordone recommends, good neuropsychological experts are selected, additional gaps can be filled. Complementing the book with a more indepth book like Lezak’s work (1983) will fill further gaps. For neuropsychologists it is an opportunity to see how and what a very well qualified colleague with exceptional experience in personal injury litigation consultation thinks about our profession in this complex arena. Your thinking will be stimulated and challenged. You probably will improve your legal consultation. Some may be inspired to write on this topic. Dr. Sbordone is to be commended for this creative contribution. It is much needed. This seminal work has the potential of growing into a mature treatise. Hopefully, future editions will nurture and expand this promising beginning.
REFERENCES The Clinical Neuropsychologist, 3(I), 22. Hartman, D. E. (1988). Neuropsychological toxicology: Identijication and assessment of human neurotoxic syndromes. Elmsford. NY: Pergamon Press. Levin, H. S., Eisenberg, H. M.. & Benton, A. L. (1989). Mild head injury. New York: Oxford
Executive Committee of Division 40 (1989). Definition of a clinical neuropsychologist.
University Press. Levin, H. S., Mattis, S., Ruff, R. M., Eisenberg, H. M., Marshall, L. F., & Tabaddor, K. (1987). Neurobehavioral outcome of minor head injury: A three center study. Journal of Neurosurgery, 66,234-243.
Levin, H. S., Benton. A. L., & Grossman, R G. (1982). Neurobehavioral consequences of closed head injury. New York: Oxford University Press. Lezak, M. D. (1983). Neuropsychological assessment (2nd ed.). New York: Oxford University Press. Reports of the INS-Division 40 Task Force on Education, Accreditation, and Credentialing (1987). Guidelines for doctoral training programs in clinical neuropsychology. The Clinical Neuropsychologist, 1.29-34.
Ziin, J. KcFaust, D. (1988). Coping with psychiatric andpsychological testimony (Vols. 1 & 2, 4th ed). Marina Del Rey, CA: Law and Psychology Press.
Lloyd I. Cripe, PhD Private Practice, Seattle, Washington