Background and aims: This article considers the complexities of neuropsychological assessment and rehabilitation in brain injury when the client is illiterate, is from a foreign culture with English as a second language, and reports highly atypical childhood feral experiences prior to injury.
Method: MC was a 63-year-old woman referred for neuropsychological rehabilitation with a diagnosis of suspected St Louis encephalitis and global cognitive impairment. In formulating her clinical presentation, consideration was given to a reported history of feral childhood living with monkeys in the Colombian jungle and subsequent physical and emotional abuse. MC participated in comprehensive neuropsychological assessment and then targeted rehabilitation.
Results: Neuroimaging documented relatively focal damage in the right temporal lobe. MC's family described her as "the same but worse"; assessment and formulation indicated an exacerbation of attentional, pragmatic, arousal and executive weaknesses but with new memory and emotion recognition impairments. Rehabilitation techniques for communication and executive difficulties were successful despite the complexities of the case.
Conclusions: The importance of carefully considered assessment and formulation in understanding MC's presentation is discussed. To the authors' knowledge, this is the only case of neuropsychological assessment and rehabilitation in brain injury involving a history of feral childhood.
Keywords: Cultural and cognition; Encephalitis; Feral childhood; Neuropsychological Assessment.