Neuropsychological rehabilitation and mediation: from the desk to real life in building subject-centered interventions

Abstract

This study is situated within the field of contemporary neuropsychological rehabilitation, drawing from the context of current clinical practice, in which a recurring gap is observed between gains achieved in structured cognitive training tasks in clinical settings and their transfer to real-life everyday situations. The research problem consisted of investigating to what extent the exclusive use of structured materials and mechanical training of isolated cognitive functions are sufficient to promote generalization of learning and functional improvement in children and adults undergoing neuropsychological rehabilitation. The initial hypothesis held that subject-centered interventions, grounded in the cultural-historical perspective, with emphasis on mediation, contextualization, and joint construction of meanings, present greater generalization potential than decontextualized and standardized approaches. The general objective was to critically analyze the theoretical and methodological foundations of subject-centered rehabilitation, articulating cultural-historical contributions and contemporary functionality-oriented models. A qualitative, analytical-critical bibliographic research was conducted, with selection and comparison of classical and recent literature. The results indicate consistent limitations in functional transfer within mechanistic models and greater theoretical-methodological coherence in approaches based on goals, compensatory strategies, and mediation. It was concluded that generalization depends on the alignment between tasks, contexts, and meaningful goals, requiring personalized and mediated interventions.