Vygotsky in applied neuropsychology

The aims of this paper are: 1) to show the role of clinical experience for the theoretical contributions of L.S. Vygotsky, and 2) to analyze the development of these theories in contemporary applied neuropsychology. An analysis of disturbances of mental functioning is impossible without a systemic approach to the evidence observed. Therefore, medical psychology is fundamental for forming a systemic approach to psychology. The assessment of neurological patients at the neurological hospital of Moscow University permitted L.S. Vygotsky to create, in collaboration with A.R. Luria, the theory of systemic dynamic localization of higher mental functions and their relationship to cultural conditions. In his studies of patients with Parkinson’s disease, Vygotsky also set out 3 steps of systemic development: interpsychological, then extrapsychological, then intrapsychological. L.S. Vygotsky and A.R. Luria in the late 1920s created a program to compensate for the motor subcortical disturbances in Parkinson’s disease (PD) through a cortical (visual) mediation of movements. We propose to distinguish the objective mediating factors — like teaching techniques and modalities — from subjective mediating factors, like the individual’s internal representation of his/her own disease. The cultural-historical approach in contemporary neuropsychology forces neuropsychologists to re-analyze and re-interpret the classic neuropsychological syndromes; to develop new assessment procedures more in accordance with the patient’s conditions of life; and to reconsider the concept of the social brain as a social and cultural determinant and regulator of brain functioning. L.S. Vygotsky and A.R. Luria proved that a defect interferes with a child’s appropriation of his/her culture, but cultural means can help the child overcome the defect. In this way, the cultural-historical approach became, and still is, a methodological basis for remedial education.