Topographical disorientation: Towards an integrated framework for assessment

Topographical disorientation, the inability to find one's way in large-scale environments, is a relatively common disorder. However, there are relatively few cognitive neuropsychological studies that investigate the nature of topographical cognition. Theoretical progress has been hindered by a number of factors including: terminological confusion; lack of theoretically driven assessment; the use of broad classifications for the nature of underlying impairments; and an ongoing failure to examine topographical skills in real-life settings. As a result, there is currently no well-established or widely accepted theoretical framework encompassing all aspects of this multifaceted area of cognition. In addition, there is a relative paucity of published case studies that include a comprehensive, theoretically based assessment of topographical disorientation, and treatment of the disorder has received virtually no formal investigation (with the exception of Davis & Coltheart, 1999). Thus, the current paper focuses on the development of a broad framework for understanding topographical cognition that integrates a number of recent theories of topographical orientation and mental imagery (Farah, 1984; Kosslyn, 1980; Riddoch & Humphreys, 1989). The aim of the paper is to present a preliminary framework that can be used as a basis for further refinement and development of theoretical proposals, and be employed by clinicians as a starting point for assessment planning.