Paediatric neuropsychology Flashcards
What patients do paediatric neuropsychologists work with?
From birth to 18 years (or more definitively when a child leaves school)
See a range of diff types of children: dev disorders (ASD, ADHD, epilepsy) and acquired probs (TBI, tumor)
What steps occur during brain development and what happens it they’re disrupted?
The brain devs from prenatal all the way to adulthood
Prenatally most of the brain dev is structural; cells form and migrate
After birth connectivity devs
Disruptions prenatally are structural, ex if fuck proliferation, can get ASD, micro or macrocephaly
If fuck migration can get lissencephaly and brain cells move to wrong parts
Myelination can be impaired by maternal malnutrition or brain injury
How is brain development inside out and back to front?
When babies are born they mainly use the brainstem (breathing, heart rate, fight or flight) so cant reg emotions
The limbic syst devs around 5 yrs so kids can better reg emotions
Exec center starts to dev around 5 up to the 20s and is the thinking center of the brain
What is The Paediatric Neuropsychologist’s Role? (8)
- Assessment of cognitive, adaptive, behavioural, emotional, academic and social abilities in young people
- Interpretation of assessment results within the context of background history, characteristics of the child’s condition/insult/injury etc.
- Feedback of results, opinion, functional implications and recommendations to:
- the child themselves (as appropriate)
- the family
- educational professionals
- health professionals
- Contribute to diagnosis and management
- Make recommendations for educational placement and support
- Make referrals (e.g., psychologist, speech therapist, occupational therapist, paediatrician)
- Monitor the child over time (reviews) and provide ongoing support
- Develop, implement and evaluate intervention programs
Developmental vs acquired disorders
- Developmental Disorders –an injury/impairment sustained in the uterus; genetic conditions, exposure to drugs and toxins in utero
- Acquired Disorders –an injury/impairment sustained during or after birth; the brain was deving normally until that moment
- Both can occur in children
What are 5 Similarities Between Adult and Child Neuropsychology?
Paediatric Neuropsychology uses the same foundations as the adult neuropsychological model
- Localisation of function
- Similar causes of brain impairment
- Similar range of functional impairments
- ‘Dose-response’ relationship remains
- Intervention/Rehabilitation is very important
How Does Paediatric Neuropsychology Differ From Adult Neuropsychology? (6)
- The dynamic vs. the (relatively) static brain
- Immature vs. mature cognitive functions
- Brain damage in children may disrupt normal ongoing development
- Always liaise with the child’s system of support
In children: - Impairments may be less immediate –> may change or emerge over time
- The impact of brain impairment is typically more generalised
How do we gather information? (4)
- Interviews (background history etc.)
- Direct observation
- Information from multiple sources –home, school, other professionals
- Standardised assessment
What do we assess? (14)
Neuropsychological domains
- Intellectual Function
- Adaptive Skills
- Attention
- Information processing
- Memory
- Language
- Visuospatial skills
- Executive Function
Academic Achievement *Reading accuracy, fluency and comprehension
*Spelling and written expression
*Numerical calculation and maths reasoning
Other Areas
*Behavioural patterns
*Emotional health
*Social skills
What is intellectual functioning? (6)
- Intellectual function is a person’s general learning ability, or “g”
- Actually consists of several domains of cognition –verbal abilities, nonverbal abilities, working memory, processing speed
- As with any assessment, you must consider cultural background, ESL status, life experience etc
- Assessed using standardised, individually administered assessment tools
Can have intellectual disabilities in specific domains
To be diagnosed with an intellectual disability have to score 2 SD below the mean of IQ test and rule out other causes (sensory probs)
What are Some Causes of Intellectual Impairment? (7 + 5 exclusions)
–> Acquired :
- Birth difficulties
- TBI
- Tumour and treatment
- Virus/infection of CNS
- Metabolic disorders
–>Developmental :
- Genetic abnormalities
- Unknown etiology
- Extreme use of drugs/alcohol during pregnancy
–> Exclusions:
- Environmental depravation
- Low SES
- Culture
- English as a second language
- Motivation/Mood
What is intellectual disability? (3)
- Deficits in intellectual functions, such as reasoning, problem-solving, planning, abstract thinking, judgement, academic learning, and learning from experience, confirmed by both clinical assessment and individualised, standidised testing.
- Deficits in adaptive functioning that limit functioning in one or more activities of daily life, such as communication, social participation, and independent living, across multiple environments (eg home, school, community).
- Onset during the developmental period (childhood or adolescence)
What are adaptive functions?
How effectively an individual copes with common life demands –how well they meet the standards of personal independence and social responsibility in comparison to others of similar age and sociocultural background.
*In three broad domains
-conceptual skills
-social and leisure skills
-practical skills
What is mild intellectual disability? (7)
- Learn and process information more slowly than people without an intellectual disability
- Require additional support to learn and gain independence
- Schooling –IM classes available for those aged 8 –18
- As an adult, may live and travel independently (with training)
- May learn to read and write at a basic level
- May work in open or supported environment
- May partner and have children
What is moderate intellectual disability? (5)
- Schooling –IO classes available from Kindergarten
- As an adult, may require supported accommodation
- May develop independence in personal care, with training
- Will have important relationships and form valued and lasting friendships
- Will need lifelong support in planning and organising their activities
