Pregnancy and Birth Flashcards
What are the characteristics of early brain development?
1) Hierarchical: First cerebellar structures develop, followed by posterior and then anterior regions once each step is complete.
2)Additive and Regressive: Many developmental brain processes increase over time, and other show an inverse development first overproduction followed by selective reduction.
3) It develops in growth spors: Processes aren’t always linear and it happens with growth spurs which leads to overproduction, followed by pruning.
What’s the correct order of neuron development during the prenatal period?
*Neurons develop
* Neurons multiply
* Neurons migrate
* Neurons branch out (form synapses)
* Neurons are Pruned(apoptosis)
* Synapses reorganize
* Myelination
What the main developments during pre- post natal periods?
Prenatal period is focused on structural development, therefore insults during this perios can affect morphology.
Postnatal period is focused on interconnections and functional networks, therefore insults during this period affect the functionality of the brain.
Does the rapid growth of early brain pose an advantage or disadvantage?
It poses both an advantage and a disadvantage. Immature brains strengths are ;
* extreme plasticity - due to being less differentiated and resulting in easier recovery from insults
Weaknesses are;
* It’s vulnerability to injury- due to its characteristic development in growth spurs, injuries may cause more severe damage, it may cause the child to miss out on crucial development stages.
*Critical periods are when the children are especially sensitive to certain enviromental inputs. This could mean higher risk of more severe injury , as well as, an opportunity for the children to be able to gain new knowledge and skills. (For example: a damage to the brain during the period of language learning, may prevent the child to ever learning language. On the contrary, more adapted stimuli during language learning period, may help the child learn more than one language easily)
How would you explain the case of two children experiencing brain insult during the same period, resulting in different outcomes? (One is largely affected, the other is unaffected)
This can be explained by The Recovery Continuum Model which acknowledges that the recovery process from an injury is not a linear process and is affected by several factors.
1. This difference can be explained by nature and severity of the insult. The insult may be global or diffused; mild or severe; and may or may not occur with complications. The very nature, severity and location fo the insult will affect the outcome and the recovery process.
2. This difference can also be explained by the developmental stage of the child and the timing of the assessment: It states that the insult occurs during the same period but it’s unclear when exactly it takes place. Although, children follow a typical developmental process, this might not always be the case. The seemingly not so affected child might have already grown into deficit by the time of the assessment, or they might have already at a higher level of skill development.
3. It can also be explained by preinjury child charasteristics as mentioned above, if the child is early at a certain degree of a specific skill, it might seem as though they’re not as affected as others. This could also be tied to their unique genetic encoding, or preexisting conditions.
4. Environmental context and the available resources could also explain the difference in the outcome. If one child has more social support, more resources available for tailored interventions and treatments, or a different socioeconomic situation, their outcome and recovery process can look a lot more different.
You are at a conference about clinical neuropsychology and start talking to an adult
neuropsychologist. She tells you: “Basically, infant brains are like adult brains, but then tinier”.
A. As a developmental neuropsychologist, you know that this statement is not correct. Respond to this statement by arguing it is not correct by using at least three arguments.
B. How does the brain volume grow from birth to adulthood? (1points)
C. How do brain networks evolve throughout lifespan? (2points) Give one example. (1point)
I would give these 3 arguments to the neuropsychologist;
1. There are neurodevelopmental differences between an adult and an infant brain. Such as; infant brains experience an abundant neurogenesis and synaptogenesis. During the early life, there is extreme neuronal growth and building interconnections. However, this overgrowth is followed by synaptic pruning and formation during infancy. This process is cruical for the infant and is very different from the adult brain where these processes have already taken place. Adult brains typically show very few neuron development and is more focused on maintaining and sustaining the existing connections.
2. There are also functional differences between an adult and an infant brain. The adult brain is already differentiated, specific regions have their own functions. Whereas in an infant brain, not every region is fully developed nor are they capable of certain tasks. For example; an adult brain has a fully developed and functioning frontal cortex which allows the individual to carry out higher executive functions, like cognition, decision making, and impulse control. However, in an infant brain, this part is underdeveloped, and although an infant is capable of certain basic tasks, they can’t be expected to carry out planning a holiday for the whole family.
3. Lastly, there’s also a difference in plasticity. An infant brain has much more plasticity than an adult brain - which is pretty differentiated as mentioned on the first argument-. This allows the infant to be more sensitive, receptive and adaptive to the environmental stimuli, as well as more vulnerable as we see during the critical periods. So, an adult is not as flexible or responsive as an infant to environmental stimuli may it be of a positive impact (as having an easier time to learn a language than an adult ) or of a negative impact (as being more vulnerable to brain insults which can result in never being able to learn a skill).
B. Brain volume increases rapidly during infancy, reaches about the 80-90% of the adult brain in the first few years. This is due to the growth spurs happening with myelination, neurogenesis and synaptogenesis. This overgrowth is followed by synaptic pruning which slows down the process, resulting in slower volume growth. Brain growth continues but at a slower pace, into adolescence and adulthood, particulary in the frontal lobes.
C. Brain networks become more specialized and efficient throughout the lifespan. In early childhood, brain is undifferentiated but the continous neurogenesis, synaptogenesis and synaptic pruning results in a more differentiated brain in later life. For example, Default Mode Network, which is responsible for self-referential thinking, becomes more developed and stable through chilhood and adolescence showing the improving of executive functions.
Yara and Henry, a young couple in their early 30’s, are in your practice. You discuss their first-born infant Sarah (4 months) who was prematurely born at 28 weeks of gestation. Sarah was in the NICU for over 6 weeks and this whole process has made the young parents extremely stressed and concerned for Sarah’s health. Try to answer the following questions from Sarah’s
parents:
A. Why is preterm birth bad for Sarah’s development? [Name 5 reasons] (5 points)
B. What can we expect in terms of cognitive development for Sarah? Will she be able
to go to normal school? (3 points)
C. Would it be helpful to start interventions early or is Sarah still too young? (2 points)
D.Can the experienced stress by the parents affect the development of Sarah? Explain why (not)? (2 points)
A. Preterm birth is bad for her development due to several reasons:
1. Her brain will have underdeveloped structures such as the cerebral cortex and white matter development. These areas are responsible for motor and cognitive functions, like movement control and higher order executive functions.
2. Preterm birth increases risk for certain neurodevelopmental disorders. She’s at a higher risk for cerebral palsy, autism, ADHD, learning disabilities, because her brain wasn’t fully developed before birth.
3. Sarah having to stay in the NICU, outside of the womb during this period also means, she’ll be exposed to environmental stimuli without the protection of the mother’s womb. This can result in immature sensory systems and impairment.
4. She’s at a high risk position for respiratory and cardiovascular diseases as her lungs and cardiovascular system haven’t fully developed.
5. She also has a weaker immune system, which can impact her development and leave her prone to infections.
B. Although preterm babies are more likely to have learning difficulties and developmental delays, it doesn’t mean she will necessarily need a special education. Depending on the care she will receive in NICU, post-discharge support and her personal resilience based on her unique genes, she may still be able to attend normal school.
As preterm babies can experience developmental delays in cognitive abilities, she may for example learn how to walk or talk later than others, but later on she could catch up. She may attend a normal school but could need some extra support during the education in case of developing a learning disability such as dyslexia. But with the right support systems she can be successful.
C. It would absolutely be helpful to already start interventions as her brain has a higher neuroplasticity, meaning her brain is more flexible in adapting and reogranizing itself early interventions can help. These can be physical therapy, occupational therapy or sensory stimulation which can help take advantage of the high plasticity level to promote a better recovery path. This can also, help you better monitor her developmental stages, to be more mindful in identifying and addressing emergenging issues early.
D. Yes, parental stress can affect her development. High levels of parental stress and anxiety affect the environment, leading to less sensitive and attentive environment. Which can then lead to underdeveloped parent-child bond and delays in development.
Kylian, a 14-year-old boy, is brought into your clinic by his parents. He mentions that he finds it challenging to learn certain new skills at school. Although he excels in language classes and tasks requiring verbal reasoning, he finds it more challenging to do tasks requiring quantitative reasoning. His teachers comment that although Kylian’s academic performance varies based on the subject, he is by no means under-performing compared to his peers. Kylian asks you if in the brain, the development of different cognitive abilities occur in a mutually exclusive manner.
* Provide and elaborate on two different views on the matter (4 points).
* In your opinion, is there one view that you predominantly agree with? If so, why? (2 points). * By giving an example, consider what the consequence of focal brain injury might be, according to these different points of view? (4 points)
- Domain-general hypothesis (1 point) argues that different cognitive skills develop together under one framework, with overlapping timelines, and are dependent on one another (1 point).
Domain-specific hypothesis (1 point) argues that the different cognitive skills develop independent to one another, in their own timelines, forming highly specialized modules (1 point). - predominantly agree with the Domain-general hypothesis because multiple brain regions are usually activated/involved when individuals engage in certain cognitive skills (eg. When learning new information, attention and memory related brain regions are often engaged).
3.According to domain-general hypothesis, focal brain injury should impact multiple cognitive skills (1 point). For example, injuries to brain regions involved in attention could give problems with learning & memory in school across multiple areas (e.g. mathematics, language, science, etc.)(1 point).
According to domain-specific hypothesis, focal brain injury should only impact cognitive skills dependent on the specific brain region affected (1 point). For example, injury to the language related regions of the brain would affect verbal reasoning but not necessarily quantitative reasoning (1 point).
What are the brain areas affected in CP?
- Motor Cortex, Frontal Lobe
- Basal Ganglia
- Cerebellum
- Corticospinal Tract
- Thalamus
What can cause CP?
- Brain injury
- Prenatal infections
- Lack of O2 during birth
- Head Trauma
- Intrauterine Growth Restriction
- Genetic Factors
- Nutrient Deficiency
What are the symptoms of CP?
- Brain lesions
- Skeletal muscle (shorter and smaller muscles)
- Decreased strength in muscles
- Stiffness
- Dystonia
- Spasticity
- Prolonged Muscle Contractions
What are the issues related with CP?
- Intellectual Disabilities
- Speech Issues
- Visual Problems
- Deafness
- Epilepsy
- Incontinence
Risk factors for CP?
- Preterm birth
- White matter damage
- Perinatal infections
- IUGR
- Birth asphyxia
What are some possible outcomes of perinatal insult?
- Psychosocial: ADHD, attention issues, ASD,Conduct Disorder
- Mental: Cognitive delays,Language problems,Lower IQ,academic problems
- Motor: Cerebral Palsy, Motor delays
- Physical: Growth delay, lower immune, visual/hearing issues,breathing issues, epilepsy
What are some management and interventions available for CP?
- Physiotherapy
- Musculoskeletal pathology management
- Medication to alleviate pain or physical symptoms
- Rehabilitation technology for vision and hearing issues,mobility support technology
- Managing non-motor syndromes like epilepsy
- ## Speech therapy if they experience speech issue
