Week 1 - intro info Flashcards
what is Neuropsychology
Brain behavior relationship
sometimes referred to as “functional localization”
application to individual pts (clinical)
individual learning differences (education)
Functional Lateralization
a function may depend on one side (hemisphere) of the brain
Definition of Nueropsychology
specialty within the field of psychology that focuses on brain-behavior relationship
Eval can define how a child is functioning in comparison to developmental expectations (strengths and weaknesses are defined)
Patterns are interpreted in the context of neuroanatomy, cognitive development, and the effect of various forms of brain injury on development –> further used to develop an intervention plan
Neuropsych vs other types of psych assessments
different tests (standard vs projective)
different application of test results
medically based (ICD-10 vs DSM)
ex) clinical/school psych primarily interested in score obtained by child; neuro is interested in how the child obtained a score as well as the pattern of scores across different tests; for a child who is struggling to follow directions –> neuro wants to know why its difficult for the child to follow directions (didnt pay attention? didn’t understand? cant remember?) neuro will then attempt to localize with brain geography
What can neuro evals do?
assist in establishment of dx
establish a performance baseline to document functional effects of medical interventions
provide a description of the child’s neurocognitive strengths and weaknesses
suggest interventions for remediation of weaknesses
Assessment issues
certain deficits may not be apparent in early childhood
easier to determine deficits in skills that are established in contrast to those that are emerging or developing
“high risk” children should be followed
use caution when providing feedback (privately, without child etc, cant take back results, language used)
reliability to assessment increase with age
Neuro test battery
- General Intellectual Ability (“IQ”)
- Attention and Concentration
- Executive functions
- Language functions
- Visual-spatial abilities
- Motor functions
- Emotional/behavioral functions
- adaptive functioning
- academics (if necessary)
Typical IQ tests
WPPSI/WISC/WAIS
Bayley/Mullen
Stanford-Binet
WJ-cog
KABC
Leiter
DAS
Adaptive measures
ABAS
Vineland
Learning/memory measures
WRAML
CMS
WMS
CVLT-C (verbal memory only)
TOMAL
NEPSY
Rey-O (visual memory only)
Attention/concentration measures
K-CPT or CPT
NEPSY
rating scales
Language tests
CELF
COWA
expressive/receptive one word
Boston Naming Test
NEPSY
TOPL-II
EF tests
DKEFS (stroop, trails, verbal, fluency, tower)
NEPSY
Category test
Tower of London
Wisconsin Card Sort
Rey-o
Rating scales (BRIEF, BROWN)
Visual-spatial/visual-motor/fine-motor tests
Beery VMI
NEPSY
Pegboard (grooves/purdue)
Finger tapping
WRAVMA
Ray-o
Academic tests
WJ-achievement
WIAT
Bracken, TERA, TEMA
TOWL, Key math
GORT
CTOPP
Social emotional tests
Rating scales (BASC, CDI, Beck, MACI, MPACI, MASC)
Projectives?
Autism tests
ADOS
Rating scales (ADI-R, SCQ, SRSS, GARS, CARS)
NEPSY (affect recognition/theory of mind)
TOPS
clinical interview
Score classification: Standard Scores
69 and below = Extremely Low
70 - 79 = Borderline
80 - 90 = Low Average
90 - 109 = Average
110 - 119 = High Average
120 - 129 = Superior
130+ = Very superior
**mean=100 SD=10
Score classification: Scaled Scores
< 3 = Extremely Low
4-5 = Borderline Range
6-7 = Low Average
8-12 = Average
13-14 = High Average
>15 = Superior
**mean=10 SD=3
Score Classification: T scores
70+ = significant
60-69 = At risk
40-60 = average
30-39 = below average
29 or below = Significantly below average
**mean=50 SD=10
How to ID/justify a patient might benefit from school services?
- could medical condition/tx possibly be affecting school performance?
- will the child need accommodations/modifications to be successful in the school curriculum
- will they be able to access the school environment/curriculum
- some services are considered not educationally necessary despite challenges (speech therapy, OT, counseling, behavioral challenges at home)
When to refer for neuropsych assessment?
- hx of known or suspected brain injury
- preexisting genetic disorder or neurodevelopmental disorders that may impact development
- strong family hx of dx
- medical problems (i.e., diabetes, seizures, chronic heart or respiratory problems, chemo/radiotherapy, that may impact brain development)
- exposure to neurotoxins such as lead, drugs, inhalants, or prenatal exposure to drugs/alcohol
- premature or complicated birth
- failure to respond to what appear to be appropriate/evidence-based interventions
Appropriate referrals for neuropsych
- tumors
- TBI/concussion
- stroke
- congenital malformation
- epilepsy
- neuromuscular or neurological disorders
- cancer/late effects
- infectious disease
- premature birth/low birth weight
- genetic disorder
- FAS/FAE
- learning disability
- ADHD
- ASD
- developmental delay/ID
Insurance considerations
most insurance plans will deny coverage for assessment used to establish an educational dx except in context of medical condition or other concerns
FAQ by parents for neuro
- how is medical or mental health challenges affecting development/progress
- will my child need a special program at school
- who do i inform about my child’s chronic illness?
- who do I talk to about setting up a 504/IEP
- Do i need a letter documenting special accommodations
- does my child need mediation? therapy?
-will my child “outgrow” this or will they ever be “normal”
