Week 3 Flashcards
What is paediatric neuropsychology
From birth to 18 years (or more definitively when a child leaves school)
They need to know about brain development because they’re looking at the impairment in the brain, and the timing it is acquired.
Brain development
Abnormalities that happen prenatally will impact on brain structure.
Neuronal proliferation - defect
Generation of lots of different neurons (peaking from 5-17 weeks)
Defect:
microcephaly (too few neurons - down syndrome)
macrocephaly (too many neurons - autism)
Migration
8-15 weeks
Once the cells develop, they move to specific structures in the brain in sheets (laminae) with similar cells.
By 5 months gestation, most cell layers are visible.
Defect:
- lissencephaly (smooth brain)
- corticol dysphasia (sheets of cells move to the wrong place - grey and white matter could be mixed up)
- polymicrogyra (thin and highly folded cortex, too many folds)
Myelination
axons are surrounded by myelin sheath which helps in conduction and velocity (important in processing speed) - starting 28 weeks and continuing postnatally.
Defect - prenatal disruption could be through the mother having traumatic brain innjuries
Prenatal development
Most of the development is structure based
Postnatal development
The most rapid development is connectivity (formulation of dendrites) and natural cell death (dying of those branches if they are not adaptive, so that the brain can become more efficient)
Synaptic density:
peaks at 6 years old, and then pruning occurs to make the brain more efficient
autism often involves not enough pruning of the brain
Survival centre of the brain:
Fight, flight, freeze
Fully functioning at birth and handles all basic instincts and functions - regulates autonomic functions (breathing, digestion, heart rate, sleep, hunger, instinctual behaviours and behaviours that sustain life)
Emotional centre of the brain
Develops between 0-5 years (limbic system)
- processes emotions
- memory
-response to stress
- nurturing
- separation anxiety
- fear, rage
- social bonding
- hormone control
Executive centre
The prefrontal cortex
- Developmental shifts around ages 5-6, 11 and 15
Handles logic, empathy, compassion, creativity, self-regulation, self-awareness, predicting, planning, problem solving, attention
What’s the paediatric neuropsychologist’s role?
- Assessment of cognitive, adaptive, behavioural, emotional, academic and social abilities in young people
- interpretation of test results within the context of background history and child’s condition
- feedback of results, functional implications and recommendations
- contributing to diagnosis and management (referrals, monitoring, educational placement)
- develop implement and evaluate intervention
Difference between developmental disorders and acquired disorders
Developmental: an injury/impairment sustained in the uterus (e.g. epilepsy, ASD, down syndrome, exposure to toxins)
Acquired: an injury/impairment sustained after birth (stroke, brain tumours, traumatic brain injuries)
What are the similarities between adult and child neuropsychology?
- Localisation of function
- Similar causes of brain impairment
- Similar range of functional impairments
- Dose-response relationships (the more extensive the brain damage, the more difficulties the child will have) remains
- Early intervention and rehabilitation
How does paediatric neuropsychology differ from adult neuropscyhology?
Dynamic vs relatively static
- kids are rapidly developing (dynamic)
- different parts of the brain interact, different parts of development interact, as such you can get much more generalized impairment in children
Immature vs mature cognitive functions
Brain damage in children may disrupt normal ongoing development
Dealing with dependents (therefore the entire family unit and teachers, etc)
In children, impairment may be less immediate, or it may change or emerge over time (i.e. the gap may widen). The impact of brain impairment is typically more generalized.
