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Summary of School Neuropsychology: MBE - Part II
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This summary contains all the literature for week three and four for the course School Neuropsychology: MBE at the RUG.
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School Neuropsychology: Mind, Brain, and EducationSummary of Literature
Week 3 and Week 4
Contents:
Book: Essentials of School Neuropsychological Assessment
Chapters: 4, 15, 16, 17
Articles:
Article #3: Sonuga-Barke, E.J.S. (2002). Psychological heterogeneity in AD/HD—a dual
pathway model of behaviour and cognition.
http://proxy-ub.rug.nl/login?url=http://doi.org/10.1016/S0166-4328(01)00432-6
Article #4: Daley, D. & Birchwood, J. (2010). ADHD and academic performance: why
do ADHD impact on academic performance and what can be done to support ADHD
children in the classroom?
https://doi-org.proxy-ub.rug.nl/10.1111/j.1365-2214.2009.01046.x
,WEEK 3
Chapter 4 – When to Incorporate Neuropsychological Principles into a Comprehensive
Individual Assessment
WM: working memory
Common referral reasons for a school neuropsychological evaluation
EFs: executive functions
High incidence neurodevelopmental disorders
SLD: specific learning disorder
Behaviourally defined neurodevelopmental disorders (i.e. ASD
or ADHD) are evaluated using psychoeducational assessments
There are times when selective neuropsychological measures can add to the
understanding of these disorders:
o Intellectual disabilities
Permanent condition originating sometime between birth and age 18
General intellectual functioning is significantly below average
Concurrent deficits in adaptive behaviour
Rarely a need to use neuropsychological assessment
Exceptions include children with an unusual scatter of performance
with splinter skills well above the significantly below average range
Then assessment can identify strengths to use in intervention
o ADHD
More detailed information in CH14
o Autism Spectrum Disorder
School neuropsychologists have a lot to offer in terms of assessing the
neuropsychological deficits associated with ASD.
The known neuropsychological
processes associated with ASD
include: EFs, attention, WM,
sensory-motor, and language
Children with a known or suspected neurological disorder
Requires a thorough record review and Rapid reference 4.1
developmental history to uncover past neurological Common referral reasons for a
traumas school neuropsychological
o Careful since some families are reluctant to evaluation
share (i.e. abuse, neglect) - Past or recent head injury
o But the child must be suffering from some - Congenital brain damage
academic or behavioural difficulties - Neuromuscular disease
o If these are not present, it is still wise to - Brain tumour
monitor the child - CNS infection or compromise
- Neurodevelopmental risk
Children with past or recent head injuries who are having - Head injury/neuro consult
behavioural or academic difficulties - Rapid decline in academics
Children with TBI and the above are often - No response to intervention
misdiagnosed with i.e. SLD strategies
Child should always be monitored as the first years - Suspected processing
after TBI hold the most potential weakness
Children may need to be evaluated more frequently - Scatter in psychoeducational
than the current standard – once every three years tests
- Sports-related concussion
, Keep in mind that damage to the same part of the brain can lead to an overall
pattern of deficits that look different from one child to another. This is because of
the differences in the secondary deficits related to axonal shearing, swelling of the
brain, infections, and so on.
Children with a history of acquired or congenital brain damage
Anoxia/hypoxia
o Anoxia refers to an absence of oxygen to the brain and other organs, whereas
hypoxia refers to a decrease of oxygen to the brain and other organs.
o Can be caused by:
strangulation, drowning, smoke inhalation, etc
o May lead to
loss of consciousness, coma, seizures, or even death
o May also lead to psychological and neurological symptoms
Mental confusion
Personality regression
Parietal lobe syndromes
Amnesia hallucinations
Memory loss
o Even minor birth hypoxia can lead to cognitive impairments including:
Selective and sustained attention
Receptive vocabulary in pre-schoolers
Emergent maths skills VLBW:
Cognitive and academic functioning Very Low Birth Weight
Social skills
Sequalae:
Cerebral vascular accidents (CVAs) A condition which is the
o Three major arteries in the cerebral cortex: consequence of a previous
Anterior cerebral artery (ACA) disease or injury
Middle cerebral artery (MCA)
Posterior cerebral artery (PCA)
o Ischemia and haemorrhage are two forms of stroke
Ischemia: blockage of blood flow, haemorrhage: blood vessel breaks
Ischemia is most common cardiac disorders or heart disease
Haemorrhagic disorders sickle cell anaemia, haemophilia
Haemorrhagic stroke caused by trauma
o Perinatal stroke (PS) may occur in utero, at birth or within the first few
months of life common in VLBW or premature birth
Majority involve the MCA and left hemisphere
Sequalae resulting from CVA vary significantly depending upon type,
location, and ancillary damage
Meningitis
o Inflammation in the lining of the brain and spinal cord
o Symptoms include:
Severe headache, stiff neck, dislike of bright lights, fever/vomiting,
drowsiness, less responsive/vacant, rash, seizures
o Surviving bacterial meningitis has a negative impact on cognitive abilities and
development
, No evidence that viral meningitis had an impact on cognitive abilities
Encephalitis
o Inflammation of the brain usually caused by viruses that occur perinatally or
postnatally, includes symptoms like: Fever, altered consciousness, seizures,
disorientation, memory loss
o Acute, sub-acute, or chronic
o Intellectual disability, irritability and lability, seizures, hypertonia, and cranial
nerve involvement are seen in more severely impacted children
o Lacks confirmatory research
Seizure disorders
o Epilepsy is a common condition that affects the brain frequent seizures.
Seizures are bursts of electrical activity in the brain that temporarily
affect how it work
o Neuropsychological deficits associated with epilepsy vary widely based on the
type and severity of the seizure disorder
Children with brain tumours
Classified according to size, location, common characteristics, and treatment
outcomes
Can cause a wide range of neurocognitive deficits
Symptoms may include unusual increased irritability, lethargy, diplopia, vomiting,
headaches, unexplained changers in personality and behaviour
Rapid reference 4.3
Common childhood brain tumours
Tumour type Characteristics Symptoms Treatment Cure rate Incident rate
Cerebellar Benign, cystic, Clumsiness of one Surgical Depends on type 20% of
astrocytoma slow growing hand, stumbling, removal and response paediatric
(5-8 years old) headache, and brain tumours
vomiting
Medullo Can metastasize Headache, Surgery and If cancer returns it 10-20% of
blastoma along spinal cord vomiting, radiation/ is within first 5 paediatric
(peak at 5 years incoordination, chemo years brain tumours
old – max 10) lethargy Boys>girls
Ependymoma Growth rate Headache, Surgery, Depends on 8-10% of
varies, obstruct vomiting, radiation and surgery success, paediatric
CSF incoordination chemo type and response brain tumours
Brainstem Tumour of the Double vision, Surgery not Low survival rate 10-15% of
glioma pons and medulla facial weakness, possible – paediatric
(average around May become difficulty walking, chemo and brain tumours
6 years old) large before vomiting radiation
symptoms
Craniopharyngio Near pituitary Vision changes, Surgery, Good but Rare, only 4%
ma stalk headache, weight radiation, endocrine paediatric
(7-12 years old) gain, endocrine combination dysfunction may brain tumours
changes persist
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