Phyllis Anne Teeter Ellison

The Neuropsychological Assessment Process

When a practitioner begins an assessment there are three major parts to the evaluation. These sections include the intake interview, the assessment, and the feedback. Each of these areas will be described in greater detail as well as the mechanics of neuropsychological report writing.

Autistic Spectrum Disorders

Research in Autistic Spectrum Disorders (ASD) has greatly increased within the past decade. DSM IV TR (APA, 2000) has grouped autism, Rett’s disorder, Asperger’s Disorder (AS), and childhood disintegrative disorder under the umbrella term, Pervasive Developmental Disorder (PDD). PDD-NOS (not otherwise specified) is a term and diagnosis with no specific criteria which is often used when a child does not meet full criteria for either diagnosis and is generally used when the child shows some, but not all of the symptoms of either AS or autism.

Language-Related and Learning Disorders

Neurodevelopmental disorders of childhood, including language-related and learning disabilities, constitute a large percentage of the childhood disorders seen by child clinical neuropsychologists. Language impairments and learning disabilities resulting from phonological core deficits are featured, as are mathematics difficulties resulting from nonverbal, reasoning, and perceptual deficits. Recently these disorders have often been combined with the new term, learning and language impaired. A large body of research has burgeoned over the past decade. There are some children who simply exhibit a language delay as well as a few children with a learning disability without a significant language delay. For that reason we will discuss language disability somewhat separate from learning disabilities although they are related and should be viewed as such.

Neuropsychological Intervention and Treatment Approaches for Childhood and Adolescent Disorders

Information about the childs neuropsychological, cognitive, academic, and psychosocial status forms the basis for designing integrated intervention and treatment plans for children and adolescents with brain-related disorders. Efforts to develop models of neuropsychological intervention have been expanding in recent years. In an effort to provide a framework for linking assessment to interventions, the Multistage Neuropsychological Assessment-Intervention Model is presented. Specific techniques for designing intervention programs addressing academic, psychosocial, and executive function (EF) deficits associated with various childhood and adolescent disorders are summarized.

Acquired Neurological Disorders and Diseases of Childhood

Though relatively rare compared to neurodevelopmental disorders, acquired neurological disorders and diseases represent some of the more common disorders seen by child clinical neuropsychologists. This chapter uses a transactional neuropsychological approach to review traumatic brain injury in children; exposure to teratogenic agents, including alcohol and cocaine; childhood cancer, and infectious diseases of the CNS, including meningitis and encephalitis. Research into these various disorders and diseases suggests the need for a transactional approach to assessing and treating children with these neurological conditions. Such an approach is particularly appropriate given the complexity of these disorders as well as the long-term effects that are present during and following recovery.

Integrating Neurological, Neuroradiological, and Psychological Examinations in Neuropsychological Assessment

This chapter provides guidelines to help psychologists determine when to refer a child or adolescent for neuropsychological assessment, neurological examination, or other neurodiagnostic testing (e.g., CT scan or MRI). Children and adolescents often need neurological, neuroradiological, and/ or neuropsychological assessments. Although not every child seen for cognitive, academic, psychiatric, or behavioral problems requires further assessment apart from traditional psychoeducational evaluations, some disorders do need further attention by specialists to investigate the child’s neurological or neuropsychological status. Clinical and school psychologists should be apprised of conditions that typically require further attention. The nature of neurologic, neuroradiologic, and neuropsychological assessment will be discussed, along with guidelines for making referrals. Further, aspects of psychological, psychosocial, and academic functioning are discussed, as these areas may be seriously compromised by brain-related disorders of childhood. Integration of these various evaluation findings are discussed.

Neuropsychological Correlates of Childhood and Adolescent Internalized Disorders: Mood and Anxiety Disorders

This chapter explores childhood mood and anxiety disorders within a transactional model. Genetic, prenatal, and postnatal history will be discussed in light of how these factors interact with neuropsychological, executive, cognitive, perceptual, and memory functioning. Moreover, the impact these factors have on the childs functioning (i.e., family, school, and social interactions) will be discussed within a transactional framework; that is, social and familial factors play a role in environmentally induced mood and anxiety disorders which, in turn, interfere with social interactions and interpersonal well-being.

Neuropsychological Assessment Approaches and Diagnostic Procedures

The purpose of this chapter is twofold. First, we will briefly review three generally accepted approaches to neuropsychological assessment. Second, we will present our transactional assessment approach. This discussion will include evaluation methods for selected functional areas of the central nervous system. The conceptual framework underlying each battery and research with each approach will also be presented.

Pediatric Psychopharmacological and Combined Interventions

Some pediatric disorders with biogenetic or neuropsychological causes may require medical treatments (Wilens, 2001). Most of these disorders, however, require multimodal treatments, where medication is used in combination with other psychosocial and behavioral interventions or therapies. A select list of common medications will be reviewed, including those designed to control ADHD, major depressive disorders, bipolar disorders, psychotic disorders, Tourette syndrome, and seizure disorders. The National Institute of Mental Health (NIMH) has funded a number of studies to investigate the safety and efficacy of medications and psychosocial interventions for common childhood and adolescent disorders. These will be briefly reviewed.

Development in the CNS

Neuronal development proceeds in an orderly fashion during development of the embryo and fetus. There are certain stages of development that are consistent across individuals during gestation. Following birth, changes in the brain are related to genetics, biology, and environmental stimulation. This chapter will provide an overview of development pre- and postnatally, and discuss challenges that develop due to environmental aspects (stress, substance abuse, toxins, etc.).