Samenvatting School Neuropsychology
Chapter 1 The Specialization of School Neuropsychology
Increased number of children with medical conditions that affect school performance
- Being born premature or with low birth weight is correlated with needing special
education risk factor
- More children are surviving birth traumas and major medical illnesses, correlates
with later academic and behavioral concerns
- Children with traumatic brain injury (TBI) present unique challenge to educators
High increase in number of children who are prescribed medication to deal with disorders
- Also polypharmacy is on the rise (multiple meds)
- Neurologically impaired children are often mislabeled as emotionally disturbed or
specific learning disabled
- Neuropsychological deficits associated with chronic illnesses, such as: asthma,
diabetes, heart disease
Specific learning disorder (SLD)
- A disorder in one or more of the basic psychological processes involved in
understanding or language (spoken or written)
- may manifest in an imperfect ability to listen, think, speak, read, write, spell or math
- Including conditions such as perceptual disabilities, brain injury, minimal brain
dysfunction, dyslexia and developmental aphasia
- Does NOT include learning problems that are primarily the result of visual, hearing or
motor disabilities, or intellectual disability
Major role of school neuropsychologist: help teachers implement educational interventions
School neuropsychological assessments are good for:
1. Identifying processing deficits in child that could affect educational attainment
2. Describing profile of child’s neurocognitive strengths and weaknesses
3. Document whether changes in learning or behavior are associated with neurological
disease, psychological condition, developmental disorder or non-neurological
4. Monitor educational progress over time in children
5. Provide comprehensive assessment data that will increase the likelihood of success
with evidence-based interventions
Roles and functions of school neuropsychologist
- Interpret results of neuropsychological assessment & develop intervention strategies
- Present recommendations for remediation on knowledge of validated interventions
- Consult with curriculum specialists in designing approaches to instruction that more
adequately reflect what is known about neuropsychological development
- Act as organizational liaison with medical community
- Conduct in-service workshops for educational personnel and parents
- Conduct both basic and applied educational research investigating the efficacy of
interventions and consultations in the schools
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Chapter 4 Common referral reasons for School Neuropsychological evaluation
Intellectual disabilities
- Permanent condition starting before age of 18
- child’s intellectual functioning is below average
- child has concurrent deficits in adaptive behavior
- using neuropsychological assessment is rare for intellectual disability (only if there is
unusual scatter of performance)
ADHD
- inattention
- poor response inhibition / impulse control
- executive dysfunction
Autism Spectrum Disorder
- Persistent deficits in socialness
- Restricted, repetitive patterns of behavior, interests
- Symptoms clearly present in early development
- Symptoms cause clinically significant social, occupational impairment
- Disturbance not better explained by intellectual disability / global development delay
Children with head injuries that are having difficulties
- Neuropsychological deficits are associated with TBI (moderate to severe)
- Often children with TBI are misdiagnosed with specific learning disabilities
- Children with TBI should be monitored and reevaluated
School-based TBI teams
1. Initial identification TBI child
2. Medical treatment planning at hospital
3. Prior to hospital discharge
4. School re-entry
Children with history of acquired/congenital brain damage
Anoxia/hypoxia
- Absence or decreased supply of oxygen to organ tissues
- Can result in cognitive impairment
Cerebral vascular accidents
- Soorten hersenbloeddingen: Ischemia and hemorrhage (bloedvat knapt in hersenen
= meest voorkomend)
- Perinatal stroke: stroke in utero, at birth or few months after
- Damage is dependent on location and type
Meningitis
- Had negative impact on cognitive abilities and development
- Approximately 5-point reduction in IQ
- 5 times more likely to have intellectual impairment
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Seizure disorders
- Should be monitored for neurocognitive strengths and weaknesses
Brain tumors
- Need to establish baseline profile of strengths and weaknesses
- If school neuropsychologist suspects there may be a tumor, student needs to be
referred immediately
- Types:
o Cerebellar astrocytoma 20% of pediatric brain tumors (peak age 5-8)
o Medulloblastoma most common malignant brain tumor, 10-20% of all
pediatric brain tumors (more in boys, peak age 5)
o Ependymoma 8-10% of pediatric brain tumors
o Brainstem glioma 10-15% of primary brain tumors children (average age 6)
o Craniopharyngioma rare, 4% of childhood brain tumors (average age 7-12)
Children with neuromuscular disorders
Cerebral palsy
- Caused by faulty development of brain structures that help control movement and
posture
- Stiff muscles, writhing movements, poor balance and coordination
- Lots of motor/fine motor problems
Muscular dystrophy disorders
- CMD: group of disorders where infants show muscle weakness at birth / shortly after
- Associated with severe intellectual disability and sometimes ADHD and anxiety
Children with CNS infection/compromise
Asthma
- Medications can have side effects that alter arousal and attention levels, memory,
motor steadiness, visual-spatial planning
- Related to deficits in academic achievement, EF, attention, learning etc
- Help parents/educators be aware of negative side effects of disorder/medication
Spina fida/hydrocephalus
- Increased cranial pressure can cause lasting brain damage due to compression
- Deficits in motor, timing, attention, EF, academic math
Juvenile diabetes
- Neurocognitive effects on visual-motor, memory, attention
Leukemia
- Treatments are toxic to Central Nervous System
- Deficits in attention, EF, motor function
- Need to monitor educational performance, provide feedback and help child maintain
self-efficacy and connection to school environment