Case 1: Brain development and brain
damage
Inhoudsopgave
Brain development.....................................................................................................................................................3
Brain development: prenatally...................................................................................................................................3
Brain development: postnatally..................................................................................................................................5
Risk factors for anomalies in CNS development.........................................................................................................7
Traumatic Brain Injury (TBI)........................................................................................................................................7
Functional impairments of TBI for neuropsychological functions...............................................................................8
TBI outcome................................................................................................................................................................9
Predictors on TBI outcome.......................................................................................................................................11
“It is better to have brain injury in childhood than in adulthood”............................................................................13
Different steps of neuropsychological examination..................................................................................................16
Assessment models..................................................................................................................................................18
Development of memory + age................................................................................................................................18
Attention................................................................................................................................................................... 20
Development of attention........................................................................................................................................21
Executive functioning + ecologically validity of tests................................................................................................22
Developmental changes in executive functioning....................................................................................................23
Attention-Deficit/Hyperactivity Disorder (ADHD).....................................................................................................28
Oppositional Defiant Disorder (ODD)........................................................................................................................29
Conduct Disorder (CD)..............................................................................................................................................30
Developmental Coordination Disorder (DCD)...........................................................................................................31
Differential diagnosis................................................................................................................................................31
Neuropsychological functioning of ADHD.................................................................................................................32
Neuropsychological profiles within ADHD................................................................................................................34
ADHD and DCD.........................................................................................................................................................36
Neurocognitive functions in ODD and CD.................................................................................................................38
Specific Learning Disorder (SLD)...............................................................................................................................42
Typical neuropsychological development of reading................................................................................................44
Atypical neuropsychological development of reading..............................................................................................46
Neuroimaging of typical and atypical readers..........................................................................................................47
Dyslexia and early intervention................................................................................................................................47
Dyscalculia................................................................................................................................................................ 49
Non-verbal learning disorder (NLD)..........................................................................................................................51
Pagina 1 van 67
,Autism Spectrum Disorder........................................................................................................................................54
Neuropsychological functioning in children with autism..........................................................................................56
Social cognitive functioning and changes in early development and adolescence...................................................58
Neural basis and brain structures in social cognition................................................................................................60
Integrated play groups as intervention for autism...................................................................................................65
Pagina 2 van 67
,Brain development
2 developmental processes:
- Additive development: accumulation or growth process (myelination, formation
and elaboration of dendritic connections throughout CNS)
- Exhibiting periods of regression, characterized by initial overproduction, followed
by elimination of redundant elements fine-tuning
Growth spurts
- 24-25 weeks gestation, coinciding with completion of neuronal generation
- 1st year of life, due to dendritic and synaptic development and myelination
- Between 7 and 9 years
- Between 16 and 19 years
Disruption to development during growth spurt may be detrimental to ongoing
development, causing cessation of development or altering course of
development – consequences will be more severe when you deprive a child in a
critical/sensitive period (for example in language)
Critical/sensitive period = stage in developmental sequence during which an aspect
of behavioral function may experience a major progression – these critical periods
have been conceptualized as a window of opportunity during which skills need to be
consolidated so that the system involved can then establish interconnections with
other systems
Brain plasticity = brain’s ability to change and adapt as a result of experience
There is a hierarchical progression within CNS:
cerebellar/brain stem areas – posterior areas –
anterior areas (particularly frontal cortex).
Brain development: prenatally
- Fastest rate of brain growth: 250.000 brain
cells per minute
- Structural formation of CNS
- Largely genetically determined
- Interruption to development during this period
is likely to have an impact on cerebral
structure
1) Dorsal and ventral induction: fertilized cell
experiences rapid cell division embryonic
disc
2) Embryonic disc comprises three layers
Inner layer (endoderm): form internal
organs
Middle layer (mesoderm): form skeletal and
muscular structures
Outer layer (ectoderm): forms nervous
system and skin surface - nervous system
emerges via process of neurulation, which
folds in on itself and forms a tube
Pagina 3 van 67
, Development from neural plate to neural tube: 2-4th week of gestation
Disruptions in development in this early stage of CNS maturation may result
in structural anomalies.
Neural tube develops along three different dimensions:
- Length: major structural aspects of CNS (forebrain, midbrain – remaining areas of
neural tube form spinal cord) - disruption in development leads to failure in
formations of these structural divisions
- Circumference: differentiation between sensory and motor systems, with dorsal
corresponding to sensory cortex and ventral corresponding to motor cortex
- Radius: layers and cell types observed within the brain (vesicles form, cells in
vesicle generate and are differentiated into specific cerebral systems)
Cellular basis of development
- Neurons: developed by neuroblasts
Cell body: metabolic functions of neuron and
holds RNA and DNA
Axon: long projection from cell body that
conducts nerve impulses away from cell
body to presynaptic terminal – mature axon
is covered by coating of myelin allowing
more rapid neural transmission
Dendrites: branch of cell body and receive
impulses from other neurons, conducting
them towards cell body – dendritic spines are
locus of synapse, where information is
transmitted from one neuron to another
Presynaptic terminals: neurotransmitters
stored and released, cross synaptic cleft and
activate neurons at postsynapse, to
dendrites of connecting neuron
Long axons and large dendritic trees: forming
basis of major connections of nervous system
Small axons and small dendritic trees:
associated with higher cortical function and
found within cortex
- Glial cells = play more supportive and nutrient
role within nervous system – supporting
neurons, enabling regeneration of damaged
neurons, producing scar tissue to occupy
damage sites, transporting nutrients from nerve
cells – 9x as many glial cells within nervous
system than neurons – glial cells are
differentiated from neurons by a lack of axons –
relatively immature in early stages of
development and continue to generate with
increased maturity of CNS – developed by glioblasts
Astrocytes: form blood-brain barrier, support cellular structure of brain, direct
migration of neurons, clean up and plug injury sites
Pagina 4 van 67
damage
Inhoudsopgave
Brain development.....................................................................................................................................................3
Brain development: prenatally...................................................................................................................................3
Brain development: postnatally..................................................................................................................................5
Risk factors for anomalies in CNS development.........................................................................................................7
Traumatic Brain Injury (TBI)........................................................................................................................................7
Functional impairments of TBI for neuropsychological functions...............................................................................8
TBI outcome................................................................................................................................................................9
Predictors on TBI outcome.......................................................................................................................................11
“It is better to have brain injury in childhood than in adulthood”............................................................................13
Different steps of neuropsychological examination..................................................................................................16
Assessment models..................................................................................................................................................18
Development of memory + age................................................................................................................................18
Attention................................................................................................................................................................... 20
Development of attention........................................................................................................................................21
Executive functioning + ecologically validity of tests................................................................................................22
Developmental changes in executive functioning....................................................................................................23
Attention-Deficit/Hyperactivity Disorder (ADHD).....................................................................................................28
Oppositional Defiant Disorder (ODD)........................................................................................................................29
Conduct Disorder (CD)..............................................................................................................................................30
Developmental Coordination Disorder (DCD)...........................................................................................................31
Differential diagnosis................................................................................................................................................31
Neuropsychological functioning of ADHD.................................................................................................................32
Neuropsychological profiles within ADHD................................................................................................................34
ADHD and DCD.........................................................................................................................................................36
Neurocognitive functions in ODD and CD.................................................................................................................38
Specific Learning Disorder (SLD)...............................................................................................................................42
Typical neuropsychological development of reading................................................................................................44
Atypical neuropsychological development of reading..............................................................................................46
Neuroimaging of typical and atypical readers..........................................................................................................47
Dyslexia and early intervention................................................................................................................................47
Dyscalculia................................................................................................................................................................ 49
Non-verbal learning disorder (NLD)..........................................................................................................................51
Pagina 1 van 67
,Autism Spectrum Disorder........................................................................................................................................54
Neuropsychological functioning in children with autism..........................................................................................56
Social cognitive functioning and changes in early development and adolescence...................................................58
Neural basis and brain structures in social cognition................................................................................................60
Integrated play groups as intervention for autism...................................................................................................65
Pagina 2 van 67
,Brain development
2 developmental processes:
- Additive development: accumulation or growth process (myelination, formation
and elaboration of dendritic connections throughout CNS)
- Exhibiting periods of regression, characterized by initial overproduction, followed
by elimination of redundant elements fine-tuning
Growth spurts
- 24-25 weeks gestation, coinciding with completion of neuronal generation
- 1st year of life, due to dendritic and synaptic development and myelination
- Between 7 and 9 years
- Between 16 and 19 years
Disruption to development during growth spurt may be detrimental to ongoing
development, causing cessation of development or altering course of
development – consequences will be more severe when you deprive a child in a
critical/sensitive period (for example in language)
Critical/sensitive period = stage in developmental sequence during which an aspect
of behavioral function may experience a major progression – these critical periods
have been conceptualized as a window of opportunity during which skills need to be
consolidated so that the system involved can then establish interconnections with
other systems
Brain plasticity = brain’s ability to change and adapt as a result of experience
There is a hierarchical progression within CNS:
cerebellar/brain stem areas – posterior areas –
anterior areas (particularly frontal cortex).
Brain development: prenatally
- Fastest rate of brain growth: 250.000 brain
cells per minute
- Structural formation of CNS
- Largely genetically determined
- Interruption to development during this period
is likely to have an impact on cerebral
structure
1) Dorsal and ventral induction: fertilized cell
experiences rapid cell division embryonic
disc
2) Embryonic disc comprises three layers
Inner layer (endoderm): form internal
organs
Middle layer (mesoderm): form skeletal and
muscular structures
Outer layer (ectoderm): forms nervous
system and skin surface - nervous system
emerges via process of neurulation, which
folds in on itself and forms a tube
Pagina 3 van 67
, Development from neural plate to neural tube: 2-4th week of gestation
Disruptions in development in this early stage of CNS maturation may result
in structural anomalies.
Neural tube develops along three different dimensions:
- Length: major structural aspects of CNS (forebrain, midbrain – remaining areas of
neural tube form spinal cord) - disruption in development leads to failure in
formations of these structural divisions
- Circumference: differentiation between sensory and motor systems, with dorsal
corresponding to sensory cortex and ventral corresponding to motor cortex
- Radius: layers and cell types observed within the brain (vesicles form, cells in
vesicle generate and are differentiated into specific cerebral systems)
Cellular basis of development
- Neurons: developed by neuroblasts
Cell body: metabolic functions of neuron and
holds RNA and DNA
Axon: long projection from cell body that
conducts nerve impulses away from cell
body to presynaptic terminal – mature axon
is covered by coating of myelin allowing
more rapid neural transmission
Dendrites: branch of cell body and receive
impulses from other neurons, conducting
them towards cell body – dendritic spines are
locus of synapse, where information is
transmitted from one neuron to another
Presynaptic terminals: neurotransmitters
stored and released, cross synaptic cleft and
activate neurons at postsynapse, to
dendrites of connecting neuron
Long axons and large dendritic trees: forming
basis of major connections of nervous system
Small axons and small dendritic trees:
associated with higher cortical function and
found within cortex
- Glial cells = play more supportive and nutrient
role within nervous system – supporting
neurons, enabling regeneration of damaged
neurons, producing scar tissue to occupy
damage sites, transporting nutrients from nerve
cells – 9x as many glial cells within nervous
system than neurons – glial cells are
differentiated from neurons by a lack of axons –
relatively immature in early stages of
development and continue to generate with
increased maturity of CNS – developed by glioblasts
Astrocytes: form blood-brain barrier, support cellular structure of brain, direct
migration of neurons, clean up and plug injury sites
Pagina 4 van 67
