PA WEEK 7: Neuropsychological Assessment

Questão	Responda
What is Neuropsychology?	* The study of brain - behaviour relationships * Understanding of neuroanatomy, neurophysiology, neurochemistry and understanding of techniques used in the analysis of behaviour. (MRI's, scanning etc)
What do neuropsychologists have expertise in?	cognitive/intellectual evaluation psychological evaluation and emotional disorders * medical disorders/injuries that effect brain Neuroscience and neuroanatomy how brain processes information *common problems in cognitive processing (LD, Developmental syndromes)
What is the basic assumption of Neuropsychology?	* Basic assumption is that behaviour is mediated by biological processes. So the brain drives our behaviour.
Some types of brain disorders cause what other kind of problem?	Emotional problems. Depression etc. Some brain disorders can disrupt the area of the brain that regulates emotion. This is a secondary disorder to the injury or brain disorder that caused it.
What is a neuropsychological assessment?	Is a comprehensive assessment of cognitive and behavioural functions using a set of standardised tests and procedures.
What types of things are tested in a neuropsychological assessment?	* Intelligence * Problem Solving * Planning and organisation * Attention, memory and learning * Langage * Academic skills * Perceptual and motor abilities * Emotions, behaviour and personality
What are the two most reported difficulties of people with neurological complaints?	Attention and memory
Neuropsychological evaluations can do the following things	Confirm or clarify diagnosis Provide a profile of strengths and weaknesses to guide rehabilitation, educational, vocational or other services. * Document changes in functioning * Clarify what compensatory strategies would help * Result in referrals to other specialists. * Assist in disability discrimination.
What are the goals of clinical neuropsychology	* Evaluate the degree that CNS damage had compromised cognitive, behavioural, and emotional functioning. * Distinguish between 'organic' and 'non organic' cases (i.e. brain damage vs. psychological disorder) * Impact on daily living *rehabilitation/treatment - managing disorders.
What are the two aspects we need to consider when writing reports in clinical neuropsychology?	* Performance - profile of strengths and weaknesses. Mapping what is cognitively possible. * Interpretive - How will impairments affect daily life? Observations of family and patient. This all needs to be incorporate into management
What are the four lobes of the brain?	Frontal Occipital Parietal Temporal
What are the cognitive functions thought to be associated with the Frontal lobe?	Prefrontal (Orbital, Dorsolateral) Motor, premotor, supplementary motor *Broca's area Damage can result in wide ranging deficits in: - Disturbance of motor functioning - Loss of divergent thinking - Poor control of behaviour - Poor temporal memory - Impaired olfaction (smelling) - Aphasia (language disorders)
What are the cognitive functions thought to be associated with the Parietal lobe?	*Primary and secondary somatosensory cortex - Representation of visual and somatic spatial world. - Some motor function (damage sees constructional apraxia - lose the ability to put things together, conceptual problem) - Left side lesions - agraphia, acalculia Right side lesions - contralateral neglect, disorders of construction and spatial ability.
What are the cognitive functions thought to be associated with the Temporal lobe?	- Auditory sensation and perception - Language comprehension - Long term memory - Selection of visual and auditory input *Damage can result in: - Wernickes aphasia - amnestic disorders (most common in damage to temporal lobes) - disorders of auditory and visual perception - Impaired categorisation of material (Memory, hearing and language comprehension)
What are the cognitive functions thought to be associated with the Occipital lobe?	This is the centre of visual perception Damage in this area can result in: - Visual field deficits - Visual illusions - Cortical blindness - Limbic Lobe system - emotional brain - connections to the thalamus, hypothalamus, amygdala and hippocampus
What are some common neuropsychological disorders?	* Acquired brain injury Executive dysfunction of higher order systems Degenerative disorders
Acquired brain damage can result from?	- Traumatic head disorder - Stroke - Infectious/inflammatory disorders (Herpes, Parasitic infections, bacterial infections). - Anoxia (deprived of oxygen) - Tumours
Acquired brain injuries can result in problems with?	- Motor disorders - Sensory impairments - Memory problems - Language difficulties
Problems with memory can occur when you have damage to a range of areas. What are they?	* Medial temporal lobe * Diencephalon * Basal Forebrain * Cerebellum * Frontal lobes
What are some disorders of memory?	* Alzheimer's Disease * Traumatic brain injury Herpes Simplex Encephalitis Korsakoff's syndrome (alcohol related) *Strokes affecting diancephalon
What do we assess when assessing memory?	* Encoding, Storage and Retrieval of information * Immediate or STM Rate and pattern of aquisition of new information Rate of decay of information * Interference: proactive vs retroactive
What scale do we use to assess memory?	Wechsler Memory Scale - IV Auditory memory Index Visual Memory Index Visual Working Memory Index Immediate memory Index Delayed memory index
Why is the Wechsler memory test considered such a good test of memory?	Because it encompasses so many domains
What are the tests of Learning?	* Rey Auditory Verbal Learning Test * California Verbal Learning Test
Tests of non Verbal memory?	* Rey complex figure test * Benton Visual retention test
What are some other memory tests?	* Recognition Memory test * Rivermead Behavioural Memory test Test of memory malingering Wide range assessment of memory and learning (WRAML)
What damage affects visuo-spatial processing? visual-spatial processing problems refer to difficulty in organizing visual information into meaningful patterns and understanding how they might change as they rotate and move through space.	* Damage to the parietal lobe may lead to hemispatial neglect (failure to attend to one side of space or body). *Occipital or temporal damage can lead to a failure to recognise people (Prosopagnosia) (Man who mistook his wife for a hat) or objects (agnosia).
What are the tests of Visual Spatial processing?	Batteries: * Birmingham Object Recognition battery (BORB): ranges from basic perception to object decision tests * Visual object and Space perception Test (VOSP) Tests of inattention Drawing Tests Construction Tests: Bender Gestalt test (copying). Rey Complex Figure Test. Block Design.
What areas of the brain are likely to affect attention?	* Likely to be mediated by frontal lobes * Connections with brain stem and cerebellum * Spatial attention associated with parietal lobes
What are the tests of attention?	* Digit span Paced auditory serial addition test Symbol Digit Modalities Test * Test of Everyday Attention * Continuous performance test
What is Executive functioning?	Executive functions consist of several mental skills that help the brain organise and act on information. These skills enable people to plan, organize, remember things, prioritize, pay attention and get started on task.
What three characteristic behaviours consequent to damage to three distinct areas of the frontal lobes	* Damage to dorsolateral area - judgement, planning, insight, * Damage to orbito-frontal region - stimulus driven behaviour, diminished social insight, distractibility, emotional lability * Damage to medio -frontal area - Diminished spontaneity, incontinence, lower extremity weakness, slowed response time.
What are the tests of executive functioning?	Batteries: - Delis -Kaplin Executive functioning system - Behavioural Assessment of executive system * Winston Card Sort Test * Colour Form Sort * Design Fluency * Verbal Fluency
What are the approaches in neuropsychology?	* Battery Approach * Process Approach (Hypothesis Testing)
What is the Battery Approach?	A battery approach to neuropsychological assessment is the administration of multiple measures that cover a wide range of cognitive abilities to fully characterize an individual’s neuropsychological strengths and weaknesses (used more in the states)
What are the strengths and weaknesses of the Battery approach?	Strengths: - Comprehensive coverage of functions - Often based on models of abilities Weaknesses: - Cumbersome, can be a waste of time - Not based on models of disorders - can be insensitive
What is the process approach in neuropsychology?	Tests administered are based upon your hypothesis. Focus on the individaul person and how they are functioning.
what are the strengths and weakness of the process approach?	Strengths: - Focuses on abilities of individual patient - Can make use of psychometric analysis - Allows development of a model of individual disability Weaknesses: - You may miss an area (not as comprehensive) - may be an overemphasis on tests you are familiar with.
Tests given in neuropsychology depend on?	* reason for referral * Client complaints * Test performance * Prior assessment and performance * need corroboration with family and take careful history
What are the limitations of neuropsychology tests?	Sensitivity: If the person has a problem, what are the chances that test will pick it up? Specificity: Knowing that this patient does not have the disorder what are the chances this test will not identify him as having it
What are some of the factors affecting expression of impairment?	Premorbid Characteristics: Age, intelligence, sex, occupation and interests, personality factors, level of independence. Disease Features: Disorder itself, nature and size of lesion, time since injury, presence of other cognitive deficits, level of awareness.
What should we consider in Treatment: rehabilitation and compensation?	* How the patient will function in the real world. Effectiveness of approach depends on - Severity of lesion and its cause - Premorbid capacity - Physical status - Family support - Level of insight - Whether executive functions are impaired
Why do we need up to date normative data in Neuropsychological testing?	Normative data is a reference system that places the tested person in relation to other persons, thus making the results interpretable and informative. Therefore we should: * Selecting most appropriate norm requires good knowledge of the research and publications associated with the test • Legitimate interpretation also demands careful consideration of the procedures and standardisation sample that produced the norms. • These issues reflect one aspect of what is meant by competence in testing

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PA WEEK 7: Neuropsychological Assessment

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	Criado por seonapalmer aproximadamente 9 anos atrás