Chapter 15 -Book- Neuropsychology :Clinical and Expt Foundations

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8 Dec 2010
Chapter 15: Neuropsychological Assessment
15.1: Participants in a Neuropsychological Assessment
Before CT or MRI scanners neuropsychological assessments were primarily concerned with
determining whether any brain damage was present (organicity) – then spent many hours to
check where the brain damage was through behavioural testing
Technological advances can now localize damage in short periods of time even in
unconscious individuals – goals of neuropsychological assessments have changed
Goals of clinical neuropsychologists diagnose conditions that can’t be readily detected
through neuroimaging (i.e., AD), assess quality of life and to evaluate the client’s capacity to
succeed in his/her present environment (i.e., can they still go to work, should they move to a
care facility?), and rehabilitation after bran injuries
The Client
AKA patient( usually form a medical/ doctor’s view), subject, or participant
Neuropsychologists refer to the people they assess as their clients consumers of
psychological services (i.e., assessment and treatment)
No typical kind of client – all ages vulnerable to nervous system damage
Younger people- usually cause of nervous system damage = brain injuries from events such
as motor vehicle accidents or falls
Elderly people – also suffer from traumatic head injury usually from falls especially in those
aged 65-70 years old but the majority of older people suffer nervous system damage due to
diseases (i.e., dementia, tumours, and CVAs)
Middle aged- motor vehicles account for most traumatic head injuries
The Neurologist
In hospital settings often refer clients to neuropsychologists
Neurology medical speciality that diagnoses, studies, and treats disorders of the CNS
Neurologists a physician that diagnoses and treats disorders of the nervous system both in
the CNS and PNS (nerves extending through the rest of the body)
Usually advise the primary care physician on the type of treatment that should be carried out
Education 2-4 years of premedical university training, four years of medical school (M.D.
= doctor of medicine or D.O =doctor of osteopathy), and 3+ years of specialty training in
neurology residency program
Disorders can be of unknown etiology or caused by trauma, infection, tumours, metabolic
disorders, etc
Trained to perform detailed examinations of neurological structures throughout the body
(sensory and motor functions) and sometimes also test cognitive abilities
Also may obtain a lumbar puncture( spinal tap) – to obtain CSF which can be tested
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Neurologists recommend surgeries and monitor surgically treated patients but they are
carried out by neurosurgeon
The Radiologist
X-rays a form of high-energy radiation that in low concentrations can be used image
structures (particularly bones) in the human body – discovered Wilhelm Conrad Rontgen
Radiologists are very rare – 1.2% of all U.S. physicians
Radiologists- trained to obtain and interpret images of the human body and/or treat
conditions using radiological science
Must also complete premedical training, medical training, and residency
They also interpret CT and MRI (taken by technologists) films and write detailed reports on
their findings for physicians or neurologists
The Clinical Neuropsychologist
Brain of neuropsychology concerned with psychological assessment, management, and
rehabilitation of neurological disease and injury regardless of cause
Mainly explain how behavioural impairments are due to disruptions in neural components
Often do not have medical training – complete an undergraduate degree in psychology (B.A.
or B.Sc. – 3-4 yrs), master’s degree in clinical psychology (M.A., M.Sc., or M.A.Sc. – 1-3
yrs), doctorate degree in clinical psychology (Ph.D. or Psy.D. – 2-6 yrs), must also complete
internship program under certified clinicians in which they practice clinical skills
Variation in the years it takes to be a neuropsychologist, i.e., don’t always need a master’s
degree to get your doctorate degree
Experimental neuropsychology focuses on how human behaviour arises from brain activity
Cognitive neuropsychology less focused on the neural basis of behaviour and more
focused on explaining behaviour and disruptions in terms of function brain units regardless
of anatomy
15.2: The Assessment
The type of doctors people first visit when they have neurological damage often depends on
the symptoms – for example, they may visit an optometrist if they have a left posterior
parietal lobe lesion and are having troubles writing and reading
Or people describe primary or secondary deficits that might make it difficult to diagnose the
Lack of insight – a lack of acknowledgement of a deficit that often accompanies a nervous
system injury
Ideally: medical treatment by general physician or emergency room attendant neurological
examination (brain imaging) radiologist neurologists more behavioural testing by
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