cognitive

Paediatric Cognitive Neuropsychology

Introduction to neurodevelopment

Black, J.E. (1998). How a child builds its brain: Some lessons from animal studies of neural plasticity. Preventive Medicine, 27, 168-171.

Assessment using the NEPSY-II

Stinnett, T.A., Oehler-Stinnett, J., Fuqua, D.R. & Palmer, L.S. (2002). Examination of the Underlying Structure of the Nepsy: A Developmental Neuropsychological Assessment.  Journal of Psychoeducational Assessment, 20, 66-82.

Attention/deficit Hyperactivity Disorder

Mahone, E.M., Crocetti, D., Ranta, M.E., Gaddis, A., Cataldo, M., Slifer, K.J., Denckla, M.B. & Mostofsky, S.H. (2011). A Preliminary Neuroimaging Study of Preschool Children with ADHD. The Clinical Neuropsychologist, 25 (6), 1009–1028.

Autism & Pervasive Developmental Disorders

The trouble with autism: Delays in early identification and diagnosis
Associate Professor Cheryl Dissanayake
   

Saitoh, O., Karns, C.M. & Courchesne, E. (2001). Development of the hippocampal formation from 2 to 42 years old: MRI evidence of smaller area dentate in autism. Brain, 124, 1317-1324.

Learning Disorders

Widmann, A., Schröger, E., Tervaniemi, M., Pakarinen, S. & Kujala, T. (2012). Mapping symbols to sounds: electrophysiological correlates of the impaired reading process in dyslexia. Frontiers in Language Sciences, 3.

Oppositional Defiant & Conduct disorders

Dick,D.M., Viken, R.J., Kaprio, J., Pulkkinen, L. & Rose, R.J. (2005).Understanding the Covariation Among Childhood Externalizing Symptoms: Genetic and Environmental

Influences on Conduct Disorder, Attention Deficit Hyperactivity Disorder, and Oppositional Defiant Disorder Symptoms, Journal of Abnormal Child Psychology, 33,219-229.

Childhood Epilepsy

Ackermann, S.  & Van Toorn, R. (2011). Managing first-time seizures and epilepsy in

Children. CME, 29, 142-148.

Traumatic Brain Injury

Understanding and managing traumatic brain injury
Professor Jennie Ponsford

Resilience of people with traumatic brain injury and their carers Emeritus Professor Roger Rees   

Can psychological interventions be adapted for people with moderate to severe traumatic brain injury?
Dr Dana Wong. Dr Adam McKay and Dr Ming-Yun Hsieh

Ethical behaviour intervention for clients with a TBI: When is it OK to intervene?
Dr Brooke Froud-Cummins and Associate Professor Malcolm Hopwood

Savage, R.C. (2012). The Developing Brain after TBI: Predicting Long Term Deficits and Services for Children, Adolescents and Young Adults. North American Brain Injury Society. Retrieved 20 June 2012 from http://www.internationalbrain.org/?q=node/112

General texts

Anderson, V., Northam, E., Hendy, J. & Wrennall, J. (2001). Developmental neuropsychology: A Clinical Approach. Hove: Psychology Press.

Appleton, R. & Baldwin, T. (Eds.) (1998). Management of Brain-Injured Children. New York: Oxford University Press.

Baron, S. (2004). Neuropsychological Evaluation of the Child. New York: Oxford University Press.

Gillberg, C. (2003). Clinical Child Neuropsychiatry. Cambridge: Cambridge University press.

Johnson, M. H. (2005). Developmental cognitive neuroscience: An introduction, 2nd edition. Oxford: Blackwell.

Panteliadis, C.P. & Korinthenberg, R. (2005). Paediatric Neurology: Theory and Practice. New York: Thieme Verlag.

Helping troubled children: Seven things you should know about the origins of mental health disorders
Professor Mark Dadds
  

The care team approach to helping troubled children
Christine Miller

Using play to help troubled children in the school setting
Dr Deborah Truneckova and Professor Linda L. Viney

Body image: Is it just for girls?
Assistant Professor Vivienne Lewis

Chapter 30: The ImPACT Neurocognitive Screening Test

AUTHORS: A. Edwards, V. Whitefield, S. Radloff

ABSTRACT: The recent development of computerized neurocognitive screening programmes has revolutionized medical management in the sports concussion arena where there is a need for mass testing of athletes, and repeat follow up testing of the concussed athlete to monitor recovery and facilitate safe return-to-play decisions.  Automated programmes of this type have the facility for more accurate evaluation on timed tasks than paper-and-pencil testing, are time and cost effective in that group testing can be undertaken, and multiple randomized versions of the tasks reduce the problem of practice effects on repeated test occasions.  In South Africa, the ImPACT test (Immediate Post Concussion Assessment and Cognitive Testing) that was developed within a research context at the University of Pittsburgh Medical Center, has been employed for clinical and research purposes since 2003, and is the only test of its type registered with the Health Professional Council of South Africa (HPCSA) for clinical use in this country.  This chapter reviews research data derived using the ImPACT test in respect of players of contact sport from school through to the professional level that attests to the clinical sensitivity of this test in the identification of subtle neurocognitive deficit in association with participation in the contact sport of rugby.  In addition, available South African normative indications in respect of the test are presented and discussed.  Finally, the potential to use the ImPACT test to facilitate medical management and increase safety within other contexts is discussed, such as screening of aviation personnel (pilots and ground control employees) on a regular basis to identify the onset of intellectual dysfunction that might have sinister consequences.

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Chapter 29: Using computerised and Internet-based testing in South Africa

AUTHOR: N. Tredoux

ABSTRACT: South Africa was an early adopter of computerised tests, with the earliest testing systems being developed in the late 1970’s. Initially computerised testing systems were developed by state-funded organisations, with some funding from the private sector. As a result of political changes in South Africa, financial support for research and development in Psychometrics in statutory organisations decreased. Psychometrics, and specifically computerised testing, was then advanced by various private commercial interests, with increasing involvement from foreign test publishers. With the development of the World Wide Web and the availability of broadband connectivity, delivery of tests and reports across the Internet became a reality.  Publishers were concerned about piracy of content and cheating by respondents who were doing the tests unsupervised.  The International Test Commission drew up guidelines for computer-based and internet-delivered testing, and these were adapted to the existing South African legislative framework and ethical guidelines for psychologist. A legal battle ensued, resulting in the repeated withdrawal and re-adopting of the South African guidelines. The main point of contention was whether or not unsupervised Internet-based testing should be allowed.  This legal battle eventually led to changes in legislation.  This chapter will discuss the regulatory framework as it currently stands.  The risks attached to different types of computerised implentations of tests will be considered, taking into account the rights of the respondent, the psychometric impact of computerisation, and the exposure for the practitioner to charges of possible misconduct. A proposal for best practice in South Africa will be formulated.

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Chapter 13: Neuropsychological assessment in SA

AUTHOR: M. Lucas

ABSTRACT: Neuropsychology is frequently defined as the relationship between brain functioning and behavior but with the collapse of Cartesian dualism, this focus has been expanded.  With the mind today seen as the output of the brain it is therefore available to objective consideration as well.  Modern Neuropsychology thus encompasses not only the understanding and interpretation of structural/functional brain systems but includes broader understandings such as the subjective experience of self (Solms, 2006). There have been two traditions in Neuropsychology: A syndrome based approach, dependent upon a clinic-anatomical analysis, which we will refer to as the clinical approach; and a cognitive neuroscientific approach, with close links to information processing and artificial intelligence.  The former approach has its origins in the times of cortical localization beginning with Broca, Wernicke and Charcot, but more recently is based upon integrated theories of brain function; while the latter approach is based on principles of cognitive psychology and assumes that mental activities operate in terms of specialized sub-systems or modules.  It has primarily researched cognitive systems that can be separated out (dissociated) from each other.  Both approaches are complementary, use case studies, experimental designs and quantitative analysis.  Each adds valuable information to the study of the brain and mind and currently they are moving towards a more unified model.

Clinical neuropsychology is primarily concerned with anatomical brain variants and pathology and uses the syndrome-based medical model as its theoretical basis.  Typically this discipline is concerned with assessment, diagnosis, management and rehabilitation of people who have neurocognitive impairment.  Deficits are usually acquired as a result of illness and injury to the nervous system; may be temporary or permanent but measurable by subjective complaints (e.g. I am forgetful) and objective measures (e.g. psychometric tests, neuro-imaging studies). Further, clinical neuropsychology is concerned not only with the cognitive impairments but the emotional and behavioural consequences of such illness and injury.  Most importantly, these areas are assessed within the framework of person’s social and cultural background. Thus, neuropsychological assessment must take place through use of triangulation using firstly, personal narratives, collateral information, medical records and investigations such as neuro-imaging and secondly, extensive knowledge on the part of the psychologist of mind/brain issues, neuroanatomy, pathology and physiology, and thirdly, careful administration, scoring and interpretation of appropriate measures of cognitive, emotional and behavioural functioning.  Test measures may be in the form of appropriate standardised or individualised batteries. In South Africa, Neuropsychologists have typically used the standardized norms supplied by test manufacturers for their middle-class, usually white, clients and made judgements on levels of function using standardized scores and statistical analyses (e.g. standard deviations, z scores, t scores, percentile ranks etc.).  However, this group forms a small part of the South African population, making this approach an invalid one for most South Africans.  There have been attempts to standardize various tests for the local population but this has met with only limited success (e.g. Nell, 1999).  The general failure to produce working norms has been for several reasons: i) population heterogeneity in terms of language, education, socio-economic status and cultural stance ii) a dynamic and emerging population, thus tests standardized for a group have limited life as members become better educated iii) changes in level of test sophistication as communities move from pre-modern (rural) to modern (urban) lifestyles. In the face of these challenges, it has been recommended that neuropsychologists use a more hypothesis driven approach first promulgated by Luria (Solms, 2008) as a basis.  Test scores can be then interpreted from a differential score or pattern analytical approach (Zilmer, Spiers & Culbertson, 2008).

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Chapter 12: The Griffiths Scales in South Africa

AUTHOR/S: L. Jacklin, K. Cockcroft

ABSTRACT: The Griffiths scales were developed by Ruth Griffiths O. B. E. The Abilities of Babies was published in 1954 followed by The Abilities of Young Children in 1970.  These scales were used extensively in the United Kingdom and a variety of other countries. Eventually, it became clear that with greater exposure of children to electronic media and early childhood education that there had been acceleration in the development of children. The Griffiths scales had to be updated to keep pace with the changes. This resulted in the publication of the revision of the Birth to 2 years in 1996 and the   Extended Revised Scales for children of between 2 years and eight years in 2006 .This text will describe the history and development of the scales. The Griffiths scales are one of a variety of tests available for assessing the development of young children. What makes them unique is that they can be used to test children from birth up to the developmental age of eight years across all areas of development. They therefore give a complete profile of the development of the child. The strengths and weaknesses of the use of the Griffiths scales as a test and as a research tool in the South African context will be described. The use of the Griffiths scales is controlled by the Association for Research in Infant and Child Development (ARICD) to ensure that the test is administered by suitably trained testers. The training process is described. Assessment and the development of tools is a dynamic process. The future development of the scales is discussed.

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Chapter 11: The APIL and TRAM learning potential instruments in South Africa

AUTHOR/S: T. Taylor

ABSTRACT: This chapter covers three main topics involving the APIL and TRAM learning potential instruments developed by Aprolab, namely, the underlying theory, the nature and contents of the instruments and technical information. Early theory by Vogotsky, Feuerstein and others suggested that learning potential is solely reflected in the zone of proximal development, the degree to which an individual’s performance improves with intervention.  APIL and TRAM instruments are based on a broader theory drawn from cognitive psychology, information processing theory and learning theory. This theory incorporates four main elements – fluid intelligence, information processing efficiency, transfer and learning rate. The first two constructs are static (not direct measures of learning potential, but nevertheless critical to learning). The last two dimensions are dynamic (direct measures of learning). Only learning rate is related to the zone of proximal development concept from which the learning potential construct originally arose. There are actually three Aprolab learning potential instruments: APIL, TRAM-2 and TRAM-1. They cover the educational spectrum from no education to tertiary education. All of them are based on the theory mentioned above and incorporate separate measures of the four constructs listed above. In some cases the constructs are broken down into sub-dimensions. APIL has eight scores, TRAM-2 six and TRAM-1 five. The sub-dimensions are described, the techniques whereby the raw-scores are converted into normed scores on these sub-dimensions explained, and examples of stimulus material provided. The APIL and TRAM instruments have been used since the mid-90’s. Technical information is given on scale inter-correlations, reliabilities, predictive and concurrent validity, and culture-fairness/lack of bias.

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Chapter 10: The Learning Potential Computerised Adaptive Test (LPCAT) in South Africa

AUTHOR/S: M. de Beer

ABSTRACT: In the multicultural and multilingual South African context where differences in socio-economic and educational background and opportunities of individuals further complicate psychological assessment, the measurement of learning potential provides additional information in the cognitive domain that has shown positive results.  This chapter deals with the history of dynamic assessment internationally and locally and provides empirical results on the LPCAT that provide support for utilizing this approach in conjunction with standard tests of cognitive ability and aptitude.  It further elucidates how the use of Item Response Theory (IRT) and Computerised Adaptive Testing (CAT) addresses a number of practical and measurement issues that have been hampering the wide-scale implementation and use of dynamic assessment of learning potential in assessment in education and in industry.

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Chapter 9: Dynamic Assessment in South Africa

AUTHOR/S: Z. Amod & J. Seabi

ABSTRACT: This chapter outlines current developments in Dynamic Assessment (DA), an interactive assessment procedure that uses deliberate and planned mediational teaching and assesses of the impact of that teaching on subsequent performance. The objective of the chapter is to critically review the major criticisms of the traditional “static“ testing approach, discuss the theoretical basis of the DA approach and its relevance within the South African context, present current empirical research on the Dynamic Assessment of children, and suggest some directions for future research. The DA approach has been motivated by the inadequacy of traditional “static” tests to provide accurate information about the individual’s ability. Given that the history of “static” testing in South Africa closely resembles the racial policies of apartheid, which attempted to preserve and perpetuate social structures (Benjamin & Lomosfky, 2002), and that many of such tests have been standardized on middle class children, concerns regarding the relevance of traditional testing have been raised.  DA is presented in this chapter as an alternative approach that minimizes discriminatory approaches to the assessment of culturally different populations and facilitates a strong link between assessment and intervention.  DA is aimed at changing and modifying the individual’s cognitive structures within the assessment process. The theoretical foundations of DA are derived primarily from Vygostky’s socio-cultural theory, specifically the zone of proximal development, and Feuerstein’s Mediated Learning Experience theory. DA has been applied with different educational and clinical groups of children and adolescents both abroad and in South Africa and has been found to be more accurate in reflecting children’s learning potential. Although the DA approach has a great appeal to many professional psychologists and educators, it has not yet become a central part of prevailing practice. Major critiques leveled against the DA approach are discussed.

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Chapter 8: The Cognitive Assessment System (CAS) in a South African context

AUTHOR/S:  Z. Amod

ABSTRACT: Limitations of current intelligence tests, the search for more equitable assessment procedures and the need to link assessment with intervention have led to the exploration of alternative forms of cognitive assessment.  Information processing models of assessment embodied in the work of Luria, Kaufman and Das, for instance, are in the forefront of the latest developments in cognitive psychology.  In this chapter the Cognitive Assessment System (CAS) developed by Das and Naglieri (Das, Naglieri & Kirby, 1994) is discussed both theoretically and in relation to research conducted mainly abroad but also in South Africa. This novel assessment approach is based on the Planning, Attention, Simultaneous and Successive (PASS) model of cognitive functioning. There is empirical support for the PASS theory and the CAS (Naglieri, 1999; Van Luit, Kroesbergen and Naglieri, 2005) and extensive research has been conducted to establish the relationship between certain cognitive processes of the PASS model and specific academic skills (Kirby and Das, 1990; Hold, 2000; Lerew, 2003; Germain, 2004). The usefulness and application of the CAS instrument in South Africa has been indicated by several studies (Chow and Skuy, 1999; Churches, Skuy & Das; Fairon, 2006; Floquet, 2008; Hofmeyer 2000; Naidoo, 2001; Reid, Kok & van der Merwe, 2000). The PASS Remedial Programme (Das et al, 1994) has been developed to provide a link between cognitive processing strategies and academic content. It is proposed in this chapter that the PASS model as operationalized by the CAS is a valuable alternative or at least adjunct to traditional intelligence tests. Further research needs to be conducted which combines the Information Processing model with Dynamic Assessment, to facilitate a link between assessment and intervention.

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Chapter 7: The Kaufman Assessment Battery for Children (K-ABC) in South Africa

AUTHOR/S:  K. Greenop, J. Fry, D. de Sousa

ABSTRACT: The K-ABC was published in 1983 (revised and re-standardised, K-ABC ll, in 2004) as a measure of cognitive ability in children aged 2-12:6 years. The revised edition appropriately extends the age band to 18:11 years and modifies, subtracts and adds subtests. The K-ABC measures fluid and crystallised abilities, short and long term memory and visual processing and aligns with the Cattell-Horn-Carroll hierarchically organized model. The battery is based on Luria’s model of mental processing and has correlated significantly with scholastic achievement. Of greatest relevance is that the K-ABC was designed to have a reduced language and cultural load and the second edition has altered two sub-scales that were shown to load differently for diverse cultures.  The degree to which the K-ABC is able to offer a reduced cultural load test is debatable. Cross-cultural research, in Zaire and South Africa predominantly, has demonstrated that the K-ABC has value in cross-cultural settings but with specific caveats. Importantly the Sequential and Simultaneous processing scale offer more value that the Mental Processing Composite which has a knowledge basis that is culturally specific. The few studies have been conducted on the K-ABC in South Africa, have demonstrated its assessment value in a diagnostic, remedial and dynamic assessment framework, especially in comparison to alternate intelligence tests. However, caution is raised due to the absence of a strong South African normative basis.

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