Pediatric Neuropsychology and Brain Injury
Presented by University of California Television
Introduction
- Speaker: Clinical neuropsychologist at UCLA.
- Topics Covered:
- Clinical neuropsychology practice in pediatrics.
- Pediatric brain injury and neuropsychology's role.
Neuropsychology Basics
- Definition: Interface of brain and behavior.
- Clinical Role: Addresses behaviors of concern such as attention, learning problems, emotional difficulties to find their etiology.
Common Pediatric Issues
- Cognitive disorders linked to medical conditions (tumors, epilepsy, strokes).
- Learning disorders (ADHD, spectrum disorders, language problems).
- Emotional and behavioral issues.
Risk Factors and Protective Factors
Risk Factors
- Genetics, environmental issues, neglect, nutrition, prenatal/perinatal factors.
- Head injuries, chronic medical conditions, treatments (radiation, chemo).
Protective Factors
- Feeling of connectedness and supportive relationships.
- Appropriate interventions and therapeutic resources.
Referrals to Neuropsychology
- Situations requiring differential diagnosis (e.g., ADHD vs. social anxiety vs. both).
- Importance of identifying comorbidities (e.g., learning issues with anxiety or behavioral problems).
- Non-response to standard treatments indicating deeper issues.
Learning Disabilities
- Definition: Difficulty achieving expected academic performance, not secondary to other conditions.
- Example: Dyslexia, which is common yet treatable with early identification and intervention.
- Statistics: High correlation between learning disabilities and behavioral/emotional issues.
Identifying and Addressing Learning Disabilities
- Red Flags: Resistance to tasks, behavioral issues, psychological distress.
- Assessment: Schools offer evaluations but may have limitations (wait-to-fail model). Private evaluations are also an option.
- Early Diagnosis Importance: Prevents loss of self-esteem and motivation, promoting better long-term outcomes.
Pediatric Brain Injury Research
- Neuropsychology helps understand cognitive issues post brain injury.
- Severity Impact: Mild injuries tend to recover over time; moderate and severe injuries show lasting cognitive impacts.
- Age Factor: Younger children with brain injuries often have worse outcomes due to developmental disruption.
Predictors of Recovery
- Positive parenting and resourcefulness improve outcomes despite initial injury severity.
Concussion and Mild Traumatic Brain Injury (TBI)
Concussion Overview
- Symptoms: Headache, dizziness, confusion, emotional issues, memory loss, unconsciousness not always present.
- Predominantly seen in sports, higher incidence in girls for same sports.
- Recovery: Typically self-limiting and predictable, resolves in children within about two weeks.
Research Findings
- Cognitive impairment post-injury often linked to pre-existing conditions, academic performance, and family background.
- Long-Term Risk Factors: Severe symptoms, premorbid psychological issues, history of injuries.
Neuropsychological Assessment and Treatment
- Identifying overlap of symptoms due to depression, headaches, and other factors post-concussion.
UCLA Brain Sport Program
- Multi-disciplinary Approach: Combines neuropsychology, neurology, sports medicine, and nursing.
- Rapid assessment and comprehensive intervention plans.
- New initiatives and research opportunities ongoing.
- Current Studies: RAPPI study on moderate to severe TBI, clinical trials for working memory and attention issues in TBI patients.
Resources
- CDC Heads Up website for clinician resources on head injury and concussion management.
Conclusion
- Importance of early and accurate diagnosis and intervention in pediatric neuropsychology and brain injuries.
- Continuous research and development of better resources and methodologies for treatment and assessment.