Pediatric Neuropsychology and Brain Injury

Jul 8, 2024

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.