Margaret Semrud-Clikeman - Child Neuropsychology

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The manner in which disturbances are approached has been revolutionized by neuroscience and medical technologies, such that any serious study of developmental problems must consider neuropsychological theories, methodologies, and empirical findings if the science of childhood and adolescent disorders is to be advanced. For this reason, information has been provided in subsequent chapters about these new technologies. Although a relatively young science, child clinical neuropsychology has been significantly advanced by the use of medical technologies including magnetic resonance imaging (MRI), positron emission tomography (PET), computerized tomography scans (CT), and regional cerebral blood flow (rCBF) (Semrud-Clikeman, ). The potential for employing functional magnetic resonance imaging techniques (fMRI) for investigating brain activity by monitoring regional changes in blood flow in children with neurodevelopmental disorders shows promise. New technology called Diffusion Tensor Imaging (DTI) allows us to view the white matter tracts of the brain (the tracts that carry neuronal impulses throughout the brain) and provides an opportunity to evaluate how efficiently the messages are able to travel.

The study of the brain-behavior relationship has been revolutionized by these medical technologies. Many psychiatric disorders of childhood once thought to be mental or functional in nature, and behavioral disorders presumed to be related to noncontingent reinforcement systems and other environmental factors have been found to have a neurodevelopmental or neurochemical basis (Pliszka et al. ).

The International Neuropsychological Society (INS), Division 40 (Clinical Neuropsychology) of the American Psychological Association (APA), and the National Academy of Neuropsychology (NAN) are major professional organizations comprised of researchers and clinicians in neuropsychology and child neuropsychology. Professional training standards have been of particular interest to these organizations in an effort to assure the expertise of those individuals practicing clinical child neuropsychology. Table summarizes guidelines established and endorsed by INS. Clinicians interested in becoming experts in child neuropsychology should consider the recommended curricula and internship standards. INS recommends Ph.D. training, with core coursework in general psychology, general clinical psychology, basic neurosciences, and clinical neuropsychology. Internship guidelines specify 1,800 hours, with 50 percent of that time devoted to clinical neuropsychology, including specialization in neuropsychological assessment and intervention techniques, and clinical neurology and neuropathology.

Many of the measures utilized for testing in neuropsychological practice have not been standardized on ethnicities beyond middle-class Caucasians. This problem has been present and is currently being studied as to what differences, if any, may exist. One aspect (culture) has only been studied recently in neuropsychology. Previously neuropsychologists have suggested that the study of the brain is nonculturally bound (Wong, Strickland, Fletcher-Janzen, Ardila, & Reynolds, ).