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Margaret Semrud-Clikeman and Phyllis Anne Teeter Ellison - Child Neuropsychology

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Margaret Semrud-Clikeman and Phyllis Anne Teeter Ellison Child Neuropsychology

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Part I
Anatomy and Physiology
Springer Science+Business Media, LLC 2009
Margaret Semrud-Clikeman and Phyllis Anne Teeter Ellison Child Neuropsychology
1. Introduction to Child Clinical Neuropsychology
Margaret Semrud-Clikeman 1
(1)
Michigan State University, 3123 S. Cambridge Road, Lansing, MI 48911, USA
(2)
Department of Educational Psychology, University of Wisconsin, 793 Enderis Hall, 2400 East Hartford Avenue, Milwaukee, WI 53211, USA
Margaret Semrud-Clikeman (Corresponding author)
Email:
Phyllis Anne Teeter Ellison
Email:
Keywords
Traumatic Brain Injury Tourette Syndrome Learn Disability Severe Brain Injury Transactional Model
Child neuropsychology is the study of brain function and behavior in children and adolescents. Brain functioning has a direct impact on the behavioral, cognitive, and psychosocial adjustment of children and adolescents. Thus, disorders must be addressed within an integrated model of child clinical neuropsychology. Further, the development of the central nervous system (CNS) and the neurodevelopmental course of childhood disorders are of importance within an integrated framework. Studies routinely have identified the importance of intact functional cortical and subcortical systems in the overall adjustment of children and adolescents. Further, researchers have recently begun to address specific strategies for treating various brain-related disorders. Initial results suggest reason to be optimistic when interventions consider the child's functional neuro-psychological status.
Clinical child neuropsychologists study and treat a variety of developmental disorders. Children with learning disorders such as dyslexia and pervasive developmental disorders (Semrud-Clikeman, ) can profit from a comprehensive neuropsychological evaluation of their strengths and weaknesses.
The Contribution of Neuroscience
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. ).
Professional Training Standards
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.
Table 1.l
Guidelines for doctoral training in neuropsychology (in original text p. 7)
Education May be accomplished through a Ph.D. program in Clinical Neuropsychology offered by a psychology department or medical facility or through completion of a Ph.D. program in a related specialty (e.g., clinical psychology, school psychology) that offers sufficient specialization in clinical neuropsychology.
Required Core
A. Generic psychology core:
1. Statistics and methodology
2. Learning, cognition, and perception
3. Social psychology and personality
4. Physiological psychology
5. Life span development
6. History of Psychology
B. Generic clinical core:
1. Psychopathology
2. Psychometric theory
3. Interview and assessment techniques
a. Interviewing
b. Intellectual assessment
c. Personality assessment
4. Intervention Techniques
a. Counseling and psychotherapy
b. Behavior therapy/modification
c. Consultation
5. Professional ethics
C. Neurosciences: Basic human and animal neuropsychology:
1. Basic neuroscience
2. Advanced physiological and psychopharmacology
3. Neuropsychology of perceptual, cognitive, and executive processes
4. Research design and research practicum in neuropsychology
D. Specific clinical neuropsychology training:
1. Clinical neuropsychology and neuropathology
2. Specialized neuropsychological assessment techniques
3. Specialized neuropsychological intervention techniques
4. Assessment practicum with children and/or adults
5. Clinical neuropsychology internship of 1,800 hours, preferably in university setting
Internship The internship must devote at least 50 percent of a one-year full-time training experience to neuropsychology. In addition, at least 20 percent of the training must be devoted to general clinical training to ensure competent background in clinical psychology. Supervisors should be board-certified clinical neuropsychologists.
Source: INS-APA Division 40 Guidelines for Doctoral Training Program, Clinical Neuropsychologist , 1, 1S16.
Multicultural Issues in Neuropsychology
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, ).
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