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Clinical Neuropsychology Glenn Smith PhD ABPP(CN) 2013

Clinical Neuropsychology Glenn Smith PhD ABPP(CN) 2013

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Clinical Neuropsychology

Glenn Smith PhD ABPP(CN)

2013

What is Clinical Neuropsychology?

Neuropsychology: The study of the relationship between brain function and behavior.

Clinical Neuropsychology: The use of specialized techniques used to assess and treat behavioral abnormalities associated with brain dysfunction.

Clinical neurosychologists work with adults and children with many types brain conditions:• Brain tumors • Dementias like Alzheimer’s disease• Developmental disorders like autism • Epilepsy• Movement disorders like Parkinson’s disease • Multiple sclerosis• Stroke• Traumatic brain injury

A large tumor in the covering of the brain is pressing on the front region of the brain producing changes in thinking and behavior

History• Aristotle thought the heart was

responsible for thinking. Hippo-crates realized it was the brain.

• Descartes thought the pineal gland at the base of the brain was the seat of the soul.

• The late 1700s phrenologists thought they could determine your mental skills and personality by the size and shape of your head

• In Europe in the 1800s, physicians like Broca, and Wernicke, were realizing different brain regions controlled different skills like understanding speech versus creating speech

• In the US, in 1930s and 40s, before the advent of CT scans Ward Halstead used behavioral techniques to help predict where neurosurgeons would find brain tumors

• In Russia, A.R. Luria studied the behaviors of WWII veterans that survived bullet wounds to the brain. His book Higher Cortical Function in Man is a classic

• Neuroimaging techniques like MRI and PET have revolutionized neuropsychology research and practice

Clinical Neuropsychologists examine:

• Cognition (thinking skills)– Intelligence– Academic Skill– Language – Visual Spatial – Attention– Memory– Executive Functions

• Noncognitive issues– Alertness– Comportment/

Demeanor– Speech– Mood– Personality– Effort/Motivation– Frustration Tolerance

Scores of a patient with Alzheimer’s Disease over 9 years. Note how memory scores are low in the beginning and over time scores all other areas except reading decline.

Readi

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Percep

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Organ

izatio

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Namin

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List R

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-3

-2

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1

2

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Initial4-yr6-yr9-yr

Example of Naming test: What do you call these?

Example of Perceptual Organization: Find the figure in white within the yellow figure.

Example of Visual Perception

Example of Visual Perception

Example of Visual Perception

Goals of the Clinical Neuropsychologist

• Help detect brain dysfunction.• Help identify the type of brain disease.• Help understand the likely impact brain disease in daily

life.• Help identify the likely future course of brain disease• Help plan patient care.• Help deliver care to patients and their families.• Conduct the research that provides the basis for all of the

above.

Resource Links

Society for Clinical Neuropsychology: http://www.div40.org/

Association of Neuropsychology Students in

training:

http://www.div40-anst.com/