Neuropsychological Evaluation Of Children Research Articles

The impact of COVID-19 related educational disruption on children and adolescents: An interim data summary and commentary on ten considerations for neuropsychological practice

Objective The coronavirus 19 (COVID-19) pandemic resulted in educational disruption of historic breadth and duration. The authors describe early studies and interim standardized assessment reports to highlight effects of educational disruption and present critical questions for neuropsychologists. Method A summary of pre-pandemic and interim literature was compiled, including analyses of national and local assessment data and preliminary studies on academic gains related to remote learning, educational and school services disruption, chronic absenteeism, and child and adolescent mental and physical health during 2020–2021. Ten major themes were identified in the early reports on impacts of educational disruption. Results Preliminary information indicates prolonged educational disruption has resulted in attenuated learning gains, most remarkably for those already at risk for educational disparities: students of color, students with disabilities, English learners, and students from low-income households. There have also been increased mental and physical health challenges for some youth during the pandemic. Other literature highlights challenges such as diagnosis of learning disabilities, reliance on normative data and development of academic recovery programs. Conclusion The effects of prolonged educational disruption and psychological stressors on learning and mental health should be considered in the neuropsychological evaluation of children and adolescents, especially marginalized students. Normative data collected prior to the pandemic may be insufficient for interpretation of scores, and evaluation and treatment may be delayed due to backlog and increased demand. Clinical practice considerations are presented.

Noncredible effort on the Nonverbal-Medical Symptom Validity Test (NV-MSVT): Impact on cognitive performance in pediatric mild traumatic brain injury

This study examined failure rates on the Nonverbal-Medical Symptom Validity Test (NV-MSVT) and its impact on cognitive performance in a sample of youths with mild traumatic brain injury (mTBI). Participants were 184 children and adolescents who presented to a multidisciplinary concussion clinic for a targeted neuropsychological evaluation. Performance Validity Tests (PVTs) were a part of the standard battery, including the NV-MSVT. Twenty-eight participants (15.2%) failed the NV-MSVT, none of whom displayed a genuine memory impairment profile (GMIP). Participants who failed the NV-MSVT performed significantly worse than those who passed the NV-MSVT on measures of IQ, memory, and immediate attention/working memory. There was no significant difference between groups on processing speed, sustained attention, cognitive flexibility, or sight word reading level. Aside from a slight difference in age, NV-MSVT failure was not impacted by demographic variables (sex, race), premorbid risk factors (pre-injury ADHD, learning disabilities, psychiatric diagnoses or treatment, developmental delays, or prior special education), injury-related variables (time since injury, positive neuroimaging findings, post-traumatic amnesia, number of prior mTBIs, etc.) or post-mTBI anxiety/depression. That said, participants who failed NV-MSVT endorsed significantly more severe postconcussive symptoms. These findings support the use of the NV-MSVT in neuropsychological evaluation of children and adolescents with mTBI.

C-44 Exploring the Criterion Validity of the WISC-IV in a Clinically Referred Sample of Children in Mexico

Abstract Objective The Weschler Scale of Intelligence (WISC-IV) is one of the most commonly used measures in the neuropsychological evaluation of children. Little published research utilizes the WISC-IV in diverse populations outside the US. The objective of this study was to examine the criterion validity of the WISC-IV’s subtests and index scores in a clinically referred sample in Mexico. Methods The present study included 86 participants, 35 clinical patients referred for neuropsychological evaluation for persistent learning difficulties at a public clinic and 51 healthy control children enrolled in public school with a GPA of 3.0-4.0 in Puebla, Mexico. Participants were between the ages of 7-12. None of the children in our clinical group had a formal diagnosis of any learning or behavior disorder, this was the first experience seeking neuropsychological evaluation. The WISC-IV was administered to all participants as part of the evaluation process. Informed consent was obtained prior to evaluation. Results Independent sample T-Tests show no significant differences in Full-Scale IQ average (FSIQ) between the clinical sample (M = 75.40, SD = 11.81) and control group (M = 79.73, SD = 10.36). Descriptive statistics for indices and subtests can be found in Table 1. Conclusions Our results demonstrate low average IQ for both groups, indicating further research is needed in understanding the criterion validity of the WISC-IV when applied to clinical populations in Mexico. Furthermore, because we were unable to explain below average scores in the control group by any confounding variable, future studies comparing the Mexican standardization of the WISC-IV with our data before utilizing as clinical evaluation tool is recommended.

The WISC-V in children and adolescents with epilepsy

ABSTRACTDespite its popularity in the neuropsychological evaluation of children, the utility of the Wechsler Intelligence Scale for Children – Fifth Edition (WISC-V) has not yet been investigated in children with epilepsy. Eighty clinically referred children and adolescents with epilepsy were administered the WISC-V as part of a comprehensive assessment and scores were compared to matched controls from the WISC-V standardization sample. T tests compared WISC-V indices and subtests between patients and controls and Chi-square analyses compared the rates of low scores. Correlational analyses assessed the relationships between epilepsy severity variables (e.g., age of onset, duration of epilepsy, number of antiepileptic drugs, seizure frequency). All WISC-V composites and subtests were significantly lower in patients versus controls and the rate of low scores was higher in patients than controls for all composites and subtests with the exception of Figure Weights. The Working Memory Index and Processing Speed Index were most sensitive to impairment, while the Verbal Comprehension Index and Fluid Reasoning Index were least sensitive. Of the epilepsy severity variables, age of seizure onset and number of antiepileptic drugs were strong predictors of deficits, whereas seizure frequency was the weakest predictor. Importantly, no significant differences were seen in children with right hemisphere epilepsy versus left on the five WISC-V composites, though a trend was seen towards a lower Visual-Spatial Index in those with right-sided focal seizures.

Factor Structure of the Wechsler Intelligence Scale for Children-Fourth Edition Spanish in a Clinical Sample.

The Wechsler Intelligence Scale for Children-Fourth Edition Spanish (WISC-IV Spanish) is a translation and adaptation of the WISC-IV that is often used in neuropsychological evaluation of children and adolescents with acquired or developmental brain disorders. However, there is limited information on the factor structure of the WISC-IV Spanish when used with clinical populations. To address the potential effects of language and culture on the validity of the WISC-IV Spanish factor structure, this study examined the construct validity of the WISV-IV Spanish scores using confirmatory factor analysis in a clinical sample of Hispanic children with Attention-Deficit/Hyperactivity Disorder (ADHD). Participants included 148 children whose primary language was Spanish, who had a primary diagnosis of ADHD, and who had been administered the WISC-IV Spanish as part of a clinical evaluation (mean age = 10.6 years; SD = 2.7). Confirmatory factor analyses were performed to evaluate if the WISC-IV Spanish was best explained by a 1-, 2-, 3-, 4-, or 5-factor model based on the Cattell-Horn-Carroll theory. A 4-factor model composed of verbal comprehension, perceptual reasoning, working memory, and processing speed factors provided the best fit for the data (comparative fit index = .95; root mean square error of approximation = .06). Findings for children with ADHD and LD support interpretation of WISC-IV Spanish Index scores based on the 4-factor model identified in Spanish- and English-speaking normative samples. Additional research with understudied clinical populations is warranted to address gaps in cross-cultural research.

C-63Assessing Performance Validity with the Medical Symptom Validity Test (MSVT) During Neuropsychological Evaluation of Children and Adolescents with Epilepsy

C-63Assessing Performance Validity with the Medical Symptom Validity Test (MSVT) During Neuropsychological Evaluation of Children and Adolescents with Epilepsy

Neuropsychological evaluation of children in low conciseness state after a severe traumatic brain injury

To follow up patterns of cognitive recovery in children (6-17 years of age) at the first four months after a severe traumatic brain injury (TBI). Seventeen children with TBI (GCS ≤8) were evaluated with the Coma Recovery Scale-R (CRS). Children were stratified into three groups according to their consciousness recovery. Seven children regained their consciousness completely and were assessed by the Luria Neuropsychological Battery test. Six children remained in the minimally conscious state (MCS) and were tested by the adapted procedure of neuropsychological assessment during the first four months. Four children with low level of consciousness were evaluated with CRS. The most destroying functions at the early recovery period were the processing speed (neurodynamics of mental activity), executive functions and memory. Children with the anterior cortex damage had the slowest dynamics of recovery. The slower dynamics of consciousness recovery was combined with severe primary damages of visual gnosis, speech and executive functions according to neuropsychological examination. The positive dynamics of consciousness recovery was combined with early behavioral changes and the greater rate of behavioral changes.

Serial Neuropsychological Evaluation of Children with Severe Epilepsy

Cognitive impairment is common in children and adolescents with epilepsy. Though there is increasing recognition that even children with more benign epilepsy syndromes may show cognitive loss over time, this is particularly true in children with severe epilepsies, termed the epileptic encephalopathies. The current article discusses general cognition in children with epilepsy, focusing on risk factors for cognitive decline over time in severe epilepsies. The “epileptic encephalopathies” are briefly introduced and methods for assessing cognitive loss over time are discussed with an emphasis on the use of reliable change indices. The strengths and the limitations of this approach are noted as they pertain to children. The article concludes with an illustrative case example of a young child with a severe epilepsy syndrome and apparent cognitive loss. The utility and limitations of reliable change indices are discussed within the context of this case.

Neuropsychological Evaluation of Children and Adolescents With Acute Carbon Monoxide Poisoning.

Carbon monoxide (CO) poisoning is a worldwide health problem. We have limited information regarding psychological adversities of CO poisoning in children and adolescents. The aim of this study was (1) to investigate the effects of severe CO poisoning on cognitive functions, mood, and behaviors in children and adolescents and (2) to identify factors related to occurrence of neuropsychological symptoms. This study included pediatric patients, who were evaluated after CO poisoning at the Department of Child and Adolescent Psychiatry between January 2012 and April 2013. The patients were evaluated at 2 time points. The first evaluation was done when they were discharged from emergency department, and the second evaluation was done 1 month after CO poisoning. Turkish versions of internationally recognized tests were used to evaluate anxiety, depressive symptoms, attention, visual-spatial skills, memory, and behaviors of patients. Twenty-seven patients were analyzed. The mean age of the patients was 11.8 ± 2.7 years (range, 6-18 years). The mean carboxyhemoglobin level was 31.5% ± 7.8% (range, 19%-51%) dir. Delayed neurological sequel was observed in only 1 patient, who had headache and tinnitus. We found that carboxyhemoglobin level was not correlated with later neuropsychiatric test scores. However, we found a correlation between history of loss of consciousness and anxiety symptom level, hyperbaric oxygen (HBO) therapy session and behavioral problems, and time to HBO therapy and attention problems. We suggest that CO exposure duration, history of loss of consciousness, time to HBO therapy, and the number of HBO therapy session affect neuropsychological symptom levels and occurrence of attention and behavioral problems.

P122 – 2666: Neuropsychological evaluation of children with middle cranial fossa arachnoid cysts, before and after decompression of the cyst through neurosurgical fenestration

Objective To evaluate cognitive outcome in children after surgical decompression of arachnoid cysts of the middle cranial fossa. An additional objective was to assess the children as one part of the decision whether to perform a surgical intervention or not. Arachnoid cysts are often considered asymptomatic incidental findings of MRI or CT. In this project the aim was to assess prevalence of cognitive symptoms correlated to the cyst and possible postsurgical improvement. Methods Neuropsychological assessment at the department of child neurology at Karolinska University Hospital, Stockholm. The assessment of intellectual ability was done using WISC-IV. Assessment of specific cognitive functions was done using NEPSY-II, Rey Oesterrieth Complex Figure test, BNT-II and FAS (test of verbal fluency). A follow-up with the same psychometric tests 4–5 months after surgery. Results To this date 6 children has gone through presurgical assessment. Four of six children showed cognitive symptoms in the assessment. Symptoms that was correlated to the location of the cyst and the neurosurgeon decided on fenestration of the cyst. Two of six children had no cognitive symptoms and the neurosurgeon decided on no surgical intervention. Two of the four children with symptoms have been evaluated 5 months after decompression of the cyst. Both clinical and psychometric results points towards reduction of cognitive symptoms in these two patients. Conclusion Neuropsychological assessment might be used as a help in decisions regarding surgery. Pre- and post-op assessment might be a way of evaluating the possible benefits of decompression of arachnoid cysts of the middle cranial fossa in children.

Multiple Perspectives on Body Image Research

Representation of the body is a nuclear aspect of self-image. Body representation includes both subjective and intersubjective experiences. The importance of visual body representation in our social life is demonstrated by the time we spend to take care of our physical appearance, including use of plastic surgery, as well as by the severe mental disorders associated to its alteration, including eating disorders (EDs) and body dysmorphic disorders. In spite of these issues, (neuro)psychological research on body representation has so far mainly focused on the body as a motor device, devoted to the perception of and interaction with objects. The complexity of factors involved in the development, maintenance, and plasticity of body image representations requires an integrated approach that facilitates the evaluation and treatment of EDs with novel, evidence-based, and more efficacious protocols. This special issue of European Psychologist aims to advance such an integrative approach, with a collection of papers that gather different perspectives on the phenomenological, cognitive, (neuro)psychological, and cultural aspects of body representation disorders.

Motor Assessment in Pediatric Neuropsychology: Relationships to Executive Function

Executive function often refers to control behaviors such as “initiating,” “sustaining,” “inhibiting,” and “switching.” These mechanisms contribute to regulation of thinking and emotion but can be observed most clearly in the motor system. Neuropsychology has been influenced by “top-down” models of cognitive control that emerged from information-processing theories of cognition. In fact, neural models provide evidence that control processes are highly interactive within the cortico-striatal-cerebellar circuits. Cognition unfolds in response to motor-driven adaptation, and evidence exists for similar firing of brain cells and circuits during “imagined action” as in actual motor behavior. The motor system develops early and yet is not routinely assessed in neuropsychological evaluation of children with neurodevelopmental disorders. This article reviews some of the approaches to motor assessment that have sensitivity to neurodevelopmental disorders, and advocates for inclusion of motor assessment, particularly in evaluating control processes independent of culture, language, and other confounders.

Datos neuropsicológicos de niños con trastorno autista y desarrollo intelectual en el intervalo considerado normal

Characteristic symptoms of autistic disorder (AD) can be the result of cognitive impairment which can be produced by specific neurological irregularities. Up until now a specific cognitive deficit in autism has not been found, although the majority of people with autism show intellectual impairment, verbal scores lower than manipulative measures and executive dysfunctions. A neuropsychological evaluation of children with AD was planned. These children had intellectual abilities in the normal range. They were compared with two other groups, one with pervasive developmental disorder not otherwise specified (PDD-NS), and the other from the general population. A battery of neuropsychological tests was carried out on five boys AD, five boys PDD-NS, and five boys of the general population. All of them were between 9 and 15 years old and their intellectual abilities were within the normal range. The children AD obtained verbal scores lower than their visual-perception scores. They also showed good dynamic coordination of movement. Scores in episodic memory tasks where executive strategies are needed were low. The characteristics described in the paper do not demonstrate a specific profile of the AD, but they can be useful in diagnoses and in planning treatment.

Neuropsychological evaluation of children after ischemic cerebrovascular disease.

The purpose of this study is to associate neuropsychological evaluation with neuroimaging results in children with cerebral tomography indicating ischemic cerebrovascular disease (ICVD). Neuroimaging, neurological exams and neuropsychological instruments were used to evaluate five children. The study revealed that the cognitive and perceptive skills in two children were normal and motor sequele in four cases. The rhythm, visual and speech receptive skills remained unchanged. In four cases the SPECT exam showed regions with hypoperfusion and in four cases the EEG was normal. Neuropsychological, neurological and image indication some degree of sequele demonstrating the importance of follow up of children who had suffered cerebrovascular disease.

The boston qualitative scoring system for the rey-osterrieth complex figure: A study of children with attention deficit hyperactivity disorder

Abstract The Boston Qualitative Scoring System (BQSS) for the Rey-Osterrieth Complex Figure (ROCF) was utilized to examine the qualitative features of ROCF performance of children with Attention Deficit Hyperactivity Disorder (ADHD). Thirty-nine children with ADHD were compared to age-matched controls (n = 39) on their reproduction of the ROCF. ADHD children performed more poorly than did control children on measures of attention to detail, expansion, accuracy, and neatness. Sensitivity and specificity of individual BQSS measures for discriminating ADHD from control subjects were determined, and a logistic regression model was derived, yielding an overall sensitivity of 64% and specificity of 97% for the classification of ADHD. Eighty-one percent of all children were correctly classified. Cross-validation of this model on an independent sample of ADHD and control subjects revealed good predictive accuracy. These findings suggest that the BQSS may be a useful measure in the neuropsychological evaluation of children with suspected ADHD.

Neuropsychological evaluation of children with intracranial tumors: Impact of treatment modalities

Antineoplastic treatment has a deleterious effect on intellectual functions, which is mainly attributable to radiotherapy. With the object of determining the neuropsychological disturbances associated with brain irradiation in the child, and to try to differentiate them from the effects caused by the other types of treatment (surgical and chemotherapy) as well as from the effects of the tumor itself, a cross-sectional study was carried out in 25 survivors of medial edge intracranial tumors. In order to monitor the effect of systemic chemotherapy on the cognitive functions, and the effect of prolonged absence from school, two control groups were formed, one made up of subjects treated with chemotherapy for extracranial tumors, and the other of patients with non-malignant chronic disease. Neuropsychological functions were measured using the Spanish version of the Wechsler scale, as well as the following tests: Spreen-Benton, ITPA and TALE scales, Yuste Memory Test, Thurstone Attention Test, and the Rey Complex Figure. In addition to a progressive decline found in the full scale intelligence quotient in children irradiated for intracranial tumors, variance analysis showed that these patients deteriorate mainly in visual attention and memory, but also significantly in verbal fluency and in the Performance Intelligence Quotient and all its subtests, when compared to the control groups. Visual attention and the Wechsler Picture Arrangement and Block Designs, were the tests whose decline correlated with the total radiation administered. The article relates this specific neuropsychological injury with the total brain irradiation dose but also with the structures located in the cone-down fields of irradiation to boost regions in the middle edge intracranial content.

A prospective neuropsychological evaluation of children treated with additional chemotherapy and craniospinal irradiation (CSI) following isolated central nervous system (CNS) relapse in acute lymphoblastic leukemia (ALL)

A prospective neuropsychological evaluation of children treated with additional chemotherapy and craniospinal irradiation (CSI) following isolated central nervous system (CNS) relapse in acute lymphoblastic leukemia (ALL)