A pediatric neuropsychologist is a specialized specialist whose functional responsibilities include diagnosis and neurocorrection for patients with signs of behavioral disorders, memory loss, and school performance. Neuropsychology is a non-drug treatment for neurological disorders in young children.
The main task of a specialist in this category is to organize effective methods of therapy aimed at developing those structures of the child’s brain that need professional correction.
At the same time, the use of neuropsychology techniques is not relevant if the patient has organic lesions of the central nervous system that require drug or surgical treatment.
Definition and essence
Child neuropsychology is one of the areas of modern science that studies the higher organization of mental processes occurring in the structure of the brain. The main subject of the study is the peculiarities of the formation of the child’s central nervous system, as well as their influence on his personal qualities, intellectual abilities and life skills.
The essence of neuropsychology, as an independent science, lies in the study of the following aspects:
- the influence of traumatic brain injuries and physiological disorders of mental development on the functional activity of the central nervous system;
- the role of the cerebral cortex in the organization and implementation of mental processes of varying complexity;
- neuropsychological differences in children of different age groups, as well as their impact on behavior, memory quality, ability to learn and assimilate information;
- the ability of neuropsychological techniques to assist in the full physical and intellectual development of the child;
- features of the formation of brain tissue in children of different ages.
Neuropsychology is a science whose methods allow us to develop a modern approach to providing psychological assistance.
A child facing difficulties in mental or physical development has the opportunity to undergo a course of neuropsychological correction, development of impaired brain functions, as well as rehabilitation after severe injuries, long-term treatment, or surgery using general anesthesia.
A pediatric neuropsychologist is a specialist who is also a psychologist and has theoretical and practical knowledge in the field of neurocorrection.
A child’s performance at school and his level of success in adulthood depend on the development of certain centers of the brain. A properly formed central nervous system is the basic foundation for the further development of new skills, abilities, and processing of information coming from the outside world.
The work of a neuropsychologist is to reveal the weaknesses and strengths in the child’s character, as well as to find out the reasons that cause difficulties in achieving life goals.
In the process of conducting neurocorrectional sessions, a child neuropsychologist is able to provide the following types of non-drug assistance:
- cope with the consequences of traumatic brain injury, which led to the emergence of central nervous system pathologies and mental retardation;
- improve memory and logical thinking in a child of the appropriate age;
- carry out effective correction of existing disorders of fine and gross motor skills of the upper limbs;
- ensure stimulation of more active speech development if the child has serious difficulties in this area (in this case, the neuropsychologist should work in close collaboration with the speech therapist).
A pediatric neuropsychologist is a specialist who carries out effective work to correct brain centers that need more active development. Due to this, the child becomes more attentive, school performance improves, and memory functions are normalized.
A neuropsychologist also allows you to develop a method for solving those difficulties and problems that negatively affect the child’s life. In the process of neuropsychological correction, the main causes that cause disturbances in the mental and physical development of children are eliminated.
Areas of neuropsychology
Acceptance of this new role has raised important questions regarding the relationship of neuropsychology to traditional models of professional training in psychology. Some neuropsychologists are beginning to consider themselves to be a separate subspecialty, similar to how clinical psychology is recognized as a subspecialty. In contrast, others perceive neuropsychology (especially its branches dealing with assessment and treatment) as a subspecialty of clinical psychology. In this model, training in clinical psychology is complemented by specialization in N.
Neuropsychologists with different orientations may also view patient populations and practice very differently. Psychologists trained in the neurological tradition most often see patients with obvious deficits in brain function, especially patients suffering from aphasia, due to the importance that many prominent neurologists attach to speech disorders. The examination methods they use are predominantly qualitative, focused on identifying how the patient performs a particular task, and not on using indicators obtained from more traditional psychol. tests. Testing procedures may be standardized, but they are often modified to suit the perceived needs of the individual patient and the impressions of the examiner.
In contrast, other psychologists may take a more quantitative approach to these problems, borrowing from the rich tradition of quantitative psychometric assessment. There are different variations of this approach, with some, such as the use of a single test, falling into obscurity, while others, such as the use of batteries of tests, are gaining increasing popularity. In any case, the quantitative approach emphasizes establishing norms for test scores and justifying the ability to objectively analyze the patient's demonstrated deficits rather than relying on purely intuitive assessment. However, the effectiveness of this approach still depends on the knowledge and experience of the clinician, since test performance patterns can change under the influence of a large number of variables, including the area of local brain damage, the speed of the pathological process, the nature of the damage, premorbid intellectual level, the degree of functional recovery, and many others.
When to see a neuropsychologist
Not all children need the help of a neuropsychologist. However, situations occasionally arise when consultation with a specialist is simply necessary. The table below lists the main indications for contacting a neuropsychologist.
| Reasons for visiting a specialist of this profile | Characteristics of behavioral disorders, signs of deviations in mental or physical development |
| Observation by doctors | Most children who are registered with a speech therapist, child psychologist, or neurologist require additional diagnostics from a neuropsychologist. A specialist in this category will conduct a high-quality diagnosis of the child, which will reveal the causes of existing neurological diseases or psychological trauma that causes behavioral disorders. |
| Inattention | A child in need of examination by a neuropsychologist is often and very easily distracted by various environmental stimuli. During the lesson, such children do not listen to the teacher’s instructions, do not respond to comments, or the reaction to the teacher’s words is too late. A child with neuropsychological disorders has serious difficulties in concentrating attention and is characterized by increased absent-mindedness and lack of concentration. |
| Marked awkwardness or clumsiness | A request for help from a neuropsychologist should take place if, compared to his peers, the child is characterized by increased awkwardness and clumsiness. The need for diagnosis and corrective work with a specialist in this profile is associated with the presence of disorders of gross and fine motor skills of the limbs. In this case, the child tries to perform all movements as accurately as possible, but dysfunctional disorders in the central nervous system do not allow the body to function in a balanced manner. In this situation, there may also be signs of difficulties in self-organization. |
| Problems with orientation in space | A consultation with a neuropsychologist is indicated for children who have difficulty navigating the environment and the margins of their own notebook. A child with similar symptoms has great difficulty remembering the way home from school and cannot find his own classroom or cafeteria. In the process of mastering writing, children cannot figure out where to write letters, and beyond which lines writing is prohibited. The child often gets lost while walking with other children. |
| Poor learning ability | Parents whose child is not following the school curriculum should seek help from a neuropsychologist. At the same time, his intellect is fully preserved and he has all the necessary skills for full mental development. In this case, there may be a decrease in the functional activity of certain brain centers responsible for learning to read, write, and basic mathematical calculations. Timely implementation of neurocorrection will improve the performance of the child’s central nervous system and prevent further lag in school. |
| Preparing to go to school soon | Most experts are inclined to believe that children need preventive consultation with a neuropsychologist. In this situation, the child is diagnosed for possible behavioral disorders, problems with mental and physical development. Children go to school psychologically prepared, eager to gain new knowledge and skills. All this has a positive effect on their success in adulthood. |
| Emotional instability | Mandatory assistance from a neuropsychologist is required for children of all age groups who show signs of emotional instability. This symptomatology is characterized by sudden changes in mood, attacks of hysteria or pronounced joy. Such behavior in a child may indicate an existing neurological disease, which can be eliminated using neurocorrection methods. Maintaining emotional instability negatively affects the child’s quality of life. Especially if this behavior disorder remains into adulthood. |
| Pathologies of central nervous system development | Children who use both hands at once when performing basic operations should also be examined by a neuropsychologist. Especially if, with the help of one upper limb, the child cannot independently eat, write, or move light and small objects. Such symptoms indicate possible disorders of the simultaneous interaction of the left and right hemispheres of the brain. High-quality neurocorrection can eliminate or significantly reduce the severity of this disorder. |
A pediatric neuropsychologist is a specialist whose diagnostic methods do not involve the use of hardware and laboratory examination methods. Timely consultation and neurocorrection make the child emotionally stable, intellectually and physically developed, and also competitive in relation to his peers.
Controversial issues in neurodiagnostic testing
There are a number of important debates in neuropsychology regarding the choice between individual and standardized testing, quantitative and qualitative testing, single-dimensional (using a single test) and multi-dimensional (using test batteries) testing, as well as the role of the clinical psychologist and rehabilitation programs.
Individual versus Standardized Testing
Proponents of an individualized approach usually advocate the choice of tests for a patient based on medical results. examination, anamnesis and clinical picture at the initial and subsequent stages of treatment. Neuropsychologists who use this approach argue that individualized assessment allows the clinician to concentrate testing efforts on those areas where a given patient shows the greatest deficits. In theory, this approach allows the clinician to conduct a thorough assessment of the patient in a shorter time. Opponents of this approach note that the accuracy of individualized assessment depends largely on the skill of the individual clinician. When the clinician's subjective judgment informs the selection of appropriate tests, such testing can be highly effective. If, however, the tests selected do not adequately measure the patient's functional deficits, the individualized assessment may be insufficient at best or misleading at worst. Moreover, opponents argue, this approach does not allow for the collection of systematic data by either category of patients or categories of disorders; as a consequence, the possibilities for drawing conclusions from the results of an examination of a group of patients, or at least for scientific confirmation of the reliability of such conclusions, are significantly limited.
Because of these limitations, many clinicians use standardized tests or test batteries tailored to what they believe to be essential. measurements relevant to the assessment of suspected brain dysfunction. All patients are assessed on these measurements. Of course, the standardized approach has its limitations. First of all, the more parties involved in the survey, the longer it takes; The most complete comprehensive battery of tests may require a full day or more to complete. In addition, tests included in standardized batteries addressed to all patients in general may sometimes not be suitable for assessing areas that are relevant to that particular patient.
An effective compromise solution to overcome the limitations of standardized testing is to combine this approach with more flexible additional testing.
Quantitative/Qualitative Testing
The quantitative approach involves reducing all the features of the test to a set of numbers, which can be used to compare the patient’s results on this test with the results obtained in normative groups of healthy people and patients with brain lesions. Based on such comparisons, a diagnostic decision can be made. Proponents of the quantitative approach emphasize its reliance on objective indicators, which are characterized by reproducibility across a variety of researchers and clinicians, and its emphasis on scientific research. results obtained under controlled conditions.
The qualitative approach emphasizes how a particular person. tries to complete the test, and not the number of points he scored. This gives the clinician the opportunity to understand the important underlying processes that determine the quality of the patient's test performance. Once these underlying processes are understood by the clinician, the clinician can identify the cause of brain dysfunction and assess its implications for the patient's recovery and rehabilitation.
These approaches should not be viewed as mutually exclusive. Effective clinicians often combine both approaches.
Single tests/test batteries
Traditionally, many psychologists have used only one test to assess disorders associated with localized brain lesions. However, it is now recognized that the single test approach to assessment is generally ineffective. Therefore, many clinicians have adopted a multitest approach, in which diagnostic decisions are made based on the patient's cumulative test performance. Ideally, the tests included in the battery should represent the different abilities affected by brain lesions.
The use of test batteries also leaves more room for complex interpretative approaches. The results of a test designed for right-hemisphere performance can be compared with the results of a test designed for left-hemisphere performance. Verbal tests and tests of right-sided motor and sensory functions are considered to reflect left-hemisphere performance, whereas nonverbal tests and tests of left-sided motor and sensory functions are considered to reflect right-hemisphere performance.
When working with test batteries, configuration analysis can also be used. Configuration analysis is probably one of the most powerful tools available to clinical neuropsychologists to analyze more difficult, subtle cases of organic brain syndrome.
A wide variety of tests are used in neuropsychological assessment, both individually and as test batteries. Among the individual tests, some of which are presented as part of others, we can name the Bender Gestalt Test, Memory for Designs, Token Test, Benton Visual Retention Test, subtests from the Wechsler Adult Intelligence Scale, Boston Boston Diagnostic Aphasia Examination, Perdue Pegboard, Stroop Color and Word Test, and Wisconsin Card Sort Test.
In addition, there are a number of test batteries, but most are used in only one or a relatively small number of contexts. Two batteries, the Halsted-Reitan Neuropsychological Battery and the Luria-Nebraska Neuropsychological Battery, have received the most widespread attention. The Halsted-Reitan battery predates the Luria-Nebraska battery and has been in use since the 1950s. Perhaps this battery, more than anything else, is responsible for the increased popularity of clinical N.
The Luria-Nebraska Neuropsychological Battery is a newer test, introduced in 1978. This battery was a departure from standard tests in that it combined Luria's qualitative, behavioral, neurological approach with Reitan's standardized, quantitative approach. This test emerged as a unique approach for neuropsychological assessment and has therefore generated heated and widespread controversy. Despite the heated debate surrounding its use, it has become one of the main ones. tests used in the field and is now taught in an increasing number of programs. The interpretation is made on the basis of an analysis of the configurations, supplemented by observations of how the patient performed the tasks included in the battery. These qualitative observations are now organized in a form that allows frequency analysis, etc. so are formalized. The strength of the Luria-Nebraska Battery lies in the integration of qualitative and quantitative approaches and the greater research opportunities provided by the quantitative system.
At what age can you attend?
Neuropsychological correction is effective if the child is in the age category from 3.5 to 12 years. At this stage of physical and mental development, the tissues of his brain are at the stage of active formation.
Properly organized work to eliminate neurological disorders, psychological trauma and other negative factors that reduce the child’s quality of life allows for the full functioning of the central nervous system. At an older age, neuropsychological correction will not bring such a positive effect.
Experimental neuropsychology
Clinical neuropsychology receives considerable attention, but experimental research is an equally important area. N., who studies both people and laboratory animals, tries to identify the relationship between the brain and behavior. Where it comes to research. in public, between experiments. human neurophysiology and clinical neurophysiology there is a very fine line. However, the goals of the two areas differ significantly. While clinical neuropsychology attempts to find rules and procedures that are effective in working with large numbers of patients, often with unspecified (and indeterminate) disorders, experimental. neuropsychology of people systematically studies patients with well-defined and limited disorders to advance our knowledge of the relationship between brain and behavior.
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System and principles of operation
Neuropsychological correction is carried out using special exercises that develop the child’s body, as well as individual centers of the brain. The main task of a specialist is to teach children who require his help to feel their body, move as smoothly and clearly as possible, and maintain a high concentration of attention.
The principle of work of a neuropsychologist is that in the process of conducting correctional classes it is possible to achieve the following results:
- develop those areas of the cerebral cortex, the full formation of which did not occur due to the negative impact of certain factors;
- strengthen the physiological connection between the structural elements of the two hemispheres of the brain (achieving this effect allows you to improve mental function, increase the child’s ability to learn and assimilate information);
- accelerate mental processes occurring in the central nervous system, as well as activate the energy supply of brain cells.
Due to systemic neurocorrection, the child acquires the skills of independent control of his movements, clumsiness and awkwardness disappear. There is a harmonious development of all zones of the central nervous system, which are necessary for the formation of a self-sufficient personality.
The work of those areas of the brain that are responsible for planning, self-organization, and also control the functions of the musculoskeletal system and psycho-emotional reactions is normalized.
Diagnostic methods
A pediatric neuropsychologist is a specialist who is able to independently diagnose a child in need of neurocorrectional help. There are several basic methods of neuropsychological examination used for children aged 3 to 12 years.
Reciprocal hand coordination test
This type of testing of a child’s neuropsychological state is used to determine the level of interaction between the two hemispheres of the brain.
This diagnostic method is carried out as follows:
- The child sits down at the table.
- The patient then places his upper limbs on the table surface with his palms facing down.
- At the neuropsychologist’s command, the child clenches one hand into a fist and straightens the other.
- These movements of the upper limbs occur alternately.
The duration of this test is at least 20 s. If the child maintains normal interaction of the cerebral hemispheres, then in this case there will be synchronous work of two palms of the upper extremities at once.
Schulte table
The Schulte table is an effective method of neuropsychological examination, which was developed by the German psychiatrist Walter Schulte. This testing is aimed at determining the child’s intellectual abilities, as well as attention properties.
This diagnostic method is carried out as follows:
- A rectangular table divided into 25 squares is attached to the wall.
- Each cell contains numbers from 1 to 25, which are randomly scattered throughout the table.
- At the specialist’s command, the child must one by one find all the numbers located in the cell.
Based on the results of the examination, the neuropsychologist assesses the patient’s work speed and counts the number of errors made. After this, appropriate conclusions are drawn regarding the performance of the child’s brain centers.
Bourdon test
This diagnostic method is also known as a correction test, and its purpose is to determine the patient’s rate of fatigue.
This neuropsychological examination is carried out in compliance with the following algorithm of actions:
- The child sits down at the desk.
- Then the neuropsychologist gives him a form with printed text, the content of which contains extra characters.
- At the “start” command, the child must quickly re-read this information while simultaneously crossing out pre-specified letters or numbers.
The duration of the testing process ranges from 3 to 10 minutes. depending on what symptoms are present in a particular child. Based on the diagnostic results, the neuropsychologist determines the patient’s reading speed, accuracy, and level of attention.
Corrective classes
The neuropsychologist independently selects correctional activities that are indicated for use in relation to a child with specific problems of mental or physical development.
Arm stretching
This exercise is the simplest. The purpose of its use is to improve the motor function of the upper limbs, as well as stimulate more active motor skills. To perform this exercise, the child must be in a standing position.
Together with a neuropsychologist, children perform a smooth and leisurely warm-up of the fingers, each joint and tissue in the area where the tendons are located is worked out. The duration of this exercise is from 15 to 20 minutes. The frequency of its implementation is determined by a specialist.
Sea
The “Sea” exercise is aimed at the simultaneous development of brain centers responsible for the mobility of the musculoskeletal system, as well as mental function.
This type of neurocorrection is performed as follows:
- The child tells the neuropsychologist various stories about sea creatures that he knows.
- At the same moment, the patient performs certain physical actions.
- The neuropsychologist monitors that during the process of neurocorrection a uniform load is created on the muscles of the musculoskeletal system and the centers of the brain.
This exercise promotes the development of muscle and verbal memory, activates the functions of the central and peripheral nervous system. The duration of one neurocorrectional lesson “Sea” is 20-30 minutes.
Oculomotor repertoire
The neurocorrectional exercise oculomotor repertoire is designed to develop the centers of the brain responsible for concentration, as well as the synchronous functioning of the organ of vision.
Conducting this lesson requires compliance with the following algorithm of actions:
- The child is in a standing position in the middle of a spacious playroom.
- The specialist places bright objects throughout the entire area of the room. These can be balls, soft toys or any other objects.
- At the command of a neuropsychologist, the child finds a specific object with his eyes.
- All the specialist’s instructions come at a certain time interval so that the patient’s eye movement is as fast as possible.
The duration of this exercise depends on the age of the child, as well as his individual ability to concentrate. In this case, severe eye fatigue should not be allowed.
Mechanical hand massage
This neurocorrection lesson is carried out by performing a contrast massage. In this case, the specialist influences the tissues of the child’s upper extremities using soft and hard objects, cold and warm devices. Stroking the skin with a feather can be used, with its sudden replacement with a toothbrush, sponge, or a special massage ball.
At this stage of neurocorrection, the effect of maximum irritation of the peripheral nerves, which carry out the continuous transmission of sensitivity impulses to the central nervous system, is achieved. With the help of this method, the centers of the brain actively develop, and the blood circulation of this organ improves.
A pediatric neuropsychologist is a person who studies the mental processes occurring in the structure of a child’s brain. A specialist in this profile analyzes the behavior of children of the appropriate age, determines the possible presence of mental and physical development disorders, the occurrence of which is associated with dysfunctional disorders in the functioning of the central nervous system.
A pediatric neuropsychologist diagnoses the child and, based on the results, selects specific types of neurocorrectional exercises. The main goal of the classes is to achieve harmonious functioning of the left and right hemispheres of the brain, improve concentration, learning ability and assimilation of information from the environment.
