Tuesday, March 5, 2019

Neuropsychological Testing

Clinical neuropsychology is a field with historical origins in both(prenominal) psychology and neurology. The principal(a) activity of neuropsychologists is assessment of thinker functioning with structured and systematic behavioral observation. neuropsychological tests be designed to experiment a variety of cognitive abilities, including speed of information processing, attention, memory, language, and executive director functions, which atomic number 18 necessary for goal-directed behavior.By scrutiny a range of cognitive abilities and examining patterns of functioning in different cognitive areas, neuropsychologists crumb make inferences about implicit in(p) brain function. Neuropsychological testing is an important component of the assessment and discussion of traumatic brain injury, dementia, neurological conditions, and psychiatric disorders. Neuropsychological testing is withal an important tool for examining the effects of toxic substances and medical conditions on brain functioning.Before the introduction of neuroimaging techniques like the computed tomography (CAT scan) and magnetic resonance imaging (MRI), the primary focus of neuropsychology was diagnosis. Since clinicians lacked non-surgical methods for directly observing brain lesions or structural abnormalities in living patients, neuropsychological testing was the only way to notice which part of the brain was affected in a given patient. Neuropsychological tests can identify syndromes associated with problems in a particular area of the brain.For instance, a patient who performs well on tests of attention, memory, and language, solely poorly on tests that solicit visual spatial skills such as copying a difficult geometric figure or do designs with colored blocks, may hold in dysfunction in the right parietal lobe, the region of the brain confused in complex processing of visual information. When a patient complains of problems with oral communication later on a stroke, s eparate tests that examine production and apprehension of language help neuropsychologists identify the location of the stroke in the left over(p) hemisphere.Neuropsychological tests can also be used as screening tests to chitchat if more extensive diagnostic evaluation is appropriate. Neuropsychological screening of immemorial people complaining of memory problems can help identify those at risk for dementia versus that experiencing normal age-related memory loss. As neuropsychological testing came to play a less vital role in fix of brain dysfunction, clinical neuropsychologists found new uses for their skills and knowledge.By clarifying which cognitive abilities are impaired or preserved in patients with brain injury or illness, neuropsychologists can predict how well individuals will respond to different forms of give-and-take or rehabilitation. Although patterns of test scores illustrate profiles of cognitive strength and weakness, neuropsychologists can also learn a grea t deal about patients by observing how they start out a particular test. For example, two patients can hit a test in very different ways even obtain similar scores.One patient may work slowly and methodically, making no errors, while another rushes through with(predicate) the test, making several errors but quickly correcting them. around individuals persevere despite repeated failure on a series of test items, while others refuse to continue after a few failures. These differences might not be apparent in test scores, but can help clinicians choose among rehabilitation and handling glide slopees. Performance on neuropsychological tests is usually evaluated through comparison to the sightly performance of large samples of normal individuals.Most tests include tables of these normal scores, oftentimes divide into groups based on demographic variables like age and education that progress to affect cognitive functioning. This allows individuals to be compared to appropriate p eers. The typical neuropsychological interrogatory evaluates sensation and perception, gross and fine motor skills, basic and complex attention, visual spatial skills, receptive and productive language abilities, recall and recognition memory, and executive functions such as cognitive flexibility and abstraction.Motivation and personality are often assessed as well, particularly when clients are seeking financial compensation for injuries, or cognitive complaints are not typical of the associated injury or illness. Some neuropsychologists prefer to use fixed test batteries like the Halstead-Reitan Battery or the Luria-Nebraska Battery for all patients. These batteries include tests of a wide range of cognitive functions, and those who advocate their use believe that all functions must be assessed in each patient in order to avoid diagnostic diverge or failure to detect subtle problems.The more common approach today, however, is to use a flexible bombardment based on hypotheses ge nerated through a clinical interview, observation of the patient, and review of medical records. While this approach is more prone to bias, it has the advantage of preventing unnecessary testing. Since patients often find neuropsychological testing stressful and fatiguing, and these factors can negatively influence performance, advocates of the flexible battery approach argue that tailoring test batteries to particular patients can cater more accurate information.Lezak, Muriel Deutsh. Neuropsychological Assessment. 3rd edition. New York Oxford University Press, 1995. Mitrushina, Maura N. , Kyle B. Boone, and Louis F. DElia. Handbook of prescriptive Data for Neuropsychological Assessment. New York Oxford University Press, 1999. Spreen, Otfried and Esther Strauss. A Compendium of Neuropsychological Tests Administration, Norms, and Commentary. second Edition. New York Oxford University Press, 1998. Walsh, Kevin and David Darby. Neuropsychology A Clinical Approach. 4th edition. Edinbur gh Churchill Livingstone, 1999.

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