Clinical NeuropsychologyClinical Neuropsychology

Vicki Veroff, Ph.D.Vicki Veroff, Ph.D.OPQ, CPA, AQNP, CADDRAOPQ, CPA, AQNP, CADDRA

What is neuropsychology?What is neuropsychology?

• Neuropsychology focuses on the impact of brain dysfunction on cognitive, behavioural and emotional functioning.

• Clinical neuropsychologists can focus on assessment, management and/or rehabilitation of cognitive, memory, sensorimotor, attention, executive, social and emotional functioning for clients with neurological and/or neuropsychiatric disorders.

• Clinical Neuropsychologists integrate medical, psychiatric and occupational aspects of rehabilitation into effective and focused treatment planning.

Neuropsychological vs Neuropsychological vs Mental DisordersMental Disorders

• Psychologists can diagnose “mental disorders,” defined as:

« clinically significant disorders characterized by a change in thought process, mood or behaviour, associated with altered mental functioning. »

• The evaluation of “neuropsychological disorders” focuses on the link between clinical disorders and possible brain changes, dysfunctions or diseases.

• Sometimes there is overlap, e.g., diagnosing disorders such as ADHD, learning disabilities and mood disorders.

Accreditation requires five courses at the university or graduate level, containing the following elements:

•1 course on neuroanatomy, brain functioning and brain development.

•1 course on theories, principles and models of neuropsychology and neuro-psychopathology.

•1 course on neuropsychological evaluation.

•Choice of 2 courses in or related to neuropsychology.

Supervised stages or internships in a clinical setting, dealing with clients who suffer from neuropsychological disorders. Requirements are:

•1500 hours in clinical neuropsychology, which must include 562 hours of client contact (375 direct client hours).

•187 hours of supervision in neuropsychology, which must include 94 hours of individual supervision.

Problem AreasProblem AreasLearning deficits/disabilities

◦ Specific Learning Disabilities Dyslexia, Dysgraphia, Mathematics Disability,

Non-Verbal Learning Disability

◦ Intellectual Disability

Neurodevelopmental disorders◦ ADHD◦ Oppositional Defiant Disorder◦ Autism Spectrum Disorders◦ Speech/language/communication disorders

and delays

Problem Areas Problem Areas cont.cont.Genetic disorders

◦ Fragile X, Down Syndrome, Chromosomal syndromes

Acquired or induced disorders◦ Cerebral palsy◦ Fetal alcohol syndrome◦ Brain injury

Stroke/Traumatic brain injury (TBI) Post-concussion syndrome Toxic exposure (neurotoxins) Post-chemo deficits Parkinson’s Dementia/Alzheimer’s

Problem Areas Problem Areas cont.cont.Schizophrenia/Schizoaffective DisorderAnxiety DisordersBipolar Disorder/ManiaMajor Depressive DisorderPersonality DisordersAddictionsTourette’sPANDAS

The puzzle of The puzzle of neuropsychologyneuropsychology

Assessment processAssessment processHistory-taking/clinical interviewBehavioural observationsSelection of tests and measureAdministration of tests and measuresInterpretation and diagnosisProvision of feedbackTreatment planningReport Writing

Treatment processTreatment process

Identification of intervention targetsSpecification of intervention needsFormulation of an intervention planImplementation of the planMonitoring and adjustment to the plan

as neededAssessment of the outcome

Neurocognitive Neurocognitive InterventionsInterventions

Cogmed Working Memory TrainingBio-Acoustical Utilization DeviceAlpha-StimMindfulness MeditationqEEG Neurofeedback

Clinical ExamplesClinical Examples

Jack, 24; Graphic Design Student

Sylvia, 55; Bookkeeper

Emily, 14; Grade 8 Student

Joaquin, 5; Daycare Attendee