A developmental approach to pediatric neuropsychological intervention

Abstract

The field of pediatric neuropsychology maintains a unique role in helping children with developmental, acquired, and degenerative disorders involving the central nervous system. Significant advances in assessment paradigms have promoted an understanding of the associated cognitive, behavioral, social, and emotional sequelae of these conditions. An understanding of treatment strategies to mitigate adverse consequences and optimize outcome is less complete, but emerging, as will be addressed in subsequent sections of this volume. Setting the stage for those examinations, the objectives of this chapter are to (1) offer a general review of neuropsychological development, (2) provide a rationale for adopting a developmental approach to clinical practice, and (3) introduce key concepts related to pediatric neuropsychological intervention. Neuropsychological development An appreciation of normal brain function and neuropsychological development is critical for informing age-appropriate intervention strategies in children. This knowledge serves as a foundation on which to base coherent approaches to clinical activity. Although a side-by-side review of corresponding structure–function relationships at each age would be ideal, efforts to correlate structural brain changes with concomitant cognitive and behavioral progression are still in their infancy (Majovski, 1997). For the purposes of this chapter, development is considered first from the perspective of central organizing principles and then from the perspective of functional neuroanatomical domains. Organizing principles Eight organizing principles of brain structure and function, adapted from Berninger and Richards (2002), provide a useful framework from which to approach the study of neuroanatomy. Neurons . The primary functional unit of the central nervous system is the neuron. Neurons are varied in morphology and function. Collections of neurons with similar structure form unique cytoarchitectonic regions throughout the brain. In some areas, these neuronal congregations are organized into distinct layers of cortex. […]

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