Neuropsychology

The role of the Neuropsychologist and the purpose of the neuropsychological assessment

Neuropsychologists are psychologists who are specially trained in the study of the relationship between brain and behaviour. As a results of brain injury or disease there can be changes in cognition (intellectual-type functions), behaviour and emotions. The Neuropsychologist is a professional who is qualified to determine the type, extent and cause of such changes. To do this, the main tool at the disposal of the Neuropsychologist is the 'neuropsychological assessment'.

The neuropsychological assessment is an evaluation of cognitive, behavioural and emotional functioning using a variety of tests and procedures. Some of the areas assessed include attention, mental speed, memory, visuospatial skills, language, planning, problem-solving, mood, and personality.

On the basis of the neuropsychological assessment, the strengths and weaknesses of each patient can be identified. The Neuropsychologist can then generate strategies and recommendations that can be used by patients and their families and other health staff to aid in rehabilitative efforts to improve each patient's quality of life.

Neuropsychological difficulties after brain injury

This section lists the neuropsychological difficulties patients may have after a brain injury. This is not an exhaustive list.

Patients may not have difficulties in all the areas listed here. It is not uncommon for patients to have problems with one or two isolated areas of brain functioning. It is also important to note that any impairment may not be static. Some impairments become less severe over time as the patient recovers from their injuries, but there can also be some permanent impairment. These points emphasise the importance of carrying out a neuropsychological assessment for each individual patient.

Attention
One area of cognition that is frequently affected by brain injury is attention. Patients may find it difficult to sustain their attention over lengthy periods of time. Patients may find it difficult to focus their attention on the task at hand and instead become easily distracted by noise or movement when they previously could filter out such things without difficulty.

After a brain injury, attention may be easily overloaded so patients cannot process the same amount of information they previously could. For example, patients may not process all the details of a conversation because too much was said to them at one time.

Patients may also have difficulty with dividing their attention between multiple tasks so that performance on one or all tasks suffers. For example, driving a car while listening to the car radio or having a conversation with a passenger.

Speed of processing
After a brain injury, it is not uncommon for patients to take longer to process information. patients may need information to be presented to them at a slower pace because their mind may not keep up. Patients are also likely to take extra time to come up with a response or take more time to do things. For example, patients may take extra time to formulate a response to a question and/or they may take extra time to complete home chores or work duties.

Memory
The types of memory difficulties vary widely from patient to patient. It's not uncommon for patients to have difficulty remembering events just prior to the accident in which they sustained their brain injury. The duration of this type of memory loss can vary.

Patients may also have difficulties with new learning (or what is commonly known as short-term memory). For example, patients may not remember having had conversations with people, recall what they did the previous day or forget one or more items they wanted to purchase when at the shop. these difficulties may occur because patients may not be processing the information properly to put into their memory to begin with, or alternatively, the information may go into memory fine but when they need to retrieve it they have difficulties. Different strategies are required to assist a person depending on the nature of the memory problems.

Visuospatial difficulties
Patients can have different types of visuospatial difficulties after brain injury. Two relatively common ones are discussed here:

• Neglect. Some patients may have a neglect for either the left or right side of space (left is more common). That is, they are inattentive to the left side of their field of vision. In it's most severe form patients may eat food on the right side of their plate but leave the left side untouched. A subtle example of left neglect is a patient who fails to see the toothpaste they want to purchase because it is on the shelves on their left side.
  
• Constructional difficulties. Patients with brain injury can have visuospatial constructional difficulties. that is, they may have difficulties putting individual items or elements together to make a whole. Examples include difficulties copying simple line drawings, putting puzzles together or putting a mechanical engine back together when it has been taken apart.
  

Last modified: Thursday, 20 April 2006