Clinical Neuropsychology Vicki Veroff, Ph.D. OPQ, CPA, AQNP, CADDRA

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 Mental 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.

Criteria for Accreditation in Quebec - Theoretical 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.

Criteria for Accreditation in Quebec - Practical 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 Areas Learning 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 cont. Genetic disorders Acquired or induced 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 cont. Schizophrenia/Schizoaffective Disorder Anxiety Disorders Bipolar Disorder/Mania Major Depressive Disorder Personality Disorders Addictions Tourette’s PANDAS

The puzzle of neuropsychology

Assessment process History-taking/clinical interview Behavioural observations Selection of tests and measure Administration of tests and measures Interpretation and diagnosis Provision of feedback Treatment planning Report Writing

Treatment process Identification of intervention targets Specification of intervention needs Formulation of an intervention plan Implementation of the plan Monitoring and adjustment to the plan as needed Assessment of the outcome

Neurocognitive Interventions Cogmed Working Memory Training Bio-Acoustical Utilization Device Alpha-Stim Mindfulness Meditation qEEG Neurofeedback

Clinical Examples Jack, 24; Graphic Design Student Sylvia, 55; Bookkeeper Emily, 14; Grade 8 Student Joaquin, 5; Daycare Attendee