Neuropsychological examination of schoolchildren, young children, adolescents and adults is the task of neuropsychology. This term hides medical science, a subsection of neurology, psychological science, neurosurgery. Science explores the topical arrangement of brain systems, correlates them with the information received by scientists on the higher functions of the psyche. Scientific successes are applicable in practice and are used to study people of different sex and age. Such skills are especially important in the work of defectologists.
Why and why
Neuropsychological diagnostics, examination of letters and reading are carried out to determine the specific mechanisms inherent in a particular child. By examining the condition, you can determine what triggered a developmental failure, why the child has difficulty adapting to society. Diagnostics performed on time and responsibly make it possible to determine which parts of the cerebral hemispheres are affected, and how widespread the disturbances are. In addition to the topical diagnosis, the examination makes it possible to analyze the extent to which mental functions are preserved. The doctor makes a complete picture of failures in the functioning of the psyche, which becomes the foundation for the development of the correction program. Restoration work will be entrusted to a group of specialists, parents are required to be involved.
A preliminary neuropsychological examination of primary schoolchildren involves the use of tests, tests designed to assess mental functionality. According to the results, we can conclude about the characteristics of a person’s memory, his ability to think, speak. Gnosis, praxis are also analyzed. Tables designed for such samples provide a detailed description of various incorrect answers. From them you can learn how brain dysfunction and disorders are related, how this can be influenced through games, exercises.
Features
Often, a neuropsychological examination of preschool children is organized in the form of stereognosis. For this, the object is given an object for palpation, while the human eyes are closed. The task of the child is to identify the received. Visual gnosis involves the recognition of images, including incomplete, covered with hatching, as well as highlighting a specific figure from the general background.
The methods of neuropsychological examination include a kinesthetic assessment of mobility, during which the specialist draws attention to the position of the fingers. Praxis in space is such an approach in which a person must reproduce the pose of the hand relative to another body. Praxis in dynamics - an alternative study, during which the object must change the position of the brush, draw pre-defined drawings.
Another neuropsychological examination technique is auditory-motor coordination. The object's task is to reproduce a given rhythm. The doctor may order a study of the ability to speak, during which a person must name objects in the displayed images, repeat words, phrases. Hearing and speech memory is studied by samples to repeat the given words in a certain order and retelling of insignificant volumes of prose. To assess the development of intelligence, it is necessary to do a test on the score, writing text, reading. A lot of information can be extracted from the drawings of the investigated object.
Special case: epilepsy
Eminent scientists, psychologists and neurosurgeons have actively worked and are working on the subject of neuropsychological examination. Glozman, in particular, proposed a popular theory of interpretation of results. Currently, it is used in an application to a wide variety of cases, including the study of the results of samples of patients with epilepsy. It is known that a pathological condition is associated not only with characteristic attacks, but also with certain cognitive dysfunctions. Their presence is not necessary, but possible. To determine the fact of the presence of such disorders, to assess their severity, the patient is sent for research, based on which they decide on the optimal therapeutic, rehabilitation program.
According to Akhutina, a neuropsychological examination aims to assess how much the mental function has changed due to illness. As a rule, they analyze the patient's attention, his ability to remember, speech skills, visual and spatial. Be sure to pay attention to psychic higher functionality. During the study, the doctor assesses how much the patient is able to think logically, how he approaches the solution of problems. Such studies are based on computer, paper, and pencil methods. Some do not last long, others stretch for hours - it depends on the nuances of the issue. Sometimes questionnaires allow you to assess the mental state, to determine what the quality level of a person’s everyday life is. The doctor reveals how abilities affect the patient's life.
Functional disorders: sources and root causes
By analyzing the album of neuropsychological examination, several types of cognitive malfunctions can be identified. Their causes are presumably usually related. Epilepsy develops against the background of structural brain damage, in which the functions of certain parts of the organ are weakened. Temporary disturbances are possible due to epileptic activity. This largely depends on the specifics of the seizures, their duration, frequency, time intervals between seizures. It is possible to limit cognitive abilities due to the use of medications, including specialized antiepileptic drugs and other drugs to combat seizure. Shortly after completing a drug program, brain functionality usually returns to normal.
If surgery is planned against the background of epilepsy, neuropsychological examination methods become an important preparatory stage. Its exclusion is strictly prohibited. The object of study is the person’s ability to speak and remember, his attentiveness, processing of data received through the organs of vision, and psychic higher functionality. The study reveals how a lack of cognitive functionality and brain structural impairment are related. In this case, already known information about the epileptic focus is taken into account.
Verification specifics: what and how?
If neuropsychological diagnosis is planned, the examination before the operation is sent primarily to the assessment of speech skills. The physician must determine which cerebral hemisphere is more responsible for this function. Hazards are formulated, based on which they plan a surgical event. Most often, functional MRI is resorted to. During the procedure, brain activity is recorded during the period when the object is working on speech tasks. A Wad test is allowed, in which the hemispheres are turned off in turn. Analyzing the results, we can understand which hemisphere in a particular case is most important for speech functionality.
Preoperative neuropsychological examination of children with epilepsy patients also includes an assessment of the dangers associated with the planned event. The doctor must determine how violations in the future can correct a person’s life, how they will affect his ability to work.
The system of neuropsychological examination of children proposed in Freiburg, and the methods used to assess the condition of patients with epilepsy, using MRI tools, help to assess the integrity of the cerebral hemispheres and the ability of individual parts to cope with the functions provided by nature. Following the results obtained, it is possible to foresee what measures will be needed in the future in order to recover from the operation. In order to fix the results of surgery for a long time, in the future it will be necessary to carry out control measures at least twice. As a rule, the first is organized a quarter of a year after surgery, the second - a year later.
Everything's under control
A neuropsychological examination of children, conducted against the background of epilepsy, allows us to clarify how effective the prescribed medications are, how this or that medicine affects brain function. Focusing on the results obtained, it is possible to choose a good dosage, to fix all the qualities of the composition shown in a particular case. In the future, if it is decided to increase the dose, the results of the samples are compared with those obtained previously. With a decrease in the background of the therapeutic course of cognitive abilities, the volumes of drugs taken reduce or completely abandon them.
Currently, the primary neuropsychological examination is usually organized using high-precision computerized technology that allows you to monitor changes during the day. Mobile monitoring is the most effective method of fixing the correction of the patient’s brain performance, as well as its psycho-emotional status. At the same time, it takes into account how much habitual conditions and everyday routine tasks affect the patient.
All-Russian approach and general recommendations
In our country, the rules and nuances of conducting a neuropsychological examination were proposed by a specialized center dealing with neurological problems of minors. Relative to the original theory of Luria, the rules developed later have a more abridged form. The main idea of the scheme used is to study the condition of the child. The All-Russian Center for Pediatric Neurology, which presented the currently widely used manual, specializes in working with patients of preschool age and primary school.
The scheme used in our country includes tests, tests designed to simplify the assessment of mental abilities, the ability to remember and speak, gnosis, practice. A special table has been developed, including all possible deviations and interpretations, the rules for their interpretation. Using such a table, a neurologist can easily identify the problems of the functionality of which particular brain structure is present in a particular patient.
Practice has shown a high level of effectiveness of such a neuropsychological examination as the main diagnostic method. Clinical in-depth events were held with the participation of kindergarteners, orphanages from institutions of a general profile. Deviations revealed in this way help to choose the best ways to educate and correct the behavior of the child.
Nuances of carrying out: preparatory stage
Neuropsychological examination begins with a conversation with the child. To do this, you need to organize a separate room. Of furniture must be present table and chairs. The child sits opposite the interlocutor. The presence of toys, strangers, bright objects that can attract the attention of the baby should be excluded. First, it is necessary to prepare images to assess the ability of the researcher to visually perceive information. For tactile testing, you need to prepare suitable items. In addition, you will need sheets of paper, pencils and pens. A preliminary conversation is aimed at challenging the location of the researcher: the child must trust the adult. When talking, the task of the responsible person is to assess the personality of the child, the nuances of his behavior, the ability to think critically. The adult must determine how the youngest relates to friends, relatives, teachers and educators.
After a preliminary acquaintance, they begin to perform tasks that help determine the tendency of the child to be left-handed. It is necessary to analyze the behavior not only for obvious, but also latent signs. The researcher should identify motor, sensory dominance, determine which hand, leg, ear, eye in the child are leading. The result of the study should be the coefficient of left-handedness, calculated as the ratio of the number of confirmed cases of left-handedness to the total number of organized studies. As a rule, they are made by 11 or more.
Main stage
For the survey, you must first prepare the scheme. The researcher is obliged to follow it in all details, without deviations. Sample results are entered in a specialized official protocol. If the features of the condition of the child do not allow the work to be carried out, it should be noted which tests have not been performed. Assignments are presented following a pre-prepared list. In the attached table, the researcher can see what functions a particular sample is aimed at. The task of the person conducting the examination is to make sure that the object understood and realized the task. If the child did not accept the instruction correctly, it is necessary to repeat it until an understanding can be achieved.
Analyzing the information received, it is possible to identify what difficulties the child is facing. To make data assessment easier, formalized schemes are used that take into account typical and pronounced violations. From the application it can be seen what anatomical, physiological features can explain the result. Each series of tests is aimed at studying a specific brain function, and violations determined by the results of the study will be cumulative. In fact, the results are not information about violations during the test, but about malfunctions.
A thorough assessment is the key to an accurate result.
Interpretation of the results of the examination includes both a statement of symptoms and its qualifications. Based on the information received, we can conclude which defect provoked a symptomatic heterogeneous complex of manifestations related to each other. As a rule, the basic restriction of the “territory” of violations is seen from the kinesthetic praxis, while other tests are aimed at clarifying the condition.
The formulation of the topical diagnosis is made using a special application approved at the federal level, including the encoding of various functional disorders, taking into account the localization of the lesion. The task of the personnel conducting the research is to isolate the detected violations and describe the topical diagnosis. The local syndromes listed in the official appendix are considered the basis for assessing disorders, but this information is general. In a separate case, individual deviations are possible due to specific factors.
To summarize
Using the generally accepted research scheme, the diagnosis can be made quick, accurate and as correct as possible. At the same time, the results of a formalized examination cannot be considered absolute truth. When interpreting them, it is important to take into account the nuances of the health status of a particular object.
Deviations determined by the described methodology help to provide an accurate picture of minimal brain dysfunction. At the same time, the psyche of the child, its physiology and the localization of violations are taken into account, which means that they can choose the optimal correction course applicable for this case.
With a local deep symptomatic complex, a deficiency can be associated with organic brain disorders. This indicates the need for additional research and diagnostic measures. In the course of those, you can find a tumor, a focus of inflammation or tissue degeneration, abnormal organ development.