Implications of Neuropsychological Functioning on Treatment

Transcription

1 Implications of Neuropsychological Functioning on Treatment Paul Connor, Ph.D. University of Washington Private Practice Des Moines, WA USA Let s Talk Adults with FASD Preconference April 18, 2018

2 Neuropsychological Assessment when Diagnosing FASD Focus is on: Establishing the individual s current pattern of cognitive impairments Establishing a historical pattern of similar cognitive functioning These patterns of deficit are critical in rendering a diagnosis of an FASD

3 Standard Deviations (mean = 0, sd = 1) Visual/Spatial Attention Processing Speed High Structure Suggestibility Academic Motor Focus on the Impairments IQ Memory Adaptive Function Low Structure Ability Report

4 Standard Deviations (mean = 0, sd = 1) Visual/Spatial Attention Processing Speed High Structure Suggestibility Academic Motor Focus on the Impairments IQ Memory Adaptive Function Low Structure Ability Report

5 Standard Deviations (mean = 0, sd = 1) Visual/Spatial Attention Processing Speed High Structure Suggestibility Academic Motor Focus on the Strengths IQ Memory Adaptive Function Low Structure Ability Report

6 Use of Neuropsychological assessment to Guide Treatment The individual s pattern of neuropsychological functioning can also give ideas on how best to work with them therapeutically

7 Standard Deviations (mean = 0, sd = 1) Academic Visual/Spatial Attention Processing Speed Suggestibility Better Language-Based Learning and Memory IQ Memory Motor Adaptive Function High Structure Low Structure Ability Report

8 Learning and Memory Differential learning/memory strengths If verbal provide language based instruction If visual, use pictographic cues and write down information For both, role play and practice

9 Standard Deviations (mean = 0, sd = 1) Better on High Structure Tasks High Structure Low Structure Adaptive Function

10 Does Better on High Structure ing When tasks are well structured and concrete, they can able to do better

11 VCI PRI WMI PSI FS IQ WRAT-Reading WRAT-Comprehension WRAT-Reading Composite WRAT-Spelling WRAT-Calculation CVLT Learn CVLT Short Delay CVLT Long Delay GSS-Immediate Recall (Administered by NNB) GSS-Delayed Recall (Administered by NNB) RCFT-Immediate Delay RCFT-Long Delay RCFT-Copy CPT-Omissions CPT-Commissions CPT-Reaction Time CPT-Standard Deviation Stroop-Word Stroop-Color Trails A Tower 1st time Tower time/move GPB-R GPB-L FT-R FT-L COWAT Stroop-Color/Word Stroop-Interference Trails B ACT-9 ACT-18 ACT-36 Tower Total Tower Accuracy Tower Rule Violations WCST_Perseverative Response WCST-Non Persev. Errors WCST-Conceptual WCST-Category complete WCST-Trials to 1st Proverbs Total Proverbs common Proverbs Uncomm Proverbs Accuracy Proverbs Abstract GSS-Yield 1 (Administered by NNB) GSS-Yiled 2 (Administered by NNB) GSS-Shift (Administered by NNB) GSS-Total Suggest (Administered by NNB) NAB Auditory Reception ACS-Social Perception ACS-Affect Naming ACS-Prosody ACS-Social Perception Pairs Texas Functional Living Scale VABS-Daily Living Skills (sister) Standard Deviations (mean = 0, sd = 1) Verbal Visual/Spatial Attention Processing Speed Motor Suggestibility Slow Processing Speed: Allow Extra Time 3 IQ Academic Memory Adaptive Function High Structure Low Structure Ability Report Current Testing -3 Average Deficit -4

12 VCI PRI WMI PSI FS IQ WRAT-Reading WRAT-Spelling WRAT-Calculation CVLT Learn CVLT Short Delay CVLT Long Delay GSS-Immediate Recall GSS-Delay Recall RCFT-Copy CPT-Omissions CPT-Commissions CPT-Reaction Time CPT-Standard Deviation Stroop-Word Stroop-Color Trails A GPB-R GPB-L COWAT Stroop-Color/Word Stroop-Interference Trails B Tower Total Tower 1st time Tower time/move Tower Accuracy Tower Rule Violations ACT-9 ACT-18 ACT-36 WCST_Perseverative Response WCST-Non Persev. Errors WCST-Conceptual WCST-Category complete WCST-Trials to 1st Proverbs Total Proverbs common Proverbs Uncomm Proverbs Abstract GSS-Yield 1 GSS-Yiled 2 GSS-Shift GSS-Total Suggest NAB Auditory Reception ACS-Social Perception ACS-Affect Naming ACS-Prosody ACS-Social Perception Pairs VABS-Communication (Father) VABS-Daily Living Skills (Father) VABS-Socialization (Father) VABS_Composite (Father) Standard Deviations (mean = 0, sd = 1) Academic Visual/Spatial Attention Processing Speed Motor Suggestibility Difficulty Understanding Emotions 2 IQ Memory Adaptive Function 1 High Structure Low Structure Ability Report Current Testing Average Deficit -5-6

13 Standard Deviations (mean = 0, sd = 1) Academic Visual/Spatial Attention Potentially Benefit from Medications for Attention/Impulsivity IQ Memory Motor Adaptive Function Ability Informant

14 In Conclusion The neuropsychological evaluation provides more than just diagnostic information It can focus on both strengths AND weaknesses It can be used to help tailor treatment strategies To maximize strengths To minimize the impacts of weaknesses

15 Paul Connor nd Ave S Des Moines, WA paul@connornp.com (p) (f)