Advances in Child Neuropsychology PDF
Preview Advances in Child Neuropsychology
Advances in Child Neuropsychology Advances in Child Neuropsychology Edited by Michael G. Tramontana Stephen R. Hooper Editorial Advisory Board Russell Barkley Raymond Dean George Hynd Francis Pirozzolo Byron Rourke Michael Rutter Paul Satz Otfried Spreen Barbara Wilson Michael G. Tramontana Stephen R. Hooper Editors Advances in Child Neuropsychology Volume 3 With 39 Illustrations Springer-Verlag New York Berlin Heidelberg London Paris Tokyo Hong Kong Barcelona Budapest Michael G. Tramontana, Ph.D. Division of Child and Adolescent Psychiatry Vanderbilt University School of Medicine Nashville, TN 37212, USA Stephen R. Hooper, Ph.D. Department of Psychiatry and the Clinical Center for the Study of Development and Learning University of North Carolina School of Medicine Chapel Hill, NC 27514, USA ISSN: 0940-8606 Printed on acid-free paper. © 1995 Springer-Verlag New York, Inc. Softcover reprint of the hardcover 1s t edition 1995 All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer-Verlag New York, Inc., 175 Fifth Avenue, New York, NY 10010, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known on hereafter developed is forbidden. The use of general descriptive names, trade names, trademarks, etc., in this publication, even if the former are not especially identified, is not to be taken as a sign that such names, as understood by the Trade Marks and Merchandise Marks Act, may accordingly be used freely by anyone. Production coordinated by Chernow Editorial Services, Inc., and managed by Francine McNeill; manufacturing supervised by Jacqui Ashri. Typeset by Best-set Typesetter Ltd., Hong Kong. 98765 432 1 ISBN-13:978-1-4612-8687-5 e-ISBN-13:978-1-4612-4178-2 DOl: 10.1007/978-1-4612-4178-2 To Maryanne and our precious gifts Michael, Christopher, and Joseph. M.G.T. To Mary with much love. Thank you for your patience, support, and understanding. S.R.H. Foreword In this, the third volume of Advances in Child Neuropsychology, the editors have once again enlisted a broad range of contributors, each of whom has written a chapter that brings us to the current level of knowl edge in their respective area. The topics range from the relationship between electrophysiological responses in infants and later language development to advances in neuropsychological constructs. Although we still do not know enough about brain-behavior relationships in the normally developing brain, let alone in the atypical brain, a good deal of innovative, exciting, and very meaningful research is herein presented that furthers our understanding of neurodevelopmental issues. The cur rent volume reflects some of the results of an active period of research in child neuropsychology. It serves to further our knowledge of the field in all of its diversity and, perhaps, to provide the spark of interest or sudden "aha!" to the reader that will lead to new insights and productive research endeavors. The first chapter, contributed by Molfese, is perhaps somewhat tech nical in its presentation for the electrophysiologically uninitiated. How ever, its results and discussion sections follow up findings related to some of the data presented in Volume 1. The earlier work, which suggested that electrophysiological responses can be used to predict long-term developmental outcomes, is supported in the present report on the relationship between auditory evoked responses in infancy and later levels of language development. In addition to shedding light on the neurophysiological substrates of early language development, these studies offer promise for the development of valuable tools in the identifi cation of a prevalent developmental disability, developmental language disorders with specifiable cognitive sequela, reading disabilities among them. In Chapter 2, Bellinger, writing from a public health/neurocognitive point of view, presents a cogent review of the recent literature related to lead exposure and neurocognitive function in children. The review sets the stage for a presentation of data resulting from a multisite, prospective vii viii Foreword study, elegant in its careful consideration of a complex web of variables. The results suggest that, although lead load and neurocognitive function may be related, many other variables must be taken into account as one interprets research findings. He also points out that no specifiable pattern of neuropsychological dysfunction serves as a "fingerprint" for lead exposure. As important as the results are, Bellinger reflects on the need for neuropsychologists who followed children exposed to a variety of neurotoxins, of which lead is only one example, to develop a "greater appreciation of concepts and methods that generally do not arise in the neuropsychological study of other medical conditions and events." He includes for consideration such factors as toxicokinetics, lead/socio demographic variables, and the effects of lead exposure on the develop ment of the central nervous system. In all, a thought-provoking chapter. Bigler, in Chapter 3, makes the case for merging quantitative neuro imaging and neuropsychological findings, and presents data that represent the beginnings of such an integration. He also reviews the seminal litera ture on relationships between neuroimaging studies and specific neuro logic, developmental, and psychiatric disorders. Bigler discusses and applauds the movement toward the quantification of neuroanatomic structures, normal and abnormal, while emphasizing the need for con tinued qualitative description of brain structures as elucidated by neuro imaging techniques. The quest, a methodology that will permit the integration of quantitative neuropsychological and neuroimaging data, is pursued, for example, in the specific case material in which both sets of data representing specific patients are given. Although in its infancy, the approach, as discussed by Bigler, appears to be viable and presents exciting prospects. The NEPSY, a test under development by Korkman and colleagues, is the focus of Chapter 4. Korkman presents a brief overview of approaches to assessment, and describes the rationale for the NEPSY as a set of measures for use in the neuropsychological evaluation of children. Much of the chapter is devoted to the description of the domains and subtests included in the NEPSY, indicating its strong points (e.g., the simul taneous standardization of a goodly number of measures on the same group) and its deficiencies (e.g., lack of a theoretical base). Three studies are presented-two already in the literature, one in press-that demon strate predictive validity of some of the subtests, discriminative validity of the NEPSY when applied to two clinical groups, and the use of the NEPSY in a follow-up paradigm. In addition, the clinical application of the instrument is demonstrated in a detailed case study. Korkman takes the position that such an instrument would add a great deal to the assess ment armamentarium for use with young children. It is certainly the case that the present armamentarium could use some beefing up! Forster and Leckliter, in Chapter 5, presented an informed discussion of the construct validity of three widely used assessment instruments, the Foreword ix Halstead-Reitan Neuropsychological Test Battery for Older Children (HRB-OC), the Wide-Range Assessment of Memory and Learning (WRAML), and the Wechsler Intelligence Scale for Children-Third Edition (WISC-III), within the framework of "working memory." To do so, they offer detailed metaanalysis of factor analytic studies involving the three assessment instruments. The authors point out that the model of memory is shifting from one of capacity (short-term memory) to one of process (working memory and executive functions), and that this shift is being reflected in the increasing numbers of papers that have addressed working memory and executive functions in children. They suggest that this shift is being reflected in test development, for example in the WRAML, the most recent of the three, in which working memory is explicitly assessed in a variety of ways. They note that there is increasing appreciation and understanding of the way in which standardized measures assess working memory, leading to more appropriate interpretation of assessment data. Further, Forster and Leckliter have proposed possible relationships between working memory and executive functions, and existing constructs such as "Freedom from Distractibility." They see these theoretical and research challenges leading toward an integrated theore tical framework for child neuropsychology. This is a thoughtful and timely contribution to the volume. The concluding chapter, contributed by Bakker and colleagues, is a capsule capitulation of the way in which neuropsychology proceeds: the formulation of a problem in brain-behavior terms, the development of a theory-driven model from which experiments are generated, and in the case of child neuropsychology, to include within it a developmental focus, the elaboration of the model as data dictate, a search for congruent validation of the model, and where appropriate and feasible, the applica tion of research findings, buttressed by a viable model, to clinical settings. Bakker has taken such a route. An initial set of hypotheses has, over the past dozen or so years, led to theory and model building, an ongoing series of studies that have ramifications for brain-behavior relationships well beyond the reading process and the development of experimental intervention techniques. More specifically, the chapter provides a brief but well-synthesized description of Bakker's Balance Model of the reading process, a descrip tion of his earlier studies, and a focused literature review that will be useful to anyone particularly interested in this area. Bakker takes the reader from an understanding of his electrophysiological and behavioral data to an understanding of the rationale for the treatment procedures he and his colleagues have developed. Bakker is the first to acknowledge that he and his colleagues do not as yet know all they need to know about who should be offered what inter vention method; the clinical applications now in progress are presented as methods of assisting some children, which is attested to in the case studies x Foreword he presents, while continuing to learn about the processes involved in a controlled clinical setting. This is an excellent, eminently readable chapter, providing a paradigm of neuropsychological research. BARBARA C. WILSON Preface Advances in Child Neuropsychology is a multivolume book series designed to serve as a forum for exemplary work and critical information in the rapidly growing field of child neuropsychology. Collectively, the preceding volumes in this series have captured some of the diversity and exciting developments in the field, while also offering fresh insights and raising important questions that could help shape future directions. This volume continues with the format and organization of Volumes 1 and 2. As before, contributions were sought within four general aspects of neuropsychological work and investigation: developmental neuro psychology, abnormal neuropsychology, assessment, and treatment. The goal was to assure a balanced coverage that includes topics dealing with intervention as well as assessment, and normal as well as abnormal developmental processes. Also, as before, each chapter was organized to provide either (1) an authoritative review of a key substantive area or methodological issue in child neuropsychology, or (2) the exposition of an exemplary line of research or applied work in the field. Volume 3 consists of six chapters divided into the four general areas noted above. Part I (developmental psychology) is comprised of a chapter by Dennis L. Moifese, in which further findings are presented relating electrophysiological responses in infancy to later language development. This represents an extension of the longitudinal work initially presented in Volume 1 of this series, based now on data from a larger set of children. In Part II (abnormal psychology), David Bellinger provides a thoughtful discussion of current knowledge concerning the neurotoxic effects of lead in children, focusing especially on the pivotal work that he and his colleagues have performed in The Boston Prospective Study. Part III (assessment) covers a variety of topics dealing with advances in the methods of or tools for evaluating brain-behavior relationships. This includes a chapter by Erin D. Bigler, which offers a "state of the art" presentation on the impressive developments in brain imaging techniques. Advances in neuropsychological assessment are then examined from two standpoints. Marit Korkman offers a novel approach, the NEPSY. The xi
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