Concepts and Categories a Cognitive Neuropsychological Perspective
A Cognitive Neuropsychological Approach to Assessment of Patients with Brain Damage
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132 ~~ Prasad, S A (1993). 'Current concepts in physiotherapy', Journal of the Royal Society of Medicine, 86, Suppl 20, 23-29. Royal College of Physicians of London and Cystic Fibrosis Trust (1 996). 'Clinical Guidelines for Cystic Fibrosis Care', Royal College of Physicians of London. Schidlow, D (1993). Present and Future of Pulmonary Therapy for Cystic Fibrosis in Clinical Ecology of Cystic Fibrosis, Elsevier Science Publishers BV, Netherlands, pages 173-1 79. Schoni, M H (1989).'Autogenic drainage: A modern approach to physiotherapy in cystic fibrosis', Journal of the Royal Society of Medicine, 82, Suppl 16, 32-37. Webb, A K (1995). 'Communicating with young adults with cystic fibrosis', Postgraduate Medical Journal, 71, 385-389. Webb, A K Dodd, M E and Moorcroft, J (1995). 'Exercise and cystic fibrosis', Journal of the Royal Society of Medicine, 88, SUPPI25,30-36. Bibliography Gumery, L (1993). 'Standards of Care, CF Physiotherapy Service', Birmingham Heartlands Hospital. International Physiotherapy Group In Cystic Fibrosis (1 995). Physiotherapy in the Treatment of Cystic Fibrosis, IPGCF, 2nd edn. Jensen, T, Pederson, S S, Garne, S, Heilmann, C, Hoiby, N and Koch, C (1987). 'Colistin inhalation therapy in cystic fibrosis patients with chronic pseudomonas aeruginosa lung infection', Journal of Antimicrobial Chemotherapy, 19, 831-838. McCracken, M J (1984). 'Cystic fibrosis in adolescence' in: Bulm, R (ed) Chronic lllness and Disabilities in Childhood and Adolescence', Grune and Stratton, New York. Abstract of Higher Degree Thesis A full list of Fellowship and higher degree dissertations and theses is available from Samantha Molloy in the Information Unit of the CSP Education Department. Those housed at the CSP may be viewed by appointment or borrowed by post - please contact the Information Unit for further details. For access to dissertations or theses housed elsewhere please contact the institution concerned. (They are not normally available for loan.) A Cognitive Neuropsychological Approach to Assessment of Patients with Brain Damage Andrew Bateman PhD MCSP This thesis is concerned with clinical assessment of the effects of brain damage. Cognitive neuropsychological models can be used to guide assessments with patients because different tests within a test battery can be devised to assess different levels within a particular model of normal cognitive functioning. The fine grained impairments that can result following brain damage may be missed if inappropriate assessment tools are My first research study developed a reasonably brief but wide-ranging screening test to detect discrete cogni- tive impairments. In chapter 1, I review the strengths and weaknesses of current screening tests. The screening test I developed is presented in chapter 2, together with the rationale for the inclusion of partic- ular subtests, and data from the assessment of 72 stroke patients and 20 controls. Many of the current neuropsychological test batteries include drawing tests which are believed to require intact conceptual, visual and action processing ability. One part of the screening test is the commonly used clock drawing test. In chapter 3, I report different types of performance deficits demonstrated by patients with left or right hemisphere damage when drawing a clock and copying a complex figure. The results led me to conclude that clock drawing may draw more on concep- tual components of action production than spatial used. components. The reverse may be true of pattern copying. Distinguishing between conceptual and spatial aspects of action impairment appears to be a useful initial approach to the assessment of dyspraxia. Relative to the domains of language and visual percep- tion, the mechanisms underlying the control of movement have received less attention in cognitive neuropsychological research. Movement control is discussed in more detail in chapter 4 and a model of praxis is proposed. Working from this model, and assessment studies of dyspraxic patients, consequent indications for the development of a clinical assessment of dyspraxia are presented in chapter 5. I propose that the clinical assessment of neuropsycho- logical impairments (where such an assessment is based on a cognitive neuropsychological model) is important, in that it may allow treatment to be specif- ically directed towards impaired processing components. Address for Correspondence Andrew Bateman, Department of Health Sciences, University of East London, Romford Road, London El5 4LZ This research was conducted while the author was employed by The School of Psychology, University of Birmingham, and was supervised by Dr M J Riddoch. Physiotherapy, March 1998, vol 84, no 3
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Transcript of A Cognitive Neuropsychological Approach to Assessment of Patients with Brain Damage
132 ~~
Prasad, S A (1993). 'Current concepts in physiotherapy', Journal of the Royal Society of Medicine, 86, Suppl 20, 23-29. Royal College of Physicians of London and Cystic Fibrosis Trust (1 996). 'Clinical Guidelines for Cystic Fibrosis Care', Royal College of Physicians of London. Schidlow, D (1993). Present and Future of Pulmonary Therapy for Cystic Fibrosis in Clinical Ecology of Cystic Fibrosis, Elsevier Science Publishers BV, Netherlands, pages 173-1 79. Schoni, M H (1989). 'Autogenic drainage: A modern approach to physiotherapy in cystic fibrosis', Journal of the Royal Society of Medicine, 82, Suppl 16, 32-37. Webb, A K (1995). 'Communicating with young adults with cystic fibrosis', Postgraduate Medical Journal, 71, 385-389. Webb, A K Dodd, M E and Moorcroft, J (1995). 'Exercise and cystic fibrosis', Journal of the Royal Society of Medicine, 88, SUPPI 25,30-36.
Bibliography Gumery, L (1993). 'Standards of Care, CF Physiotherapy Service', Birmingham Heartlands Hospital. International Physiotherapy Group In Cystic Fibrosis (1 995). Physiotherapy in the Treatment of Cystic Fibrosis, IPGCF, 2nd edn. Jensen, T, Pederson, S S, Garne, S, Heilmann, C, Hoiby, N and Koch, C (1987). 'Colistin inhalation therapy in cystic fibrosis patients with chronic pseudomonas aeruginosa lung infection', Journal of Antimicrobial Chemotherapy, 19, 831-838. McCracken, M J (1984). 'Cystic fibrosis in adolescence' in: Bulm, R (ed) Chronic lllness and Disabilities in Childhood and Adolescence', Grune and Stratton, New York.
Abstract of Higher Degree Thesis A full list of Fellowship and higher degree dissertations and theses is available from Samantha Molloy in the Information Unit of the CSP Education Department. Those housed at the CSP may be viewed by appointment or borrowed by post - please contact the Information Unit for further details. For access to dissertations or theses housed elsewhere please contact the institution concerned. (They are not normally available for loan.)
A Cognitive Neuropsychological Approach to Assessment of Patients with Brain Damage
Andrew Bateman PhD MCSP
This thesis is concerned with clinical assessment of the effects of brain damage. Cognitive neuropsychological models can be used to guide assessments with patients because different tests within a test battery can be devised to assess different levels within a particular model of normal cognitive functioning. The fine grained impairments that can result following brain damage may be missed if inappropriate assessment tools are
My first research study developed a reasonably brief but wide-ranging screening test to detect discrete cogni- tive impairments. In chapter 1, I review the strengths a n d weaknesses of cur ren t screening tes ts . The screening test I developed is presented in chapter 2, together with the rationale for the inclusion of partic- ular subtests, and data from the assessment of 72 stroke patients and 20 controls.
Many of the current neuropsychological test batteries include drawing tests which are believed to require intact conceptual, visual and action processing ability. One part of the screening test is the commonly used clock drawing test. In chapter 3, I report different types of performance deficits demonstrated by patients with left or right hemisphere damage when drawing a clock and copying a complex figure. The results led me to conclude that clock drawing may draw more on concep- tua l components of action production than spatial
used.
components. The reverse may be t rue of pat tern copying. Distinguishing between conceptual and spatial aspects of action impairment appears to be a useful initial approach to the assessment of dyspraxia.
Relative to the domains of language and visual percep- t ion, t h e mechanisms underlying t h e control of movement have received less attention in cognitive neuropsychological research. Movement control is discussed in more detail in chapter 4 and a model of praxis is proposed. Working from this model, and assessment studies of dyspraxic patients, consequent indications for the development of a clinical assessment of dyspraxia are presented in chapter 5 .
I propose that the clinical assessment of neuropsycho- logical impairments (where such an assessment is based on a cognitive neuropsychological model) is important, in that it may allow treatment to be specif- ically directed towards impaired processing components.
Address for Correspondence Andrew Bateman, Department of Health Sciences, University of East London, Romford Road, London E l 5 4LZ
This research was conducted while the author was employed by The School of Psychology, University of Birmingham, and was supervised by Dr M J Riddoch.
Physiotherapy, March 1998, vol 84, no 3
