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Neuropsychological functioning of pediatric patients with long COVID. 长程COVID儿科患者的神经心理功能。
Pub Date : 2024-04-25 DOI: 10.1080/13854046.2024.2344455
J. Luedke, Gray Vargas, D. Jashar, Laura A Malone, Amanda K Morrow, Rowena Ng
Objective: To determine the neurocognitive profile for youth with long COVID presenting with cognitive concerns. Method: This study is a case series of 54 pediatric patients (65% female, Mage = 13.48, SDage = 3.10, 5-19) with long COVID who were referred for neuropsychological testing from a post-COVID-19 multidisciplinary clinic. The outcomes of interest were neuropsychological test scores and parent ratings of mood, attention, and executive functioning. The percentage of patients with neuropsychological test scores below the 9th percentile (below average range) and those with at-risk or clinically significant scores (T-scores > 59) on parent-informant inventories were computed. Results: A portion of children with long COVID showed weaknesses in sustained attention (29%) and divided attention (35%). This portion of patients did not significantly differ when comparing patients with and without pre-existing attention and mood concerns. A high percentage of parents reported at-risk to clinically significant concerns for cognitive regulation (53%), depression (95%), anxiety (85%), and inattention (66%) on standardized questionnaires. Conclusions: The present case series showed that approximately a third of children with long COVID demonstrate objective weaknesses on sustained and divided attention tasks but were largely intact in other domains of neuropsychological functioning. Importantly, children with long COVID had similar difficulties in attention, regardless of pre-existing attention or mood concerns. Parents reported high rates of mood, anxiety, and executive functioning difficulties which likely impact daily functioning. Attention and emotional regulation should be closely monitored and treated as necessary in pediatric patients with long COVID to aid functional recovery.
目的确定出现认知问题的长期 COVID 青少年的神经认知概况。研究方法:本研究是一项病例系列研究,涉及 54 名患有长 COVID 的儿科患者(65% 为女性,平均年龄 = 13.48 岁,平均年龄 = 3.10 岁,5-19 岁),他们都是从 COVID-19 后多学科诊所转诊来进行神经心理学测试的。研究结果包括神经心理测试得分以及家长对情绪、注意力和执行功能的评分。我们计算了神经心理学测试得分低于第 9 百分位数(低于平均范围)的患者比例,以及在家长告发清单中得分处于风险或具有临床意义(T 值大于 59)的患者比例。结果显示部分患有长COVID的儿童在持续注意力(29%)和分散注意力(35%)方面存在缺陷。这部分患儿在与原有注意力和情绪问题的患儿比较时没有明显差异。很高比例的家长在标准化问卷调查中表示,他们对认知调节(53%)、抑郁(95%)、焦虑(85%)和注意力不集中(66%)等问题有临床意义。结论本病例系列显示,约有三分之一的长期 COVID 患儿在持续注意和分散注意任务中表现出客观弱点,但在神经心理功能的其他领域却基本正常。重要的是,无论之前是否存在注意力或情绪问题,患有长时注意力缺陷症的儿童在注意力方面都存在类似的困难。据家长报告,情绪、焦虑和执行功能障碍的发生率很高,这很可能会影响日常功能。对于患有长期COVID的儿童患者,应密切监测其注意力和情绪调节能力,并在必要时对其进行治疗,以帮助其恢复功能。
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引用次数: 0
Gender and Autism Program: A novel clinical service model for gender-diverse/transgender autistic youth and young adults. 性别与自闭症计划:针对不同性别/变性自闭症青少年和年轻人的新型临床服务模式。
Pub Date : 2024-04-25 DOI: 10.1080/13854046.2024.2318155
John F Strang, Abigail L Fischbach, Sharanya Rao, Ann Clawson, Megan Knauss, Sarah N Bernstein, A. V. D. van der Miesen, Anne P Inge, Kenia Alonzo, Julia Zeroth, Lauren Kenworthy, Colleen I Morgan, Abigail Brandt, Christina C Moore, Kaitlyn Ahlers, Mary K Jankowski, Lucy S McClellan, Shane B. Henise, Caitlyn J Cap, Shannon L Exley, Amy Youmatz, Minneh Song, Jennifer L McLaren, B. Parchem
Objective: Situated in Children's National Hospital (CNH)'s Neuropsychology Division, the Gender and Autism Program (GAP) is the first clinical service dedicated to the needs of autistic gender-diverse/transgender youth. This study describes GAP clinical assessment profiles and presents a multi-perspective programmatic review of GAP evaluation services. Method: Seventy-five consecutive gender- and neuropsychologically-informed GAP evaluations were analyzed, including demographics, gender and autism characterization, and primary domains evaluated. Three program-based Delphi studies were conducted and identify: clinician priorities and challenges in providing care, program administrator lessons learned and ongoing barriers, and considerations adapting this model for a rural academic medical center. Results: Nearly two-thirds of referrals were transfeminine. Most youth had existing autism diagnoses; of those undiagnosed, three-quarters were found to be autistic. Five goals of evaluations were identified: Mental health was always assessed, and most evaluations also assessed gender-related needs in the context of autism neurodiversity. Neuropsychological characterization of strengths and challenges informed personalized accommodations to support youth gender-related self-advocacy. Clinicians emphasized frequent youth safety concerns. Administrators emphasized the need for specialized training for working with families. Components for adaptation of the GAP in a rural academic medical center were identified. Conclusions: Since its founding, the GAP has proven a sustainable neuropsychology-based service with consistent referral flow and insurance authorizations. Capturing staff perspectives through rigorous Delphi methods, and addressing the GAP's feasibility and replicability, this study provides a road map for replicating this service. We also highlight GAP training of specialist clinicians, fundamental to addressing the desperate shortage of providers in this field.
目标:性别与自闭症项目(GAP)位于国立儿童医院(CNH)的神经心理学部,是首个专门针对自闭症性别多元化/变性青少年需求的临床服务机构。本研究描述了 GAP 的临床评估概况,并对 GAP 评估服务进行了多视角的项目回顾。方法:对 75 项连续的性别和神经心理学 GAP 评估进行了分析,包括人口统计学、性别和自闭症特征以及主要评估领域。进行了三项基于项目的德尔菲研究,并确定了:临床医生在提供护理时的优先事项和挑战、项目管理人员的经验教训和持续存在的障碍,以及将此模式应用于农村学术医疗中心的注意事项。研究结果近三分之二的转诊患者为女性。大多数青少年已有自闭症诊断;在未确诊的青少年中,四分之三被发现患有自闭症。确定了五项评估目标:心理健康始终是评估的重点,大多数评估还结合自闭症神经多样性评估与性别相关的需求。对优势和挑战的神经心理学描述为支持青少年与性别相关的自我主张提供了个性化的便利。临床医生强调了经常出现的青少年安全问题。管理者强调了与家庭合作的专业培训需求。此外,还确定了在农村学术医疗中心调整 GAP 的要素。结论:自成立以来,GAP 已证明是一项以神经心理学为基础的可持续服务,具有稳定的转诊流程和保险授权。本研究通过严格的德尔菲方法收集了员工的观点,并探讨了 GAP 的可行性和可复制性,为复制这项服务提供了路线图。我们还强调了对专科临床医生的 GAP 培训,这是解决该领域医疗服务提供者严重短缺问题的基础。
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引用次数: 0
A roadmap for psychometrist training: Moving from condemnation and confusion to cooperation and collaborationA Neuropsychologist’s Guide to Training Psychometrists: Promoting Competence in Psychological Testing. edited by Ghilain, C. S. New York: Routledge. (2021), ­160 pages. ISBN: 036756498X. $140.00 (hbk) 心理测量师培训的路线图:从谴责和困惑到合作和协作——神经心理学家培训心理测量师指南:提高心理测试的能力。吉兰编辑,C. S.纽约:劳特利奇出版社。(2021), -160页。ISBN: 036756498 x。140.00美元(hbk)
Pub Date : 2023-10-18 DOI: 10.1080/13854046.2023.2271610
Nicholas A. Vissicchio, Joseph F. Kulas
Click to increase image sizeClick to decrease image size Additional informationFundingThe author(s) reported there is no funding associated with the work featured in this article.
点击增大图片尺寸点击缩小图片尺寸附加信息资金来源作者报告没有与本文所述工作相关的资金来源。
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引用次数: 0
Introductory editorial to the special issue: Assessment and diagnosis of autism spectrum disorder (ASD) and related clinical decision making in neuropsychological practice 特刊导论社论:评估和诊断自闭症谱系障碍(ASD)和相关的临床决策在神经心理学实践
Pub Date : 2022-06-09 DOI: 10.1080/13854046.2022.2085629
Kira Armstrong, Susanne W. Duvall
Autism spectrum disorder (ASD) is a complex developmental disability characterized by challenges with social communication, restricted interests, and repetitive behaviors. Recent CDC estimates of US prevalence for ASD suggests that 23 out of 1,000 8-yearold children (i.e. one in 44) meet criterion for ASD, an increase from prior estimates (Maenner, et al., 2021). While some have raised concerns regarding the methodology of this research (e.g. due to varying metrics for identifying ASD cases, high cross-site variation, regional differences, and systemic disparities in educational supports and health care) (Mandell & Lecavalier, 2014; Yuan et al., 2021), it is stil clear that ASD is a fairly common disorder with clinically significant challenges persisting into adulthood. Given the high prevalence, ASD characteristics should be considered in neuropsychological differential diagnostic conceptualization across settings and patient populations. This special issue brings together original research, literature reviews, and clinical guidance to enhance neuropsychological practice in the assessment of ASD while emphasizing holistic diagnostic considerations and person-centered care. We begin with a survey of neuropsychologists’ first-person reflections on ASD assessment practices, the training they received, and where they believe the field should progress. This article sets the stage for the subsequent three sections, which focus on: (1) assessment tools and evaluative approaches; (2) case conceptualization in the context of complex comorbidities; and (3) higher level clinical recommendations and person-centered approaches to recognizing and diagnosing ASD. Section 1, comprised of 5 articles, focuses on assessment measures and approaches. Pulsipher and Lieb (2022) paper opens the discussion through their evaluation of an ASD symptom intake screening measure. Despite aligning this measure with DSM-5 criteria (which most screening measures have yet to do), this approach did not improve diagnostic predictions. As such, their findings continue to support the need for behavioral assessment by trained clinicians. On the other hand, McKernan and Kim’s (2022) paper demonstrates that screeners relating to semantic, syntactic, and pragmatic communication skills at kindergarten entry do predict academic, social, and adaptive skills at kindergarten exit, emphaszing the importance of early social pragmatic/ semantic skills intervention, even in children who historically may not receive them due to their many intact skills. Hudock and Esler (2022) provide a concise summary
自闭症谱系障碍(ASD)是一种复杂的发育障碍,其特征是社交障碍、兴趣限制和重复性行为。美国疾病控制与预防中心最近对美国ASD患病率的估计表明,每1000名8岁儿童中有23名(即每44名儿童中有1名)符合ASD标准,比先前的估计有所增加(Maenner等,2021年)。虽然有些人对这项研究的方法提出了担忧(例如,由于识别ASD病例的不同指标,高跨站点差异,区域差异以及教育支持和医疗保健方面的系统差异)(Mandell & Lecavalier, 2014;Yuan et al., 2021),但仍然清楚的是,ASD是一种相当常见的疾病,其临床挑战持续到成年期。鉴于ASD的高患病率,在不同环境和患者群体的神经心理学鉴别诊断概念中应考虑ASD的特征。这期特刊汇集了原始研究、文献综述和临床指导,以加强ASD评估中的神经心理学实践,同时强调整体诊断考虑和以人为本的护理。我们首先调查了神经心理学家对自闭症谱系障碍评估实践的第一人称反思,他们接受的培训,以及他们认为该领域应该在哪些方面取得进展。本文为接下来的三个部分奠定了基础,重点是:(1)评估工具和评估方法;(2)复杂合并症背景下的病例概念化;(3)更高水平的临床建议和以人为本的方法来识别和诊断ASD。第一部分包括5篇文章,重点介绍了评估措施和方法。Pulsipher和Lieb(2022)的论文通过对ASD症状摄入筛查措施的评估展开了讨论。尽管这种方法与DSM-5标准一致(大多数筛查方法尚未做到这一点),但这种方法并没有提高诊断预测。因此,他们的发现继续支持由训练有素的临床医生进行行为评估的必要性。另一方面,McKernan和Kim(2022)的论文表明,与幼儿园入学时的语义、句法和语用沟通技巧相关的筛选确实预测了幼儿园毕业时的学业、社会和适应技能,强调了早期社会语用/语义技能干预的重要性,即使是在那些由于许多完整的技能而在历史上可能没有得到干预的儿童中也是如此。Hudock和Esler(2022)提供了一个简明的总结
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引用次数: 1
Affirmative neuropsychological practice with transgender and gender diverse individuals and communities. 积极的神经心理学实践跨性别和性别多样化的个人和社区。
Pub Date : 2022-06-01 DOI: 10.1080/13854046.2022.2073915
Erica Anderson, J. Eleazer, Zoë E. Kristensen, C. S. St Amand, A. M. Baker, A. Correro, M. Cottingham, K. Hinrichs, B. Parmenter, Julija Stelmokas, Emily H. Trittschuh
Objective: To provide guidance and resources on how to practice culturally safe and humble neuropsychology with transgender and gender diverse (TGD) individuals and communities. Methods: We gathered a multidisciplinary team of clinicians with relevant professional and/or lived experience to review pertinent literature, discuss important concepts, and identify key resources. From this process, we outline practical steps to advance gender affirmative neuropsychological practice. Results: Professional awareness and knowledge regarding how to gather context-relevant, gender identity information is critical. TGD individuals form a heterogenous group; a one-size-fits-all approach is not adequate. It is incumbent upon neuropsychologists to engage in clinical and research practices in a manner that does not perpetuate gender minority stress and trauma. Creating an open, safe environment of care requires intentionality and careful thinking to determine what information is relevant for a particular referral question. We provide recommendations and resources for neuropsychologists. Conclusion: When neuropsychologists are proactive, responsible, and intentional, they can better provide individualized, person-centered, and trauma-informed care to TGD individuals.
目的:为跨性别和性别多样性(TGD)个体和社区提供文化安全、谦逊的神经心理学实践指导和资源。方法:我们召集了一个由具有相关专业和/或生活经验的临床医生组成的多学科团队,回顾相关文献,讨论重要概念,并确定关键资源。从这个过程中,我们概述了推进性别肯定神经心理学实践的实际步骤。结果:关于如何收集与情境相关的性别认同信息的专业意识和知识至关重要。TGD个体形成异质群体;一刀切的方法是不够的。神经心理学家有责任从事临床和研究实践,以一种不会使性别少数群体的压力和创伤永久化的方式。创造一个开放、安全的护理环境需要有意识和仔细思考,以确定哪些信息与特定转诊问题相关。我们为神经心理学家提供建议和资源。结论:当神经心理学家积极主动、负责任、有意识时,他们可以更好地为TGD患者提供个性化、以人为本、创伤知情的护理。
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引用次数: 1
Winners of the seventh annual TCN/AACN student project competition 第七届年度TCN/AACN学生项目竞赛获奖者
Pub Date : 2022-04-19 DOI: 10.1080/13854046.2022.2059399
Y. Suchy, D. Beebe, Leslie Guidotti-Breting, A. Hahn-Ketter
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引用次数: 0
Editorial from the TCN department of culture and gender in neuropsychology: Moving the field toward broader representation in neuropsychological studies 来自TCN神经心理学文化和性别系的社论:在神经心理学研究中向更广泛的代表性领域移动
Pub Date : 2022-04-18 DOI: 10.1080/13854046.2022.2056924
R. Hilsabeck, M. Marquine
The Culture and Gender in Neuropsychology (CGN) Department at The Clinical Neuropsychologist (TCN) continued its efforts to advance the science and practice of diversity and inclusion in 2021 through provision of a special issue (detailed below) and virtual workshop at the annual meeting of the American Academy of Clinical Neuropsychology (Rivera Mindt et al., 2021). In this end-of-year editorial, we summarize 2021 publications in TCN that addressed various forms of diversity (cultural, linguistic, and gender).
临床神经心理学家(TCN)的神经心理学文化与性别(CGN)部门通过在美国临床神经心理学学会(Rivera Mindt et al., 2021)年会上提供特刊(详情如下)和虚拟研讨会,继续努力推进多样性和包容性的科学和实践。在这篇年终社论中,我们总结了TCN上涉及各种形式的多样性(文化、语言和性别)的2021年出版物。
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引用次数: 0
20th Annual AACN Conference and Workshops of the American Academy of Clinical Neuropsychology (AACN), June 22-25, 2022 美国临床神经心理学学会(AACN)第20届年会暨研讨会,2022年6月22-25日
Pub Date : 2022-03-28 DOI: 10.1080/13854046.2022.2054361
T. Vannorsdall
and H. Stricker, Ph.D., ABPP Biomarkers have changed the landscape of alzheimer’s disease (aD) research and now have direct relevance for who may be eligible for current and forthcoming aD therapeutics. This workshop will review alzheimer’s disease (aD) biomarkers, with a focus on traditional imaging and CsF biomarkers and the projected impact of plasma biomarkers on clinical trials and practice. Mri classification of amyloid-related imaging abnormalities (aria) will also be reviewed. The status of disease-modifying therapies for aD will be discussed, including drugs that were approved and those that may be on the verge of being approved. aD biomarkers and emerging aD therapeutics will also impact neuropsychology. We will highlight considerations for normative data, the use of composite scores in the clinic, how we think about the diagnostic accuracy of neuropsychological measures, and how digital cognitive measures are needed to help with increased demand for and equitable access to cognitive screening and monitoring. ABSTRACT This workshop will focus on typical and atypical neurodevelopment in infants and young children, first examined through the results and challenges faced by developmental neuroimaging researchers, and then by an exploration of the myriad socio-contextual factors that impact developmental and pediatric assessment in the united states and globally. our understanding of what is known about early cortical organization and hemispheric specialization will be discussed. The speakers will then focus on current practice and challenges in assessing typical and atypical development in the united states and in low and lower middle-income countries (lMiCs). The workshop will address the impact of socio-demographic and socio-cultural factors in pediatric assessment. We will discuss the need for population-based assessment methods in global health, and common neurodevelopmental insults and their impact on young children living in poverty. preliminary findings from: (1) a longitudinal, multisite study of a new early childhood development measure, pediaTrac; (2) a large cohort of infants and young children who have sustained inflicted traumatic brain injuries; and (3) assessment of neurodevelopment in a large cohort of infants and young children in rural guatemala will be discussed. evaluate examinees with claims of posttraumatic disorder (pTsD) and traumatic brain injury (TBi) arising from a single precipitating (e.g. motor vehicle accident, participation in combat). in the current workshop, clinical neuropsychologist and clinical integrated overview of the various complexities that accompany these “combined” claims. The presenters will provide a review of contemporary diagnostic criteria for pTsD and TBi and highlight certain parallels and differences that exist with regard to the abnormalities in serum studies can be associated with changes in mental status and cognition. some relationships have been clearly demonstrated, such as some el
ABPP生物标志物改变了阿尔茨海默病(aD)研究的前景,现在与谁可能有资格接受当前和即将到来的aD治疗有直接关系。本次研讨会将回顾阿尔茨海默病(aD)的生物标志物,重点是传统的成像和CsF生物标志物以及血浆生物标志物对临床试验和实践的预期影响。淀粉样蛋白相关成像异常(aria)的Mri分类也将被回顾。我们将讨论aD疾病修饰疗法的现状,包括已经批准的药物和可能即将批准的药物。阿尔茨海默病生物标志物和新兴的阿尔茨海默病治疗方法也将影响神经心理学。我们将强调对规范数据的考虑,在临床中使用综合评分,我们如何看待神经心理学测量的诊断准确性,以及如何需要数字认知测量来帮助增加对认知筛查和监测的需求和公平获取。本次研讨会将重点关注婴幼儿的典型和非典型神经发育,首先通过发育神经影像学研究人员面临的结果和挑战进行检查,然后探索影响美国和全球发育和儿科评估的无数社会背景因素。我们对早期皮层组织和半球特化的理解将被讨论。然后,演讲者将重点讨论评估美国以及低收入和中低收入国家(lMiCs)典型和非典型发展的当前实践和挑战。讲习班将讨论社会人口和社会文化因素对儿科评估的影响。我们将讨论在全球健康中采用基于人口的评估方法的必要性,以及常见的神经发育损伤及其对生活在贫困中的幼儿的影响。初步发现:(1)一项新的儿童早期发展指标——儿科的纵向、多地点研究;(二)大量遭受创伤性脑损伤的婴幼儿;(3)对危地马拉农村一大批婴幼儿的神经发育进行评估。对声称因单一突发事件(如机动车事故、参加战斗)而导致创伤后精神障碍(pTsD)和创伤性脑损伤(TBi)的考生进行评估。在目前的研讨会上,临床神经心理学家和临床综合概述了伴随这些“联合”主张的各种复杂性。主讲人将对创伤后应激障碍和创伤性脑损伤的当代诊断标准进行回顾,并强调在血清研究中存在的与精神状态和认知变化相关的异常的相似之处和差异。一些关系已被清楚地证明,如一些电解质异常和谵妄的发展。其他血清研究提供了非脑器官功能障碍的标记物,这些标记物可能增加认知功能改变的风险,尽管这一发现与认知功能之间的关系尚不清楚。虽然神经心理学家不是医生,但对我们来说,在概念化病例并提供诊断和建议时,了解这些情况是很重要的。本讲座将讨论与认知变化相关的常见实验室值,以及对神经心理学家有帮助的信息。重点是电解质、非电解质、维生素和与肝肾功能相关的实验室值。是通过持续的神经发育,包括网络连接的完善。这些改进包括调节执行功能的神经回路,在青春期稳步改善,以及调节奖励敏感性的神经回路,在青春期中后期达到顶峰。奖励敏感度的峰值给开发执行系统带来了挑战,因为当动机非常突出时,控制很难实现。此外,环境经验,如果足够强烈,可以改变成熟的轨迹。一种这样的经历是药物使用。在主动物质使用障碍的情况下,执行控制和动机过程受到损害。神经回路也受到影响。但是,究竟是亚临床水平的使用,还是从小就开始使用,导致了这种偏差的持续出现,还存在争议。本次演讲将回顾这些动态的最新发现,包括从大规模纵向研究中收集到的结果,如美国国立卫生研究院资助的青少年大脑认知发展(aBCD)研究。概述(aBpp)和美国临床神经心理学委员会(aBCn)认证维护(MoC)过程。
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引用次数: 0
Mild cognitive impairment from a nearly international perspective 从几乎国际的角度来看轻度认知障碍
Pub Date : 2022-01-11 DOI: 10.1080/13854046.2021.2022213
Anthony Rinaldi
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引用次数: 0
A Cultural Humility Exercise: Raising Awareness About the Implications of Neuropsychological Practice with Asians and Asian Americans 文化谦逊练习:提高对亚洲人和亚裔美国人的神经心理学实践含义的认识
Pub Date : 2020-09-01 DOI: 10.1080/13854046.2020.1813334
Torrii Yamada
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引用次数: 0
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The Clinical neuropsychologist
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