Clinical Neuropsychology
Glenn Smith PhD ABPP(CN)
2013
What is Clinical Neuropsychology?
Neuropsychology: The study of the relationship
between brain function and behavior.
Clinical Neuropsychology: The use of specialized
techniques used to assess and treat behavioral
abnormalities associated with brain dysfunction.
Clinical neurosychologists work with adults
and children with many types brain
conditions:
• Brain tumors
• Dementias like Alzheimer’s disease
• Developmental disorders like autism
• Epilepsy
• Movement disorders like Parkinson’s disease
• Multiple sclerosis
• Stroke
• Traumatic brain injury
A large
tumor in the
covering of
the brain is
pressing on
the front
region of the
brain
producing
changes in
thinking and
behavior
History
• Aristotle thought the heart was
responsible for thinking. Hippocrates realized it was the brain.
• Descartes thought the pineal gland at
the base of the brain was the seat of
the soul.
• The late 1700s phrenologists thought
they could determine your mental
skills and personality by the size and
shape of your head
• In Europe in the 1800s, physicians
like Broca, and Wernicke, were
realizing different brain regions
controlled different skills like
understanding speech versus
creating speech
• In the US, in 1930s and 40s,
before the advent of CT scans
Ward Halstead used behavioral
techniques to help predict where
neurosurgeons would find brain
tumors
• In Russia, A.R. Luria studied the
behaviors of WWII veterans that
survived bullet wounds to the
brain. His book Higher Cortical
Function in Man is a classic
• Neuroimaging techniques like
MRI and PET have
revolutionized neuropsychology
research and practice
Clinical Neuropsychologists examine:
• Cognition (thinking skills)
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Intelligence
Academic Skill
Language
Visual Spatial
Attention
Memory
Executive Functions
• Noncognitive issues
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Alertness
Comportment/Demeanor
Speech
Mood
Personality
Effort/Motivation
Frustration Tolerance
Scores of a patient with Alzheimer’s Disease over 9 years.
Note how memory scores are low in the beginning and over
time scores all other areas except reading decline.
3
2
1
Initial
4-yr
6-yr
9-yr
0
-1
-2
-3
-4
Example of Naming test: What do
you call these?
Example of Perceptual Organization: Find the
figure in white within the yellow figure.
Example of Visual Perception
Example of Visual Perception
Example of Visual Perception
Goals of the Clinical
Neuropsychologist
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Help detect brain dysfunction.
Help identify the type of brain disease.
Help understand the likely impact brain disease in daily life.
Help identify the likely future course of brain disease
Help plan patient care.
Help deliver care to patients and their families.
Conduct the research that provides the basis for all of the
above.
Resource Links
Society for Clinical Neuropsychology:
http://www.div40.org/
Association of Neuropsychology
Students in training:
http://www.div40-anst.com/