Neuropsychology Services in Canberra

Neuropsychological assessment/testing is a process by which a person's cognitive, psychological/emotional and behavioural functioning is comprehensively assessed.

The focus is usually on cognitive functioning. Standardised tests are used.
Specific skills which are tested include concentration, memory, visuo-spatial awareness, language and problem solving.
A testing session can take between 2 - 5 hours and may be conducted over more than one visit.

Neuropsychological assessment may assist in:

Clarifying diagnosis
Clarifying prognosis
Establishing a treatment plan
Providing rehabilitation recommendations

Included in the assessment:

Standardised testing
Detailed assessment report
Tailored recommendations
A comprehensive feedback session

ADHD

Attention Deficit Hyperactivity Disorder (ADHD) is a commonly misconceived condition which can result in chronic difficulties for learners, both diagnosed and undiagnosed.

Assessments may be conducted for children, adolescents and adults who may be experiencing differences in their executive functioning skills, such as attention and concentration, task initiation and completion, planning and organisation skills, working memory, impulsivity, emotion regulation and hyperactivity.
Assessment can help determine whether an individual meets the diagnostic criteria for ADHD, understand, appreciate and capitalise on their strengths, and also investigate whether symptoms may be better explained by another presentation, such as anxiety, depression, stress or another neurodevelopmental difference such as Autism.

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Learning Disability

When learning disorders impact on a person's ability to function, they may be referred to as Learning Disabilities. Learning disabilities include disorders that impair functions such as reading (dyslexia), writing (dysgraphia) and mathematical calculation (dyscalculia). They vary widely within each category in the patterns they exhibit.

Having a learning disability can have serious effects, some of which are -

Achievement Levels: The level of academic achievement revealed by written tests does not correspond to perceived or expected ability.
Organising difficulties: Students may go off at a tangent in conversation and/or in writing and seem personally disorganised.
Auditory processing: Some students may experience difficulty in integrating information presented orally.
Reading difficulties: Reading may be slow and deliberate and comprehension may be impaired for students with a learning disability.
Writing and note taking difficulties: Legibility, writing speed and spelling may be severely hampered under the pressure of time constraints.

The marked discrepancy between intellectual capacity, and achievement and output (expressing information and responding) is what characterises a learning disability. Learning disability often goes undiagnosed. Neuropsychological assessment can determine the presence and subtype of Learning Disorder, which can inform prognosis and treatment possibilities.

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Acquired Brain Injury

Traumatic Brain Injury (TBI) is the leading cause of acquired brain injury (ABI), affecting two in every 1000 people. TBI affects roughly three times more males than females. Those between the ages of 15 and 24 years are at the highest risk of sustaining a TBI. Open head injuries account for less than 10% of TBIs. Closed head injury results from rapid acceleration and deceleration forces. Damage to the brain is caused when it moves within the skull and collides with the inner surface. The frontal and temporal lobes of the brain are particularly susceptible to bruising from these forces. Another mechanism of injury is diffuse axonal injury. This is when nerve cells in the brain are stretched and sometimes torn due to the rapid acceleration and deceleration forces. This occurs more globally throughout the brain. Secondary complications such as bleeding, hydrocephalus and swelling of brain tissue can cause further damage.

Substance Use which is excessive and/or chronic can have a substantial effect on neuropsychological functioning, depending on the substance(s) that have been used. Alcohol is the most widely abused substance in the western world. Significant chronic alcohol use results in diminished cognition over time, even when a person is sober. A severe and irreversible result of significant long-term alcohol consumption is the Wernicke-Korsakoff Syndrome. This syndrome results in a dramatic loss of ability to learn and remember new information, along with other cognitive and behavioural difficulties. Those with the syndrome have clear physical brain changes.

Hypoxic Brain injury occurs when the oxygen supply to the brain has been significantly disrupted. The lack of oxygen causes cells in the brain to die. Hypoxic brain injury may be subtle or severe and neuropsychological assessment can determine the impact of damage on cognitive functioning.

Brain infections are rare. They are caused by infiltration of the brain by either a virus or bacteria. Some examples include HIV/AIDS and Herpes Simplex. Different infectious agents tend to affect different parts of the brain, and therefore a neuropsychological assessment can assist with both diagnosis and treatment of infectious brain conditions.

Brain tumours are an abnormal growth of cells in the brain. The extent and nature of cognitive impairment resulting from a brain tumour depends on the size and location of the tumour, among other factors.

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Dementia

Dementia refers to a neurodegenerative process whereby a person experiences cognitive and functional decline. Such decline is over and above the gradual decline experienced in normal ageing.With Australia's ageing population, the incidence of dementia is likely to increase.

Caring for someone with dementia is a very challenging role. Neuropsychological assessment can assist in diagnosis, and may also assist carers and staff in aged care facilities with strategies managing the often challenging behaviours of people with dementia. Carer burden is associated with increased behavioural disturbance in dementia.

It can be difficult to determine when a person is in the early stages of dementia. There are many different forms of dementia, including:

Alzheimer's Dementia: This represents the manifestation of Alzheimer's Disease, a pathological brain process. Alzheimer's Disease can only be diagnosed on autopsy but Alzheimer's Dementia can be diagnosed while a person is living. This form of dementia is associated with memory encoding deficits (difficulty forming new memories) and problems with object naming and carrying out routine practical tasks (dyspraxia).

Vascular Dementia: Although it is highly associated with stroke, it may occur in someone who has not experienced an obvious stroke, and not all people who sustain strokes will develop Vascular Dementia. The memory difficulties in Vascular Dementia relate more to the organisation and retrieval of information from mind and tend to be variable.

Dementia with Lewy Bodies: This is a form of dementia associated with a high number of particular proteins (called Lewy Bodies) within brain cells. Dementia with Lewy Bodies tends to present with Parkinsonian features, visual hallucinations, variable cognition and early difficulties with attention, processing speed, visuo-spatial functioning and executive skills.

Fronto-Temporal Dementia: This refers to a range of dementias associated with degeneration of the frontal and temporal lobes. Dementia of the Frontal Lobe Type is associated with significant changes in behaviour, personality and mood. A person with this condition may become socially disinhibited, impulsive, disorganized and irritable. Conversely, they may become apathetic, disengaged and blunted in their emotions. Semantic Dementia is associated with a loss of knowledge about objects and concepts, however, day to day memory is usually relatively well preserved. Primary Progressive Aphasia is associated with word-finding difficulties, grammatical errors and articulation errors. Memory and other cognitive skills are usually well preserved, even though a person with this condition may progress to mutism.

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Stroke

There are two main types of stroke, ischaemic and haemorrhagic. Because stroke varies significantly in the parts of the brain that are affected, there is no single neuropsychological profile for stroke. To a large extent, the neuropsychological phenomena associated with stroke depend on the vessel and side of the brain affected.

Ischaemic Stroke is where there is a disruption to the blood supply to the brain, which causes neurons (brain cells) to dysfunction and in many cases die. Ischaemic stroke accounts for over 60% of all strokes and usually affects those over the age of 55 years.

Haemorrhagic Stroke is where a blood vessel in the brain ruptures. This can cause bleeding either within or around the brain. Half of those that have a haemorrhagic stroke will die as a result. Of the 50% that survive, outcome is usually better than that of those who sustain ischaemic strokes. Haemorrhagic stroke accounts for many of the strokes that occur under the age of 45 years.

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