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Flashcards in Lecture 1 - Normal Development Deck (54)
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1
Q

What ages does a Paediatric neuropsychology deal with?

A

birth-18years. In practice, from 3or4 till 16.

2
Q

How does brain damage affect children that differs from the way it affects adults?

A

Brain damage in children DISRUPTS normal development - as it disrupts foundational skills and brain areas essential for further development.

THEREFORE:
* difficulties may manifest during later stages of brain or cognitive development - when foundational skills or brain areas come into play

  • AND, the impact of brain impairment is thus typically more generalised
3
Q

In what three ways can brain damage disrupt normal development in children?

(i.e., it may ___ development, or make it ____, or lead to _____)

A
  • it may delay development (set it back by X time)
  • it may make development abnormal (i.e., fundamentally different)
  • it may lead to the loss of previously acquired skills
4
Q

In what way is the paediatric neuropsychology model SIMILAR to adult neuropsychology model?

A

It uses many of the same foundations as adult neuropsychology model

e. g.,
* localisation of function

  • similar causes of brain impairment
  • similar range of functional impairment
  • ‘dose-response’ relationship remains (i.e., more damage –> worse outcomes)
  • Intervention/rehabilitation is still very important
5
Q

KEY QUESTION: why might a young child with an ABI at a young age only have 5% (difference) in impairment from their peers — but then have this difference increases with age? (i.e., small gap at a young age –> large gap later in development?)

A

The immediate effects on the child’s brain functioning may be relatively mild, but nevertheless affect fundamental abilities and may damage previously learnt skills.

This leads to cascading effects such as failure to active experience dependant or expectant cognitive functions –> resulting in either delayed or abnormal development trajectories; and more generalised impairment than what you would see in adults.

6
Q

Prenatal CNS development is mainly concerned with (1)________;

Whilst, postnatal CNS development is mainly concerned with (2)_______>

A

(1) structural formation, aka the basic ‘hardware’ of the CNS
(2) elaboration of the CNS or establishing connectivity

7
Q

When does the fastest rate of CNS growth occur?

A

Prenatally

8
Q
Describe the prenatal order of structural CNS development:
1. Conception
2. week 2
3. week 3
4, week 4
5. week 5
A
  1. Rapid cell-division
  2. formation of embryonic disc
  3. Neural plate forms (neuralation)
  4. Neural tube forms
  5. cell proliferation of neural tube
9
Q

What are the three layers of the embryonic disc and what do they become?

A
  1. endoderm (bottom layer, becomes internal organs like the respiratory and digestive systems.
  2. mesoderm (middle layer, becomes skelatal and muscular structure.
  3. Extoderm (outer layer, skin surface and CNS)
10
Q

What is neurulation?

A

The formation of the neural plate in week 3/4 of prenatal development.

[AKA: The folding process in vertebrate embryos, which includes the transformation of the neural plate into the neural tube.]

11
Q

What is the process whereby the neural plate/neural tube forms?

A

Neurulation

12
Q

What are the 3 dimensions along which the neural tube develops?

A
  1. Length
  2. Circumference
  3. Radial differentiation
13
Q

How does each of the 3 dimensions of the neural tube relate to features of the CNS?

A
  1. Length - Major structural aspects: the forebrain, midbrain, & spinal cord
  2. Circumference - differentiation between sensory and motor sysmptoms (i.e., the dorsal and ventral stream)
  3. Radial differentiation - different layers and cell types observed in the braion
14
Q

Describe the order in which the structural components of the CNS develop?

A

cerebellar/brainstem –> posterior regions –> anterior regions –> frontal cortex

15
Q

During week 5 of gestation the neural tube, what three primary vesicles does the neural tube divide into during cell proliferation?

A
  1. Prosencephalon
  2. Mesencephalon
  3. Rhombencephalon
16
Q

What are the 3 primary vesicles the neural tube proliferates into. and what are the 5 sub-divisions.

+ what areas of the brain do these divisions become?

A
  1. Prosencephalon
    a. Telencephalon (forebrain/ i.e., cerebral cortex/cerebrum)
    b. Diencephalon (thalamus, hypothalamus, optic vesicles)
  2. Mesencephalon (mid-brain)
  3. Rhombencephalon
    a. Metencephalon (pons and cerebellum)
    b. Myelencephalon (medulla oblongata
  4. Spinal cord (the remainder)
17
Q

What are the openings of the neural tube called? Where are they? When do they close?

A

Neuropores.

For a short time the neural tube is open both cranially (Top) and caudally (bottom). These openings, called neuropores, close during the 4th week in humans. Improper closure of the neuropores can result in neural tube defects such as anencephaly or spina bifida.

18
Q

List some possible malformations of the neural tube.

A
  • Anencephaly (malformation at the top end of the neural tube)
  • Holoprocenphaly
  • Carniosynostosis
  • Encephalocelese
  • Spina bifida (malformation at the bottom end of the neural tube)
  • Arnold-Chiari Malformation
19
Q

The dorsal part of the neural tube contains the (1) ______ plate ; which is associated primarily with (2)_____.

A
  1. Alar

2. Sensation

20
Q

The ventral part of the neural tube contains the (1) ______ plate ; which is associated primarily with (2)_____.

A
  1. Basal

2. Motor control (i.e., muscle control)

21
Q

What are the four MAIN important processes in prenatal brain CELL development?

A
  1. Proliferation - rapid cell divisions and generation of neurons and glial cells
  2. Migration - cells move to their permanent location
  3. Differentiation - neurons differentiate into distinct cell types (4 substages)
  4. Myelination - axons are surrounded by a myelin sheath
22
Q

What is proliferation? (prenatal cell development).

When is the peak time for proliferation in prenatal CNS development?

What are some brain development consequences associated with abnormal proliferation?

A

Proliferation - rapid cell divisions and generation of neurons and glial cells. It peaks at 5-17 weeks.

Abnormalities –> microcephaly and macrocephaly

23
Q

What is Migration? (prenatal cell development)

What is the peak time for migration in prenatal CNS development?

What are some brain development consequences associated with abnormal migration?

A

Migration - cells move to their permanent location. Peaks at 8-15 weeks gestation.

Abnormaties –> Lissencephaly [smooth brain]; cortical dysplasias [wrong cell types in an area of the brain]

24
Q

What is Differentiation? (prenatal cell development)

What are its 4 sub-stages?

A

Differentiation - neurons differentiate into distinct cell types (4 substages)

  1. Development of cell bodies
  2. Selective cell death
  3. Dendritic and axonal growth
  4. Formation of synaptic connections
25
Q

What is Myelination? (prenatal cell development)

A

Myelination - axons are surrounded by a myelin sheath fromed by olygondendroctyes - resulting in increased conduction velocity, lowered action potentials (efficient neural connectivity).

This is very vulnerable to disruption.

26
Q

True or false…. sub-compnents of the CNS are formed from cells whose destination and function are largely predetermined before they mirgrate from the wall of the ventricles

A

True

27
Q

True or false …. Development is marked by an initial abundance of cells, branches and connections with an important part of subsequent maturation consisting of cell death or pruning

A

True

28
Q

Post-natally, when is the major growth spurt for simple motor and sensory abilities? (Major growth spurts)

A

birth - 2 years.

gradual emergence of object permanence, symbolic through, early language and communication

29
Q

What major growth spurts occur from birth - 2 years.

A

Major growth spurt for simple motor and sensory abilities.
gradual emergence of object permanence, symbolic through, early language and communication.

e.g.,

  • Crawling and babbling by 6 months
  • First words and stand/walk around 1
  • Word combos and complex movements by 2
30
Q

Post-natally, when is the major growth spurt for Language? (Major growth spurts)

A

3-5 years; massive increase in full sentence use; social use of language; asking questions etc

31
Q

What major growth spurt occurs between 3-5 years old?

A

Language

massive increase in full sentence use; social use of language; asking questions etc

32
Q

Between the ages of 7-10 what major functional growth spurts should be occuring?

A
  • increased executive skills (Reasoning, problem-solving, and flexibility)
  • increased capacity to think in multiple dimentions
  • increased ability to make inferences
33
Q

Between what years is the initial functional growth spurt for executive functioning?

A

Between the ages of 7-10

34
Q

From adolesence onward, children begin to develop (1)____ cognitive functions

A
  1. Adult
35
Q

Describe some reasons why young children have poorer attention/attention spans than adults?

A

Reflects the immaturity of the CNS - for example, incomplete myelination, frontal lobe development and connectivity between cortical and subcortical pathways.

Also a degree of environmental/practice development.

36
Q

What are some components of attention? (i.e., attention subtypes)

A
  1. sustained attention - Vigilance, maintained over time.
  2. Divided attention - Attending to two (or more) different tasks.
  3. Shifting attention - Changing attention to relevant targets
  4. Selective attention - Focus on targets and ignore distractors
  5. Inhibition (also considered an executive function)
37
Q

During what ages is there considerable development of sustained attention?

A

11-adulthood

38
Q

During what ages is there considerable development of selective attention?

A
  • 7 years - reach around adult levels

BUT between 7-9 years - kids still distractable - significant interference effects

39
Q

During what ages is there considerable development of inhibition ?

A
  • 7-9 years rapid development

* 9 years - adult levels (maybe)

40
Q

What are some problems that can arise from poor attention?

likely implications of poor attention

A
  • can’t concentrate in the classroom; therefore misses important information and doesn’t get as much ‘time’ to learn skills
  • Easily distracted
  • Can’t change or inhibit topics
  • Poor self-monitoring
41
Q

What are some recommendations for poor attention functioning?

A
  • Seat away from distractions
  • Provide class-outlines in a written format with key points on them
  • Lists and reminders to help with self-monitoring
  • Do work in small blocks
42
Q

What are some of the non-direct ways kids can have poor learning and memory?

A

via attentional or executive dysfunction.

Specific language learning disabilities e.g., dyslexia, dysgraphia, dyscalculia

43
Q

What are some of the facets of memory?

A
  1. Immediate
  2. Working
  3. short-term
  4. long-term
  5. encoding
  6. storage
  7. retrieval
44
Q

Describe the developmental course of learning and memory…

when do memories start? trajectory of immediate memory span? Strategies?

A
  • Development
  • initially believe that young babies did not form memories, but preferential looking tasks even in very young babies suggest they do
  • immediate memory span increases quantitatively with age.
  • Encoding, storage and retrieval strategies change qualitatively with age
  • spontaneous strategy use is infrequent in 6 year olds; 7-10 years is a transitional period;effective strategy use by 11
45
Q

What are some problems that can arise from poor learning and memory?

(likely implications of poor attention)

A
  • Spontaneous retrieval problems in exam
  • Recalling class content
  • modality/material specific
46
Q

What are some recommendations for poor learning and memory?

A
  • Changing format of exams from short answer to multiple choice
  • Use of other modality when one is affected (e.g., visual when verbal is impaired and vice versa)
  • Allow use of notes in exams etc
  • Provide notes, recordings and additional time
47
Q

Briefly describe the funtional correlates of:

  1. motor cortex
  2. premotor cortex
  3. frontal eye fields
  4. broca’s area
  5. prefrontal cortex
    a. dosolateral
    b. orbito-frontal
    c. medial
A
  1. motor cortex - power and voluntary control of movements
  2. premotor cortex - motor organization and skilled movement
  3. frontal eye fields - visual attention and saccadic eye movements –> scanning impairments,
  4. broca’s area - contains motor programs for the production of speech
  5. prefrontal cortex - higher-level thinking
    a. dosolateral - working memory, planning, problem solving
    b. orbito-frontal - behaviour and emotional regulation
    c. medial - drive, apathy, initiation, motivation.
48
Q

Describe the developmental of frontal lobe functions.

why is it hard to isolate frontal functions? Welsh 1991 stages (number and ages)

A
  • While there is sequential improvement in executive functions through childhood, and while this coincides with growth spurts in frontal lobe development; it is difficult to isolate frontal functions from those of other developing cerebral regions. (e.g., attention, processing speed)
  • executive functioning is multifaceted
  • there are developmental gains in executive abilities with age
  • each executive ability seems to have its own developmental trajectory
  • Not a lot of research on development of executive functioning
  • welsh et al 1991 suggested three stages of executive dysfunction = 6 years, 10 years, early adolescence
49
Q

What are some problems that can arise from executive dysfunction?

(likely implications of poor attention)

A
  • Poor approach to tasks - poor plans, inefficient learning or task completion –> lots of incomplete tasks
  • Poor organisation (physically messy) and also mentally, difficulty retrieving information.
  • failure to self-monitor and use feedback
  • Behavioural and emotion regulation - tantrums
50
Q

What are some recommendations for executive dysfunction?

A

Many executive functioning skills can be taught.

Teach executive functioning skills like planning, organisation, and check lists (self-monitoring).

51
Q

What are some components of language?

A
  • Vocabulary - words
  • phonology - sounds
  • grammar and syntax - structure
  • semantics - meaning
  • pragmatics/discourse - practical use
52
Q

What is the most basic binary division of language functioning?

A

Expressive and Receptive (comprehension).

53
Q

Describe the development of language? (from 8months —> 5+)

A
  • 8-10 months - first signs of comprehension
  • 11-13 months - single word production starts
  • 18-20 months - word combinations appear
  • 20-36 months - grammatical development
  • > 3 years - rapid development in vocabulary, grammar, phonology etc. that lasts until adulthood
  • Rapid development between 2 and 5 years –> ‘critical’ period of development
54
Q

Think about what would be the likely implications of language impairment?

A
  • Poor comprehension
  • Difficulty speaking
  • difficulty reading
  • difficulty writing
  • difficulty with maths
  • difficulty with social use of language
  • difficulty with phonology hearing or speaking
  • difficulty with articulation