Neuropsychological diagnostics and therapy rehabilitation, counseling
Clinical neuropsychology, in close collaboration with neurology, deals with the examination and therapy of congenital or acquired disorders of cognitive functions (perception, attention, executive functions, memory, language, writing, reading, counting). In our consulting room we work with children from 6 months to 18 years of age and with their families. Neuropsychological diagnosis and therapy may be necessary for the following disorders and symptoms:
In cases where the development is different from average, halting or delayed psychomotoric development of infants and toddlers. When the child is late to reach the milestones defining the development of movement (sitting without support, standing, independent walking) or stops in their development. The child’s speech development and communication level is behind the level of children of the same age. His or hers initiative, attention to the environment, exploration activity, autonomy does not reach the level of his or hers age. His or hers playing activity is poor.
For children with speech development in a special run. In some cases speech difficulties may indicate language difficulties. If the child gets stuck on a speech development level or the pace of reaching a certain developmental level is slow (babbling, prattling, word selection according to meaning, use of grammatical structures, language development). The disturbance of speech and communication in some cases can only affect the expressive speech (speech production) and in other cases it can affect the production and speech comprehension together.
Learning difficulty may occur in the event of disruption of a part skill of a particular cognitive function. If the child has a poorer school performance than his or hers intellectual level or the child’s previous performance is deteriorating, then it may be a result of the immaturity of cognitive functions. Differences in the level of individual skills may be due to dyslexia, disruption of writing and spelling (dysgraphia), counting disturbances (dyscalculia). Disturbance in development may affect the attention and execution functions, some memory systems, or thinking. The deterioration in school performance can cause behavioral and integration problems. It can make it difficult for the child to connect with others, also symptoms of attention-deficit hyperactivity and difficulty in emotion and temper control may occur.
In some neurological disorders, the development of cognitive functions occur at a pace other than the average, for example, in certain syndromes (eg Williams syndrome, Turner's syndrome, Fragile X syndrome, etc.). The development of mental capabilities is often affected by various types of epilepsy. Some degenerative diseases are associated with a decline in mental capacity. Neuropsychology has an important task after trauma (skull, or brain injury) and before or after surgical intervention (tumor removal, epilepsy surgery). The aim of the examination in such cases is to understand the nature and possible causes of cognitive disorders and to correlate brain lesions with behavioral signs. This has significance in clinical cases such as aphasias, agnosias, memory disorders, perceptual disturbances, emotional regulation disorders and behavioral disorders.
Intelligence testing is carried out from the age of 3. More detailed examination of cognitive abilities, mapping of the cognitive profile (strengths / weaknesses) may be necessary at later age, e.g. in career choice.
The main question of diagnostic work is to determine that how can the disorders encountered in congenital or developmental ways best be attributed to cognitive functions. Diagnostics is based on taking into account the entire clinical picture, so besides cognitive functions (perception, attention, executive functions, memory, language, writing, reading, counting), other cognitive processes (motion control, action control, emotional processes) also play an important role. The examination is performed using neuroscientific methods (paper pencil tests, computer software). By setting up a cognitive profile, we perform quantitative and qualitative analysis of competences (retained and damaged or underdeveloped abilities / skills). The diagnostic section includes 2-5 appointments (50-55 minutes each). At the first appointment we will take the history of the disease and perform a screening test. The next 4 times we will develop a therapeutic and rehabilitation plan in the differential diagnosis process.
In cases of acquired disorders, our main task is to restore damaged cognitive functions. In the case of congenital abnormalities the main purpose of the therapy is to develop compensatory strategies and to assist in their acquisition.
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