ABSTRACT
Although children with myelomeningocele often display atypical patterns on psychometric testing, this case study demonstrates the sensitivity of neuropsychological instruments to detect altered neurological functioning in a patient with spina bifida. The subject had a history of myelomeningocele at the lumbosacral level and placement of a ventriculoperitoneal shunt. During a routine neuropsychological evaluation, a 44-point discrepancy between his verbal (verbal IQ = 98) and nonverbal abilities (performance IQ = 54) on the Wechsler Intelligence for Children-Revised was found. In comparison to high average academic achievement, test findings suggested depressed memory skills and extreme slowing in psychomotor speed. A pattern of acute decline in overall cognitive functioning was suggested. Magnetic resonance imaging revealed a left frontoparietal brain mass, which was surgically removed. Follow-up neuropsychological testing 9 months postsurgery indicated an increase in nonverbal intelligence with improved psychomotor speed and information processing. This case study illustrates the importance of obtaining baseline evaluations in this neurologically high-risk population as well as the clinical usefulness of psychometric data in diagnostic workups.
Subject(s)
Learning Disabilities/diagnosis , Meningomyelocele/diagnosis , Neurologic Examination , Neuropsychological Tests , Brain Neoplasms/diagnosis , Brain Neoplasms/surgery , Child , Dominance, Cerebral/physiology , Follow-Up Studies , Humans , Learning Disabilities/rehabilitation , Male , Meningomyelocele/rehabilitation , Neuropsychological Tests/statistics & numerical data , Postoperative Complications/diagnosis , Postoperative Complications/rehabilitationABSTRACT
Writing fluency, the ability to write rapidly and easily, is critical for the timely completion of written assignments in the classroom. Children who possess basic writing skills and have an ability to communicate ideas are often penalized for slowness in completing written tasks. The present study used frequently administered nonverbal tasks to predict performance on the Writing Fluency subtest of the Woodcock-Johnson Tests of Achievement--Revised for 146 subjects from 6 to 16 years old. A stepwise-regression analysis indicated the Coding subtest of the WISC--R, Beery Developmental Test of Visual Motor Integration, the Grooved Pegboard, and gender accounted for 32% of the variance. Logistic regression suggested cut-off scores falling one standard deviation below the mean on Coding and Beery's visuomotor test would signal need for further evaluation of writing dysfluency, particularly for boys.
Subject(s)
Learning Disabilities/diagnosis , Neuropsychological Tests , Writing , Adolescent , Affective Symptoms/diagnosis , Affective Symptoms/psychology , Child , Child Behavior Disorders/diagnosis , Child Behavior Disorders/psychology , Female , Handwriting , Humans , Intelligence , Learning Disabilities/psychology , Male , Neuropsychological Tests/statistics & numerical data , Psychometrics , Reference ValuesABSTRACT
The effectiveness of bibliotherapy as an adjunct to stimulant medication in the treatment of children with attention-deficit hyperactivity disorder was investigated. Subjects were randomly assigned to the experimental group, or the control group. Parents in the experimental group received a written protocol (bibliotherapy) outlining behavioral techniques for managing oppositional child behavior. Results indicated significant differences favoring the experimental group on standardized measures of the intensity of behavior problems in the home, parental knowledge of behavioral principles, and teacher ratings of behavior. This bibliotherapy approach appears to offer an inexpensive adjunct to stimulant medication in the treatment of attention-deficit hyperactivity disorder when individual or group behavior management training is not feasible.
Subject(s)
Attention Deficit Disorder with Hyperactivity/therapy , Bibliotherapy/standards , Attention Deficit Disorder with Hyperactivity/prevention & control , Child , Combined Modality Therapy , Female , Humans , Male , Methylphenidate/therapeutic use , ParentingABSTRACT
A behavior-based protocol was developed which outlined all necessary behaviors for successful self-catheterization to an anxious child with myelomeningocele. The subject had been wearing diapers daily since birth, and he expressed fear of pain and lacked confidence because of previous unsuccessful attempts. The present protocol included progressive muscle relaxation, guided visual imagery, and behavioral rehearsal that was implemented by his parents. Data collected showed daily successful intermittent self-catheterization skills two weeks and 6 months posttreatment. Thus, an alternative to traditional educational methods exists that can successfully enhance the acquisition of self-catheterization skills.
