Best Practices in School Neuropsychology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Geisteswissenschaft
• Sprache: Englisch

Seitenzahl: 1509

Veröffentlichungsjahr: 2009

Beschreibung

A comprehensive guide to the practice of school neuropsychology It is an exciting time to specialize in school neuropsychology, with countless theoretically and psychometrically sound assessment instruments available for practitioners to use in their evaluations of children with special needs. Yet the field faces the challenges of establishing evidence-based linkages between assessment and interventions and of broadening its approaches to culturally diverse populations. Edited by a leading expert in school neuropsychology, Best Practices in School Neuropsychology: Guidelines for Effective Practice, Assessment, and Evidence-Based Intervention addresses these challenges and their solutions and provides learning specialists and school psychologists with clear coverage and vital information on this burgeoning area of practice within school psychology. This insightful reference features comprehensive discussion of: * Current school neuropsychological assessment and intervention models * Best practices in assessing cognitive processes * An overview of what neuroscience offers to the practice of school neuropsychology * How school neuropsychology fits within a Response to Intervention (RTI) model * The rationale for the importance of school psychologists' collaboration with parents, educators, and other professionals to maximize services to children * Clinical applications of school neuropsychology with special populations, academic disabilities, processing deficits, and medical disorders * Unique challenges in working with culturally diverse populations Featuring contributions from internationally renowned school psychologists, neuropsychologists, clinicians, and academics, Best Practices in School Neuropsychology is the first book of its kind to present best practices and evidence-informed guidelines for the assessment and intervention of children with learning disabilities, as well as other issues practitioners working with children encounter in school settings. DANIEL C. MILLER, PhD, is a Professor and Chair of the Department of Psychology and Philosophy at Texas Woman's University in Denton, Texas. He is a former director of the School Psychology Graduate Training Programs and past president of the National Association of School Psychologists. He is the author of Essentials of School Neuropsychological Assessment. Dr. Miller is also the President and founder of KIDS, Inc., a company that specializes in early childhood education and screening products.

Leseprobe

Table of Contents

Title Page

Copyright Page

Dedication

Foreword

Preface

PROFESSIONAL ISSUES IN SCHOOL NEUROPSYCHOLOGY

PRACTICE ISSUES IN SCHOOL NEUROPSYCHOLOGY

CLINICAL APPLICATIONS OF SCHOOL NEUROPSYCHOLOGY

About the Editor

Contributors

SECTION I - PROFESSIONAL ISSUES IN SCHOOL NEUROPSYCHOLOGY

CHAPTER 1 - School Neuropsychology, an Emerging Specialization

THE NEED FOR PROFESSIONAL ORGANIZATIONS TO RECOGNIZE SPECIALIZATIONS

SCHOOL NEUROPSYCHOLOGY AS A SPECIALTY

THE ROLES AND FUNCTIONS OF A SCHOOL NEUROPSYCHOLOGIST

STATE OF THE ART OF SCHOOL NEUROPSYCHOLOGY

WHEN TO REFER FOR A SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OR CONSULTATION

SUMMARY

REFERENCES

CHAPTER 2 - School Neuropsychology Training and Credentialing

THE ISSUE OF COMPETENCY

TRAINING STANDARDS IN CLINICAL NEUROPSYCHOLOGY

TRAINING SCHOOL PSYCHOLOGISTS TO INTEGRATE NEUROPSYCHOLOGICAL PRINCIPLES INTO PRACTICE

WHAT’S IN A NAME?

WHO OFFERS CREDENTIALING IN THE NEUROPSYCHOLOGY AREAS?

MODEL SCHOOL NEUROPSYCHOLOGY TRAINING PROGRAM

SUMMARY

REFERENCES

CHAPTER 3 - Ethical and Legal Issues Related to School Neuropsychology

ETHICAL PRINCIPLES RELATED TO THE PRACTICE OF SCHOOL NEUROPSYCHOLOGY

REVIEW OF LEGISLATION THAT IMPACTS THE ROLES AND FUNCTIONS OF SCHOOL NEUROPSYCHOLOGISTS

ETHICAL AND LEGAL ISSUES RELATED TO THE PRACTICE OF SCHOOL NEUROPSYCHOLOGY

SUMMARY

REFERENCES

CHAPTER 4 - Multicultural School Neuropsychology

HISTORY OF DIFFERENCE VERSUS DISABILITY DIFFERENTIATION ATTEMPT

LEGISLATIVE HISTORY RELATED TO NONDISCRIMINATORY ASSESSMENT

ISSUES AND CONSIDERATIONS PRIOR TO THE SELECTION OF INSTRUMENTS AND PROCEDURES

MULTICULTURAL SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT INSTRUMENTS AND PROCEDURES

SELECTION OF CULTURALLY AND LINGUISTICALLY APPROPRIATE INTERVENTIONS

SUMMARY

REFERENCES

SECTION II - PRACTICE ISSUES IN SCHOOL NEUROPSYCHOLOGY

CHAPTER 5 - School Neuropsychological Assessment and Intervention

IMPORTANCE OF A CONCEPTUAL MODEL TO GUIDE ASSESSMENT AND INTERVENTION

SUMMARY

REFERENCES

CHAPTER 6 - Integrating Cognitive Assessment in School Neuropsychological Evaluations

INTEGRATED FLUID-CRYSTALLIZED THEORIES OF COGNITIVE FUNCTIONING AND ...

RESPONSE TO INTERVENTION

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT

AN INTEGRATIVE FRAMEWORK BASED ON PSYCHOMETRIC, NEUROPSYCHOLOGICAL, AND LURIAN PERSPECTIVES

SUMMARY

REFERENCES

CHAPTER 7 - The Application of Neuroscience to the Practice of School Neuropsychology

TRANSLATING BRAIN RESEARCH INTO EDUCATIONAL PRACTICE

THE ROLE OF GENETICS ON EDUCATIONAL PRACTICE

THE ROLE OF BRAIN IMAGING IN EDUCATIONAL PRACTICE

WHAT LIES AHEAD FOR THE BRAIN RESEARCH- EDUCATION LINKAGE?

SUMMARY

REFERENCES

CHAPTER 8 - Linking School Neuropsychology with Response-to-Intervention Models

HISTORICAL IDENTIFICATION OF LD

PROBLEMS WITH THE DISCREPANCY MODEL

THE RESPONSE-TO-INTERVENTION (RTI) APPROACH TO THE IDENTIFICATION OF LD

THE TIERED ASPECT OF RTI MODELS

THE OPPORTUNITY FOR A BETTER MODEL OF LD IDENTIFICATION

INTRODUCTION TO A RESPONSE TO THE RIGHT INTERVENTION (RTRI) MODEL

SUMMARY

REFERENCES

CHAPTER 9 - School Neuropsychology Collaboration with Home, School, and Outside Professionals

THE ROLE OF THE SCHOOL NEUROPSYCHOLOGIST CONSULTANT

COMMUNICATING SCHOOL NEUROPSYCHOLOGICAL RESULTS

SUMMARY

REFERENCES

CHAPTER 10 - School Reentry for Children Recovering from Neurological Conditions

MENINGITIS

SICKLE CELL DISEASE AND STROKE

CANCER

TRAUMATIC BRAIN INJURY (TBI)

BEST PRACTICES IN SCHOOL REENTRY

SUMMARY

REFERENCES

SECTION III - CLINICAL APPLICATIONS OF SCHOOL NEUROPSYCHOLOGY: SPECIAL POPULATIONS

CHAPTER 11 - Assessment and Intervention Practices for Children with ADHD and ...

THE BIOLOGICAL BASIS OF ADHD

COGNITIVE/NEUROPSYCHOLOGICAL FUNCTIONING IN ADHD

ACADEMIC ACHIEVEMENT AND DISABILITY IN ADHD

DIFFERENTIATING ADHD AND OTHER FRONTAL-SUBCORTICAL CIRCUIT DISORDERS: THE ...

DIFFERENTIATING ADHD AND OTHER FRONTAL-SUBCORTICAL CIRCUIT DISORDERS: THE ...

IMPLICATIONS FOR INTERVENTION: ACHIEVING CIRCUIT BALANCE

SUMMARY

REFERENCES

CHAPTER 12 - Assessing and Intervening with Children with Autism Spectrum Disorders

CORE DEFICITS IN AUTISM

SCREENING FOR AUTISM SPECTRUM DISORDERS

COMORBIDITY AND ASSOCIATED DISORDERS

NEUROPSYCHOLOGICAL APPROACH: BRAIN/BEHAVIOR FUNCTIONING IN AUTISM

ASSESSMENT OF NEUROCOGNITION

EFFECTIVE INTERVENTION RECOMMENDATIONS

SUMMARY

REFERENCES

CHAPTER 13 - Assessing and Intervening with Children with Asperger’s Disorder

NEUROPSYCHOLOGICAL FUNCTIONING IN ASPERGER’S DISORDER

COMPONENTS OF A SCHOOL NEUROPSYCHOLOGICAL EVALUATION TO ADDRESS ASPERGER DISORDER

INTERVENTION APPROACHES FOR WORKING WITH STUDENTS WITH ASPERGER’S DISORDER

SUMMARY

REFERENCES

CHAPTER 14 - Assessing and Intervening with Children with Developmental Delays

DEFINITIONS OF DEVELOPMENTAL DELAYS

EARLY IDENTIFICATION ISSUES

COMPETENCY-BASED PERFORMANCE MONITORING

THE RELEVANCE OF NEUROPSYCHOLOGICAL PROCESSES

THE ASSESSMENT OF DEVELOPMENTAL DELAY USING A NEUROPSYCHOLOGICAL PERSPECTIVE: ...

POSSIBLE ASSESSMENT INSTRUMENTS TO INCORPORATE INTO A DEVELOPMENTAL EVALUATION ...

NEUROCOGNITIVE DEFICITS ASSOCIATED WITH DEVELOPMENTAL DELAY

EVIDENCE-BASED INTERVENTIONS FOR CHILDREN WITH DEVELOPMENTAL DELAYS

SUMMARY

REFERENCES

CHAPTER 15 - Assessing and Intervening with Children with Externalizing Disorders

NEUROPSYCHOLOGY AND NEUROBIOLOGY CONTRIBUTING FACTORS

OTHER CONTRIBUTING FACTORS

COMORBIDITY WITH OTHER CHILDHOOD DISORDERS AND LEARNING DISABILITIES

SCHOOL NEUROPSYCHOLOGICAL EVALUATION

EVIDENCE-BASED INTERVENTIONS FOR THE TREATMENT OF EXTERNALIZING DISORDERS

SUMMARY

REFERENCES

CHAPTER 16 - Assessing and Intervening with Children with Internalizing Disorders

RELATIONSHIP BETWEEN NEUROPSYCHOLOGY AND INTERNALIZING DISORDERS

CLASSIFICATION OF INTERNALIZING DISORDERS

DEVELOPMENTAL PSYCHOPATHOLOGY

NEUROCOGNITIVE DEFICITS ASSOCIATED WITH INTERNALIZING DISORDERS

LIKELIHOOD OF COMORBIDITY WITH OTHER CHILDHOOD DISORDERS AND LEARNING DISABILITIES

COMPONENTS OF A SCHOOL NEUROPSYCHOLOGICAL EVALUATION TO ADDRESS INTERNALIZING DISORDERS

EVIDENCE-BASED INTERVENTIONS FOR THE TREATMENT OF INTERNALIZING DISORDERS

SUMMARY

REFERENCES

CHAPTER 17 - Assessing Children Who Are Deaf or Hard of Hearing

FREQUENCY, CLASSIFICATION, AND TYPES OF HEARING LOSS IN CHILDREN: AN OVERVIEW

NEUROCOGNITIVE DEFICITS, ETIOLOGIES, AND SYNDROMES ASSOCIATED WITH HEARING LOSS

DHH DEMOGRAPHICS AND SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT: A CONTEXTUAL TEMPLATE

DIVERSITY, DEAFNESS, AND SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT

PUTTING IT INTO PRACTICE: THE SNP MODEL OF ASSESSMENT AND THE DHH CONTEXTUAL TEMPLATE

INTERVENTIONS

SUMMARY

REFERENCES

CHAPTER 18 - Assessing and Intervening with Visually Impaired Children and Adolescents

ISSUES RELATED TO TEST DEVELOPMENT

CONSIDERATIONS IN TEST SELECTION AND EVALUATION OF THE VI/B STUDENT

ACCOMMODATION AND REMEDIATION OF IDENTIFIED DEFICITS

SUMMARY

REFERENCES

SECTION IV - CLINICAL APPLICATIONS OF SCHOOL NEUROPSYCHOLOGY: ACADEMIC DISABILITIES

CHAPTER 19 - Assessing and Intervening with Children with Reading Disorders

CONTROVERSIES IN ASSESSMENT PRACTICES

THE NEUROBIOLOGY OF READING

SUBTYPES OF READING DISORDERS

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF READING

SUMMARY

REFERENCES

CHAPTER 20 - Assessing and Intervening with Children with Written Language Disorders

DEFINITIONS

DIAGNOSTIC ISSUES

NEUROCOGNITIVE FUNCTIONS RELATED TO DEVELOPMENTAL WRITING DISORDERS

EVIDENCE-BASED INTERVENTIONS FOR TREATMENT OF WRITTEN LANGUAGE DISORDERS

SUMMARY

REFERENCES

CHAPTER 21 - Assessing and Intervening with Children with Math Disorders

DEFINITIONS

NEUROPSYCHOLOGICAL SUBTYPES

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF MATH DISORDERS

EVIDENCE-BASED INTERVENTIONS FOR THE TREATMENT OF CHILDREN WITH MATH DISORDERS

FUTURE RESEARCH

SUMMARY

REFERENCES

CHAPTER 22 - Assessing and Intervening with Children with Speech and Language Disorders

NEUROCOGNITIVE CORRELATES OF SPEECH AND LANGUAGE DISORDERS

COMORBIDITY WITH OTHER CHILDHOOD DISORDERS AND LEARNING DISABILITIES

SCHOOL NEUROPSYCHOLOGICAL EVALUATION FOR SLI

EVIDENCE-BASED INTERVENTIONS FOR THE TREATMENT OF CHILDREN WITH SLI

INTERVENTION IMPLEMENTATION: CROSS-CULTURAL CONSIDERATIONS

SUMMARY

REFERENCES

CHAPTER 23 - Assessing and Intervening with Children with Nonverbal Learning Disabilities

NLD ASSETS AND LIABILITIES

COMORBIDITY OF NLD WITH OTHER CONDITIONS AND DISORDERS

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF NLD

NLD INTERVENTION

SUMMARY

REFERENCES

SECTION V - CLINICAL APPLICATIONS OF SCHOOL NEUROPSYCHOLOGY: PROCESSING DEFICITS

CHAPTER 24 - Assessing and Intervening in Children with Executive Function Disorders

DEFINITION OF EXECUTIVE FUNCTIONS

NEUROLOGICAL BASES OF EXECUTIVE FUNCTIONS

DEVELOPMENTAL ASPECTS OF EXECUTIVE FUNCTIONING IN CHILDREN

ASSESSMENT OF EXECUTIVE FUNCTIONS IN CHILDREN AND ADOLESCENTS

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF EXECUTIVE FUNCTIONS IN CHILDREN AND ADOLESCENTS

EVIDENCE-BASED INTERVENTIONS OF EXECUTIVE FUNCTIONS IN CHILDREN AND ADOLESCENTS

SUMMARY

REFERENCES

CHAPTER 25 - Assessing and Intervening with Children with Memory and Learning Disorders

MEMORY AND LEARNING

OVERVIEW OF MEMORY SYSTEMS

ORGANIZATION OF MEMORY FROM THE COGNITIVE NEUROSCIENCE PERSPECTIVE

ORGANIZATION OF MEMORY FROM THE SCHOOL NEUROPSYCHOLOGY PERSPECTIVE

NEUROBIOLOGY OF MEMORY AND LEARNING

EXAMPLES OF THE ASSESSMENT OF MEMORY AND LEARNING

EVIDENCE-BASED INTERVENTIONS FOR THE TREATMENT OF CHILDREN WITH MEMORY AND ...

CASE EXAMPLE: FROM ASSESSMENT TO INTERVENTION

SUMMARY

REFERENCES

CHAPTER 26 - Assessing and Intervening with Children with Sensory-Motor Impairment

SENSORY AND MOTOR FUNCTIONS

SENSORY-MOTOR AND PERCEPTUAL-MOTOR INTEGRATION

SENSORY-MOTOR IMPAIRMENTS IN CHILDHOOD DISORDERS AND LEARNING DISABILITIES

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF SENSORY-MOTOR FUNCTIONS

EVIDENCE-BASED INTERVENTIONS FOR THE TREATMENT OF CHILDREN WITH SENSORY-MOTOR IMPAIRMENTS

SUMMARY

REFERENCES

CHAPTER 27 - Assessing and Intervening with Chronically Ill Children

CENTRAL NERVOUS SYSTEM (CNS) INFECTION OR COMPROMISE

HIV/AIDS

CHRONIC MEDICAL ILLNESSES

CHILDREN WITH A HISTORY OF ACQUIRED OR CONGENITAL BRAIN DAMAGE

CHILDREN WITH NEURODEVELOPMENTAL RISK FACTORS

SUMMARY

REFERENCES

CHAPTER 28 - Assessing and Intervening with Children with Brain Tumors

MAJOR TYPES OF BRAIN TUMORS

VARIABLES CONTRIBUTING TO NEUROCOGNITIVE FUNCTIONING

REVIEW OF NEUROCOGNITIVE ABILITIES IN PEDIATRIC BRAIN TUMOR SURVIVORS

COMORBIDITY

COMPONENTS OF A SCHOOL NEUROPSYCHOLOGICAL EVALUATION

INTERVENTIONS FOR CHILDREN WITH BRAIN TUMORS

SUMMARY

REFERENCES

CHAPTER 29 - Assessing and Intervening with Children with Seizure Disorders

CLASSIFICATION OF SEIZURE DISORDERS IN CHILDREN

NEUROCOGNITIVE DEFICITS ASSOCIATED WITH SEIZURE DISORDERS

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF CHILDREN WITH SEIZURE DISORDERS

INTERVENTION APPROACHES FOR CHILDREN WITH SEIZURE DISORDERS

THE ROLE OF A SCHOOL NEUROPSYCHOLOGIST IN WORKING WITH CHILDREN SUSPECTED OR ...

SUMMARY

REFERENCES

CHAPTER 30 - Assessing and Intervening with Children with Traumatic Brain Injury

INTRODUCTION AND OVERVIEW

SPECIAL CONSIDERATIONS FOR PEDIATRIC TBI

NEUROCOGNITIVE DEFICITS ASSOCIATED WITH TBI

RECOVERY FROM TBI AND LONG-TERM IMPLICATIONS

SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OF CHILDREN WITH TBI

TBI REHABILITATION AND INTERVENTION

SUMMARY

REFERENCES

APPENDIX - Resources for School Neuropsychology

AUTHOR INDEX

SUBJECT INDEX

This book is printed on acid-free paper.

Copyright © 2010 by John Wiley & Sons, Inc. All rights reserved.

Published by John Wiley & Sons, Inc., Hoboken, New Jersey.

Published simultaneously in Canada.

No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, scanning, or otherwise, except as permitted under Section 107 or 108 of the 1976 United States Copyright Act, without either the prior written permission of the Publisher, or authorization through payment of the appropriate per-copy fee to the Copyright Clearance Center, Inc., 222 Rosewood Drive, Danvers, MA 01923, [phone], fax [phone], or on the web at www.copyright.com. Requests to the Publisher for permission should be addressed to the Permissions Department, John Wiley & Sons, Inc., 111 River Street, Hoboken, NJ 07030, [phone], fax [phone].

Limit of Liability/Disclaimer of Warranty: While the publisher and author have used their best efforts in preparing this book, they make no representations or warranties with respect to the accuracy or completeness of the contents of this book and specifically disclaim any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives or written sales materials. The advice and strategies contained herein may not be suitable for your situation. You should consult with a professional where appropriate. Neither the publisher nor author shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.

Designations used by companies to distinguish their products are often claimed as trademarks. In all instances where John Wiley & Sons, Inc. is aware of a claim, the product names appear in initial capital or all capital letters. Readers, however, should contact the appropriate companies for more complete information regarding trademarks and registration.

For general information on our other products and services please contact our Customer Care Department within the U.S. at [phone], outside the United States at [phone] or fax [phone].

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books. For more information about Wiley products, visit our website at www.wiley.com.

Library of Congress Cataloging-in-Publication Data:

Best practices in school neuropsychology: guidelines for effective practice, assessment, and evidence-based intervention/edited by Daniel C. Miller. p. cm.

Includes bibliographical references and index.

eISBN : 978-0-470-59771-2

1. Pediatric neuropsychology. 2. Clinical neuropsychology. 3. School psychology. 4. School children—Mental health services. 5. Crisis intervention (Mental health services) 6. Evidence-based psychiatry. I. Miller, Daniel C.

RJ486.5.B.92’ 8—dc22

2009010839

This book is dedicated to all school psychology practitioners who believe that“MindsDo Matter: All Children Can Learn”; to my loving wife Michie, my best friend and supporter; and to my parents who have provided me support and love throughout all my years.

Foreword

WE ARE SO lucky to be school psychologists in this day and age. The face of psychology, in general, has been changed by neuroscience in the last two decades and it promises more knowledge, better tools, and improved outcomes and quality of life for individuals who need our help. An avalanche of research on the brain is rushing into the clinical practice of all specialties in psychology. For example, geropsychology is rapidly becoming geroneuropsychology because research is enlightening practitioners about differential diagnosis of aging problems. Research on the dementias, vascular irregularities, stroke, and depression in the elderly population is abundant and well funded; therefore practitioners who work with senior patients meld much of this new research into their daily practice. They use the information because it is critical to successful outcomes. When a clinician improves differential diagnosis, then the interventions used are more specific to the etiology of the problem and confounding variables in the single-patient research design are kept to a minimum. This is simply good practice. It requires that the clinician keep up with the latest developments in research that might improve his or her diagnostic skills. Indeed, this also is mandated by professional ethical standards.

The reverse is true as well. For example, exponential growth in the numbers of children identified with neurodevelopmental disorders, that are very difficult to diagnose and treat, is pressing for expansion of neuroscientific research. Disorders such as autism and Asperger’s disorder are clearly brain-related and the understanding of the brain processes involved is critical not only for treatment, but also for prevention. Psychologists working with children understand that the treatments for autism are very different than the treatments for mental retardation, metabolic disorders, learning disorders, and seizure disorders. Children with the later disorders may exhibit a few of the behavioral characteristics associated with autism and therefore the chance of misdiagnosis, inflated incidence/prevalence numbers, inappropriate treatment, and poor outcomes is high. The need for neuroscientific information to assist practice has never been more pressing and essential. The collective plea for more information has never been so loud.

This bilateral relationship between research and practice is not an accident. The National Institutes of Health (NIH) have been calling for and funding “translational research” efforts for some time. The NIH have long recognized that while excellent research on the brain was being conducted in laboratories around the country and the world, the findings of that research was not being translated down to prospective patients. Hence, the NIH continues to push for research information in the neurosciences to go from “bench to bedside.” So far, significant translational research results have been obtained regarding polio, memory, blindness, Parkinson’s disease, multiple sclerosis, stroke, stress, depression, bipolar disorder, schizophrenia, and drug addiction.

Leading universities are also naturally pushing the boundaries of neuroscientific inquiry. Advances in technology, and imaging in particular, have allowed researchers such as Sally Shaywitz, Jack Fletcher, Bob Schultz, Erin Bigler, Margaret Semrud-Clikeman (to name just a few) to look inside the brain and glean important information about neuroanatomical correlates of reading disabilities, Attention Deficit Hyperactivity Disorder, and autism. The findings about reading disabilities, for example, have translated into more effective differential diagnosis of dyslexia and remediative activities. These research studies have also shed light on how plastic the brain is and how we can influence that plasticity to achieve long-term positive reading outcomes. When neuroscience translates directly into the classroom for positive outcomes, we have the perfect marriage. Of course, the perfect marriage requires that both partners are aware of what the other is doing. Researchers who conduct brain imaging studies must be interested in the functional application of their findings and clinicians must be interested in the neuropsychological makeup of the problems that they see in the classroom. We have seen enough of research that does not see the outside of the laboratory, and we have seen enough of clinical and educational personnel not understanding why academic problems exist.

Up until this day and age, the field of school psychology was ruled by certain ideas about who and how we practice. Those ideas were results of preconceived values and the level of knowledge that we had about the brain. For example, it was thought that intelligence could be represented by a single number that adequately described the ability of a child, was immutable, and precisely predicted success. That genes unilaterally dictated how development would unfold. It was thought that a discrepancy between two numbers could describe and remediate differences in learning. That differences in behavior could only be described by behavioral observations. We thought that once a child was disabled, that they would always be disabled. Autism was caused by “refrigerator mothers.” Reading problems existed because of minimal brain damage. These types of beliefs carved out the role of the school psychologist. They dictated our job descriptions and directed our professional boundaries.

Why don’t we believe these things anymore? And if we do not believe them, what do we believe and how does it influence our roles as school psychologists? What forces proved these ideas to be incorrect or off the mark? The answer is: Neuroscience. The 1990s was called the “Decade of the Brain” and the only trouble with sectioning off the 1990s for the brain is that the decades after the 1990s have been far more exciting and continue to grow more exciting every year! It seems that the force of outstanding neuropsychological findings is pushing every decade to be the decade of the brain. Advances in technology and imaging are developing so fast it is very difficult to translate the avalanche of new research findings into clinical practice, but new ideas and beliefs are emerging. The concept of “neural Darwinism” has emerged where we are beginning to understand how the individual brain develops a dynamic and plastic dance between genes and experiences. Another new belief that guides treatment of early childhood normal and problematic development is “use it or lose it.” This concept reflects new understanding of neural pruning of information that is learned but not used by the young brain. A new understanding of “automaticity,” how the brain must get information to an automatic level, is also important because it will help us understand how fluid a skill must be before we pursue another new skill. Perhaps the most exciting new belief that guides practice is “neurons that fire together, wire together” suggesting that remediation of learning issues can be enhanced by helping new axonal growth tap into existing neural networks. Of course, to apply these new beliefs we must change our usual way of doing business, or more specifically, we must change our practice methods and standards.

Neuropsychological practice principles are being drawn into everyday school psychology practice because neuroscience has localized areas of brain function that are imperative to the understanding of academic difficulties. Executive functions, for example, are critical to reading comprehension and it is becoming just plain silly to evaluate a child for reading problems without examining how that child organizes, plans, and evaluates what he or she has just read! We could say that we are assessing a child’s organizing skills or we could say that we are assessing a child’s executive functions, and in general, the terms mean the same thing. The difference in this day and age, as opposed to what went before, is that when the school psychologist assesses executive functions, he or she is also seeing how those functions relate to working memory, short-term memory, and several forms of attention. Why would the school psychologist want to do that?—because differentiating memory, attention, and executive function skills will determine which evidence-based interventions will work with a certain child and which ones will not. This is school psychology at a higher level of competence and at a level that is commensurate with knowledge translated down from the neurosciences. Of course, the school psychologist could always just informally estimate the child’s organizational skills, omit any evaluation of organizational skills, or not relate deficits in organizational skills to academic problems. Indeed, this is how it has been done for years. But the main question in this day and this age is: Should we charge school psychologists with the task of keeping abreast of new neuroscientific research developments that translate into psychoeducational evaluation practice?

This book, Best Practices in School Neuropsychology: Guidelines for Practice, Assessment, and Evidence-Based Intervention edited by Dr. Dan Miller answers the question with a resounding “yes!” It begins the long journey of establishing guidelines that reflect the advances in neuroscience critical to good practice. It sets down the minimal knowledge that school psychologists of the future will need to know to adequately carry out a comprehensive assessment of a child who experiences sustained academic difficulties despite having exposure to differentiated instruction with highly qualified teachers. This is not a “nice to have” book. It is an essential book for school psychologists in training and those who are in practice. For the school psychologist in training, it will imprint the highest standards of the day as a base of future practice. For the practicing school psychologist, it will help retool and redesign the current level of practice to knowledge that incorporates neuroscience. The later was omitted from training because technology and findings in genetics and imaging simply were not present in older training programs: At that time, a cohesive understanding of the research did not exist, and beliefs and outcomes were commensurate with the level of knowledge. Now it does exist, and incorporating neuropsychological principles into school psychology practice is a seamless and natural process that will advance good outcomes.

Readers will find that Dr. Miller and his co-authors have labored very hard to present a balanced and comprehensive set of practice standards for school psychologists. Dr. Miller provides a detailed explanation of the breadth and depth of knowledge that is needed for basic practice. He addresses the complex and sometimes difficult issues that present with the re-definition of the role of the school psychologist and the leaning toward subspecialization with detailed analyses and wisdom. The clinical applications, special populations, medical disorders, and resource sections grow into a comprehensive view of applying neuropsychological principles to the practice of school psychology and also show the outstanding wealth of expertise and experience of the respective authors.

This work indicates that the authors and editor have insatiable curiosity about the brain! It demonstrates that the authors and editor are pushing the boundaries of what school psychologists believe because it is the ethical thing to do. Beliefs, ideas, and ethics direct how we act. It is obvious that the individuals involved in the writing of this book take their ethical obligation to incorporate neuroscience into practice very seriously and are acting on that obligation. We are all very lucky to have these colleagues with us in school psychology in this day, and in this age.

Elaine Fletcher-Janzen, Ed.D., NCSP Cleveland, OhioApril, 2009

Preface

AFTER SPENDING MOST of 2006 writing my first book, Essentials of School Neuropsychological Assessment, I told family, friends, and colleagues that I would probably not jump into writing a new book too soon. Writing a book is akin to childbirth: nine months of labor following by the blessed event, or publication in this case. Women tell me they forget the pain of childbirth and soon look forward to having another child. I must have forgotten the arduous process of putting a book together because two years later I suggested to my publisher that this book needed to be published. This time around I am blessed with many gifted, talented, and insightful colleagues that have joined me in crafting this edited book.

For me, scholarly writing must be guided by a passion for the topic, and I have been passionate about school neuropsychological theory and practice since I entered the field of school psychology in 1980. After working as a school psychologist practitioner for six years, I decided to go back to school for a doctoral degree. I was very fortunate to be offered a full-time graduate research position in the Brain Behavior Laboratory at Ohio State University (OSU) working with my mentor Dr. Marlin Languis. Dr. Languis established the first U.S. laboratory using the relatively new technology of quantitative EEG or topographic brain mapping to study children with learning disorders. I spent three years at OSU obtaining a one-of-a-kind doctoral degree that blended school psychology, pediatric neuropsychology, and electrophysiology. As a result of my doctoral studies, I realized the importance of recognizing the biological bases of behavior and their influences on individual differences.

In 1990, after I completed my doctoral studies, I accepted a faculty position at Texas Woman’s University to develop an area of specialization in school neuropsychology for school psychology and counseling psychology doctoral students. Eighteen year later, and counting, I have continued to train future psychologists to integrate neuropsychological principles into their professional practices. The integration of neuropsychological principles into the practice of school psychology specifically has emerged as a subspecialization within school psychology since the early 1990s.

From 2003 to 2004, I had the privilege of serving as the President of the National Association of School Psychologists. I set the theme for the 2004 annual conference as “Minds Matter: All Children Can Learn.” That conference theme still resonates for me today. In this new era of implementation of response-to-intervention models across the country, our profession has become polarized between those who advocate for a strict behavioral, curriculum-based measurement approach to identifying children with disabilities and those who continue to see the value of assessing individual differences and tailoring interventions to assessment data.

Another major impetus for this book comes from my review of the most recent Best Practices in School Psychology V. I was discouraged that in this comprehensive five-volume set there was not a single chapter that addressed the biological bases of behavior. This book, Best Practices in School Neuropsychology: Guidelines for Effective Practice, Assessment, and Evidence-Based Intervention will attempt to fill that void. The best practice of school psychology is not complete without considering the biological bases of behavior. This book is organized into three broad sections: Professional Issues in School Neuropsychology, Practice Issues in School Neuropsychology, and Clinical Applications of School Neuropsychology.

PROFESSIONAL ISSUES IN SCHOOL NEUROPSYCHOLOGY

In this section, Chapter 1 provides a rationale for why school neuropsychology is an emerging subspecialty within school psychology. Chapter 2 discusses the issue of what constitutes competency in school neuropsychology, reviews training standards in related fields (e.g., clinical neuropsychology), compares certification requirements in clinical and school neuropsychology, and proposes a set of school neuropsychology training standards. Chapter 3 provides a succinct review of legal and ethical issues that arise in the practice of school neuropsychology. Chapter 4 covers the unique challenges in working with culturally diverse populations using school neuropsychological techniques.

PRACTICE ISSUES IN SCHOOL NEUROPSYCHOLOGY

There are six chapters in this section of the book. Chapter 5 describes current school neuropsychological assessment and intervention models. Chapter 6 describes best practices in assessing for cognitive processes. Chapter 7 provides an overview of what neuroscience offers to the practice of school neuropsychology currently and in the future. Chapter 8 presents a comprehensive model of how school neuropsychology fits within a response-to-intervention model. Chapter 9 presents a rationale for the importance of school neuropsychologists collaborating with parents, educators, and other professionals to maximize services to children. Chapter 10 describes the various roles and responsibilities a school neuropsychologist can assume when children return to school after serious neurological injuries.

CLINICAL APPLICATIONS OF SCHOOL NEUROPSYCHOLOGY

The third section of the book is divided into four sections: clinical applications of school neuropsychology with: 1) special populations, 2) academic disabilities, 3) processing deficits, and 4) medical disorders. The special populations section presents the best practices for assessing and intervening with: ADD/ADHD children (Chapter 11), children with autism (Chapter 12), children with Asperger’s Syndrome (Chapter 13), children with developmental delays (Chapter 14), children with externalizing disorders (Chapter 15), children with internalizing disorders (Chapter 16), children who are deaf or hard of hearing (Chapter 17), and children who are visually impaired (Chapter 18).

The academic disabilities Section (Section IV) presents the best practices for assessing and intervening with: children with reading disorders (Chapter 19), children with writing disorders (Chapter 20), children with math disorders (Chapter 21), children with speech and language disorders (Chapter 22), and children with nonverbal learning disabilities (Chapter 23).

The processing deficits section presents the best practices for assessing and intervening with children who have executive function disorders (Chapter 24), memory and learning disorders (Chapter 25), and sensory-motor impairments (Chapter 26).

The medical disorders Section (Section V) presents the best practices for assessing and intervening with children with chronic illnesses (Chapter 27), brain tumors (Chapter 28), seizure disorders (Chapter 29), and traumatic brain injury (Chapter 30).

Writing this book has been a collaborative effort. The chapter authors represent a well-respected group of school psychologists, school neuropsychologists, neuropsychologists, clinicians, professors, and advanced doctoral students committed to sharing their knowledge and expertise. My sincere thanks goes to all of the authors who took time from their busy schedules to contribute to this project.

Special thanks to my colleague at work, Glenda Peters, who tirelessly proofed every chapter and covered the department while I hid away from the phones, e-mail, students, and faculty to write. Also special thanks to Isabel Pratt, my editor at Wiley, who kept me on track. Special thanks to the doctors and staff at the Denton Regional Hospital who gave me a second lease on life in December 2008, which afforded me the opportunity to finish this book project. Last but not least, I want to thank my wife Michie for her continued support as my best friend, live-in editor, and chief supporter.

Daniel C. Miller April, 2009

About the Editor

DANIEL C. MILLER, Ph.D., is a Professor and Department Chair in the Department of Psychology and Philosophy at Texas Woman’s University in Denton, Texas. He is also the Director of a national school neuropsychology post-graduate certification program available at multiple locations across the country. Dr. Miller has more than 25 years of experience working in the field of school psychology and the emerging specialty of school neuropsychology as a practitioner and trainer. Dr. Miller is credentialed as a Licensed Psychologist, Licensed Specialist in School Psychology, Diplomate in School Psychology from the American Board of Professional Psychology, Diplomate in School Neuropsychology from the American Board of School Neuropsychology, and a National Certified School Psychologist. Dr. Miller has been an active leader in both school psychology and school neuropsychology. He was the founding president of the Texas Association of School Psychologists (1993) and a past president of the National Association of School Psychologists (2003-2004). Dr. Miller is a frequent presenter at state and national conferences about school neuropsychology-related topics. He is an active researcher and the author of the Essentials of School Neuropsychological Assessment (2007) by John Wiley & Sons, Inc.

Contributors

Vincent C. Alfonso, Ph.D.

Professor and Associate Dean for Academic Affairs

Graduate School of Education

Fordham University

New York, New York

Erin Avirett, B.A.

Doctoral Student

Department of Psychology and Philosophy

Texas Woman’s University

Denton, Texas

Elizabeth L. Begyn, Ph.D.

Postdoctoral Fellow

Department of Psychiatry

Neuropsychology Service

Children’s Medical Center Dallas

Dallas, Texas

Virginia W. Berninger, Ph.D.

Professor

Department of Educational Psychology

University of Washington

Seattle, Washington

Jessica L. Blasik, MS.Ed.

Doctoral Student

Department of Counseling, Psychology, and Education

Duquesne University

Pittsburgh, Pennsylvania

Christine L. Castillo, Ph.D.

Neuropsychologist

Department of Psychiatry, Neuropsychology Service

Children’s Medical Center Dallas

Dallas, Texas

and

University of Texas Southwestern Medical Center

Dallas, Texas

Ginger Depp Cline, Ph.D.

Postdoctoral Fellow

Texas Children’s Hospital

Houston, Texas

Beth Colaluca, Ph.D.

Neuropsychologist

Department of Neuropsychology

Cooks Children’s Medical Center

Fort Worth, Texas

Andrew Davis, Ph.D.

Associate Professor

Department of Educational Psychology

Ball State University

Muncie, Indiana

Scott L. Decker, Ph.D.

Assistant Professor

College of Education

Department of Counseling and Psychological Services

Georgia State University

Atlanta, Georgia

Philip A. DeFina, Ph.D., ABSNP

Chief Executive Officer and Chief Scientific Officer

International Brain Research Foundation, Inc.

Edison, New Jersey

Douglas A. Della Toffalo, Ph.D., ABSNP

School Neuropsychologist

Licensed Psychologist

Cranberry Area School District

Seneca, Pennsylvania

Kathy DeOrnellas, Ph.D.

Assistant Professor

Department of Psychology and Philosophy

Texas Woman’s University

Denton, Texas

Catherine L. Dial, B.S.

Vocational Services Coordinator

Clinical & Consulting Neuropsychology

Dallas, Texas

Jack G. Dial, Ph.D.

Licensed Psychologist and Licensed Specialist in School Psychology

Clinical & Consulting Neuropsychology

Dallas, Texas

Cristin Dooley, Ph.D.

Psychologist

Lewisville Independent School District

Lewisville, Texas

Agnieszka M. Dynda, Psy.D.

Adjunct Assistant Professor

St. John’s University

Queens, New York

Jonelle Ensign, M.S.

Licensed Specialist in School Psychology

Fort Worth Independent School District

Fort Worth, Texas

and

Doctoral Student

Texas Woman’s University

Denton, Texas

Eleazar Eusebio, M.A.

Doctoral Student

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

Steven G. Feifer, D.Ed., ABSNP, NCSP

School Psychologist

Frederick County Public Schools

Frederick, Maryland

Dawn P. Flanagan, Ph.D.

Professor

Department of Psychology

St. John’s University

Queens, New York

Lisa Hain, Psy.D.

Doctoral Student

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

James Brad Hale, Ph.D., ABSNP

Associate Professor

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

Julie Henzel, M.A.

Doctoral Student

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

Jacqueline Hood, Ph.D.

Psychologist, Center for Pediatric Psychiatry

Children’s Medical Center Dallas

and

Assistant Professor of Psychiatry

University of Texas Southwestern Medical School

Colleen Jiron, Ph.D., ABCN

Clinical Neuropsychologist

Professional School Psychologist

Boulder Valley School District

Boulder, Colorado

Wendi Johnson, Ph.D.

Licensed Specialist in School Psychology

Denton Independent School District

Denton, Texas

Mary Joann Lang, Ph.D., ABPN

Neuropsychologist

Irvine School of Medicine

Department of Pediatrics

University of California

Irvine, California

and

Beacon Day School

Orange, California

Ann Marie T. Leonard-Zabel, Ph.D., ABSNP, NCSP

Associate Professor

Psychology Department

Curry College

Milton, Massachusetts

and

School Neuropsychologist

President of N.E.A.L.A.C. Clinic

Plymouth, Massachusetts

Denise E. Maricle, Ph.D.

Associate Professor

Department of Psychology and Philosophy

Texas Woman’s University

Denton, Texas

Robb N. Matthews, M.A.

Doctoral Student

Department of Educational Psychology

Texas A & M University

College Station, Texas

Marie C. McGrath, Ph.D., NCSP

Assistant Professor

Department of Graduate Psychology

Immaculata University

Immaculata, Pennsylvania

Amy McLaughlin, M.A.

Doctoral Student

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

Kurt Metz, Ph.D., ABSNP

Researcher

The Madrillon Group, Inc.

Vienna, Virginia

Daniel C. Miller, Ph.D., ABPP, ABSNP, NCSP

Professor

Department of Psychology and Philosophy

Texas Woman’s University

Denton, Texas

Jeffrey A. Miller, Ph.D., ABPP

Associate Professor

Department of Counseling, Psychology, and Special Education

Duquesne University

Pittsburgh, Pennsylvania

Margery Miller, Ph.D.

Professor

Psychology Department

Gallaudet University

Washington, D.C.

Jennifer Morrison, Ph.D.

Neuropsychologist

Kids Brains, LLC

Dallas, Texas

Raychel C. Muenke, B.S.

Doctoral Student

Department of Psychology and Philosophy

Texas Woman’s University

Denton, Texas

Brooke Novales, Ph.D.

Licensed Specialist in School Psychology

Denton Independent School District

Denton, Texas

Samuel O. Ortiz, Ph.D.

Associate Professor

Department of Psychology

St. John’s University

Jamaica, New York

H. Thompson Prout, Ph.D., ABSNP

Professor

Department of Educational and Counseling Psychology

University of Kentucky

Lexington, Kentucky

Susan M. Prout, Ed.S.

School Psychologist

Fayette County Schools

Lexington, Kentucky

Lynsey Psimas-Fraser, B.A.

Doctoral Student

Department of Psychology and Philosophy

Texas Woman’s University

Denton, Texas

Mittie T. Quinn, Ph.D.

Licensed School Psychologist

Adjunct Faculty

George Mason University

Fairfax, Virginia

Linda A. Reddy, Ph.D.

Associate Professor

Rutgers Graduate School of Applied and Professional Psychology

Piscataway, New Jersey

Robert L. Rhodes, Ph.D.

Professor, Department

Special Education & Communication Disorders

New Mexico State University

Las Cruces, New Mexico

Cynthia Riccio, Ph.D.

Professor

Department of Educational Psychology

Texas A & M University

College Station, Texas

Amy Stern, M.S.

Doctoral Student

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

Tania N. Thomas-Presswood, Ph.D., ABSNP

Associate Professor

Psychology Department

Gallaudet University

Washington D.C.

Nichole Wicker, M.A.

Doctoral Student

Department of Educational Psychology

Texas A & M University

College Station, Texas

Gabrielle Wilcox, M.S.

Doctoral Student

Department of Psychology

Philadelphia College of Osteopathic Medicine

Philadelphia, Pennsylvania

Jed Yalof, Ph.D., ABSNP

Professor

Department of Graduate Psychology

Immaculata University

Immaculata, Pennsylvania

Audrea R. Youngman, B.A.

Doctoral Student

Department of Educational Psychology

Texas A & M University

College Station, Texas

SECTION I

PROFESSIONAL ISSUES IN SCHOOL NEUROPSYCHOLOGY

CHAPTER 1

School Neuropsychology, an Emerging Specialization

DANIEL C. MILLER

“WE BELIEVE IT is no longer possible for the school psychologist to master all of the areas of knowledge needed to function ‘ethically and effectively in so many domains. The time for the development of specializations in school psychology has come” (Hynd & Reynolds, 2005, pp. 11-12).

The preceding quote is from George Hynd and Cecil Reynolds, the principal pioneers behind the development of the school neuropsychology specialty. The purpose of this chapter is to provide a rationale for why the time is right for our national school psychology organizations to recognize specialties/subspecialties. The focus of this chapter will be on the need to specifically recognize school neuropsychology as a subspecialty. The chapter will also review the various roles and functions of a school neuropsychologist, review the history of school neuropsychology, and review the common reasons for referral for a school neuropsychological evaluation.

THE NEED FOR PROFESSIONAL ORGANIZATIONS TO RECOGNIZE SPECIALIZATIONS

In this chapter, the term emerging specialty or emerging specialization will be used in reference to school neuropsychology, which implies that the author believes that the practice of school psychology has matured into a separate and distinct profession from the practice of psychology in general.

For the past forty years there has been a debate between the American Psychological Association (APA) and the National Association of School Psychologists (NASP) about how school psychology relates to the broader field of psychology. The question remains whether the practice of school psychology has become a separate profession or remains a recognized specialty within the broader field of psychology. If school psychology were considered a separate and distinct profession from psychology in general, then school neuropsychology would be viewed as an “emerging specialization/specialty” within school psychology. In APA, school psychology is already a recognized specialty area within the broader field of psychology. If specializations were recognized within the specialty of school psychology, then school neuropsychology would be viewed as an emerging “subspecialization or subspecialty.”

Another long-standing controversy in school psychology is the use of the title “school psychologist.” Again, this contentious debate has been between APA and NASP. Within APA’s Model Act for State Licensure of Psychologists (American Psychological Association, 1987) there has been a long-standing exemption that allows nondoctoral practitioners to use the title “school psychologist” if they are state certified for practice. In 2007, APA proposed that the language granting this exemption be removed and the title school psychologist only be reserved for doctoral licensed practitioners. At the time this chapter was written, this issue was still unresolved. In this chapter, the term school psychologist will be used to describe specialist-level and doctoral-level practitioners who offer the full array of school psychological services.

The evidence exists to suggest that the days of being a school psychologist generalist are numbered. The term generalist implies that a broad array of entry-level knowledge and skills within the field of school psychology are known and demonstrated respectively. Fagan (2002) noted “that the point has been exceeded where a school psychologist can be trained to perform all roles and functions with competence” (p. 7). The challenge for trainers and their students has been to remain abreast at the entry-level depth of knowledge and skills required within each domain of practice (Miller, DeOrnellas, & Maricle, 2008).

Miller et al. (2008) and Miller, DeOrnellas, and Maricle (2009) stated that the increase in specialized knowledge within our field has led many school psychology practitioners to choose (voluntarily or through necessity) to specialize within a particular area. It is important to realize that such specialization is a luxury afforded to school districts that have a sizable number of school psychologists. School psychologists working in large school districts, often in urban areas, have opportunities for specialization that are not afforded to those school psychologists working in rural, and often underserved, areas. In rural areas, school psychologists are “generalists” by necessity. Therefore, as the profession enters into discussing the merits of recognizing specializations within the field of school psychology, the urban versus rural service delivery differences need to be considered.

Another issue that must be weighed is the impact of recognizing specializations on the existing shortage of school psychologists. Curtis, Hunley, and Chesno-Grier (2004) reviewed the potential negative impact of the shortage of school psychologists on service delivery to children. Any time a profession makes credentialing of its practitioners more difficult, the risk increases that there will be fewer practitioners to offer services. Specialization within a profession may be a natural progression that takes place within a profession with specialization being viewed as a sign of organizational maturity (Fagan, 2002; Hynd & Reynolds, 2005; Miller et al., 2008, Miller, DeOrnellas, & Maricle, 2009); however, professional organizations should carefully consider the potential impact of recognizing specializations on the shortage of school psychologists and on rural service delivery.

Miller, Maricle, and DeOrnellas (2009) conducted a random survey of 1,000 regular members of the National Association of School Psychologists (NASP), and 80.9 percent of the respondents were in favor of NASP recognizing subspecialties with school neuropsychology being one of the top ten recommended areas of specialization. Specialization occurs when a school psychologist is either asked, or volunteers through interest, to assume the duties within a narrow range of focus. For example, a school psychologist may be assigned to work on the autism assessment team. While the school psychologist may have some basic training in differential diagnosis in the identification of autism spectrum disorders, he or she is often lacking in the specialized expertise required to expertly perform the required duties. In order to hone professional skills in autism, the ethical practitioner will seek out training, supervision, and professional resources (e.g., books, tests). The question then becomes what ultimately constitutes entry-level competency within a specialization. This question will be discussed in Chapter 2 of this book entitled School Neuropsychology Training and Credentialing.

SCHOOL NEUROPSYCHOLOGY AS A SPECIALTY

The body of specialized school psychology knowledge has grown exponentially in recent years. We truly live in an amazing age of vast information. The training requirements for entry-level school psychology practitioners have increased dramatically since the early 1990s. Trainers of school psychologists do their best to train entry-level and advanced practitioners in a variety of roles and functions, including data-based problem solving, assessment, consultation, counseling, crisis intervention, and research. Most school psychology curriculums at the specialist-level have a class that covers the biological bases of behavior, but there is no in-depth exposure to neuropsychology. School psychology trainers often feel that they only have enough time to introduce specialist-level students to the broad array of roles and functions available to them as practitioners. Increased specializations in areas such as school neuropsychology must occur either through organized, competency-based postgraduate certification programs or through doctoral school psychology programs that offer specialization in school neuropsychology.

There are several reasons for recognizing school neuropsychology as a specialty within school psychology, including the following:

• The growing acknowledgment within the medical and education communities of the neurobiological bases of childhood learning and behavioral disorders.

• The influences of federal education laws such as IDEA, which have included traumatic brain injury as a disability and continued to emphasize the identification of processing deficits in specific learning disabled children.

• The increased number of children with medical conditions that affect their school performance.

• The increased use of medications with school-aged children often including multiple medications with unknown combined risks or potential interactions.

• Limited access to neuropsychological services within the schools. There is a tremendous need for school psychologists to receive enhanced training in school neuropsychological practice. When neuropsychological services are provided to the school by outside professionals, the reports are often not useful to the schools in developing educationally relevant interventions (see Miller, 2007, for a review).

THE ROLES AND FUNCTIONS OF A SCHOOL NEUROPSYCHOLOGIST

ASSESSMENT

One of the specialized roles that a school neuropsychologist can perform is specialized assessment. School neuropsychological assessments are more in-depth than traditional psychoeducational or psychological evaluations. School neuropsychological assessments typically measure a wider variety of neurocognitive constructs such as sensory-motor functions, attentional processes, visual-spatial processes, language processes, memory and learning, executive functions, speed and efficiency of cognitive processing, general intellectual ability, academic achievement, and social-emotional functioning (see Miller, 2007, for a review and Chapter 5 in this book, which reviews the best practices in school neuropsychological assessment and intervention).

CONSULTATION

A school neuropsychologist will have specialized knowledge of brain-behavior relationships and an awareness of how education is affected by impairment of function. School neuropsychologists can assist in the interpretation of neuropsychological findings or medical records from outside agencies. School neuropsychologists can help translate brain research into educational practice by consulting with educators and parents about specific child-related issues and about broader systemic educational issues. See Chapter 9 in this book for a more thorough discussion of the best practices in school neuropsychology collaboration with home, school, and outside professionals.

AGENCY/SCHOOL LIAISON

An important role of a school neuropsychologist is to monitor interventions and to facilitate re-entry planning for children and youth who are medically incapacitated due to a neurological insult or injury. As an example, a school neuropsychologist should act as a liaison between the hospital and the schools when a child is being treated for a traumatic brain injury. Finding out for the first time about “Johnny,” who experienced a head injury six months ago and is now sitting in your office wanting to be educationally served, is not good practice. Miller (2007, pp. 79-80) detailed several activities that a school neuropsychologist can perform as a liaison between the schools and a medical facility. Also see Chapter 10 of this book for a more thorough discussion of the best practices in school reentry for children recovering from neurological conditions.

EDUCATOR

School neuropsychologists can conduct inservice trainings for parents and teachers about neuropsychological factors that relate to common childhood disorders. As an example, a school neuropsychologist could offer a workshop on the biological bases of ADHD and discuss how psychopharmacology assists in managing the disability in some cases.

EVIDENCE-BASED RESEARCHER

Another important role and function for a school neuropsychologist is to conduct both basic and applied educational research to continually investigate the assessment-intervention linkage and to evaluate the efficacy of neuropsychologically based interventions and consultations (Miller, 2007). In the last two decades, many new assessment instruments and interventions have been made available to school neuropsychologists. As a good consumer of new products or techniques, the school neuropsychologist must continually evaluate the quality and the applicability of these new tools. When evaluating a new assessment instrument or a new intervention, the practitioner should always be asking the questions: How does this new assessment offer new insight into the neuropsychological processing of the child compared to established assessment techniques? or What is the effectiveness of this new intervention compared to other established interventions?

The emerging specialty of school neuropsychology has been historically influenced by the disciplines of clinical neuropsychology, school psychology, and education. The state of the art and a review of the history of school neuropsychology are discussed in the next section.

STATE OF THE ART OF SCHOOL NEUROPSYCHOLOGY

In order to appreciate the current state of the art in school neuropsychological assessment, it is important to review some of the historical approaches to neuropsychological assessment. Rourke (1982) labeled three stages to describe the history of clinical neuropsychology: (1) the single-test stage, (2) the test battery/lesion specification stage, and the (3) functional profile stage. Miller (2007) labeled the current state-of-the-art practice in neuropsychology as the integrative and predictive stage.

The single-test stage dominated the early years (1900-1950s) of clinical neuropsychology in the United States. As the name of the stage implies, clinicians attempted to use a single test to differentially classify patients with and without brain damage. Clinicians looked for signs of organicity or brain dysfunction in patients using single tests such as the Bender Visual-Motor Gestalt, Benton Visual Retention, or the Memory for Designs tests (Miller, 2007). In current practice, school neuropsychologists may use a few stand-alone tests that have been created to assess specific neurocognitive skills. For example, the Wisconsin Card Sorting Test (Heaton, 1981) assesses executive functions, and the Bender-Gestalt Second Edition (Brannigan & Decker, 2003) assesses visual perceptual-motor ability. The single-test approach to differentiate brain damage did not work with sufficient validity (Rourke, 1982), so the field progressed to using fixed test batteries.

During the test battery/lesion specification stage (1940-1980s), there were several major test batteries that were designed to provide multiple measures of the same neuropsychological constructs, thereby improving the reliability and validity of the tests. In the 1940s, World War II shaped the required role and function of early clinical neuropsychologists, which was to use a battery of tests designed to determine the source of possible brain dysfunction. In 1955, Ralph Reitan published the Halstead-Reitan Neuropsychological Test Battery (HRNTB), which became the gold standard in clinical neuropsychological assessment. The HRNTB is still used in adult clinical neuropsychology practice today, largely due to updated norms that were developed in the early 1990s (Heaton, Grant, & Matthews, 1991).

Reitan and Davidson (1974) published a downward extension of the HRNTB for children ages 9 to 14 called the Halstead-Reitan Neuropsychological Test Battery for Older Children (also see Reitan & Wolfson, 1992). Reitan and Wolfson (1985) also published a version of the HRNTB for young children ages 5 to 8 called the Reitan-Indiana Neuropsychological Test Battery. These versions of the HRNTB for children had several limitations, including poor conceptualization of childhood developmental disorders, inadequate norms, covariance with measures of intelligence, an inability to distinguish psychiatric from neuropsychological conditions in children, and the inability to localize dysfunction or predict recovery of function after brain injury (see Teeter & Semrud-Clikeman [1997] for a review).

It is not state-of-the-art practice to use the Halstead-Reitan Batteries to assess neuropsychological functions in children. Unlike the adult versions of the test, which have updated norms, the children’s versions of the HRNTB have not been renormed in over fifty years. In current practice, many of the HRNTB tests have been modified and updated and included in more recent neuropsychological test batteries. For example, the Reitan-Klove Sensory-Perceptual Examination from the HRNTB has been restandardized, updated, and serves as the foundation for the Dean-Woodcock Sensory-Motor Battery (DWSMB; Dean & Woodcock, 2003). One of the advantages of using the DWSMB is the fact that the test is co-normed with the Woodcock-Johnson III Tests of Cognitive Abilities (Woodcock, McGrew, & Mather, 2001). As another example, the Trail Making Test (TMT) from the HRNTB has been widely used in isolation by practitioners. An updated version of the TMT was included in the Delis-Kaplan Executive Function System (D-KEFS; Delis, Kaplan, & Kramer, 2001). The D-KEFS version of the TMT is co-normed with a battery of other executive function measures, and it includes detailed process assessment information to aid in clinical interpretation.

Another early “gold standard” in the practice of adult clinical neuropsychology was the Luria-Nebraska Neuropsychological Battery (LNNB) for adults (Golden, Hammeke, & Purish, 1978). The LNNB was an attempt by U.S. neuropsychologists to standardize the largely qualitative approach to clinical neuropsychology used by the Russian neuropsychologist, Alexander Luria. Luria’s theory of brain functioning has provided the foundation for many of the more modern neuropsychological assessment instruments used today (e.g., Cognitive Assessment System [Naglieri & Das, 1997]; Kaufman Assessment Battery for Children, 2nd Edition [Kaufman & Kaufman, 2004]). Golden (1986) also published a children’s version of the LNNB for ages 8 to 12 called the Luria-Nebraska Neuropsychological Battery: Children’s Revision (LNNB-CR). Teeter and Semrud-Clikeman (1997) provided an extensive review of the LNNB-CR. They found studies that supported the use of the LNNB-CR for differentiating LD from non-LD children, but there was little evidence that the LNNB-CR was effective in differentiating neurologically impaired from nonclinical groups.

The third major clinical approach that emerged during the test battery/ lesion specification stage became known as the process assessment approach. In the 1960s and 1970s, a group of clinicians and researchers (e.g., Norman Geschwind, Harold Goodglass, Nelson Butters, Heinz Warner, Edith Kaplan) investigated variations in cognitive functions across clinical populations, but did not use the typical fixed batteries (e.g., HRNTB or the LNNB) (see Hebben & Milberg, 2002 for a review). The process assessment approach used a flexible, rather than fixed, battery approach and put emphasis on the qualitative aspects of behavior. As clinicians, those trained in the process assessment approach were just as interested in the strategies that an individual used to derive a test score, if not more than the test score itself. The principle of “testing the limits” to determine why a particular test was difficult for an individual was developed by these process assessment clinicians.

In current practice, the process assessment approach has been integrated into tests such as the Cognitive Assessment System (Naglieri & Das, 1997), the Wechsler Intelligence Scale for Children, 4th Edition Integrated (Wechsler, 2004), the Kaufman Assessment Battery for Children, 2nd Edition (Kaufman & Kaufman, 2004), the D-KEFS (Delis, Kaplan, & Kramer, 2001), and the NEPSY-II (Korkman, Kirk, & Kemp, 2007).

In summary, the HRNB, the LNNB, and the process assessment approach emerged during the test battery/lesion specification stage, and each has produced a lasting impact upon clinical neuropsychological assessment. However, the need to move beyond assessment only for the sake of diagnosis to a model that links assessment to prescriptive interventions laid the foundation for the next stage in clinical neuropsychology, called the functional profile stage (Miller, 2007).

The functional profile stage (1970s-1990s) described the period in clinical neuropsychology and the emerging specialization of school neuropsychology. In the 1970s, there were three major factors that helped to reshape neuropsychology: (1) Neuropsychologists who specialized in working with children started to question the logic of using downward extensions of adult assessment models and applying these to children, (2) neuropsychologists started to question the validity of neuropsychological test batteries to localize brain lesions and predict recovery of functions, and (3) the emergence of noninvasive brain imaging techniques that replaced the need for neuropsychological tests to make inferences regarding the site of brain lesions or dysfunction (Miller, 2007). The focus of neuropsychological testing during this period shifted away from localizing lesions to identifying functional strengths and weaknesses that would aid in the remediation of impaired abilities.

Rourke (1982) referred to this functional profile stage as the cognitive stage because clinicians integrated the principles of cognitive psychology into the practice of neuropsychology. However, despite the call for neuropsychologists to provide more functional assessments of cognitive strengths and weaknesses and for better linkages to prescriptive interventions, the assessment tools available to neuropsychologists did not change until the early 1990s.

The integrative and predictive stage was a term used by Miller (2007) to describe the period of neuropsychological assessment from the 1990s to present time. Within the past two decades, there has been a convergence of research on brain-behavior relationships that has influenced school neuropsychology and the assessment tools. School neuropsychology started to emerge as a specialization in earnest in the 1990s. The multidisciplinary influences on school neuropsychology include the development of tests specifically designed for children, advancements in neuroimaging techniques (see Chapter 7 in this book for a review of the best practices in the application of neuroscience to the practice of school neuropsychology), advancements in the theoretical foundations for neuropsychological tests, cross-battery assessment, the process assessment approach, focus on ecological validity, and the emphasis on linking assessment with evidence-based interventions (Miller, 2007).

Table 1.1 presents the major tests of cognitive abilities and school neuropsychological tests published since the 1990s. The tests of cognitive abilities were included in this table because the major tests of cognition have increasingly incorporated neuropsychological constructs (e.g., processing speed, working memory, executive functions). The wealth of theoretically based and psychometrically sound assessment instruments that we as practitioners have at our current disposal is unprecedented in the history of school psychology or the emerging specialization of school neuropsychology. However, many of these neuropsychological constructs now mainstream in assessment require the practitioner to have better training in the biological bases of behavior and understanding of neuropsychological theories. Training issues will be discussed in more depth in Chapter 2 of this book.

WHEN TO REFER FOR A SCHOOL NEUROPSYCHOLOGICAL ASSESSMENT OR CONSULTATION

It would not be prudent or practical to conduct a comprehensive school neuropsychological assessment on every child experiencing learning difficulties. Neuropsychological evaluations are more in-depth than psychoeducational and psychological evaluations because they assess a wider variety of constructs (e.g., sensory-motor functions, memory and learning, executive functions, and others). One of the first roles a school neuropsychologist must assume with a school district is to set some policies and procedures for educators and parents about when to refer for a school neuropsychological evaluation.

Table 1.1 Major School Neuropsychological Tests Published Since 1990

Table 1.2 lists some of the common reasons for a school neuropsychological assessment.

CHILDREN WITH A KNOWN OR SUSPECTED NEUROPSYCHOLOGICAL DISORDER

This is a broad category of potential referral candidates. It could be argued that all learning and behavior has a neuropsychological basis; however, the targeted referral source in this case is more specific. Many school districts are implementing a Response-to-Intervention approach to monitor educational interventions and perhaps lead to more comprehensive diagnosis of a disability. When a child consistently does not respond to a variety of evidence-based interventions, a comprehensive school neuropsychological assessment could help identify a profile of the child’s neurocognitive strengths and weaknesses and perhaps an underlying neuropsychological condition. The goal of the school neuropsychological evaluation will be to develop appropriate educational interventions based on the neurocognitive assessment data.

Table 1.2 Common Reasons for a School Neuropsychological Evaluation

It is important to keep in mind that not all children with known or suspected neuropsychological disorders will be experiencing current academic or behavioral difficulties. Ideally, school neuropsychologists should work with educators in a preventive manner to maximize the learning environment for all children in an effort to minimize future learning and behavioral difficulties. However, if a child with a known or suspected neuropsychological disorder starts to manifest educational problems, appropriate assessments and interventions should be taken to help that child.

CHILDREN WITH HEAD INJURIES WHO ARE HAVING ACADEMIC OR BEHAVIORAL PROBLEMS

During the early years of development many children have incidences of hitting their heads. Bumps and bruises seem to be a normal process of growing up for most children. However, when a hit to a child’s head causes loss of consciousness, the potential adverse impact of that injury dramatically increases. It is not uncommon for a child to sustain a head injury and to appear afterward (perhaps for days, weeks, or years) as if there were no side effects, only to have academic or behavioral difficulties surface at a later date that are related to the head injury. At a minimum, school neuropsychologists should monitor those children who have suffered head traumas to make sure there are no lasting effects. A comprehensive school neuropsychological evaluation would provide baseline data about the child’s neurocognitive strengths and weaknesses that could aid in intervention planning. See Chapter 30 in this book for a review of the best practices of assessing and intervening with children who have traumatic brain injuries.

CHILDREN WITH ACQUIRED OR CONGENITAL BRAIN DAMAGE

Not all head injuries are caused by traumatic events such as blows to the head. Some head injuries caused by disorders of the brain, such as anoxia or meningitis, can adversely affect some brain functions. A comprehensive school neuropsychological evaluation for children with acquired or congenital brain damage would provide baseline data about the child’s neurocognitive strengths and weaknesses that could aid in intervention planning. See Miller (2007, pp. 65-66) and Chapter 27 in this book for a comprehensive review of the best practices of assessing and intervening with children who have chronic illnesses.

CHILDREN WITH NEUROMUSCULAR DISEASES

Children with neuromuscular disorders may or may not have neurocognitive deficits associated with their primary disorder. The very nature of neuromuscular disorders makes traditional assessment methods difficult to apply. An example would be children with cerebral palsy, which prohibits or impairs motor movements, interfering with motor output, including speech and gross and fine motor control. In such as cases, school neuropsychologists will need to collaborate with other specialized practitioners such as occupational and physical therapists when assessing children with neuromuscular diseases. See Miller (2007, pp. 66-72) for a review of cerebral palsy and muscular dystrophy disorders and their potential related neuropsychological deficits.

CHILDREN WITH BRAIN TUMORS