[W1] - CH5 Flashcards
Three contemporary models for conceptualising school neuropsychology
The Cognitive Hypothesis Testing Model [CHT] - (Fiorello, Hale, & Wycoff, 2012)
Combines two approaches:
1. Individual psychoeducational assessment.
2. Intervention development and monitoring.
Important in this Model:
- Assessing the child’s behavior within the confines of their environment, and assessing the influences of neuropsychological constraints on their behavior.
- Single-subject designs and the use of behavioral analyses to track intervention progress.
- Engaging SNPs in more indirect service delivery (i.e., consultations/work with pre-referral intervention teams) - particularly relevant concern because of SP shortages.
Four component parts: [THID]
- Theory
- Hypothesis
- Data collection
- Interpretation
There are 13 steps in this model that move up and down between the four component parts - with most psychoeducational evaluations stopping at step 5 (cognitive strengths and weaknesses) - however educators should carry on the steps from 9 to 13 [Intervention consultation → choosing plausible intervention → collecting objective intervention data → determining intervention efficacy → continue/terminate/modify intervention]
CHT is grounded in Lurian theory and a process-oriented approach. If a global deficit is observed
in a child’s assessment data, a reason for the global deficit is hypothesized and
then further tested for specific deficits.
Neurodevelopmental Model (NDM) of Evaluation and Intervention - (Fletcher-Janzen, 2017)
The NDM provides a framework for single-case evaluations and related interventions for school-age children (from birth to 18 years of age). It requires clinicians to translate neuropsychological information to enhance sensitivity and specificity in determining disabilities, as well as to inform and direct interventions to improve quality of life.
The focus of any comprehensive NDM assessment is guided by the Lurian developmental periods:
- Block 1: Sensory ~ 0/4 years ~ Basic sensory and perceptual processes that become integrated over the course of neurodevelopment.
- Block 2: Integrative ~ 4/11 years ~ Cognitive processes in block 2 facilitate the learning of basic skills, further integration of sensory processing, and increase fluency or automaticity of responding.
- Block 3: Generative ~ 11/Adult ~ Cognitive processes within Block 3 represent mastery of multiple processes directed by executive functions
The seven cognitive processes emphasized by NDM:
1. Auditory Processing.
2.Visual processing.
3. Sensory/Motor processing.
4. Language processing.
5. Attention and executive functioning.
6. Memory
7. Social-emotional processing
[Then Reading, Math and Writing as products]
There are block 1 abilities for each process (and 2/3) - so the clinician starts with the Block 1 processes and then progresses from there.
The 9/10-step NDM Evaluation Process:
- History
- Cultural context
- Neuro-based evaluation
- Medical consultation
- Intervention
- Consultation
- Progress Monitoring
- Follow-up
- Quality of life (how was it affected by the assessment/intervention)
[this step is unique in neuropsychoeducational evaluations but is included in the NDM to assist in evaluating the validity of the assessment process and to reiterate the ultimate reason for the evaluation]
What is the purpose of the Integrated SNP/CHC Model (Miller, 2013)
- Facilitate clinical interpretation by providing an organizational framework for assessment data
- Strengthen the link between assessment and evidence-based interventions
- Provide a common frame of reference for evaluating the effects of neurodevelopmental disorders on neurocognitive processes
[Note: it was first introduced to organize school-age, cross-battery assessment data by the underlying principal neuropsychological constructs being measured]
What Theoretical and Clinical approaches does the Integrated SNP/CHC model synthesize?
Lurian theory (i.e.,
systematically determining neurocognitive strengths and weaknesses by varying the input, processing, and output demands of tasks - an attentional processing problem diagnosis is too broad; break it down into shifting, sustained, or selective - allows for more refined recommendations)
A process-oriented approach to assessment (i.e., qualitative and quantitative assessment data - WHAT strategies are employed are virtually as important as the test score itself)
Neuropsychological theories.
The cross-battery assessment approach.
Cattell-Horn-Carroll (CHC) theory.
The Four Major Classifications of the Integrated SNP/CHC Model
- Basic sensorimotor functions/capabilities
- Facilitators and inhibitors for cognitive processes and acquired knowledge skills
- Cognitive processes
- Acquired knowledge
Sensorimotor Functions in the Integrated SNP/CHC Model
The essential building blocks for all other higher order cognitive processes, and the acquistion of acquired knowledge.
Sensory functions include baseline assessments of vision, hearing, and touch.
Motor functions include baseline assessments of fine and gross motor functions, visual-motor integration, visual scanning (and balance/coordination)
It is important to asses these root impairments so as to not attribute poor performance to something specific when, in reality, it may be something more fundamental.
Cognitive Processes in the Integrated SNP/CHC Model
[V.A.L.E]
- Visuospatial = visual-spatial perception and visual-spatial reasoning
- Auditory Processes = sound discrimination and auditory/phonological processing
- Learning and Memory = dependent on sensory-motor functions, attentional processes, visuospatial processing, and auditory processes
[rate of learning, immediate memory, long-term (delayed) memory, and associative memory and learning] - Executive Functions = command and control centre for other cognitive processes [Concept formation; problem solving and reasoning; qualitative behaviours; behavioural and emotional regulation]
Facilitators/Inhibitors in the Integrated SNP/CHC Model
The facilitators/inhibitors influence both cognitive processes and acquired knowledge, and their influence on our capacities to perceive, feel, think, or act will vary depending on the Neurocognitive Demands of the ongoing process.
Broken Down Into: [S.A.W]
- Speed, Fluency, and Efficiency of processing ~ [performance fluency, retrieval fluency, acquired knowledge fluency, the influence of fluency on performance accuracy, and qualitative behaviours]
- Attention ~ [selective/focused attention, sustained attention, shifting attention, and attentional capacity components]
- Working Memory ~ [verbal and visual]
Acquired Knowledge in the Integrated SNP/CHC Model
Further broken down into acculturation knowledge (previously classified as semantic memory), language abilities, reading achievement, written language achievement, and mathematical achievement. (5)
Note that it is important to consider the student’s social-emotional, environmental, and cultural factors so as not to misdiagnose a processing disorder on the basis of an environmental influence.
What is the CHC theory?
A hierarchical and multidimensional theory of cognitive abilities often used as a framework for intelligence researchers to communicate their findings.
Issues with CHC Theory Alone
CHC theory does not adequately classify all of the basic neuropsychological constructs (less specificity/narrow ability classifications)
CHC theorists have not yet identified narrow abilities for visual-motor integration skills or visual scanning.
Within the broader classification of learning and memory, CHC theory does not provide specificity (i.e., doesn’t distinguish between free recall vs recognition)
It doesn’t address the construct of attention in detail (i.e., it does not distinguish between selective/focused, sustained, shifting, response inhibition, or attention capacity). However, it does discuss the narrow ability of Attentional Control, the ability to manipulate the spotlight of attention flexibly to focus on task-relevant stimuli and ignore task-irrelevant stimuli.
CHC theory does not define narrow abilities for written language achievement skills such as expository composition and handwriting, nor does it define narrow abilities for mathematical achievement skills (such as oral counting or fact retrieval).
The Stages of the Levels of Assessment Model
- Informal assessment/intervention by the classroom teacher.
- Formal Intervention/progress monitoring by the student assistance team.
- Psychoeducational Assessment (to identify strengths and weaknesses or to qualify the child for special education services)
- Neuropsychological Assessment.
- Neurological Assessment (e.g., MRI/CAT scan) - (in cases of rapid cognitive function decline)
The Three Tiers of the Response to Intervention Model
Tier I = General Education Initiatives
Tier II = Targeted Interventions
Tier III = Comprehensive Assessment and Referral for Special Education
