Week 5 Flashcards by Josephine Dijk

What kind of plasticity is this?

genetically encoded, time-dependent, and
sequenced maturational processes

Network plasticity
Functional plasticity
Structural plasticity
Process brain plasticity
Potentional brain plasticity

Potentional brain plasticity

varies with age

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What kind of plasticity is this?

changes in response to experience > intrinsic property of the brain to
undergo maturation, structural and functional changes in response to the environment,
experience, and injury

Network plasticity
Functional plasticity
Structural plasticity
Process brain plasticity
Potentional brain plasticity

Process brain plasticity

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What kind of plasticity is this?

dendritic spine density, spine morphology, synaptic protein levels

Network plasticity
Functional plasticity
Structural plasticity
Process brain plasticity
Potentional brain plasticity

Structural plasticity

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What kind of plasticity is this?

long-term potentiation, long-term depression, homeostatic scaling

Network plasticity
Functional plasticity
Structural plasticity
Process brain plasticity
Potentional brain plasticity

Functional plasticity

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What kind of plasticity is this?

learning, memory, cognition

Network plasticity
Functional plasticity
Structural plasticity
Process brain plasticity
Potentional brain plasticity

Network plasticity

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Children from higher SES generally have …. cortex (structural) and … segregation of
brain networks (functional)

thicker

superior segregation

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how does low socioeconomic status (SES) impact brain development in children?

A) Children from lower SES backgrounds have a thicker cortex due to increased stimulation.
B) Chronic stress in low-SES environments accelerates brain development via overactivation of the HPA axis.
C) SES influences development only through access to material resources, not biology.

B) Chronic stress in low-SES environments accelerates brain development via overactivation of the HPA axis.

Explanation: Low SES is linked to chronic stress, which causes overactivation of the HPA axis and accelerated brain development in infants.

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What best describes brain plasticity

A) Plasticity occurs only in adulthood in response to injury.
B) Brain plasticity is genetically encoded, time-dependent, and peaks during sensitive periods.
C) Plasticity only emerges during severe environmental deprivation.

B) Brain plasticity is genetically encoded, time-dependent, and peaks during sensitive periods.

Plasticity is part of a genetically driven, sequenced maturational process, and is heightened during time-sensitive periods.

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Which form of plasticity is most directly associated with learning, memory, and cognition?
A) Structural plasticity
B) Functional plasticity
C) Network plasticity

C) Network plasticity

Network plasticity refers to changes in large-scale brain networks, supporting learning, memory, and cognitive functions

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What key finding emerged from studies using LENA to assess early language environments?
A) Conversational turns were highest in low-SES families.
B) Child vocalisations were unaffected by socioeconomic factors.
C) Family income-to-needs ratio (ITN) significantly predicted adult word count directed at the child.

Correct answer: C

Explanation: Among LENA measures, adult word count was positively predicted by ITN, suggesting higher SES families talk more to their children.

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In SES-related research on executive functioning, which of the following is true regarding cognitive performance tasks?

A) Only working memory was influenced by SES; inhibitory control and flexibility were unaffected.
B) All tasks, including memory, inhibition, and flexibility, were influenced by both income and parental education.
C) SES was found to influence only verbal tasks, not cognitive control tasks.

Correct answer: B

Explanation: Performance on digit span (memory), Simon Says (inhibition), and sorting (flexibility) was significantly affected by income and education.

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What is the role of cognitive stimulation in the relationship between SES and executive function, according to research findings?

A) It weakens the link between SES and executive function by introducing noise.
B) It mediates the relationship so strongly that, when accounted for, SES no longer predicts executive function.
C) It is a confounding variable but not a true mediator.

Correct answer: B

Explanation: Cognitive stimulation—measured by access to books, toys, variety of experiences, and language exposure—is such a strong mediator that removing it eliminates the SES–executive function link.

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What does the HOME (Home Observation for the Measurement of the Environment) assess in this context?
A) Parental income and housing stability
B) Neurobiological measures of cognitive function
C) Environmental cognitive stimulation including access to learning materials and parental involvement

Correct answer: C

Explanation: The HOME measure captures environmental factors such as access to books, toys, parental engagement, and language exposure—all key to cognitive development.

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What components are assessed in the Infant-Toddler HOME in relation to language development?

A) Income level, media use, and daycare access
B) Parental warmth, physical environment, and discipline routines
C) Genetic predisposition, sleep patterns, and dietary habits

Correct answer: B

Explanation: The Infant-Toddler HOME includes factors like parental involvement, warmth, discipline behaviours, and the quality of the physical environment, including books and toys.

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What does a lower discrimination ratio in a foreign language suggest about a child’s language development?

A) The child struggles with all languages equally.
B) The child has more exposure to foreign languages than their native language.
C) The child is more attuned to their native language, indicating stronger native language development.

Correct answer: C

Explanation: Lower foreign language sound discrimination reflects better tuning to native language, which is seen as positive development.

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According to the research, how is a high-quality HOME environment linked to language discrimination?

A) It leads to higher foreign language sound sensitivity due to increased exposure.
B) It is associated with reduced foreign language discrimination, indicating stronger native language processing.
C) It has no measurable effect on early language discrimination.

Correct answer: B

Explanation: A better HOME environment (more warmth, involvement, and learning materials) is linked to stronger native language tuning, meaning less sensitivity to non-native sounds.

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What does the Kennard principle suggest about brain injury and recovery?

A) Injuries in adulthood lead to the best recovery outcomes due to mature networks.
B) Earlier brain injuries result in better outcomes due to greater neuroplasticity.
C) Brain injuries during adolescence cause irreversible functional losses.

Correct answer: B

Explanation: The Kennard principle, based on animal research, suggests better outcomes when injuries occur earlier, due to presumed higher plasticity.

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Why has the Kennard principle been challenged in human research?
A) It fails to consider emotional development after injury.
B) It overestimates the role of environmental stimulation in recovery.
C) It does not hold true for human cognitive outcomes, especially IQ.

Correct answer: C

Explanation: Human research shows that early-life lesions often lead to poorer IQ outcomes, suggesting that early vulnerability can outweigh the benefits of plasticity.

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Which statement is supported by current research on the timing of brain injury and cognitive development?
A) Brain lesions later in life are associated with better IQ outcomes than early-life lesions.
B) Brain plasticity in infancy completely compensates for early brain damage.
C) Age at injury has no measurable effect on cognitive development.

Correct answer: A

Explanation: Studies with large samples show a trend toward better cognitive outcomes (e.g., IQ) when injury occurs later in life, challenging early plasticity assumptions.

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What is a key feature of the distributed network/interactive specialisation model of recovery?
A) All brain areas can equally take over any function after injury
B) Functions are fixed to specific brain areas from birth
C) Recovery occurs through flexible reorganisation within interconnected brain networks

Correct answer: C

Explanation: This model highlights that functions emerge from interactions between brain regions. If one part is damaged, others in the network can adapt, promoting plasticity and recovery.

Explanation: The interactive specialisation model suggests that functions emerge from the interaction of brain regions over time. Unlike equipotentiality (A) or localisation (B), this model supports network-based reorganisation, where other parts of the network can adaptively compensate after damage, especially in development.

Promotes plasticity and better recovery

Explanation: The distributed network/interactive specialisation model suggests that recovery is possible via network-level compensation, rather than rigid localisation or universal equipotentiality.

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Which of the following networks is most susceptible to irreversible functional decline following early focal brain injury?

A) High-level cognitive-emotional networks due to their flexible integration
B) Local sensory networks due to their highly segregated and specialised architecture
C) Functional motor networks due to their reliance on bilateral hemispheric control

Correct answer: B

Explanation: Low-level, local networks (e.g. sensory systems) are highly specialised and difficult to compensate when damaged early in development.

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What conclusion can be drawn from the comparison of the innate specialisation and equipotentiality views of brain function?

A) Both suggest that early injury results in worse outcomes due to network instability.
B) Both have been replaced by network-based models due to oversimplification of brain function.
C) Both remain valid, depending on the cognitive domain in question.

Correct answer: B

Explanation: Both innate specialisation and equipotentiality are outdated, and the field now favours interactive specialisation through network-level integration.

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All brain regions are EQUALLY possible to take on functions

> early brain regions are not specifically related to a function so functions disrupted earlier can be subsumed by other areas of the brain
associated with better outcomes (outdated)

Equipotentiality

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According to recent findings, why are young children often more vulnerable to long-term effects of brain injury than older individuals?

A) Their neural networks are already fully formed and rigid.
B) Their brains have low levels of plasticity, especially in low-level systems.
C) Their high-level brain networks are not yet fully integrated, making compensation more difficult.

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Correct answer: C

Explanation: Early in life, functional networks are still maturing, making compensation less efficient despite theoretical plasticity.

Which of the following statements best describes the importance of lesion timing in early brain development? A) Timing is only critical for motor development, as sensory and cognitive functions are genetically fixed. B) Early lesions typically lead to better outcomes due to unformed networks and higher compensation. C) Lesions during sensitive periods may disrupt foundational functions, which cascade into later deficits.

Correct answer: C Explanation: Sensitive periods are sequential—early disruptions (e.g. in hearing) can negatively affect language, which then influences higher cognition.

Which finding supports the equipotentiality view in language reorganisation after brain injury? A) People with epilepsy consistently show typical left-lateralised language processing. B) People with epilepsy often show atypical language lateralisation, including right-hemisphere or bilateral involvement. C) Epileptic seizure activity enhances left-hemisphere dominance for language.

Correct answer: B Explanation: The increased likelihood of right-hemisphere or bilateral language representation in epilepsy supports equipotentiality, i.e. alternative brain areas taking over function. All brain regions are equally capable of taking on functions (especially early in life). So, if the left hemisphere (dominant for language) is damaged (e.g. due to epilepsy), other regions like the right hemisphere or both sides can step in.

Which form of language reorganisation occurs when the brain recruits nearby areas within the SAME hemisphere? A) Inter-hemispheric B) Intra-hemispheric C) Crossed inter-hemispheric

Correct answer: B Explanation: Intra-hemispheric reorganisation occurs when language-related areas near the original site (e.g., within the left hemisphere) are recruited due to lack of contralateral compensation. Dus blijft dicht bij (intra)

Which form of language reorganisation occurs when the INHIBITORY connections between the hemispheres is affected? A) Inter-hemispheric B) Intra-hemispheric C) Crossed inter-hemispheric

A) Inter-hemispheric there is a lateral shift to right hemisphere and it becomes right lateralised (inhibitory> lijkt op introvert > interI

Which form of language reorganisation occurs when there can no recruitment of contra-lateral hemisphere be done? A) Inter-hemispheric B) Intra-hemispheric C) Crossed inter-hemispheric

C) Crossed inter-hemispheric language related areas close to the main areas in the same (left) hemisphere are recruited

What pattern of language organisation is associated with disrupted inter-hemispheric inhibitory communication following early brain insult? A) Intra-hemispheric recruitment near the left-language areas B) Typical left-lateralisation of language C) Right-hemisphere lateralisation or bilateral (delateralised) representation

Correct answer: C Explanation: Inter-hemispheric disinhibition may result in language shifting to the right hemisphere or being represented bilaterally, depending on the extent of inhibition loss.

What conclusion was drawn from research on functional reorganisation of language after early stroke? A) Shifting language to the right hemisphere results in better verbal fluency. B) Children who maintained left-lateralised language showed better language outcomes. C) Early lesions always lead to better reorganisation regardless of hemisphere.

Correct answer: B Explanation: Left-lateralised language was associated with better language outcomes post-stroke. Reorganisation to the right was less favourable.

Which of the following statements best reflects current understanding of recovery following early Acquired Brain Injury (ABI)? A) Due to higher plasticity, children always show better long-term outcomes than adults after comparable injuries. B) While early plasticity offers reorganisation potential, immature network integration may increase vulnerability to long-term deficits. C) Functional outcomes after ABI are primarily determined by lesion location, with environmental and family factors having minimal influence.

Correct answer: B Explanation: Although early childhood is a period of high plasticity, the brain is also more vulnerable due to immature and unstable neural networks. Long-term outcomes are influenced by this interplay, as well as environmental, socioeconomic, and injury-specific factors.

Which of the following statements best reflects the current understanding of paediatric TBI and its assessment? A) Injury severity is primarily determined by presence of skull fracture or intracranial lesion seen on imaging. B) Loss of consciousness, post-traumatic amnesia, and neurological examination are key components in evaluating TBI severity. C) The most reliable predictor of long-term outcome after TBI is the child’s age and cause of injury.

Correct answer: B Explanation: Severity of TBI is assessed using loss of consciousness (e.g. GCS: eye, motor, verbal), duration of post-traumatic amnesia (e.g. disorientation, memory), and neurological exam—not just imaging. While age and cause matter, they are not the core clinical tools for severity determination. AND SKULL FRACTURE & INTRACRANIAL LESION

Which of the following statements about head injuries and TBI is TRUE? A) All head injuries are considered forms of traumatic brain injury. B) Traumatic brain injury always results in visible neurological damage on imaging. C) Not all head injuries meet the criteria for TBI, which includes specific neurological or neuropsychological symptoms.

Correct answer: C Explanation: TBI requires specific symptoms such as amnesia, decreased consciousness, or intracranial lesions. Some head injuries (e.g., scalp trauma) may not meet this threshold.

Which factor is most commonly used to distinguish between mild, moderate, and severe TBI? A) Mechanism of injury B) Duration of post-traumatic amnesia and consciousness level C) Type of skull fracture

Correct answer: B Explanation: Severity classification relies on loss of consciousness and duration of post-traumatic amnesia, alongside motor/verbal responses and orientation—not skull fracture alone.

Which of the following statements about the epidemiology of paediatric TBI is correct? A) The incidence of TBI peaks between ages 8–10 due to sports injuries. B) TBI incidence is highest before the age of 4 and shows male predominance through early adulthood. C) Mild and severe TBI have significantly different population-level prevalence across childhood.

Correct answer: B Explanation: The highest incidence is seen in children under 4 years, with a higher risk in males up to early adulthood. Mild and moderate/severe TBI are surprisingly similar in prevalence.

Which of the following pre-injury factors is associated with increased risk or poorer outcomes in TBI? A) Elevated blood pressure B) Lower SES and poor family functioning C) Left hemisphere language dominance

Correct answer: B Explanation: Socioeconomic status, family functioning, and pre-morbid child functioning are key risk and resilience factors in TBI incidence and recovery.

How is the Glasgow Coma Scale (GCS) adapted for use in infants and young children? A) It removes all verbal components and replaces them with EEG-based scores. B) It focuses more on eye opening, motor responses, and developmentally appropriate verbal responses. C) It uses only parental reporting to estimate consciousness levels in preverbal children.

Correct answer: B Explanation: The GCS for children places greater emphasis on eye opening and motor response, and uses age-adjusted verbal scoring due to infants' limited language ability.

Which of the following correctly pairs a GCS duration category with its TBI severity classification? A) Loss of consciousness <30 minutes → Moderate TBI B) Loss of consciousness >24 hours → Severe TBI C) Loss of consciousness between 30 minutes and 6 hours → Mild TBI

Correct answer: B Explanation: Severe TBI is classified as loss of consciousness greater than 24 hours, according to standard GCS criteria.

What is the correct progression of impaired consciousness levels from least to most severe? A) Clouding → Confusional state → Stupor → Lethargy → Coma B) Clouding → Confusional state → Lethargy → Stupor → Coma C) Clouding → Lethargy → Confusional state → Stupor → Coma

Correct answer: B Explanation: The correct order is: Clouding → Confusional state → Lethargy → Obtundation → Stupor → Coma.

In the Children’s Orientation and Amnesia Test (COAT), which of the following items assesses temporal orientation? A) “What is your name?” B) “Can you say these numbers back to me?” C) “What time is it right now?”

Correct answer: C Explanation: Temporal orientation refers to awareness of time, which is assessed by questions like “What time is it?”

In the Children’s Orientation and Amnesia Test (COAT) Memory oriëntation

"Say numbers in the same order as I do"

In the Children’s Orientation and Amnesia Test (COAT) General orientation

"What is your name? "

How is the duration of post-traumatic amnesia (PTA) classified using COAT in children with TBI? A) Moderate PTA is defined as lasting more than 7 days. B) Mild PTA is under 24 hours; severe is over 7 days. C) Mild PTA is 24–48 hours; severe is over 3 days.

Correct answer: B Explanation: According to COAT: Mild = <24h Moderate = 24h–7 days Severe = >7 days

Which of the following statements best reflects the characteristics of post-concussive syndrome (PCS) following a mild TBI? A) PCS only occurs in cases of moderate to severe TBI and is typically irreversible. B) PCS can develop after mild TBI, particularly in cases with diffuse damage, and symptoms are often transitory. C) PCS is only diagnosed if symptoms persist for over six months and include seizures.

Correct answer: B Explanation: PCS is listed in ICD-10, and can arise even after mild TBI due to diffuse damage. It often includes cognitive, physical, and emotional symptoms, and is not necessarily permanent.

According to research on mild TBI (MTBI), what post-injury factor influences the likelihood of developing disorders such as ODD/CD and ADHD? A) Age at injury B) Hospital admission versus general practitioner (GP) visit C) GCS score below 12

Correct answer: B Explanation: Research shows that children with MTBI who were hospitalised had higher rates of behavioural disorders (ODD, CD, ADHD) than those who only visited a GP, despite the TBI being classified as mild.

What distinguishes secondary ADHD from developmental ADHD in the context of TBI recovery? A) Secondary ADHD is a pre-existing disorder that gets worse after TBI. B) Secondary ADHD results from post-injury brain changes and is not present prior to the trauma. C) Secondary ADHD only occurs in cases involving post-traumatic seizures.

Correct answer: B Explanation: Secondary ADHD is not developmental, but rather a consequence of brain injury, particularly involving frontal executive function networks.

What is the general nature of symptoms across the stages of TBI recovery? A) Symptoms are fixed immediately post-injury and do not change over time. B) Symptoms involves non-fixed evolving symptoms. C) Cognitive symptoms only appear after the acute phase and are irreversible.

Correct answer: B Explanation: TBI recovery involves non-fixed, evolving symptoms, which vary across the acute, post-concussive, and long-term phases, influenced by severity and mechanisms like diffuse damage. Symptoms emerge in stages and may change or resolve, depending on injury severity and recovery

Which of the following answer options best represents the three main symptom domains commonly seen in post-concussive syndrome (PCS)? A) Cognitive impairments, physical symptoms, emotional/psychological changes B) Language deficits, motor tics, and sensory enhancements C) Improved attention, faster memory recall, and emotional stability

Correct answer: A Explanation: PCS typically includes: Cognitive symptoms (e.g. memory, attention, executive function) Physical symptoms (e.g. headaches, nausea, balance problems) Emotional/psychological symptoms (e.g. mood swings, irritability, sleep disturbances)

Which of the following combinations best predicts poor cognitive recovery after paediatric TBI? A) Older age at lesion and low family SES B) GCS score above 12 and internalising behaviour C) Early age at lesion combined with high injury severity ("double hazard")

Correct answer: C Explanation: Research shows a “double hazard”—early age at injury + high severity—is strongly associated with poor long-term cognitive outcomes.

Which of the following is TRUE regarding predictors of behavioural outcomes (e.g., internalising/externalising problems) following TBI? A) Behavioural outcomes are primarily predicted by lesion severity and GCS score. B) Behavioural outcomes are largely independent of family or child factors. C) Family characteristics and child’s pre-existing behaviours are stronger predictors than injury severity.

Correct answer: C Explanation: Unlike cognitive outcomes, behavioural outcomes are better predicted by child and family factors (e.g. age, family distress, SES), and less influenced by injury characteristics.

What does a GCS score below 5 indicate based on recovery research? A) It predicts increased risk of mortality. B) It is associated with good recovery outcomes, contrary to expectations. C) It rules out the possibility of developing post-concussive syndrome.

Correct answer: B Explanation: Surprisingly, research found that a GCS < 5 can still be a predictor of good recovery, challenging assumptions that low GCS always predicts poor outcome.

In cases of mTBI (mild traumatic brain injury), what factor is associated with delayed recovery? A) Hospitalisation B) GCS < 8 C) More and longer-lasting post-concussive symptoms

Correct answer: C Explanation: Even in mTBI, a higher number and longer duration of post-concussive symptoms are associated with delayed recovery and worse life quality.

Which of the following is the most accurate predictor of social outcomes (e.g. loneliness, peer relationships) after paediatric brain injury? A) Injury severity and socioeconomic status B) Family burden, caregiver mental health, and overall family functioning C) Child IQ and externalising behaviours

Correct answer: B Explanation: Social outcomes like getting teased or feeling lonely are best predicted by post-injury family health, including caregiver mental health and family stress, not injury severity or SES.

What factor set best predicts quality of life after paediatric brain injury, including domains like school function and emotional wellbeing? A) Cognitive functioning and post-concussive symptoms B) Injury severity and age at lesion C) Family characteristics and socioeconomic status

Correct answer: C Explanation: Quality of life (school, physical, emotional, social) is most closely related to family factors and SES, and not directly to injury or child characteristics

Which of the following is a key predictor of academic achievement following paediatric TBI? A) Family functioning, cognitive performance, and classroom behaviour B) Social peer status and post-traumatic amnesia duration C) Parental education and caregiver depression

Correct answer: A Explanation: Academic success depends on cognitive functioning, behaviour in class, and family support, rather than social or emotional outcomes directly.

Which of the following statements best reflects the distinction between predictors of social outcome and quality of life? A) Both are primarily determined by injury severity and child intelligence. B) Social outcome is best predicted by SES, while quality of life depends on injury recovery. C) Social outcomes depend on family emotional functioning; quality of life depends on SES and broader family context.

Correct answer: C Explanation: Social outcomes are tied to caregiver and emotional aspects of the family; quality of life reflects material and structural factors like SES and general family functioning.

Which model of brain recovery suggests that functions emerge through interactions between brain regions, allowing for flexible reorganisation after injury? A) Localisation theory B) Equipotentiality model C) Distributed network/interactive specialisation model

Correct answer: C Explanation: The distributed network/interactive specialisation model proposes that brain functions are not fixed but arise through dynamic interactions, supporting adaptive compensation after damage.

Week 5 Flashcards

(58 cards)