Week 7 Flashcards by Josephine Dijk

What is a core aim of paediatric neuropsychological intervention when treating children with brain disorders?

A) To eliminate all neurological abnormalities
B) To limit participation in complex environments to reduce stress
C) To reduce impairments while promoting healthy development and community participation

Correct answer: C

Explanation: The “triad” goal includes reducing impairments, supporting development, and enabling participation, even with constraints.

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What does the ‘O’ (Outcome) in the PICO model refer to in neurointervention research?

A) The duration of the intervention
B) The theoretical background supporting the intervention
C) The specific change in functioning the intervention aims to produce

Correct answer: C

Explanation: The Outcome refers to what the intervention is meant to change (e.g. ADHD symptoms, functional school outcomes). It must be defined precisely due to the many influencing variables.

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Why is it important to consider the quality of intact abilities when planning interventions?

A) To determine whether medication is necessary
B) To focus exclusively on deficits rather than strengths
C) To build interventions that leverage existing cognitive or emotional strengths

Correct answer: C

Explanation: Understanding which abilities are still intact allows practitioners to tailor strategies that support weaker areas by relying on strengths.

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Which of the following is an example of an Outcome variable in a PICO-based neurointervention for children with ADHD?

A) Number of hours of cognitive training received
B) Reduction in teacher-reported inattention symptoms
C) The location where the intervention is delivered

Correct answer: B

Explanation: In PICO, O = Outcome, and here it refers to the measurable improvement—e.g. less inattention in a school setting.

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What factor is considered essential when determining a child’s capacity for adaptation in intervention planning?

A) The child’s handedness
B) The child’s pre-existing neurobehavioral profile
C) The number of siblings at home

Correct answer: B

Explanation: Knowing a child’s neurobehavioral functioning (e.g. language skills, working memory) helps shape interventions to their unique profile.

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Which setting is least likely to provide pharmacological intervention as part of a child’s neuropsychological treatment?

A) School-based programs
B) Hospital-based clinics
C) Paediatric psychiatric unit

Correct answer: A

Explanation: School-based interventions tend to focus on cognitive and behavioural support, not medical treatments like pharmacotherapy, which are hospital/clinic-based.

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Why is it necessary to specify the context (home, school, hospital) in intervention planning?

A) Context allows researchers to randomise participants correctly
B) Contextual setting determines what intervention tools and supports are accessible
C) Context is only relevant in severe disability cases

Correct answer: B

Explanation: Home-based, school-based, and hospital-based contexts each come with different tools, personnel, and goals, which must be aligned to the child’s needs.

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What do the letters in the PICO framework stand for in the context of neuropsychological intervention research?
A) Population – Intervention – comparison – Outcome
B) Patient – Indicator – comparison – Outcome
C) Participant – Investigation – comparison – Outcome

Correct answer: A

Explanation:
PICO stands for:

P: Population/Patient (e.g. children with ADHD)

I: Intervention (e.g. cognitive training)

C: Comparison (e.g. medication or placebo)

O: Outcome (e.g. reduction of symptoms)

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In the PICO framework, which component identifies what is being tested or applied to improve outcomes?
A) Outcome
B) Intervention
C) Comparison

Correct answer: B

Explanation: The Intervention (I) refers to the treatment, technique, or support being applied — such as cognitive training, behavioural therapy, or medication.

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What is the role of the Comparison (C) in the PICO framework?

A) It defines the statistical method
B) It identifies an alternative or control condition
C) It determines which child is eligible for the intervention

Correct answer: B

Explanation: The Comparison provides a reference point, like another treatment or placebo, to determine whether the Intervention is effective.

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What is the central mechanism targeted by interventions aiming to influence critical and sensitive periods in brain development?

A) Behavior
B) Signaling cascades
C) Synaptic and network activity

Correct answer: C

Explanation: Synaptic and network interactions lie at the heart of critical and sensitive periods and can be influenced by upstream or downstream modulation.

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Which of the following interventions can potentially modify the trajectory of brain plasticity during sensitive periods?

A) Genetic engineering and gene editing
B) Pharmaco modulation, cell-based therapy, and electromagnetic stimulation
C) Passive behavioral observation

Correct answer: B

Explanation: These interventions (shown in blue box) can influence networks, signaling, or synaptic functioning, potentially opening or extending sensitive periods.

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According to the model, what must be fulfilled to allow the opening of a sensitive period?

A) Sufficient behavioral modulation
B) Genetic and synaptic levels
C) Increased signaling cascade activity

Correct answer: B

Explanation: The model shows that “prerequisites” must be met (left side of red bar) to open critical/sensitive periods, indicating dependency on early development cues.

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How do behavioral modulation interventions influence brain development according to the diagram?

A) Only by directly altering genetic structure
B) Indirectly, by acting on networks
C) Exclusively during adulthood

Correct answer: B

Explanation: Behavioral modulation influences networks, which feedback into synaptic and signaling processes that affect the critical/sensitive period window.

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What is the role of Genetic Molding and Epigenetic Modulation in this framework?

A) They serve as downstream effects of behavioral change
B) They are independent of synaptic plasticity
C) They influences whether critical periods open or close

Correct answer: C

Explanation: This layer (beneath the red bar) sets the developmental stage for whether the brain is receptive to change, shaping how plasticity unfolds over time.

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Which of the following combinations successfully reopened the sensitive period for vision in animal models?

A) Environmental enrichment and cochlear implantation
B) Pharmacological modulation and deep brain stimulation
C) Fluoxetine, darkness, and environmental enrichment

Correct answer: C

Explanation: Research in animals used fluoxetine, darkness, and enriched environments to restore visual plasticity, demonstrating reopening of sensitive periods.

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What is the primary goal of pharmacological interventions during the acute phase of brain injury in children?

A) To improve academic performance
B) To prevent permanent damage
C) To stimulate synaptic pruning

Correct answer: B

Explanation: During the acute phase, medications are used to prevent long-term neural damage, not necessarily for neurodevelopment yet.

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Which of the following neuromodulation techniques is considered non-invasive?

A) Vagal nerve stimulation
B) Deep Brain Stimulation (DBS)
C) Repetitive Transcranial Magnetic Stimulation (rTMS)

Correct answer: C

Explanation: rTMS is a non-invasive form of brain stimulation that is being progressively integrated, unlike DBS or vagal nerve stimulation.

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In the treatment of ADHD, pharmacotherapy is:

A) The first-line intervention for all children under 6
B) Recommended as the first step for children over 6
C) A second- or third-step intervention after psychoeducation and CBT

Correct answer: C

Explanation: Pharmacological treatment is not first-line, especially not before age 6. Guidelines suggest psychoeducation and CBT first, followed by medication only when needed.

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What distinguishes invasive from non-invasive neuromodulation techniques in children?

A) Invasive methods are always pharmacological
B) Invasive methods require internal devices or stimulation, non-invasive use external tools
C) Non-invasive methods only apply to adults

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Correct answer: B

Explanation: Invasive methods like DBS involve internal implants, while non-invasive ones (like rTMS and tDCS) are applied externally without surgery.

What is a core component of multimodal intervention as seen in the animal study?

A) Targeting only one sensory modality
B) Isolating the animal from all sensory input
C) Combining pharmacological, sensory, and environmental stimulation

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Correct answer: C

Explanation: The animal study used a multimodal approach—fluoxetine, darkness, and enriched environments—to trigger neural plasticity.

Which treatment combination was most effective in reducing ADHD symptoms 14 months post-randomisation?

A) Community care
B) Behavioural therapy only
C) Combination treatment and medication

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Correct answer: C

Explanation: After 14 months, combination treatment and medication had the strongest effect on ADHD symptoms.

What did the 36-month follow-up of the ADHD multimodal treatment study reveal?

A) Combination treatment maintained significantly superior results over all others
B) All treatment groups had converged in their effectiveness
C) Behavioural therapy alone showed the best long-term effects

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Correct answer: B

Explanation: After 36 months, symptom levels equalised across treatment groups, showing no lasting superiority of one approach.

In hemiparetic cerebral palsy, what happens to contralateral and ipsilateral pathways during early brain development when a lesion is present?

A) They are eliminated due to competition
B) They remain active and may control motor output
C) They become the dominant pathway for both limbs

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Correct answer: B

Explanation: Normally, ipsilateral pathways are eliminated; but with early lesions, they remain and may interfere with proper motor control.

Normally during development, the contralateral motor pathway (brain controls opposite side of body) wins a competition.

The ipsilateral pathway (same side of brain/body) gets pruned/eliminated.

BUT:

If a brain lesion occurs early (like in hemiparetic cerebral palsy), this pruning process doesn’t happen.

Result: the ipsilateral pathway remains active and tries to control motor output, which is less efficient and causes impaired motor control.

Think of the brain like a two-team relay race.
Normally, one team (contralateral) wins and the other sits out (ipsilateral).
If the strong team (contralateral) gets injured early, the weaker team (ipsilateral) is forced to run — but they’re not really up to the job.

According to ADHD treatment guidelines, when is pharmacotherapy typically recommended? A) As a first-line treatment in all children regardless of age B) Only after age 6, when behavioural strategies have been insufficient C) Only if there is no school involvement

Correct answer: B Explanation: Guidelines recommend starting with behavioural and educational interventions; pharmacotherapy is added only after age 6 if symptoms persist.

What is the mechanism by which fluoxetine and enriched environments restored visual plasticity in animal models? A) They suppressed inhibitory neurotransmitters in the auditory cortex B) They mimicked deprivation to delay closure of the sensitive period C) They reopened the sensitive period for vision through synaptic and network reorganisation

Correct answer: C Explanation: The combination reopened sensitive periods by promoting plasticity at synaptic and network levels.

Which of the following best describes the goal of behavioural therapy in multimodal ADHD treatment? A) To reduce EEG spikes associated with motor tics B) To train parents and teachers to shape positive behaviour and improve self-regulation C) To improve blood flow to prefrontal cortex during inhibition tasks

Correct answer: B Explanation: Behavioural therapy includes parent/teacher training and CBT to support self-regulation and functional skills in children with ADHD.

What is a key limitation of multimodal treatment for ADHD based on 36-month outcomes? A) Behavioural symptoms worsen dramatically after 1 year B) Medication shows no effect past 6 months C) Treatment effects converge across groups, reducing long-term superiority of combination therapy

Correct answer: C Explanation: Long-term follow-up shows no sustained difference between treatments, highlighting the temporary nature of effects and cost concerns.

Which intervention is most likely to involve restricting the unaffected limb to promote use of the affected one? A) HABIT B) CIMT C) EEG Neurofeedback

Correct answer: B Explanation: CIMT (Constraint Induced Movement Therapy) works by constraining the stronger limb, forcing use and reorganisation of the weaker limb’s pathways.

Which intervention is specifically designed to promote bimanual motor learning in children with hemiparetic cerebral palsy? A) CIMT B) rTMS C) HABIT

Correct answer: C) Hand-Arm Bimanual Intensive Therapy (HABIT) HABIT focuses on improving coordination between both hands by engaging the child in bimanual tasks. In contrast: CIMT promotes unimanual function by restricting the unaffected limb. rTMS is a neuromodulation technique, not a therapy focused on motor learning directly.

What distinguishes HABIT from CIMT in treating children with hemiparetic cerebral palsy? A) HABIT promotes unimanual use of the impaired limb B) HABIT excludes the less-impaired limb from therapy C) HABIT encourages coordinated use of both hands in functional tasks

Correct answer: C) HABIT is designed to promote bimanual motor learning, unlike CIMT, which restricts the unaffected limb.

Which of the following best describes the goal of Constraint-Induced Movement Therapy (CIMT)? A) To enhance auditory processing via passive stimulation B) To improve functional use of the impaired limb by constraining the unaffected limb C) To train the patient in ambidextrous writing

Correct answer: B) CIMT involves restricting the stronger limb to encourage use of the weaker one, enhancing functional recovery.

Why might inhibitory rTMS be used in hemiparetic cerebral palsy treatment? A) To strengthen ipsilateral pathways B) To inhibit overactive ipsilateral motor pathways C) To stimulate auditory brain regions

Correct answer: B) Inhibitory rTMS is used to suppress the less functional ipsilateral pathways, promoting contralateral control.

Which neurorehabilitation technique focuses on bimanual coordination without constraining any limb? A) CIMT B) rTMS C) HABIT

Correct answer: C) Unlike CIMT, HABIT allows free use of both hands, specifically targeting bimanual motor skills.

In the context of psychosocial interventions, why is paid maternity leave considered a protective factor? A) It delays the return to work and reduces income-based stress B) It improves maternal empathy and enhances the quality of mother-child interaction C) It increases paternal involvement and moderates child neurocognitive risk

Correct answer: B Paid maternity leave is associated with better maternal mental health, increased secure attachment, and higher-quality interactions, all of which promote the child’s development.

Which of the following best explains the neurodevelopmental effect observed at 1 year of age in children whose families received unconditional financial support? A) Enhanced language acquisition reflected in increased EEG activity across all frequencies B) Elevated mid- and high-frequency EEG power indicative of advanced cognitive maturation C) Decreased low-frequency EEG power associated with increased socioemotional functioning

Correct answer: B Explanation: EEG findings at age 1 showed increased mid- and high-frequency activity, which reflects faster or more mature cognitive development. Language or socioemotional development did not significantly change by age 3.

What key outcome was uniquely observed in the Initial Education (IE) program when combined with CCT? A) Increased child well-being, independent of parental participation B) Sustained improvement in child development outcomes, amplified by educational promotion C) Reduction in maternal stress but not child cognitive performance

Correct answer: B Explanation: The multimodal approach (financial + educational support) led to significant improvements in child development, showing that resources must be combined with active engagement to be most effective.

Despite the cognitive maturation benefits observed with financial support, which domain showed no significant improvement by age 3? A) Language and socioemotional development B) Early learning activities C) EEG frequency activity

Correct answer: A Explanation: While EEG changes and early learning stimulation were improved, the studies showed no impact on socioemotional development or developmental delays by age 3 from financial support alone

Which of the following was a key result of the “Take a Breath” intervention program? A) Improved language comprehension in children with traumatic brain injury B) Increased physical activity levels in caregivers of children with brain injuries C) Reduced post-traumatic stress symptoms and better coping with uncertainty in parents

Correct answer: C Explanation: “Take a Breath” is a psychological skills-based ACT program for parents of children with life-threatening illness. It reduced PTSS, improved emotional regulation, and coping with uncertainty.

What distinguishes the Stepping Stones Triple P intervention in terms of accessibility and format? A) It must be delivered exclusively through hospital-based professionals B) It is a pharmacological treatment focused on managing ADHD symptoms C) It offers both online and in-person CBT-based support, proven effective across contexts

Correct answer: C Explanation: Stepping Stones Triple P is a flexible parenting program available online or in person, with group or individual CBT formats. It improves child behavior and increases access to care, especially in low/middle-income countries.

What was the primary limitation in the outcome of the post-mTBI psychoeducation program? A) No measurable reduction in parent anxiety B) No change in child’s post-concussive symptoms C) No significant improvement in age-appropriate participation at home or school

Correct answer: C Explanation: While quality of life and symptoms improved, there was no significant effect on the child’s participation in everyday contexts like school or home.

What strategy is most aligned with adaptive functioning in children with acquired brain injury (ABI)? A) Punitive behavior correction to ensure compliance B) Removal from classroom environments during cognitive fatigue C) Cued or prompted compensatory strategies to increase participation

Correct answer: C Explanation: Adaptive functioning is supported by external cues. someone gives prompts of the child with the activities they have to do at a certain time of the day > helps with the child to do their activity and participate

Which of the following is an example of an environmental modification used to improve functioning in children with ABI? A) Mandating social skills training for all parents B) Providing additional medication at school C) Adjusting task demands and reinforcing positive behavior

Correct answer: C Explanation: Environmental modifications include changing the task (e.g. allowing more time), using positive reinforcement, and modeling desired behavior, which improves both engagement and behavior.

Why do attention and working memory remediation tasks often show limited impact on real-world outcomes like academic performance? A) They are too challenging for most clinical populations B) They rely heavily on language-based assessments C) They have low ecological validity despite high effect sizes in-task

Correct answer: C Explanation: These tasks often show large effect sizes in lab conditions but fail to generalize to real-world applications, indicating low ecological validity.

What is the primary goal of Goal Management Training in individuals with TBI? A) Improving visual-motor integration skills B) Enabling individuals to self-monitor and manage their functional goals C) Reducing hyperactivity through behavioral conditioning

Correct answer: B Explanation: Goal Management Training is aimed at enhancing evaluative skills, including self-monitoring, metacognitive awareness, and prospective memory to manage tasks effectively.

Which of the following techniques is most associated with improving metacognitive control in executive function training? A) Visual-spatial sketchpad exercises B) Self-instruction and self-monitoring strategies C) Passive observation of therapist behavior

Correct answer: B Explanation: Self-instruction and self-monitoring are central to metacognitive approaches, which train patients to reflect on, plan, and regulate their own cognitive processes.

What distinguishes the “Specific Skills: Independent Strategy Use” phase in cognitive rehabilitation? A) Emphasis on spontaneous recovery without intervention B) Therapist-guided retraining of basic sensorimotor functions C) Focus on identifying goals, planning steps, and reviewing performance independently

Correct answer: C Explanation: This stage is about autonomy in strategy use, where individuals are trained to recognize challenges, make a plan, and evaluate outcomes, increasing real-life functioning.

Which of the following is a typical component of skill training programs to enhance evaluative power? A) Inhibition tasks with time constraints B) Stories illustrating executive dysfunction C) Pure working memory drills without reflection

Correct answer: B Explanation: Using narratives about executive dysfunction helps individuals recognize and relate to errors, which builds metacognitive insight and supports strategy development

Week 7 Flashcards

(48 cards)