9-1 neuropsychology

Module Overview18.html

Other Cognitive Domains

Foundational and Higher-Level Abilities

Modules Six and Eight of this course covered memory and language functions. However, the course resources do not fully describe many other cognitive domains. This module reviews the remaining cognitive functions. It emphasizes attention and executive functions. These cognitive domains are affected by different disorders. A neuropsychological assessment typically will assess all these cognitive domains to do the following:

• Identify the extent to which they have been affected by a diagnosis.
• Identify the strengths and weaknesses in other cognitive areas.
• Make a diagnosis.
• Provide treatment recommendations.

Think of the collection of cognitive abilities as a pyramid, with the foundational abilities at the base. Attention and processing speed are among these base abilities. If one of those abilities is impaired, most other cognitive functions will also be negatively affected. For example, if attention is impaired, one cannot attend to a stimulus long enough to encode it into memory. Language, memory functions, and visual-spatial skills are higher on the pyramid, above attention and processing speed. At the top are the executive functions, the most complex abilities and the last to develop in humans. Problems with base skills can affect higher-level abilities. Similarly, impairment can also be top-down, such as when impaired executive functioning negatively affects memory retrieval. Therefore, all cognitive abilities can be, to some extent, interrelated.

Speed of information processing, or processing speed, refers to motor response speed (or reaction time) and the speed at which mental activities are performed (Lezak et al., 2004). Timed tasks typically measure processing speed. This cognitive process is related to the myelination of axons, with better myelination lending to quickened processing speed (Blumenfeld, 2010). Therefore, the development of processing speed is linked to myelination in early childhood. Some research suggests that information processing speed across the lifespan in part accounts for age-based changes in other skills. These include attention and resistance to interference (Saito et al., 2022).

Processing speed is also a basic measure of cognitive load. Think about how much effort it takes to read a very technical passage on an unfamiliar topic, such as one related to neuroanatomy. Because more cognitive burden is used, the task is performed more slowly. Processing speed is also one of the most sensitive domains to organic brain damage. Thus, this is a commonly impaired domain in cases of dementia or head trauma (Groth-Marnat, 2003).

Attention is another foundational process. It can be divided into four types. Focus, or selective attention, refers to the ability to attend to a simple stimulus while not attending to other stimuli in the environment. Sustained attention, or vigilance, is the ability to focus on a task over longer periods. Divided attention is the ability to focus on multiple tasks at once. Alternating attention is the ability to quickly shift attention from one task to another (Lezak et al., 2004). Just as attention may contribute to many types of memory impairment, slowed processing speed commonly contributes to poor attention.

Visual-spatial skills include the following:

• Perceptual organization skills
• Visual reasoning
• Construction (the ability to draw or construct with physical objects, such as when working on a jigsaw puzzle)

These skills are generally more right (nondominant) hemisphere skills and generally occur in the parietal lobe.

Finally, the executive functions are a collection of skills housed in the frontal lobes. The frontal lobes occupy a large portion of the cortex in humans. They are related to the functions of the following:

• Motor control and planning
• Speech production (Broca’s area)
• Emotional regulation
• Metacognition (the ability to think about thinking)
• Energization (initiation and sustaining activity)
• The executive functions (Stuss, 2011)

A simplistic model of functional neuroanatomy is that the medial frontal cortex involves functions of energization or apathy. The orbitofrontal cortex involves behavioral inhibition and impulsivity. The dorsolateral prefrontal cortex houses the executive functions (Miller & Cummings, 2007). In contrast to sensory and motor skills that develop first in childhood, the executive functions are the last set of skills to develop. They fully mature when people are in their early twenties.

Many different models of executive functioning skills have been proposed. In general, the skills relate to how or whether one does something, as opposed to what or how much they do (Lezak et al., 2004). The executive functions typically include the following:

• Volition (the ability to choose and initiate a response)
• Planning
• Resistance to interference
• Monitoring
• Adjusting activity to feedback
• Abstract reasoning
• The use of strategies
• Novel problem-solving

References

Blumenfeld, H. (2010). Neuroanatomy through clinical cases (2nd ed.). Sinauer Associates.

Groth-Marnat, G. (2003). Handbook of psychological assessment (4th ed.). John Wiley & Sons, Inc.

Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment (4th ed.). Oxford University Press, Inc.

Miller, B. L., & Cummings, J. L. (2007). The human frontal lobes (2nd ed.). The Guilford Press.

Saito, D. N., Fujisawa, T. X., Yanaka, H. T., Fujii, T., Kochiyama, T., Makita, K., Tomoda, A., & Okazawa, H. (2022). Development of attentional networks during childhood and adolescence: A functional MRI study. Neuropsychopharmacology Reports, 42(2), 191–198. https://doi-org.ezproxy.snhu.edu/10.1002/npr2.12246.

Stuss, D. T. (2011). Functions of the frontal lobes: Relation to executive functions. Journal of the International Neuropsychological Society, 17, 759–765. https://doi-org.ezproxy.snhu.edu/10.1017/S1355617711000695.

Reading and Resources8.html

Textbook: Physiology of Behavior, Chapter 6 (pp. 149–153) and Chapter 15 (pp. 494–497)

Library Article: The Development of Academic Achievement and Cognitive Abilities: A Bidirectional Perspective This article explains the relationship between academic achievement and the development of cognitive domains.

Library Article: Adolescent Executive Cognitive Functioning and Trait Impulsivity as Predictors of Young-Adult Risky Drinking and Alcohol-Related Problems This article explores whether individual variability in impulsivity and reward-related mechanisms is associated with a higher level of engagement in risky behavior.

Graduate Discussion Rubric.html

Graduate Discussion Rubric

Overview

Your active participation in the discussions is essential to your overall success this term. Discussion questions will help you make meaningful connections between the course content and the larger concepts of the course. These discussions give you a chance to express your own thoughts, ask questions, and gain insight from your peers and instructor.

Directions

For each discussion, you must create one initial post and follow up with at least two response posts.

For your initial post, do the following:

• Write a post of 1 to 2 paragraphs.
• In Module One, complete your initial post by Thursday at 11:59 p.m. Eastern.
• In Modules Two through Ten, complete your initial post by Thursday at 11:59 p.m. of your local time zone.
• Consider content from other parts of the course where appropriate. Use proper citation methods for your discipline when referencing scholarly or popular sources.

For your response posts, do the following:

• Reply to at least two classmates outside of your own initial post thread.
• In Module One, complete your two response posts by Sunday at 11:59 p.m. Eastern.
• In Modules Two through Ten, complete your two response posts by Sunday at 11:59 p.m. of your local time zone.
• Demonstrate more depth and thought than saying things like “I agree” or “You are wrong.” Guidance is provided for you in the discussion prompt.

Discussion Rubric

Module Overview18.html

Other Cognitive Domains

Foundational and Higher-Level Abilities

Modules Six and Eight of this course covered memory and language functions. However, the course resources do not fully describe many other cognitive domains. This module reviews the remaining cognitive functions. It emphasizes attention and executive functions. These cognitive domains are affected by different disorders. A neuropsychological assessment typically will assess all these cognitive domains to do the following:

• Identify the extent to which they have been affected by a diagnosis.
• Identify the strengths and weaknesses in other cognitive areas.
• Make a diagnosis.
• Provide treatment recommendations.

Think of the collection of cognitive abilities as a pyramid, with the foundational abilities at the base. Attention and processing speed are among these base abilities. If one of those abilities is impaired, most other cognitive functions will also be negatively affected. For example, if attention is impaired, one cannot attend to a stimulus long enough to encode it into memory. Language, memory functions, and visual-spatial skills are higher on the pyramid, above attention and processing speed. At the top are the executive functions, the most complex abilities and the last to develop in humans. Problems with base skills can affect higher-level abilities. Similarly, impairment can also be top-down, such as when impaired executive functioning negatively affects memory retrieval. Therefore, all cognitive abilities can be, to some extent, interrelated.

Speed of information processing, or processing speed, refers to motor response speed (or reaction time) and the speed at which mental activities are performed (Lezak et al., 2004). Timed tasks typically measure processing speed. This cognitive process is related to the myelination of axons, with better myelination lending to quickened processing speed (Blumenfeld, 2010). Therefore, the development of processing speed is linked to myelination in early childhood. Some research suggests that information processing speed across the lifespan in part accounts for age-based changes in other skills. These include attention and resistance to interference (Saito et al., 2022).

Processing speed is also a basic measure of cognitive load. Think about how much effort it takes to read a very technical passage on an unfamiliar topic, such as one related to neuroanatomy. Because more cognitive burden is used, the task is performed more slowly. Processing speed is also one of the most sensitive domains to organic brain damage. Thus, this is a commonly impaired domain in cases of dementia or head trauma (Groth-Marnat, 2003).

Attention is another foundational process. It can be divided into four types. Focus, or selective attention, refers to the ability to attend to a simple stimulus while not attending to other stimuli in the environment. Sustained attention, or vigilance, is the ability to focus on a task over longer periods. Divided attention is the ability to focus on multiple tasks at once. Alternating attention is the ability to quickly shift attention from one task to another (Lezak et al., 2004). Just as attention may contribute to many types of memory impairment, slowed processing speed commonly contributes to poor attention.

Visual-spatial skills include the following:

• Perceptual organization skills
• Visual reasoning
• Construction (the ability to draw or construct with physical objects, such as when working on a jigsaw puzzle)

These skills are generally more right (nondominant) hemisphere skills and generally occur in the parietal lobe.

Finally, the executive functions are a collection of skills housed in the frontal lobes. The frontal lobes occupy a large portion of the cortex in humans. They are related to the functions of the following:

• Motor control and planning
• Speech production (Broca’s area)
• Emotional regulation
• Metacognition (the ability to think about thinking)
• Energization (initiation and sustaining activity)
• The executive functions (Stuss, 2011)

A simplistic model of functional neuroanatomy is that the medial frontal cortex involves functions of energization or apathy. The orbitofrontal cortex involves behavioral inhibition and impulsivity. The dorsolateral prefrontal cortex houses the executive functions (Miller & Cummings, 2007). In contrast to sensory and motor skills that develop first in childhood, the executive functions are the last set of skills to develop. They fully mature when people are in their early twenties.

Many different models of executive functioning skills have been proposed. In general, the skills relate to how or whether one does something, as opposed to what or how much they do (Lezak et al., 2004). The executive functions typically include the following:

• Volition (the ability to choose and initiate a response)
• Planning
• Resistance to interference
• Monitoring
• Adjusting activity to feedback
• Abstract reasoning
• The use of strategies
• Novel problem-solving

References

Blumenfeld, H. (2010). Neuroanatomy through clinical cases (2nd ed.). Sinauer Associates.

Groth-Marnat, G. (2003). Handbook of psychological assessment (4th ed.). John Wiley & Sons, Inc.

Lezak, M. D., Howieson, D. B., & Loring, D. W. (2004). Neuropsychological assessment (4th ed.). Oxford University Press, Inc.

Miller, B. L., & Cummings, J. L. (2007). The human frontal lobes (2nd ed.). The Guilford Press.

Saito, D. N., Fujisawa, T. X., Yanaka, H. T., Fujii, T., Kochiyama, T., Makita, K., Tomoda, A., & Okazawa, H. (2022). Development of attentional networks during childhood and adolescence: A functional MRI study. Neuropsychopharmacology Reports, 42(2), 191–198. https://doi-org.ezproxy.snhu.edu/10.1002/npr2.12246.

Stuss, D. T. (2011). Functions of the frontal lobes: Relation to executive functions. Journal of the International Neuropsychological Society, 17, 759–765. https://doi-org.ezproxy.snhu.edu/10.1017/S1355617711000695.