School Neuropsychology - RUG - B3 - Lecture Notes 2014/2015

Lecture 1

Neuropsychology is becoming increasingly important at schools. An important question is what can be done in assessment and treatment at schools, and what teachers can do to help.
Most children who have problems at school are comorbid. ADHD is the biggest problem at schools, with a prevalence rate of 3 to 6% in school-aged children. Thereby, 30 to 40% of the referrals to child guidance clinics considers children with ADHD. Teachers are part of the assessment of ADHD, but do not always know how to handle children who suffer from this disorder. The children with ADHD have difficulties in complying with the rules and instructions. Therefore, teachers sometimes misjudge the behavior of a child with ADHD as unmotivated, unwilling and disruptive. These low expectations influence their behavior towards an ADHD child, working as a self-fulfilling prophecy. The teachers experience certain behavior as disruptive, develop low expectations, which in their turn influence their behavior towards the child. This of course does not have a stimulating effect on the child, who therefore acts in a way that confirms the low expectations of the teacher. Luckily, nowadays there’s more awareness for the symptoms of ADHD.
Boys show more externalizing symptoms of ADHD and therefore their behavior is often experienced as more disruptive than the behavior of girls with ADHD. Girls with ADHD mostly show the inattention symptoms and are considered to be dreamy. These expectations create the possibility of a gender based referral bias. The male to female ratio in ADHD is 3,4:1.
The diagnosis of ADHD is based on the following core symptoms;

  • inattention

  • hyperactivity

  • impulsivity

The main clinical picture we see shows excessive task-irrelevant activity and motor restlessness. We do have to consider that ADHD is a huge spectrum, which means that not all people who are affected have all the symptoms. Not everybody with ADHD shows the same behavior, and we all show behavior related to ADHD. The diagnosis has to do with severity and frequency. Diagnosis can be tricky though, because the DSM is

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