The American Board of Pediatric Neuropsychology (ABPdN) defines pediatric neuropsychology as a specialty within the field of psychology and related health-care sciences. The emphasis in pediatric neuropsychology is the study and understanding of brain-behavior relationships specifically in children with known or suspected brain injury.
A pediatric neuropsychologist uses special tools and assessment devices to test children and to determine their strengths and weaknesses across the domains of executive functioning and attention, learning and memory, language, sensory and motor abilities, as well as visual and spatial abilities. Although the definition specifically cites children with known or suspected brain injury, the reasons to obtain the services of a pediatric neuropsychologist go well beyond brain injury.
Understanding the brain-behavior relationship is a key to understanding all human beings. For children, brain behavior is not evaluated in isolation from their developmental level, social environment or family system.In other words, pediatric neuropsychology looks at the whole child in relation to cognitive functioning, while considering the impact of nature and nurture on their development. This is commonly known as the biopsychosocial model.
A pediatric neuropsychologist has advanced clinical training to understand the dynamic developmental changes of a child’s brain and how behavior quickly evolves during the child’s rapid periods of development.The child is not seen as a static entity. These dynamic changes and the knowledge of appropriate developmental phases helps pediatric neuropsychologists identify what is considered a deficit versus normal behavior and development.
Pediatric neuropsychology is drastically different than educational psychology. Whereas the pediatric neuropsychologist looks at the origin of learning skills and motivation in the brain, the educational psychologist focuses on assessment outcomes and behavior. In my experience, most educational psychologists function as school psychologists, who are most commonly known for administering psycho-educational evaluations.
A psycho-educational evaluation generally is a determination of the child’s intellectual and achievement abilities.For years Public Law 94-142 (originally known as the Education of All Handicapped Children Act) mandated that psycho-educational testing be used to determine which children receive services for learning disorders and stipulated how that would take place in the least restrictive environment. The law also heralded the advent of what became known as the discrepancy model.
A child can meet the discrepancy model in either of two ways:
- The child’s intellectual score is 1.5 standard deviations (approximately 22 points) above their achievement test scores.
- The child is functioning two grade levels below grade placement based on achievement test scores.
Unfortunately, Public Law 94-142 handcuffed school psychologists from rendering an accurate clinical diagnosis of learning disorders. The discrepancy model is not a clinical diagnosis of learning disorders. It became a means of ‘drawing a line in the sand’ and determining that children on one side of the line received special education services, while children on the other side of the line did not. Many children who have learning disorders such as phonological dyslexia or dyscalculia never met criteria for the discrepancy model rule and were denied services. Public Law 94-142 was re-authorized in 2004 with the advent of No Child Left Behind legislation (and renumbered PL 108-446). Now known as the Individuals with Disabilities Education Act (IDEA), it eliminated the requirement to use the discrepancy/achievement model; however, many states still use the original laws’ guidelines to identify students with learning disabilities to determine which students receive services.