Gudrun Gudmundsdottir, M.D., Child Psychiatrist

1
WHAT IS THE RELATIONSHIP BETWEEN POSITIVE
NEUROPSYCHOLOGICAL TEST CONCLUSIONS AND FINDINGS
FROM SUPPLEMENTARYNEUROLOGICAL EXAMINATIONS?

• Gudrun Gudmundsdottir, M.D., Child Psychiatrist
• Centre for Child and Adolescent Psychiatry
• and
• Bente Gjærum. M.D., Ph.D., B.S (Ed.)
• Centre for Child and Adolescent Psychiatry and
  Regional Centre for Centre for Child and
  Adolescent Psychiatry. Region East and South.

2
INTRODUCTION

• Experience from previous research shows that
  deviant results on neuropsychological
  examinations performed in early childhood may
  indicate that the childs problem is compatible
  with neurobiological dysfunction. In some cases,
  when positive findings from clinical and/or
  supplementary neurological tests is available,
  these findings will validate the
  neuropsychological conclusion.
• The existing data from Bente Gjærums project,
  forms the basis for this project. In this study,
  we will look at the relationship between
  neuropsychological assessment based conclusions
  regarding brain integrity versus findings from
  supplementary neurological examinations such as
  CT, MR, PET, EEG, metabolic screening,
  chromosomes, etc.

3
RESEARCH QUESTIONS

• Primary question For how many children referral
  to neuropsychological examination with positive
  test conclusions will positive findings also be
  found on supplementary neurological examinations?
• Secondary questions
• - Is there a correlation between the
  neuropsychological assessment based presumptions
  about the brain integrity (based on rules for
  describing tests findings which is validated
  empirically for older children and adults) and
  the results of supplementary tests?
• - Given that supplementary examinations show a
  positive CNS finding, what is the sensitivity and
  specificity for each of the supplementary
  neurological examination techniques?
• - What is the positive predictive validity for
  the different supplementary examinations from the
  neuropsychological conclusion?
• - If these two examination methods show
  diverging results, what are possible explanations
  for this and what can the follow up studies tell
  us about the sensitivity and specificity of these
  two methods?

4
SAMPLE

• Approximately 250 children have been examined
  with NPM-X.
• 96 of these children have been re-examined 5
  years later and information on supplementary
  neurological examinations were then obtained.
• For the rest of the total sample, similar
  information is collected.

5
METHODS AND PROCEDURES

• Results from supplementary examinations are
  partly filed in the childrens journals. In
  cases where such information has not been
  collected yet, permission will be obtained from
  the parents to collect this missing information.
• The results on the neuropsychological assessment
  will be classified by Gjærum according to what
  degree they indicate neurobiological disturbance.
• The findings from clinical neurological
  examinations and supplementary neurological
  examinations will be classified by Gudmundsdottir
  in a similar way.
• The results from both types of classifications
  will be systematically compared
• quantitatively (statistically) and
• qualitatively, i.e. substantial analysis of the
  findings in the different types of examinations
  will be compared.