1	Investigating the Cognitive Characteristics of Individuals with Alternating Hemiplegia Joshua Magleby, M.S. Janiece Pompa, Ph.D.
2	Neuropsychology Essentially, the study of the brain bases of behavior Involves the assessment of the many cognitive abilities of the individual Aptitude, attention, memory, reasoning, processing speed, academic achievement, visual system, auditory system, problem solving, impulse control, and behavior The present study on AHC is in the exploratory phase i.e. what tests are valid with AHC?
3	Aptitude AKA Intelligence “The aggregate or global capacity of the individual to act purposefully, to think rationally and to deal effectively with his environment” (Wechsler, 1958) “…mental activity involved in purposive adaptation to, shaping of, and selection of real-world environments relevant to one’s life” (Sternberg, 1986) As measured by an Intelligence Quotient (IQ) Difficult to assess with AHC Verbal IQ assessed with the Peabody Picture Vocabulary Test-Third Edition (PPVT-III)
4	Academics Information learned through school experience Highly verbally loaded Subtests from the Woodcock-Johnson Tests of Achievement and Cognition, 3^rd Edition (WJ-III) Decoding, vocabulary, comprehension, math reasoning, visual scanning and recognition of objects
5	Memory Three types: Short-term (primary memory store), Working (executive and attentional with limited capacity), Long-term (secondary memory store) Two modes: Recall and Recognition. Faces subtest from the Children’s Memory Scale (CMS) Digit Span subtest from the Wechsler Intelligence Scale for Children-Third Edition (WICS-III) California Verbal Learning Test for Children (CVLT-C)
6	Attention Attention is part of nearly every task one attempts Attentional difficulties are associated with most forms of brain injury and disease, congenital learning disabilities, and emotional or psychiatric disorders (Ponsford, 2000) Multidimensional (shifting, sustained, focused, working memory) Digit span, Faces, CVLT-C
7	Processing Speed Appears to reflect the ability to employ a high degree of concentration and attention in processing information rapidly by scanning an array (Sattler, 1992) Very difficult to assess in AHC
8	Executive Functioning Higher-order abilities believed to be localized in the frontal lobes of the brain Reasoning, planning, strategizing, problem solving, inhibition, maintaining focus, cognitive flexibility, sequencing. Raven’s Matrices Used to a certain degree in all other tests
9	Behavior Are there “typical” behaviors in children with AHC? Behavior Assessment System for Children Externalizing behaviors: aggression, hyperactivity, conduct problems Internalizing behaviors: anxiety, depression, somatization Other clinical scales: atypicality, withdrawal, attention problems Adaptive scales: adaptability, social skills, leadership
10	Behavior continued… Scales of Independent Behavior-Revised (SIB-R) Assesses adaptive skills: communication, social, motor, daily living Specifies behaviors in these domains: language fluency, language production, gross motor, fine motor, dressing, eating, etc.
11	Chicago Conference Behavior assessment 26 subjects Average age = 9.5 years Three age scales: preschool (2.5-5.11), child (6.0-11.11), adolescent (12.0-18.11) Preliminary findings were not stratified; all three age scales were analyzed together Some behaviors are not valid for all ages
12	Chicago Conference “Clinically significant” Hyperactivity, atypicality, attention problems, leadership Behavioral Symptoms Index (overall clinical scale) and Adaptive Index (overall adaptive scale)
13	Chicago Conference “At-risk” Depression, withdrawal, somatization Externalizing index (overall externalizing behaviors) “Average” Aggression, conduct problems, anxiety, adaptability, social skills
14	Chicago Conference Adaptive behaviors Vineland Adaptive Behavior Scale (Vineland) Communication, Social Skills, Daily Living Skills, Motor Skills (up to age 5.11) In general, all areas significantly below average No statistically significant relationship (patterns) between AHC, age, and adaptive skill However, social skills were generally elevated Vineland may not be specific enough to elicit patterns in adaptive behavior
15	Chicago Conference Neuropsychological assessment 4 completed evaluation Motor and speech difficulties significantly impacted completion of some tasks Therefore these evaluations may not be valid
16	Goals Primary goals Move from exploratory to assessment stage Brain localization Find neuropsychological patterns unique to AHC Academic interventions Behavioral interventions Secondary goals Develop neuropsychological tests designed for use with motor impairments Involving speech language pathology Other?
17	Contact Information Joshua Magleby, MS (Primary Investigator) joshuam30@aol.com OR jm37@ed.utah.edu