A Cognitrace Study, or Complex EEG with Auditory and Visual Evoked Potentials, is a non-invasive (no needles), brain imaging examination interpreted by a Pediatric Neurologist. This Neurophysiological exam is included as the part of the comprehensive exam available for children and adolescents in the Neurobehavioral/Neuropsychiatric units at the Meridell Achievement Center, a Residential Treatment Center for children.
If the child’s behavior is not deemed severe enough to meet criteria for inpatient treatment, but is still episodically severely out of control, the Cognitrace Study will usually be recommended as a first step to try and prevent hospitalization. Positive findings will allow for precise medication selection which can offer more immediate relief of impulsive, explosive aggression. Testing typically takes about one hour. Our consulting Child Neuropsychiatrist will recommend medications to treat the affected brain areas and stabilize behavior on the basis of the Pediatric Neurologist’s report..
A neuropsychological assessment is a comprehensive evaluation and development of strategies for remediation and methods of management of brain disorders. This type of testing can lead to a clearer picture of the interventions needed. It will also identify impairments that may have serious consequences in terms of school performance if untreated. These may also impact social success, family interaction, and general psychological functioning. This evaluation should be the second part of a complete Neuropsychiatric Evaluation. Ideally, it is DELAYED until after recommended medications have provided emotional and behavioral stability. Unfortunately, at this time, we are only able to offer this testing for patients who are inpatient at the Meridell Achievement Center. Dr. Dan Matthews routinely recommends and provides consultation to Neuropsychologists in the home community at the family’s request.
Prime candidates for this type of testing include children and teens:
- Age 5 and older with known or suspected brain disorder complications or who are non-responsive to treatment
- Severe ADHD
- Mild to moderate impairments with several of the “Indicators for a Possible Brain Disorder”
How is Neuropsychiatric Treatment Different?
Children and teens, with irritability, or impulsive or explosive aggression may have an untreated brain disorder. Traditional psychiatry has often been unsuccessful for these more neurologically complex youth.
A Neuropsychiatric assessment can be conducted on an Outpatient basis to diagnose or rule out a brain disorder. Findings assist in the selection of specific medications to treat areas identified as unstable. Functional impairments, learning disabilities and other obstacles to treatment can also be identified.
While each patient’s situation may have unique complicating factors, this method has reported success in preventing rehospitalization in 80% of children with impulsive, explosive aggression at one year after discharge from residential treatment (Wetherill, ANPA 2006).
Several risk factors may indicate that a child would benefit from a thorough assessment of brain function, and psychosocial issues.
INDICATORS OF POSSIBLE BRAIN DISORDER
- Repetitive rage behavior (Pathological Aggression) with no provocation or gain
- Impulsivity with impulsive aggression
- Chronic irritability
- Poor planning skills (runaway with no plan, no money, nowhere to go)
- Short attention span & poor memory
- Laboratory evidence (abnormal CT scan, MRI, EEG)
- History of neurological disease (seizure disorder, encephalitis)
- Abnormal Neuropsychological test results
- Head injury or multiple concussions
- Exposure by fetus to toxic substances (medications/substance abuse in pregnancy)
- Lack of prenatal care, difficult pregnancy or childbirth with late development
- No birth history or early developmental history available due to adoption