Children's Stroke program
Assessment - Neuropsychology: Assessment & Programming
Robyn Westmacott, Ph.D., C.Psych., Supervisor
Stroke in Kids: Arterial ischemic stroke (AIS) and cerebral sinovenous thrombosis (CSVT) are frequent causes of neurological disability in Canadian children and incidence is increasing, yet it remains an under-recognized and under-researched entity. Many of these children face chronic disability and handicap because of deficits in sensory, motor, cognitive and behavioural function. Although motor deficits are most visible to an observer, there is evidence to suggest that cognitive and behavioural impairments are particularly detrimental to psychological well-being, social interaction and functional independence.
The Role of Neuropsychology: Children who have had a stroke (AIS or CSVT) may be referred by a member of the stroke team for a neuropsychological assessment. The goal is to provide a comprehensive evaluation of cognitive, academic, social, emotional and behaviour development, in the context of the child’s neurological history. The neuropsychologist also consults with parents, educators, stroke team members, and other health care professionals regarding academic planning and intervention. Finally, the neuropsychologist can act as an advocate for the child and family within the school system and the broader community.
The SickKids Stroke Program – A Multi-Disciplinary Approach: The Children’s Stroke Program has evolved since its establishment in 1994, and now consists of an acute inpatient program, weekly stroke prevention clinic, and an outcomes research program. The team has expanded to include three neurologists, two clinical/research fellows, a neuropsychologist, a staff nurse, an advanced practice nurse, and a research team. Through the Neurology Department, patients also have access to inpatient rehabilitation services (physiotherapy, occupational therapy, speech-language therapy), and social work services. The formation of additional partnerships with paediatric sub-specialists including a neurosurgeon, neurointerventional radiologist, neuroradiologists, haematologists, rheumatologists and an adult regional stroke centre has further strengthened the ability of the Stroke Program to enable earlier identification of paediatric stroke through the establishment of urgent neuroimaging protocols, hyper-acute and acute medical therapies.
Internship Rotation in Clinical Neuropsychology: This rotation is appropriate for interns with or without a background in pediatric neuropsychology – learning goals and responsibilities will be adjusted according to the individual’s experience. Assessments typically involve a broad range of neuropsychological and psychoeducational tests, interviewing children and parents, and reviewing medical and academic histories. The intern will gain experience in formulating diagnostic interpretations of assessment results, making appropriate recommendations and plans for intervention, consulting with physicians, families and schools, and writing comprehensive assessment reports. In addition to structured supervision of clinical cases, the intern will have the opportunity to interact with other members of the multi-disciplinary Stroke Program and participate in directed readings relevant to developmental neuropsychology and cognitive neuroscience.
Research Rotation Option: A research rotation in Paediatric Stroke can also be arranged.