CHAPTER SUMMARYThe field of neuropsychology has witnessed tre-
mendous growth over the past several decades.
Neuropsychology is the study of the relations
between brain function and behavior. Neuropsy-
chologists are called on to consult with neurologists
or other physicians to assess functioning, to make
predictions regarding prognosis and course, and to
plan interventions and rehabilitation. Models of
brain functioning have evolved from localization
of function to equipotentiality and, finally, to the
functional model. The functional model holds that
different areas of the brain interact to produce
behavior and that behavior is a result of several dif-
ferent functional systems of brain areas.
We have briefly reviewed the major structures
of the brain, a number of antecedents or causes of
brain damage, and various consequences of neuro-
logical damage. Neuropsychological assessment
involves the use of noninvasive standardized testing
methods that are sensitive to various forms of brain
functioning. A critical distinction is that between the
standard (or fixed) battery approach, in which a stan-
dard set of tests is given to all patients regardless of
the clinical picture, and the flexible (or hypothesis-
testing) approach, in which only selected tests are
administered. Major areas of functioning that are tar-
geted by neuropsychologists include intellectual
functioning, abstract reasoning, memory, visual-
perceptual processing, and language functioning.
Neurodiagnostic tests may also be used to diagnose
problems. A clinical neuropsychologist’s evaluation
canthenbeusedtoformulateandimplementa
plan of intervention or rehabilitation tailored to the
individual patient. The program of rehabilitation
should be maximally beneficial to the patient and
efficient in terms of staff time and supervision.
Specialty training in clinical neuropsychology is
necessary because of the complexity and sophistica-
tion of the procedures involved. Most graduate
programs are not able to devote sufficient time,
coursework, and practicum experience to the
study of brain–behavior relationships. Therefore,
an integrated model for the training of clinical neu-
ropsychologists has been adopted that includes pre-
doctoral, internship, and postdoctoral experiences.
Many challenges lie ahead for the field, including
the need for more sophisticated and more econom-
ical assessment and rehabilitative techniques, as well
as a tightening in the job market as a result of man-
aged care.KEY TERMSagnosiaImpairment in sensory perception.
aphasiaImpairment in language ability.
apraxiaImpairment in the ability to perform
certain voluntary movements.
cerebellumA subcortical structure associated
with motor coordination and the control of
muscletone,posture,andequilibrium.
cerebral hemorrhageA situation in which a
blood vessel ruptures and the blood escapes onto
brain tissue, either damaging or destroying it. The
symptoms of a hemorrhage are determined by its
site and severity.
concussionJarring of the brain sufficient to result
in a momentary disruption of brain function.
A single concussion usually does not cause
permanent damage, but repeated ones may.
contusionsBruises. In the brain, contusions result
when the brain has been shifted from its normal
position and pressed against the skull. Brain
contusions may be severe and may result in
delirious or comatose states.
degenerative diseaseA group of disorders—such
as Alzheimer’s disease, Parkinson’sdisease,and
Huntington’schorea—that result from the
degeneration of neurons in the central nervous
system. These disorders are characterized by
progressive cerebral degeneration and disturbance
in several behaviors or functions.536 CHAPTER 18