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Biomedical subjects

Ruth Brunsdon

Publications and source records attributed to Ruth Brunsdon.

4 recordsLinked to original sources

Topographical disorientation: towards an integrated framework for assessment.

Topographical disorientation, the inability to find one's way in large-scale environments, is a relatively common disorder. However, there are relatively few cognitive neuropsychological studies that investigate the nature of topographical cognition. Theoretical progress has been hindered by a number of factors including: terminological confusion; lack of theoretically driven assessment; the use of broad classifications for the nature of underlying impairments; and an ongoing failure to examine topographical skills in real-life settings. As a result, there is currently no well-established or widely accepted theoretical framework encompassing all aspects of this multifaceted area of cognition. In addition, there is a relative paucity of published case studies that include a comprehensive, theoretically based assessment of topographical disorientation, and treatment of the disorder has received virtually no formal investigation (with the exception of Davis & Coltheart, 1999). Thus, the current paper focuses on the development of a broad framework for understanding topographical cognition that integrates a number of recent theories of topographical orientation and mental imagery (Farah, 1984; Kosslyn, 1980; Riddoch & Humphreys, 1989). The aim of the paper is to present a preliminary framework that can be used as a basis for further refinement and development of theoretical proposals, and be employed by clinicians as a starting point for assessment planning.

Cognition↗

Assessment and treatment of childhood topographical disorientation: a case study.

Topographical disorientation refers to individuals who are unable to find their way around large-scale environments in a normal manner. Childhood topographical disorientation is rarely investigated or reported. Treatment of topographical disorientation is also rare with only one reported treatment study in an adult (Davis & Coltheart, 1999) and no known description of treatment in a child. This paper reports a detailed case analysis of CA, a 6-year-old child with topographical disorientation, and a description of a treatment programme focused on training orientation in the school environment. Assessment of CA revealed mild to moderate visual agnosia in conjunction with severe impairments in general spatial learning and memory, topographical new learning and memory, and a total inability to learn new topographical routes. CA was also unable to use a mental image of his environment, a simple visual plan of his environment or a simple visual map, but was able to follow verbally mediated topographical instructions. The treatment programme focused on improving CA's topographical orientation in the school environment. The programme first involved training in recognition of major school buildings and landmarks and then focused on practical training in route finding along commonly used routes in the school environment. Clear benefits from treatment were evident. The assessment and treatment methods employed provide practical and useful ideas for management of this condition in other children.

Child↗

Idiopathic macrocephaly in the infant: long-term neurological and neuropsychological outcome.

RATIONALE: The long-term outcome of idiopathic macrocephaly is presently unknown. METHODS AND RESULTS: In the current study (n=15), MRI conducted at long-term review showed regression of orbito-frontal extradural collections and normal or slightly enlarged ventricular space compared to infant examination. Head circumference had normalised in all but one participant. Neuropsychological assessments of nine participants showed general intellectual ability within the normal range in the majority of participants; however, specific deficits in attention were evident. Clinical interviews conducted with a smaller sub-group revealed anecdotal histories of behavioural difficulties and reading or arithmetic difficulties in half of the total sample. CONCLUSIONS: Prospective review studies such as this indicate that abnormal radiological findings in infancy are not necessarily predictive of neurodevelopmental problems and may reflect a normal variant. However, while overall intellectual ability may be within average limits in this diagnostic sample, considerable individual variations remain in specific areas of neuropsychological function.

Brain Diseases↗

Visual agnosia and prosopagnosia in childhood: a prospective case study.

Selective impairments in visual processing are well documented in adults but rarely reported in children. The few childhood cases reported are mostly retrospective accounts with little attention paid to developmental, assessment or management issues. We report a prospective case study of a boy with prosopagnosia and visual processing deficits of presumed developmental origin. At the age of 4 years, AL presented with a range of cognitive and visual recognition deficits. Subsequent assessments revealed an evolving pattern in visual recognition and dissociations between developing skills. At the age of 7 AL has impairments in early perceptual analysis, visual organisation and in complex visual processing. Although he can identify facial features and match faces he is unable to recognise familiar faces. His reading and spelling are developing normally. The nature of his deficits and his progress are discussed within a cognitive neuropsychological framework.

Achievement↗