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Biomedical subjects

B P Rourke

Publications and source records attributed to B P Rourke.

At least 19 recordsLinked to original sources
PubMed2002

Child clinical/pediatric neuropsychology: some recent advances.

The neuropsychological assets and deficits of several types of pediatric neurological disease, disorder, and dysfunction are described. These are examined from the perspective of the syndrome of nonverbal learning disabilities (NLD) and the "white matter model" designed to explain its complex manifestations. It is concluded that children with some of these diseases exhibit the NLD phenotype, whereas others do not. For the most part, the diseases in which the NLD phenotype is particularly evident are those wherein it has been demonstrated that perturbations of white matter (long myelinated fibers) are particularly prominent.

Asperger Syndrome↗
PubMed2001

Classification rules for basic phonological processing disabilities and nonverbal learning disabilities: formulation and external validity.

Rules for the classification of two subtypes of learning disabilities (LD), namely, Basic Phonological Processing Disabilities (BPPD) and Nonverbal Learning Disabilities (NLD), are reported. These rules (refined as a result of application to two separate samples of children with LD) were used to select children from an entirely new sample who could be classified as having "definite" or "probable" BPPD or NLD. As a first step in the external validation of these rules, the patterns of psychosocial functioning exhibited by these two subtypes of LD were determined. As predicted, the vast majority of the BPPD subtype exhibited a pattern most consistent with normal or relatively normal psychosocial adjustment, and no appreciable increase in the incidence of significant psychosocial disturbance with advancing years. Also, as predicted, an increasing incidence of internalized psychosocial dysfunction (a form of significant psychosocial disturbance) was evident in the NLD subtype with advancing years. It is clear that children classified as having BPPD or NLD using these rules exhibit quite different, and predicted, relative patterns of psychosocial functioning. Thus, in this sense, the rules have concurrent validity. Finally, sets of rules/criteria for classification are presented that reflect their actual incidence in the two subtypes of LD generated for use in the validation phase of this investigation. These rules would appear to be useful for clinical purposes. It is also clear that they should be subjected to further validation studies in a broader age range for clinical and research purposes.

Adolescent↗
PubMed2000

A history of the International Neuropsychological Society: the early years (1965-1985).

A history of the early years (1965-1985) of the International Neuropsychological Society (INS) is presented. Themes than run through these years--such as the need for an organizational structure, attempts to make the Society truly international, and the involvement of the membership, especially, the "younger" members, in governance--are clearly evident. After a somewhat shaky start, the Society came of age toward the end of this formative 20-year period.

History, 20th Century↗
PubMed1999

Neuropsychological subgroups of patients with Alzheimer's disease: an examination of the first 10 years of CERAD data.

Neuropsychological CERAD data from 960 patients with Alzheimer's disease and 465 controls were subjected to separate yet identical classification procedures. Consistent with past research, three patient subgroups were reliably identified: Subgroup 1 (LAD; n = 312) was characterized by severe naming impairment yet borderline-normal figure-copying skills; Subgroup 2 (RAD; n = 247) displayed average naming ability but moderately-impaired copying performance; Subgroup 3 (GAD; n = 161) evinced profound anomia and constructional dyspraxia. LAD patients were older and less educated than those of the other subgroups. Control subgroups (n = 2) did not resemble the patient subgroups. Initial patterns of performance remained discernible across time for LAD and GAD, but were less consistent for RAD. Members from patient subgroups were present across disease stage.

Aged↗
PubMed1997

Unmasking the heterogeneity of Alzheimer's disease: case studies of individuals from distinct neuropsychological subgroups.

Case descriptions of patients with probable Alzheimer's disease (AD) who were reliably classified into three neuropsychological subgroups (global [GAD], right-hemisphere [RAD], and left-hemisphere [LAD]) in an earlier cluster analytic study (Fisher et al., 1996) are presented. Concordance between the neuropsychological patterns and clinical histories of randomly selected and hand-selected cases from within each subgroup was high. Longitudinal analysis revealed stable subgroup-specific neuropsychological progression patterns. Results are discussed in terms of future research avenues worth pursuing, in addition to the conceptual shift in research design necessary to uncover both quantitative and qualitative subgroup-specific ability differences.

Aged↗
PubMed1996

Neuropsychological subgroups of patients with Alzheimer's disease.

Neuropsychological data from 134 patients diagnosed with probable Alzheimer's disease (AD) were studied retrospectively to investigate whether subgroups of patients with qualitatively distinct profiles could be identified. Three empirical classification approaches were undertaken in this regard: Q-type factor analysis, hierarchical agglomerative cluster analysis, and iterative partitioning. Three subgroups were consistently identified across the clustering methods. Subgroup 1, the largest of the groups, was marked by moderate to severe anomia and constructional dyspraxia. Individuals in subgroup 2 displayed relatively spared visual-perceptual/constructional functioning but severe anomia. Members of subgroup 3 exhibited intact naming and nonverbal reasoning and moderate difficulty in copying overlapping figures. The three subgroups did not differ with respect to age, age at disease onset, duration of illness, educational level, or Hamilton depression rating. Detailed description of the data analyses are provided as a tutorial outlining subtyping methodology. Results are discussed in terms of the subgroup and the stage model approaches to the conceptualization of AD.

Aged↗
PubMed1995

Validity and neuropsychological characterization of Asperger syndrome: convergence with nonverbal learning disabilities syndrome.

The authors investigated the validity of Asperger Syndrome (AS) by comparing the neuropsychological profiles in this condition and Higher-Functioning Autism (HFA). Diagnostic assignment followed a stringent procedure based on ICD-10 research criteria for the two disorders. The groups had comparable age and Full Scale IQ distributions. The groups differed significantly in 11 neuropsychological areas. The profile obtained for individuals with AS coincided closely with a cluster of neuropsychological assets and deficits captured by the term nonverbal learning disabilities, suggesting an empirical distinction from HFA.

Adolescent↗
PubMed1994

Principal identifying features of the syndrome of nonverbal learning disabilities in children.

The identifying features of the syndrome of nonverbal learning disabilities (NLD) were examined with a view to determining their relative discriminant validity. A stepwise linear discriminant function analysis of children with NLD (n = 29), children with reading and spelling disabilities (Group R-S; n = 27), and a group of nonclinical children (NC; n = 27) on 15 neuropsychological variables yielded a subset of scores on four tests (Target Test; Trail Making Test, Part B; Tactual Performance Test; and Grooved Pegboard Test) that accurately (> 95%) discriminated the NLD group from the R-S and NC subjects. Of the neuropsychological features of NLD described by Rourke (1987, 1988b, 1989), deficits in visual-perceptual-organizational psychomotor coordination and complex tactile-perceptual skills appeared to be most representative (in the sense of most discriminative) of the NDL syndrome in the children examined. These are also the dimensions that are considered to be "primary" in the NLD model (Rourke, 1989). Replication of these results, employing children with other clinical disorders, is necessary.

Child↗
PubMed1993

Psychosocial functioning of children: relations between personality subtypes and academic achievement.

Five hundred children from ages 6 to 12 who had been referred for neuropsychological assessment were clustered into six subtypes using a k-means technique applied to 10 PIC scales. Five of the six subtypes were virtually identical to subtypes identified in previous research (viz., normal, somatic concern, mild anxiety, externalized psychopathology, and internalized psychopathology). A sixth subtype (conduct disorder) was also found. Wide Range Achievement Test (WRAT) Reading and Spelling scores discriminated between normal, somatic concern, and conduct disorder subtypes on the one hand vs. the more disturbed externalized and internalized psychopathology subtypes on the other; the latter groups scored higher on these measures. The internalized psychopathology subtype also showed large discrepancies between reading vs. arithmetic and spelling vs. arithmetic. The results support the view that psychosocial functioning is related to assets and deficits in cognitive/academic functioning in children, and that particular patterns of such assets and deficits are related to particular forms of psychopathology.

Affective Symptoms↗
PubMed1993

Arithmetic disabilities, specific and otherwise: a neuropsychological perspective.

From a neuropsychological perspective, this article summarizes research that addresses some of the developmental interactions of disabilities in reading, spelling, and mechanical arithmetic. The focus is on two subtypes of children with learning disabilities who exhibit equally impaired levels of arithmetic achievement, but with vastly different patterns of neuropsychological assets and deficits. Qualitative as well as quantitative analyses lead to the conclusion that one of these patterns of neuropsychological assets and deficits (i.e., the nonverbal learning disabilities syndrome; NLD) leads--at the same time and in much the same manner--to specific patterns of impairment in mechanical arithmetic and in psychosocial functioning. The other pattern (Group R-S) is found to lead to particular patterns of academic deficits (including arithmetic), but not to any particular level or type of psychosocial dysfunction. The manifestations of the NLD profile in various types of neurological disease, disorder, and dysfunction are also explored.

Child↗
PubMed1992

A five-factor model for motor, psychomotor, and visual-spatial tests used in the neuropsychological assessment of children.

Previous confirmatory factor analysis has supported a distinction between simple and complex motor skill tests in a modified and expanded Halstead Reitan test battery (HRB). The present study used a sample of 722 right-handed boys and girls, aged 9 through 12, and expanded the sample of motor, psychomotor, and visual-spatial tests to further clarify this distinction. Restricted maximum-likelihood factor analysis resulted in correlated factors of Simple Motor Skill, Complex Visual-Spatial Relations, Simple Spatial Motor Operations, Motor Steadiness, and Speeded Motor Sequencing. These results provide additional evidence for the discriminant validity of this particular battery of tests, and explicate further the skills and abilities measured in neuropsychological assessments of children referred for evaluation.

Adolescent↗
PubMed1992

Assessing the reliability of clinical scales when the data have both nominal and ordinal features: proposed guidelines for neuropsychological assessments.

The purpose of this article is to present, for the first time, a comprehensive methodology for assessing the reliability of a clinical scale that is frequently utilized in neuropsychological research and in biomedical studies, more generally. The dichotomous-ordinal scale is characterized by a single category of "absence" and two or more ordinalized categories of "presence" of a symptom trait, state, or behavior, and it also has special properties that need to be understood in order for its reliability to be appropriately assessed. Using the Brief Psychiatric Rating Scale (BPRS) as a clinical example, we cover the principles of expressing scale reliability in terms of a dichotomy ("absence" - "presence" of a given BPRS symptom); as a trichotomy ("none"; "mild to moderate" symptomatology; and "severe" symptomatology); and as the full 7-category dichotomous-ordinal scale: "none," "very mild," "mild," "moderate," "moderately severe," "severe," and "extremely severe." Criteria are presented that can be used to evaluate which of these three formats produces the most reliable results. Finally, we address, with a second sample, the important issue of replication, or whether the original reliability findings generalize to other independent populations.

Adult↗
PubMed1992

The validity of discrepancy-based definitions of reading disabilities.

This study addressed the validity of distinguishing children with reading disabilities according to the presence or absence of discrepancies between intelligence test scores and academic achievement. Three definitions of reading disability were used to provide criteria for five groups of children who (a) met a discrepancy-based definition uncorrected for the correlation of IQ and achievement; (b) met a discrepancy-based definition correcting for the correlation of IQ and achievement; (c) met a low achievement definition with no IQ discrepancy; (d) met criteria a and b; and (e) met none of the criteria and had no reading disability. Comparison of these five groups on a set of 10 neuropsychological tests corrected for correlations with IQ showed that group differences were small and accounted for little of the variability among groups. These results question the validity of segregating children with reading deficiencies according to discrepancies with IQ scores.

Achievement↗
PubMed1992

Emotional adjustment of children with hydrocephalus and of their parents.

Emotional and behavioral adjustment after infantile hydrocephalus were investigated. Children's and parents' adjustments were assessed by means of questionnaires (PIC-R, SCL-90-R) in a sample of 48 children with shunted hydrocephalus. The PIC-R patterns of the children were mostly reflective of their anomalous physical and cognitive development, but there was no evidence for a specific "hydrocephalic personality" pattern. Discriminant analyses revealed that there were no strong relationships between distress of the parents (as assessed by the SCL-90-R) and a variety of physical and psychosocial variables, despite the fact that many parents were significantly distressed. It was concluded that the majority of children with hydrocephalus do not present with a specific psychiatric profile, that clinically significant levels of distress are quite common in their parents, and that such distress is typically not related to the hydrocephalus per se.

Child↗
PubMed1992

Long-term vocational functioning after severe closed head injury: a controlled study.

Vocational functioning at least 2 years postinjury was examined in a group of 57 severely closed-head injured (CHI) patients and 50 nonbrain-injured spinal-cord injured (SCI) patients. The two groups were equated on the following preinjury parameters: age, education, socioeconomic status (SES), male/female ratio, and marital status. The CHI and SCI patients had a similar number of members who were employed at follow-up. However, mean follow-up socioeconomic status was significantly lower in the CHI group and premorbidly employed CHI patients suffered a greater loss of SES than did premorbidly employed SCI patients. These results indicate that the degree of vocational impairment after severe CHI goes beyond impairment seen with another chronic disabling condition (i.e., SCI) that is associated with severe physical impairment but not neuropsychological impairment. In the CHI group, the following variables were all correlated with SES at follow-up: preinjury education, posttraumatic amnesia duration, degree of neuropsychological impairment soon after injury, and emotional adjustment at follow-up.

Journal Article↗
PubMed1991

Neuropsychological functioning of hydrocephalic children.

A group of 30 five- to eight-year-old hydrocephalic children was administered a comprehensive battery of neuropsychological tests. As a group, they displayed a pattern of lower PIQ than VIQ. Their performance was within the average range of many neuropsychological tests, but they performed poorly on some measures of complex visuospatial functioning. It is concluded that hydrocephalic children at this early age exhibit relatively reduced efficiency in processing complex or novel nonverbal stimuli. The possibility of dysfunction in the posterior regions of the right cerebral hemisphere is discussed.

Brain Damage, Chronic↗