Emotional Symptoms of Neurological Disorders in Children

Article excerpt

Research increasingly demonstrates the central role of emotions in neurological or biophysical disorders. Is there any doubt within the scientific community that environmental experiences can change biology - as biology is broadly defined to include the impact of genetics, neurotransmitters, brain structure and function - and that biology can impact behavior? Regrettably, however, in daily delivery of psychological and educational services the interplay of neurological and emotional dynamics often leads to misdiagnosis, then to inappropriate interventions, and eventually to less tangible benefits.

There is ample reason to believe that contemporary psychologists often inappropriately attribute children's adjustment and developmental difficulties primarily to cognitive and emotional factors, and give short shrift to neurological considerations.In this article I wish to focus on five issues and anticipate later discussion concerning these complex matters. First, several case vignettes are reviewed, using masked data: these brief case studies illustrate possible consequences of intervention strategies which solely rely on environmental and curricular intervention and ignore neurological considerations. I then link the two vignettes to epidemiological evidence that the incidence of children's neurological disorders is far higher then generally recognized. Bandura's self-efficacy model is reviewed with respect to the interplay of neurological, cognitive and emotional symptoms. Next I discuss various levels at which neurological factors can impact on emotional symptoms children present and how standardized tests, both aptitude and achievement, constitute some - and I emphasize some - of the most trustworthy and useful assessment arrows in the psychologist's diagnostic quiver for facilitating appropriate matches between a child's abilities, motivations and assigned tasks. Fifth and finally, current opposition to the use of aptitude and other standardized measures is examined in the context of the current drive to mainstream students, and a perplexing question arises: do psychologists and educators shoot themselves in the foot and create obstacles to modulating the impact of neurological disorders by uncritically supporting reform movements aimed at ignoring evidence of human diversity and reducing or even eliminating neuropsychological, projective and, more generally, standardized aptitude and achievement tests?

Probably all of us can recall individual children with whom we have worked and for whom in retrospect we might have facilitated greater self confidence and success, had appropriate attention been given to the interaction of neurological and emotional factors. Not all those memories stem from clinical experience. I vividly recall memories of problems endured by Kenny, a high school classmate in my Wisconsin hometown; he seemed hopelessly incapable of learning. Confused in all academic areas and inclined to prematurely and disruptively cease problem solving, Kenny possessed little self esteem, was noticeably anxious when called upon to recite in class, anticipated failures, bullied classmates, and constructed a self-isolating wall to protect himself from embarrassment. I cannot recall a single classroom incident in which Kenny experienced an opportunity to demonstrate his advanced artistic and visual spatial skills.

Only in recent years did I learn that Kenny's schooling and emotional difficulties were very probably attributable to two primary neurological factors which had gone undetected. First and representing nomothetic considerations, Kenny was left handed and possessed greater competence in right hemispheric than those left hemispheric tasks upon which curricular success is largely dependent. Second, there were ideographic factors: a blue baby at birth, Kenny's early oxygen deprivation probably restricted acquisition of certain language skills which are highly correlated with academic success. The fact that Kenny eventually became a successful businessman, exercising acute skills in visualizing how and where future Wisconsin campsites could be constructed, suggests that he was eventually and independently capable of overcoming hurdles unwittingly erected by well intentioned educators who inordinately focused on standard curricular and largely left hemispheric objectives, while ignoring evidence of markedly stronger right hemispheric skills which have the potential to enable many students to become happy and productive adults. …


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