The modification of Luria's neuropschological investigation for use with white, English-speaking South African children aged eight to fourteen years.

Abstract

Alexandria Luria's approach to neuropsychological assessment and his theory of brain functioning have been exploited in order to develop a neuropsychological evaluation procedure for children which incorporates a conceptualization of brain-behaviour development. Luria's Neuropsychological Investigation for adults was administered to intact children aged eight to 14 years in order to ascertain which tasks were beyond their capabilities. These were then adapted or deleted. The adapted version of the protocol was then administered to a second group of intact children to determine that the proposed adaptations were appropriate. This process was guided by the results of a statistical analysis which revealed significant findings with respect to age, socioeconomic status, and task performance. A model of brain-behaviour development and interpretive protocol were devised. Together these provide a conceptual and interpretive framework for the battery. Developmental trends which emerged whilst developing Luria's Neuropsychological Investigation for Children (LNI-C) were consistent with the progressive development of successively more complex forms of information processing as depicted in this model. They were also in keeping with prominent developmental theories such as those of Piaget and Vygotsky. These trends revealed that children made most mistakes on adult LNI tasks involving abstract reasoning, the simultaneous synthesis of data, and complex goal-directed behaviour - all of which apparently reflect tertiary cortical zone functioning. Fewer mistakes were related to a lack of training and inability to process the same quantity of information as adults - difficulties which seemed related to secondary zone functioning. None of the mistakes made appeared to reflect subcortical or primary zone functioning. The LNI-C was applied to brain-damaged children who had had a CT scan in order to demonstrate its application and the hypothetico-deductive process of interpreting findings using the concepts of syndrome analysis and double dissociation. The LNI-C findings were consistent with the general pattern of symptoms Luria described for different brain disorders and lesion localities in children, although additional insight into the nature of the sequelae present was gained in each case. In early brain damage, the most frequent disturbances were a disruption in the role played by executive functions and the ability to process data simultaneously - both of which are associated with the tertiary zones of the brain. Furthermore, these disturbances appeared to be important factors underlying disturbances to language and educationally acquired skills. The qualitative, process-orientated nature of the LNI-C proved effective for identifying the factors underlying disturbances described in paramedical reports. These seemed to be the linchpins on which retraining should focus. It was argued that the CT scan was limited in its ability to identify the type of diffuse and/or multifocal brain pathology frequently found in children. The usefulness of the model of brain-behaviour ontogeny and interpretive protocol for diagnosis, understanding and predicting the developmental consequences of childhood brain pathology was demonstrated on the basis of nine brain disorders. Finally, areas of future research were highlighted by the study.