April 19, 2004

On Friday George-Anne, Russ and I met with the neuropsychologist at Kessler to discuss the results of his evaluation. Below I have included the highlights of the evaluation. In order to understand the report I had to consult WebMD for the definitions which I also included.

Russ did well in many areas

Follows commands appropriately

Properly oriented to year month date and place

Can perform simple mental control tasks

Can perform simple mental calculations

Short term memory in the low average range

He does not feel depressed

He feels he is capable of significant improvement

Is able to draw simple geometric figures from verbal commands

Is able to spell

Can write a simple sentence without errors in grammar or spelling

Was able to copy a 3 dimensional cube

The areas that Russ needs to work on include

Significant motor apraxia of speech

Apraxia is a neurological disorder characterized by the inability to perform learned (familiar) movements on command, even though the command is understood and there is a willingness to perform the movement. Both the desire and the capacity to move are present but the person simply cannot execute the act. Apraxia is believed to be caused by a lesion in the neural pathways of the brain that contain the learned patterns of movement. It is often a symptom of neurological, metabolic, or other disorders that can involve the brain. (WebMD)

Uses his keyboard well but has processing speed problems

Severe expressive language deficit but intact receptive language

Russ and I discussed this and he is aware of this problem. He says that he understands everything quickly but when he goes to respond he knows what he wants to say but has trouble finding the words and getting them out.

Fine motor deficit

This shows up in many tasks Russ tries to complete ranging from tying his shoes to other detail oriented tasks. He is usually successful but it takes time.

Significant deficits in verbal abstraction ability

Has frontal executive deficits

WebMD defines executive functions as reasoning, judgment, and self-control. I have not noticed that Russ has significant problems in this area

Unaware or is in denial of his significant cognitive deficits

Based on these results the doctor does not think that Russ can take full advantage of the therapy groups. Right now it takes too long for Russ to compose an answer to a question. The group will move on to other topics. For that reason they are going to put together a customized program for Russ composed of some individual therapy and some group therapy. If Russ does well in the group the therapy format could change.

Thanks for following Russ’ progress.

Bob