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学习障碍的神经心理学:过去与未来

Neuropsychology of Learning Disabilities: The Past and the Future.

作者信息

Fletcher Jack M, Grigorenko Elena L

机构信息

1University of Houston,Houston,Texas.

2St. Petersburg University,St. Petersburg,Russia.

出版信息

J Int Neuropsychol Soc. 2017 Oct;23(9-10):930-940. doi: 10.1017/S1355617717001084.

Abstract

Over the past 50 years, research on children and adults with learning disabilities has seen significant advances. Neuropsychological research historically focused on the administration of tests sensitive to brain dysfunction to identify putative neural mechanisms underlying learning disabilities that would serve as the basis for treatment. Led by research on classifying and identifying learning disabilities, four pivotal changes in research paradigms have produced a contemporary scientific, interdisciplinary, and international understanding of these disabilities. These changes are (1) the emergence of cognitive science, (2) the development of quantitative and molecular genetics, (3) the advent of noninvasive structural and functional neuroimaging, and (4) experimental trials of interventions focused on improving academic skills and addressing comorbid conditions. Implications for practice indicate a need to move neuropsychological assessment away from a primary focus on systematic, comprehensive assessment of cognitive skills toward more targeted performance-based assessments of academic achievement, comorbid conditions, and intervention response that lead directly to evidence-based treatment plans. Future research will continue to cross disciplinary boundaries to address questions regarding the interaction of neurobiological and contextual variables, the importance of individual differences in treatment response, and an expanded research base on (a) the most severe cases, (b) older people with LDs, and (c) domains of math problem solving, reading comprehension, and written expression. (JINS, 2017, 23, 930-940).

摘要

在过去的50年里,针对有学习障碍的儿童和成人的研究取得了显著进展。历史上,神经心理学研究主要集中在进行对脑功能障碍敏感的测试,以确定学习障碍潜在的神经机制,为治疗提供依据。在学习障碍分类和识别研究的引领下,研究范式的四个关键变化使人们对这些障碍有了当代科学、跨学科且国际化的理解。这些变化包括:(1)认知科学的兴起;(2)定量和分子遗传学的发展;(3)非侵入性结构和功能神经成像技术的出现;(4)针对提高学业技能和解决共病状况的干预实验性试验。对实践的启示表明,有必要将神经心理学评估从主要关注对认知技能的系统、全面评估,转向对学业成绩、共病状况和干预反应进行更具针对性的基于表现的评估,从而直接制定基于证据的治疗方案。未来的研究将继续跨越学科界限,以解决有关神经生物学和情境变量相互作用、治疗反应中个体差异的重要性,以及在以下方面扩大研究基础的问题:(a)最严重的病例;(b)患有学习障碍的老年人;(c)数学问题解决、阅读理解和书面表达领域。(《神经心理学报》,2017年,第23卷,第930 - 940页)

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