Conference of the APS College of Clinical Neuropsychologists 2015

Workshops

Workshop 1: Mild Traumatic Brain Injury in Sports, Daily Life, and Military Service Date/Time : Thursday 19th November , 9.30 am – 1.00 pm Presenter : Grant L. Iverson, Ph.D. Professor, Department of Physical Medicine & Rehabilitation, Harvard Medical

School /Director, MassGeneral Hospital for Children Sports Concussion Program /Associate Director, Traumatic Brain

Injury, Red Sox Foundation and Massachusetts General Hospital Home Base Program

This presentation will describe a diverse literature relating to outcome from mild traumatic brain injury in athletes, civilians, and active duty service members. The vast majority of injured athletes appear to recover functionally within 2-28 days post injury. In civilian trauma patients, acute psychological distress, measured in the first few days post injury, is strongly associated with the presence of the post-concussion syndrome at one month post injury. For athletes, civilians, and service members, a brief period of prescribed rest is likely helpful to promote recovery, but prolonged rest might be harmful for some people. Some athletes and service members are slow to recover from concussion and do not return to sport or duty within the first month following injury. The rationale for early active rehabilitation for those who are slow to recover will be presented. Treatment and rehabilitation strategies for those with chronic symptoms and problems will also be presented. Learning Objectives

To differentiate typical from atypical recovery patterns for athletes and trauma patients with mild traumatic brain injuries.

To understand the strong association between psychological distress and post-concussion symptoms.

To appreciate the limitations of “watchful waiting” in patients with mild TBIs.

To encourage active rehabilitation for athletes, workers, and military service members who are slow to recover following head trauma.

Workshop 2: Neurons to Neighbourhoods: A bio-psycho-social model of child development Date/Time : Thursday 19th November , 9.30 am – 1.00 pm Presenters: Vicki Anderson, Royal Children’s Hospital/Murdoch Research Institute & Jane Nursey, Phoenix Australia Centre for Posttraumatic Mental Health/University of Melbourne. Vicki.Anderson@rch.org.au jnursey@unimelb.edu.au

The field of developmental neuroscience is in its infancy, but early research has identified exciting links between brain development neurocognition and early environment. These links provide an opportunity to modify outcomes, by improving children’s environments, via family and community based interventions. This workshop aims to provide an understanding of the vulnerability of the developing brain to environmental influences, such as deprivation, abuse and trauma and to explore the impact of the early childhood environment on brain structure and function, and on cognitive, behavioural and emotional development. The importance of these early experiences for both child and adult neuropsychological practice, and the key role to be played by neuropsychology, will be considered. Using a bio-psycho-social model framework, this workshop will review the neurodevelopmental, cognitive and behavioural aspects of normal child development and demonstrate how environmental insults can disrupt these

processes, with lifelong consequences. There will be a focus on trauma exposure occurring at different stages of the developmental continuum. Impacts on language development, attention and executive function, emotional regulation and social and interpersonal skills will be highlighted. Behavioural and educational implications and current evidence based approaches to interventions will be explored. This workshop will be suitable for clinical psychologists, neuropsychologists, developmental and educational psychologists and counselling psychologists working with children and young people across a range of settings, including acute health, community and juvenile justice. It will also be relevant to managers and policy makers responsible for setting policy, curriculum and program priorities in schools, child protection, health and mental health facilities. By the end of this workshop participants will:

Have a sound understanding of normal neurodevelopmental processes from conception to adulthood

Be aware of critical vulnerable periods where environmental stressors can have the most powerful impact

Know the difference between a Type 1 and Type 2 trauma

Understand how different types of trauma exposure (e.g., neglect, abuse, natural disaster) impact normal developmental processes, including both brain and behaviour dimensions

Be familiar with a range of current evidence based interventions designed to enhance the longer terms outcomes for children and adolescents who have been exposed to significant trauma.

Level: Introductory

Workshop 3: From Trials to Translation: Implementing a Neuropsychological Intervention Date/Time : Thursday 19th November , 2.00 pm – 3.30 pm Presenters: Glynda Kinsella & Liz Mullaley, La Trobe University & Caulfield Hospital g.kinsella@latrobe.edu.au Through a pilot study and a randomised controlled trial, we have been able to evaluate and demonstrate the efficacy of a neuropsychological intervention (the LaTCH Memory Group program) for improving memory performance in older people, including those with amnestic mild cognitive impairment (aMCI). The LaTCH group is a six-week program covering practical applications of memory strategies in day to day life. The program is now being provided though Alzheimer's Australia Victoria and several health services including the La Trobe University Psychology Clinic. Within this mini workshop we will not be presenting the components of LaTCH. Instead, through two themes we will discuss our experiences of translating an evidence-based neuropsychological intervention into community-based practice. Firstly, we will be focusing on the approaches and processes that we have used in training of facilitators for the groups, and the issues and challenges in maintaining the fidelity and sustainability of the program. Secondly, we will present our experiences in integrating the program into the practical training of our postgraduate neuropsychology students, which has provided opportunity for capacity building in skills in neuropsychological interventions. This workshop will be most appropriate for neuropsychologists with clinical experience in rehabilitation and aged care management settings, or academically-oriented neuropsychologists with an interest in translating research findings into clinical intervention practice. Participants should have basic skills in neuropsychological intervention and evaluation. Through participation in this mini workshop, participants will gain:-

Knowledge about the effectiveness of translating an evidence-based memory group program (LaTCH) into community and health services for older people, including those with aMCI;

Knowledge about the resources required to implement a sustainable neuropsychological intervention Level: Intermediate/Advanced

Workshop 4: Through a glass, darkly: Clinical conundrums and ethical dilemmas in Neuropsychiatry Date/Time : Thursday 19th November , 2.00 pm – 5.30 pm

Presenters: Wendy Kelso, D. Velakoulis, R. Mocellin, S. Atherton & S.M. Loi (Neuropsychiatry Unit, Royal Melbourne Hospital, Melbourne Health) wendy.kelso@mh.org.au Neuropsychiatry is a sub-specialty area of psychiatry, at the interface of psychiatry, neurology and general medicine. It is a specialised area of psychiatry committed to understanding brain-behaviour relationships, and to the care of individuals who experience neuropsychiatric illness. The Neuropsychiatry Unit, Royal Melbourne Hospital is a tertiary referral, statewide service that provides neuropsychiatric assessment and advice to psychiatric, neurological and other medical and mental health services. This 3-hour workshop will use case presentations to illustrate the rapidly advancing, diverse and fascinating discipline of neuropsychiatry. Case presentations will include neuropsychiatric and neuropsychological assessment principles, neuroimaging, neuropharmacology and neuropathology results and client video footage. The specialist role of the neuropsychologist in assessing cognition, personality and behaviour will be highlighted. This workshop will assist participants in how to approach neuropsychiatric assessment, outline what is required to complete a comprehensive assessment and expand knowledge about common and rare neuropsychiatric and neurodegenerative conditions. Differential diagnoses will be explored and information provided about how to include or exclude a diagnosis. Each case will be presented from a holistic perspective, with discussion about the moral and ethical dilemmas faced when diagnosing an individual with a neuropsychiatric condition. While the workshop will largely focus on neuropsychiatric diagnostic conundrums, information will be presented on ethical issues related to predictive and symptomatic genetic testing, diagnostic biases and the challenges of treatment in the absence of evidence based guidelines. Discussion will include rights and responsibilities of clients and health professionals once a diagnosis has been made, changes in roles and family systems, grief and loss, the burden of normality and how to best support the family after the diagnosis has been made. This workshop is designed for intermediate to advanced clinicians interested in clinical aspects of neuropsychiatry. It is suitable for clinicians who wish to further their skills and education in complex diagnostic decision-making in a neuropsychiatric population. Desirable knowledge prior to attending would be a familiarity with high prevalence psychiatric and neurodegenerative conditions and experience in their assessment. A basic understanding of the fundamental principles of neuroimaging, genetic inheritance, biochemistry and neuropathology would be an advantage.

Learning outcomes:

Increase knowledge of common and rare neuropsychiatric and neurodegenerative conditions that clinicians may not have had exposure to in everyday practice

Provide a framework of how to approach neuropsychiatric assessment

Extend knowledge base about neuropsychological profiles in individual neuropsychiatric conditions

Develop a greater understanding of the role of neuropsychology in assessing psychiatric clients, including comprehensive assessment of mental state, personality and behaviour

Expand knowledge of Younger Onset Dementia, diagnostic principles, treatment, interventions and management

Promote awareness of the ethical and moral dilemmas faced in neuropsychiatry with regards to the implications of a diagnosis being made

Increase knowledge of Deep Brain Stimulation as a potential treatment for neuropsychiatric conditions

Level: Intermediate to Advanced

Workshop 5: Neuropsychology of focal epilepsies: Is there more to learn? Date/Time : Thursday 19th November , 2.00 pm – 5.30 pm Presenter: Michael Saling, University of Melbourne & Austin Health (mmsaling@unimelb.edu.au) Since Brenda Milner’s seminal work, neuropsychology has enjoyed a special and sometimes illustrious association with epileptology. Focal epilepsies, and temporal lobe epilepsy in particular, have loomed large in neuropsychological research, contributing greatly to our understanding of neurocognitive disturbances. The field of epilepsy is under constant revision as our knowledge of the underlying neurobiology of seizures and neuroimaging technologies improve, creating a dynamic matrix for neuropsychological research and the development of clinical practice.

Neuropsychology has gained much from research on, and clinical engagement with patients suffering from medically intractable focal seizure disorders. Cases with intractable temporal lobe epilepsy, in particular, are reasonably homogenous with respect to underlying neuropathology and seizures characteristics, and are generally very well documented by EEG-videomonitoring, structural and functional neuroimaging, neuropsychological evaluation, and post-operative neuropathology. This level of work-up, usually prior to neurosurgical intervention for seizure relief, facilitates neurocognitive investigation. Classification and re-classification of seizures and epilepsy syndromes is a work in progress, responding to advances, inter alia, in the pathological, neurogenetic, electrophysiological, and neuroradiological underpinnings and correlates of seizures. The next frontier is neurocognition, and this is stimulating a reconsideration of neuropsychological methodology, diagnostic reasoning, and management. There has also been some re-evaluation of the most studied case in the annals of clinical neuropsychology, namely HM, leading to some re-evaluation of the concept of amnesia. A number of other disorders are characterized by disruption of neurofunctional networks common to temporal lobe epilepsy. aMCI, transient amnestic states, and some stroke syndromes are cases in point. Lessons learned from temporal lobe epilepsy have found applicability in the early detection of aMCI, for instance, and have led to a reconceptualization of plasticity in temporal lobe mechanisms of memory. Participants should have an understanding of neuroanatomy, neurocognitive disorders, and a basic awareness of the diagnostic uses of neuroimaging. Learning Outcomes:

Participants will gain an understanding of progress in our understanding of the focal epilepsies, and the relevance of these advances for clinical neuropsychology.

At a skills level, they will also gain an enhanced understanding of neurocognitive hierarchy and architecture in the assessment of memory and in diagnostic reasoning.

Level: Introductory/Intermediate

Workshop 6: Memory impairments in children with neurological disorders: How to diagnose and treat Date/Time : Thursday 19th November , 2.00 pm – 5.30 pm Presenters: S. Lah, N. Phillips, M. Gascoigne (The University of Sydney), L. Gonzalez (The Royal Children’s Hospital Melbourne), L. Parry (Sydney Children’s Hospital), S. Meeth, (The Children’s Hospital at Westmead) Memory is a complex system that is critical for child development. It comprises many functions which are supported by overlapping networks of brain structures. This intricate neurocognitive system has prolonged maturation, with differential developmental trajectories being found for specific networks and memory processes. This differential developmental maturation of memory functions may l ead to disparity in emergence of memory deficits. While some memory deficits may be apparent in childhood other may not be noticed until adolescence. In this workshop, we will focus on development and impairments of declarative memory. We will examine clinical manifestations, diagnosis and treatment of deficits in encoding, learning, storage and retrieval of information in children with neurological disorders. We will focus on children with epilepsy and traumatic brain injury. We will scrutinise features and functional implications of memory deficits in the developmental context. We will describe new forms of memory impairments found in children with epilepsy and traumatic brain injury and examine shortcomings of current assessment procedures for diagnosis of these new forms of memory disorders. We will also examine approaches to rehabilitation of memory deficits, as memory problems that interfere with everyday living are frequently reported by children with neurological disorders and their parents. Evidence is emerging that neuropsychological rehabilitation can reduce functional impact of memory deficits or even promote restoration of functions. We will discuss and demonstrate several approaches to paediatric memory rehabilitation, such as strategy training, learning how to use memory aids and computerised cognitive rehabilitation. The workshop will include illustrative cases and research findings. The workshop will be of value to practitioners who have working knowledge of memory disorders and standardized

assessment procedures used to assess memory in patients with neurological disorders, especially in children. Learning Outcomes:

Increased knowledge and understanding of memory disorders in children,

Development of skills to critically evaluate currently used assessment tools for diagnosis of different types of memory disorders in children

Develop an understanding of techniques that can be used for memory rehabilitation in children. Level: Intermediate/Advanced

Workshop 7: Dementia in people with an intellectual disability Date/Time : Friday 19th November , 11.30 am – 3.30 pm Presenter: Julian Trollor, Chair, Intellectual Disability Mental Health, UNSW; Head, Department of Developmental Disability Neuropsychiatry; Professor, School of Psychiatry, UNSW Medicine j.trollor@unsw.edu.au Compared to the general population, people with an intellectual disability (ID) experience an over -representation and earlier onset of dementia. Despite the rapid increase in lo ngevity of this population group, services and practitioners remain ill equipped to assess and manage age-related cognitive disorders in people with an ID. This workshop aims to equip attendees with enhanced knowledge, skills and approaches to dementia in ID. Attendees will engage in an interactive session which reviews the epidemiology of dementia in people with ID, examines the presentation and clinical profile of cognitive disorders and dementia, describes adjustments required in the assessment of a person with ID, and reviews some of the screening and neuropsychological tools which may be of use when evaluating cognitive decline in a person with ID. This workshop will be of particular interest to neuropsychologists, clinical psychologists and psychologists who assess or who may be asked to assess people with age-related cognitive disorders. Participants will develop and enhance their understanding of:

the epidemiology of age-related cognitive disorders in people with ID

the presentation and clinical profile of cognitive disorders and dementia

the adjustments required in the assessment of a person with ID

the screening and neuropsychological tools which may be of use when evaluating cognitive decline in a person with ID.

Level: Intermediate

Workshop 8. The neuropsychological impact of the sedatives and hypnotics. Date/Time : Friday 19th November , 2.00 pm – 3.30 pm Presenter: Simon F. Crowe, School of Psychological Science, La Trobe University, Australia (s.crowe@latrobe.edu.au) The sedative and hypnotic drugs are a group of agents which act upon the GABAergic neurotransmitter system to depress the activity of the central nervous system inducing sleep and reducing anxiety and epileptic activity. This group includes the barbiturates, the benzodiazepines and the so-called “Z” drugs (i.e. Zaleplon, Zopiclone, Eszopiclone and Zolpidem). Inevitably when the level of consciousness is altered this has significant effects upon many neuropsychological functions. This workshop will review the mechanism of action of these agents and then meta-analytically address the effect of these agents on all levels of neuropsychological functioning. The level of their effect will be analysed both acutely and following longer term administration as well as analysing the impact of their discontinuation on neuropsychological functioning and attempting to determine whether there is residual compromise following discontinuation and ascertaining for how long these effects might persist. The analysis will indicate that the effect of these agents does lead to the possibility of false positive diagnosis of brain impairment and the possibility of incorrect attribution of cognitive compromise to the drug effect may indeed occur. Parameters for clinical concern and decision rules for the impact of these agents upon the assessment process will be presented.

This workshop is designed to help you:

Characterise the mechanisms of effect of the sedative and hypnotic drugs and distinguish between the psychotropic effect of these medications on the underlying disease state and their effect on intrinsic neurobiological processing.

Identify the impact of these medications on neuropsychological functioning as determined meta-analytically, acutely, chronically and following withdrawal.

Discuss a set of decision rules for ensuring appropriate differential diagnoses with regard to the effects of the sedative and hypnotic drugs in the attempt to avoid false positive diagnosis of neurocognitive impairment.

Level: Intermediate

Workshop 9: Optimally assessing HIV-associated neurocognitive disorder in the era of long-term antiretroviral treatment Date/Time: Friday 19th November , 2.00 pm – 3.30 pm Presenters: Lucette Cysique, Neuroscience Research Australia, UNSW Australia & Sydney St. Vincent’s Hospital Applied Medical Research Centre, Jodi Kamminga, Hunter New England LHD & Peggy Bain, Sydney St. Vincent’s Hospital, Neurology Department HIV-associated neurocognitive disorder (HAND) remains a potential complication of Human Immunodeficiency Virus (HIV) infection despite the advent of antiretroviral treatment. In long-term treated HIV-infected persons, HAND can also be complicated by brain aging and co-morbid factors. Neuropsychological assessment has a pivotal role in documenting the presence of sub-clinical or clinically relevant levels of impairment, the contribution of co-morbid factors to cognitive difficulties, as well as the extent of any decrease in independence in activities of daily living. Diagnosis of HAND is typically based on neuropsychological assessment in combination with a neurological exam, MRI and laboratory investigations. HAND is a diagnosis of exclusion (i.e., exclusion of other causes such as non-HIV neurological impact, and HIV brain opportunistic infection). Antiretroviral treatment is now very effective at reducing HIV, which by replicating can cause a severe encephalopathy also called HIV-associated dementia. Despite HIV-infected persons being stable on antiretroviral treatment, they can still develop neurocognitive difficulties, ranging from subtle impairment to more severe impairment. Importantly, HAND can potentially respond to treatment and so early detection of HIV-related neurocognitive impairment in untreated HIV positive persons is key to enabling timely initiation of antiretroviral treatment and avoidance of irreversible brain damage. In treated HIV infection, the clinical profile mostly includes mild forms of cognitive impairment, which needs to be monitored. In this context neuropsychological assessment has an increasingly important role, as some neurocognitive difficulties are only apparent upon comprehensive standardised testing. The workshop will introduce key and up to date knowledge on HIV epidemiology, immunology and virology, and treatment. It will then review optimal tests that should comprise a neuropsychological assessment for HIV patients. Case presentations and discussion with clinical experts will highlight typical HAND impairments and the impact of HIV co-morbid conditions (i.e., HIV-related opportunistic infections) and non-HIV co-morbid conditions (e.g., depression, alcohol & substance use) as well as aging factors (e.g., cardio-vascular disease, neurodegenerative diseases). Participants will gain up to date knowledge and skills on how to evaluate HAND and be able to apply this in clinical settings. This workshop will be of interest to students at various level in neuropsychology; clinical neuropsychologists interested in acquiring knowledge on how to assess HIV-infected persons for neurocognitive deficits; psychologists interested in gaining neuropsychology knowledge about HIV-infected persons; all interested in gaining knowledge of articulation between peripheral and CNS immune system. Level: Intermediate

Workshop 10: Social cognition, theory, assessment and treatment Date/Time: Saturday 19th November , 8.30 am – 11.50 am Presenter: Skye McDonald, School of Psychology, UNSW, Australia (s.mcdonald@unsw.edu.au)

This workshop will address the broad area of social cognition focusing upon how these manifest in adults with traumatic brain injuries. Social cognition refers to the ability to identify, process and interpret social cues to make sense of social behaviour. Such cues include facial and vocal expressions, body and gestural cues and contextual information. These cues are used to make inferences about others, including inferences as to what they are feeling, what they know and the intentions behind their behaviour. People with a range of neurological disorders (brain injury, dementia and focal lesions) and developmental disorders (e.g. ASD) can have difficulty with social cognition even in the absence of broader cognitive impairments. This workshop will examine some of the evidence for social cognition deficits after brain injury and consider how these inform a theory of the neuropsychology of social cognition. In addition, some assessment tools for assessing social cognition in adults and children will be reviewed. Remediation for social cognition is an emerging area although there is not a great deal of evidence to date. This workshop will outline some of the approaches that have been taken and review what evidence there is for their efficacy. As a result of this workshop it is anticipated that participants will be familiar with the basic principles of social cognition, will be aware of what assessment tools are available, including their strengths and weaknesses and will be informed about potential remediation approaches. Learning Outcomes:

Understanding of different aspects of social cognition including emotion perception, theory of mind and empathy

Knowledge of how these constructs may be related and possible neural underpinnings

Knowledge of available assessment instruments

Knowledge of emerging remediation research. Level: Introductory

Workshop 11: Clinical, neuroimaging and genetic characteristics of the younger-onset dementias Date/Time: Saturday 19th November , 8.30 am – 11.50 am Presenter: Olivier Piguet, Neuroscience Research Australia and UNSW o.piguet@neura.edu.au Although the risk of dementia increases with age, individuals aged < 65 years account for ~20% of all dementia cases. Frontotemporal dementia and Alzheimer’s disease are the most common younger -onset dementia (YOD) syndromes in this age bracket. Each syndrome is characterized by unique clusters of clinical signs and symptoms which have been codified in recently published con sensus diagnostic criteria. Evidence, however, has shown a considerable overlap in clinical features across YOD syndromes, making an accurate diagnosis early in the disease process fraught with difficulties. In addition, the prediction of the underlying pathology in YOD syndromes is variable. This workshop will examine the recent evidence on YOD with a focus on Alzheimer’s disease, frontotemporal dementia and the language presentations known as primary progressive aphasias (semantic dementia, progressive nonfluent aphasia, logopenic progressive aphasia). The following topics will be considered: review of the current diagnostic criteria for dementia, clinical phenomenology of the main YOD syndromes, neuroradiological signatures of YOD syndromes (with a focus on MRI and PET), and genetics for YOD. The workshop will aim to provide attendees with tools to improve diagnosis of YOD syndromes, an understanding of the possible trajectories of these disorders, and the impact of these YOD syndromes on patient management and carer burden. This workshop is intended for clinicians working with individuals diagnosed with dementia in clinical settings (acute, post acute, rehabilitation) or researchers who are interested in the differential diagnosis and management of younger-onset dementia syndromes. Knowledge of broad dementia categories is desirable but not mandatory. Some prior knowledge of brain neuroanatomy will be an advantage. Knowledge of common neuropsychological tests will be assumed. By the end of the workshop, participants will be able to:

Understand the main younger-onset diagnostic categories;

Recognise the clinical presentations of younger-onset dementia syndromes;

Recognise the cardinal features of younger-onset dementia syndromes on structural brain imaging;

Understand the genetic risks associated with younger-onset dementia;

Identify potential management issues and likely sources of burden for carers and family members. Level: Intermediate

Workshop 12: Reading published studies for your patient’s benefit: Critical appraisal of treatment studies. Date/Time: Saturday 19th November , 8.30 am – 12 noon Presenter: Stephen Bowden, School of Psychological Sciences, University of Melbourne, and Department of Clinical Neurosciences, St. Vincent’s Hospital, Melbourne. sbowden@unimelb.edu.au In an era of proliferating research, maintaining up-to-date skills is an increasing challenge for clinicians. A set of skills designed to address professional knowledge-maintenance and to aid clinician’s independent learning has evolved under the rubric of critical appraisal. Although widely adopted across medical and allied health-care disciplines, critical appraisal skills are not so well-known amongst psychologists. Ironically, many psychologists enjoy high quality methods training as part of their accredited undergraduate degrees. It will be shown that the critical appraisal skills consolidate much of the research methods training psychologist acquire. When focused with critical appraisal techniques, clinicians are able to read research articles to determine the quality of methods, risks of bias, importance of study findings and patient relevance. In this first workshop the principles of critical appraisal of treatment studies will be described. Critical appraisal skills will be explained in the context of practical guidelines for ranking quality of research evidence according to consensus criteria. Critical appraisal skills encourage clinicians to place greater reliance on the findings of quality systematic reviews or, in the absence of a quality review, evaluate the methods-rigor and patient relevance of single treatment studies. Critical appraisal skills also facilitate the formulation of individualized probability statements regarding treatment-benefit. Risk-reduction analysis and individual patient effect-size statistics for interpretation of treatment studies will also be described. Critical appraisal skills are embedded in the patient-centred evidence-based practice approach which seeks to complement clinical expertise by assisting clinicians to stay up-to-date, and overcome knowledge gaps and perceived limitations in their training and experience. Readily accessed worksheets and online tools for critical appraisal of systematic reviews will be described together with worksheets for critical appraisal of single treatment-effectiveness studies. Participants will have the opportunity to practice the critical appraisal skills during the workshop.

Workshop 13: Is it time for a regional Paediatric Neuropsychology Research Network?

Date/Time: Saturday 21st November , 8.30 am – 12.00 noon Chair: Peter Anderson, Murdoch Childrens Research Institute & The University of Melbourne.

While only a relatively small number of clinical neuropsychologists specialise in paediatrics in Australia, there is a growing demand for researchers to study brain behaviour relationships in paediatric disorders including neurodevelopmental, neurological, medical and mental health conditions. Findings from these studies have direct clinical implications as they inform the structure of surveillance programs, neuropsychological assessment protocols, and new intervention approaches. Though some world-leading research is being conducted in Australasia, groups conducting paediatric neuropsychology research tend to work independently which is potentially limiting the range and scale of studies that are conducted, access to funding sources, and training opportunities for PhD students and post-docs. Following some brief presentations highlighting the breadth of research being conducted, there will be an open discussion regarding the state of paediatric neuropsychology research in Australasia, with a particular focus on bringing groups closer together to facilitate multi-site studies (& trials), sharing of resources (eg. Neuroimaging, genetics), and enhanced training of post-graduate researchers and post-docs. A proposal to form a regional Paediatric Neuropsychology Research Network will also be discussed, and if supported, the goals, structure, and functions will be debated. Examples of other networks will be presented to demonstrate what can be achieved with different models. All individuals interested in brain-behaviour relationships in paediatric conditions are invited to attend, especially those conducting research or have a strong interest in this field of research.

Workshop 14: Are you for real? : feigning, exaggeration and overwhelm in the clinical and medicolegal setting Date/Time: Saturday 21st November , 8.30 am – 5.30 pm Presenter: Jan Ewing, Queensland Neuropsychology Pty Ltd, J.Ewing@uq.edu.au Clinicians often struggle with the issues surrounding the concepts of malingering and exaggeration, which, when suspected, often create discomfort and anxiety in the examining or treating practitioner. Perhaps for this reason, there is a tendency to only assess for suboptimal effort or feigned symptomatology for court reports or when the client’s behaviour is overtly unusual. Even then, the methods used to determine validity are often unreliable and are more a ‘glance in the direction’ of the issues rather than a thorough, fair and reliable assessment of symptom validity. This workshop discusses the history of the concept of malingering, past and current definitions, differential diagnoses, implications for under and over-diagnosing symptom invalidity and how to measure and report symptom validity in both clinical and legal (forensic/medico-legal) settings. These issues are discussed for a range of presentations including feigning or exaggeration of cognitive dysfunction, pain and psychiatric symptoms. Current research findings regarding the effectiveness of different approaches to identification of invalidity are presented, together with an examination of the reliability of the most commonly used measures in clinical practice. Recommendations for effective assessment of symptom validity are included, together with several case studies and practice examples throughout the presentation. This workshop will be of interest to all clinical psychologists and neuropsychologists in both treatment and evaluative settings but is particularly relevant to those involved in medicolegal, forensic or compensatory assessments. Qualifications and experience in test administration and interpretation and familiarity with common neuropsychological tests are required. Experience in medicolegal and/or forensic settings would be an advantage but is not essential. Post-graduate students are welcome. At the completion of this workshop, participants will

Be familiar with common myths about malingering

Gain an understanding of the multifactorial nature of invalidity assessments

Be familiar with important differential diagnoses when considering invalid profiles

Have a sound understanding of the meaning and importance of sensitivity, specificity and positive & negative predictive power

Be familiar with current best practice in terms of test selection, administration and interpretation when assessing for validity for both neurocognitive and psychiatric presentations

Level: Intermediate/Advanced

Workshop 15: An update on the neuropsychology of frontal lobe functions Date/Time: Saturday 21st November , 2.00 pm – 5.30 pm Presenter: Gail Robinson, The University of Queensland g.robinson@psy.uq.edu.au Almost 50 years ago, Luria proposed the existence of “frontal lobe syndromes” where distinct frontal subregions have different functional roles. It is now widely held in clinical practice that “executive functions” such as the generation of novel ideas, inhibition of inappropriate responses, problem solving and abstract reasoning are crucial for complex and socially-appropriate behaviour. However, the terms “executive functions” and ‘frontal lobe functions’ are not synonymous and there still remains a debate as to whether frontal functions are overlapping or separate. It is only more recently that lesion studies have started to consider frontal patients in their subgroups rather than under the umbrella of a frontal group. The aim of this workshop is to present some of the recent research investigating: (i) classical executive function tests (e.g., Trail making) in patients with focal frontal and non-frontal lesions; and (ii) frontal lobe fractionation and whether functionally separate systems within the frontal lobes exist.

This workshop is intended for clinical neuropsychologists in all settings who either assess or provide rehabilitation for individuals who have disturbances to frontal lobe functions. At a minimum participants should have a background in neuropsychology and be enrolled in a post-graduate training programme or a practicing clinical neuropsychologist. Level: Advanced

Workshop 16: Early detection of Alzheimer’s disease: Neuropsychological insights from the AIBL Study of Ageing Date/Time: Saturday 21st November , 2.00 pm – 5.30 pm Presenters: Greg Savage (Macquarie University), & Jo Robertson (The Florey Institute of Neuroscience & Mental Health) (greg.savage@mq.edu.au) The Australian Imaging, Biomarkers & Lifestyle (AIBL) Study of Ageing is a large cohort ( N >1000) longitudinal investigation into the causes of Alzheimer’s disease, with the aim of informing development of disease -modifying therapies. Data have been collected at 18-month intervals for 6 years so far, encompassing comprehensive neuropsychological assessment, structural (MRI) and molecular (PET) imaging, blood biomarkers, and dietary and exercise measures. Cognitive data have been pivotal in characterising the co hort into three main groups: healthy elderly (with and without subjective memory complaint), elderly people with Mild Cognitive Impairment, and those with Alzheimer’s disease dementia. The workshop will present a broad selection of findings from the study, focusing on cognitive aspects but also highlighting principal outcomes from the broader scope of AIBL projects. Participants will gain an appreciation of the challenges and solutions associated with large-scale longitudinal studies, and a clinically useful understanding of current conceptualisations of the prodromal and preclinical stages of Alzheimer’s disease. The workshop will be of primary interest to neuropsychologists working in aged care settings, but also those interested in large-scale and/or longitudinal cohort studies of any kind. It will cover background relating to recent consensus research criteria for diagnosing Alzheimer’s disease dementia and Mild Cognitive Impairment, justification of tests included in the AIBL neuropsychological assessment battery (including modifications to the CVLT-II), development of biomarkers, neuroimaging techniques, and assessment of lifestyle indicators; against this background, recent findings from the AIBL Study will be reported and future directions indicated. Level: Mostly intermediate

Workshop 17: Neuropsychological intervention: Could you be doing more for your patients? (A practical guide/workshop) Date/Time: Saturday 21st November , 2.00 pm – 5.30 pm Presenters: Jamie Berry (Macquarie University, Advanced Neuropsychological Treatment Services) & Melanie Porter (Macquarie University) jamie.berry@neurotreatment.com.au melanie.porter@mq.edu.au Despite the fact that numerous reviews of neuropsychological intervention now abound in the scientific literature that justify, and in some cases urge the clinical neuropsychologist to intervene (e.g., Cicerone et al., 2000, 2005, 2011), the focus of clinical neuropsychological practice remains very much on assessment . A significant contributor to this problem is that neuropsychologists lack the experience and confidence with respect to conducting neuropsychological intervention (Wong, Mckay, & Stolwyk, 2014). A primary aim of this workshop is to provide neuropsychologists with tools and skills to facilitate the incorporation of evidence-based intervention into their practice. The content will be relevant to those working with paediatric and working-age adult populations. A holistic clinical neuropsychological model is presented within which a range of intervention skills are applicable, including, but not limited to, cognitive rehabilitation, motivational interviewing, goal setting, and neuropsychological feedback. Accurate formulation of the cognitive, emotional and behavioural factors and how they interact is central to this model. Evidence-based interventions for a range of neuropsychological phenomena will be summarized, with consideration given to the practical implementation of the same. Clinical intervention and measurement tools will be presented and/or provided to facilitate the process of transitioning to conducting more intervention. As an example,

a version of Goal Attainment Scaling (GAS) specifically modified for use by clinical neuropsychologists will be described and practiced. Some interpretive anomalies and controversies as well as reasons best practice has lagged behind best evidence with respect to neuropsychological intervention will be addressed. Participants will be encouraged to question the ecological validity of established neuropsychological assessment and intervention methods and be provided with tools to optimize the ultimate goal of improving real world functioning for patients. Expected outcomes of participation in this workshop include a developed understanding of what constitutes neuropsychological intervention, practical steps of how to implement the same and the acquisition of tools and techniques with which to demonstrate relevant ecological intervention outcomes. The workshop is intended for clinicians who are interested in developing clinical neuropsychological intervention skills. Case examples and techniques will be applicable to those who work across both paediatric and working age adult settings, with some reference and applicability to older aged populations. The workshop is most relevant to clinicians who are interested in expanding their repertoire of intervention skills, which may be implemented during the process of assessment and feedback, as well as separately, in the form of independent treatment programs. The workshop will provide a “how to” guide with respect to building on well established neuropsychological assessment and feedback skills in order to expand the range and opportunities for intervention work. Participants should be proficient with clinical neuropsychological assessment and formulation. Experience conducting neuropsychological feedback is desirable but not essential. Participants should also have a good working knowledge of the uses and limits of psychometric tools. Participants will learn new, or update their working, knowledge and skills with respect to motivational interviewing, goal setting, neuropsychological feedback and cognitive rehabilitation/remediation techniques. They will also learn how to implement a version of Goal Attainment Scaling (GAS) specifically modified for use by clinical neuropsychologists. Level: Intermediate

Workshop 18: Chronic Traumatic Encephalopathy: What do we really know currently? Date/Time: Saturday 21st November , 2.00 pm – 5.30 pm Presenter: Andrew Gardner (Hunter New England Local Health District Sports Concussion Program, Centre for Translational Neuroscience and Mental Health, School of Medicine and Public Health, University of Newcastle ) andrew.gardner@hnehealth.nsw.gov.au This workshop will discuss the current knowledge around the concern that neurotrauma, and specifically a history of repetitive neurotrauma such as that experienced by many athletes who participate in contact/collision sports, will lead to later-life dementia (chronic traumatic encephalopathy, CTE) in some individuals. The current evidence to support this notion will be critically reviewed from a historical and more modern perspective. The classical descriptions were first documented in boxers, however in recent times a number of other collision sports athletes have also been described as suffering from CTE. Both the classical and the modern descriptions have documented clinical and neuropathological profiles, and these will be reviewed. A more comprehensive overview of the proposed clinical signs will be highlighted and discussed in terms of a neuropsychologist’s clinical practice. In addition an overview of the neuroimaging techniques and the research findings will be reviewed. The current research focuses and the recommendations for fut ure research will also be presented. This workshop is intended for anyone who may receive referrals of clients/patients who are currently or were formally involved in contact sports in their childhood, youth or during young adulthood. While the focus will be on sport-related concussion and athletes, the workshop content may also be of relevance to clinicians who see patients with previous exposure to neurotrauma (e.g., servicemen and service women, police officers, prison wardens etc.) and clinicians that are interested in neurodegenerative disease. You may be a current athlete yourself or you may be the parent of a child who is involved in collision sports, then this is a workshop that will inform you about the current state of knowledge around the potential long-term consequences of concussion. At present the general knowledge pertaining to CTE and the potential consequences of a career in collision sports has been so biased by the media and a few research groups worldwide that the reality of risk and the prevalence of

the condition have been lost. This workshop will aim to provide an overview of the current state of knowledge and the future direction of research required to better delineate this condition. Learning outcomes

Advanced knowledge of sport-related concussion (acute, sub-acute and chronic management).

An update of the current state of the knowledge around sports concussion and CTE.

Signs and symptoms that may raise concerns in the clinic.

An understanding of the actual risks for developing CTE later in life.

Future research directions.

Knowledge of some of the advanced neuroimaging techniques being employed to investigate retired athletes.

Level: Intermediate