This leading-edge volume offers a new framework for neuropsychological testing rooted in the current evidence base on large-scale brain system interactions. Expert coverage brings traditional discrete areas of cognitive functioning (e.g., attention, memory) in line with highly nuanced relationships between cortical and subcortical processing. The new findings point to more accurate and targeted testing, as authors expand on the judicious addition of nonstandardized methods to core diagnostic tools and the underused capacity of neuropsychological testing to assess social behavior and personality. The book's emphasis on cognition in context gives practitioners better understanding of assessment and evaluation, leading to improved diagnosis, treatment, and outcomes for individuals as well as significant improvements in the field. This innovative reference: Reframes cognitive functioning in light of current data on brain interconnectivity. Critiques current methods of neuropsychological test interpretation. Reviews known, useful interpretive methodologies within a new context. Features instructive case examples emphasizing accurate historical and test data. Revisits the strengths and limitations of the bell curve construct. Examines the interpretive significance of pathognomonic signs. Details strategies for making neuropsychological evaluations more clinically relevant. Large-Scale Brain Systems and Neuropsychological Testing combines current findings, clinical sense, and common sense to ground neuropsychologists, school psychologists, child psychologists, and clinical social workers in the effective assessment of real-world functioning.

This leading-edge volume offers a new framework for neuropsychological testing rooted in the current evidence base on large-scale brain system interactions. Expert coverage brings traditional discrete areas of cognitive functioning (e.g., attention, memory) in line with highly nuanced relationships between cortical and subcortical processing. The new findings point to more accurate and targeted testing, as authors expand on the judicious addition of nonstandardized methods to core diagnostic tools and the underused capacity of neuropsychological testing to assess social behavior and personality. The book's emphasis on cognition in context gives practitioners better understanding of assessment and evaluation, leading to improved diagnosis, treatment, and outcomes for individuals as well as significant improvements in the field. This innovative reference: Reframes cognitive functioning in light of current data on brain interconnectivity. Critiques current methods of neuropsychological test interpretation. Reviews known, useful interpretive methodologies within a new context. Features instructive case examples emphasizing accurate historical and test data. Revisits the strengths and limitations of the bell curve construct. Examines the interpretive significance of pathognomonic signs. Details strategies for making neuropsychological evaluations more clinically relevant. Large-Scale Brain Systems and Neuropsychological Testing combines current findings, clinical sense, and common sense to ground neuropsychologists, school psychologists, child psychologists, and clinical social workers in the effective assessment of real-world functioning.

Executive functioning: we measure it, assess it, document its development in youth, track its decline in age and use it as a basis for diagnoses, treatment planning and-of course-theories. Could it be possible that science has spent decades chasing a cognitive phantom?

Noting the lack of consensus concerning definition, component skills, and location within the brain, "The Myth of Executive Functioning" calls basic assumptions, prominent theories, commonly used test methods, and even the phrase "executive" "functioning" into question. The book's deceptively simple argument takes an evolutionary/neuroscience look at the cornerstones of cognitive organization, including memory, planning, decision-making and adaptation to novel circumstances. From there, gaps are identified between systems of cognitive control and those behaviors that are evaluated in neuropsychological testing-gaps that contribute to the disconnect between how science views mind and body, brain and behavior. The author's problem-solving metaphor places new emphasis on stimulus processing and on the relationship between movement and thought as he offers thought-provoking perspectives on:

The limits of neuropsychological constructs.The components of adaptive thinking.The automatic aspects of problem solving.The left-brain/right-brain dichotomy.Problems with the domain approach to cognition.New paradigms for testing cognitive functioning.

A controversial presentation with the potential to change clinical practice and training, "The Myth of Executive Functioning" will be read, debated and learned from by neuropsychologists, clinical psychologists, psychiatrists, cognitive neuroscientists and rehabilitation specialists.

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Clinical psychologists and neuropsychologists are traditionally taught that cognition is mediated by the cortex and that subcortical brain regions mediate the coordination of movement. However, this argument can easily be challenged based upon the anatomic organization of the brain. The relationship between the prefrontal cortex/frontal lobes and basal ganglia is characterized by loops from these anterior brain regions to the striatum, the globus pallidus, and the thalamus, and then back to the frontal cortex. There is also a cerebrocerebellar system defined by projections from the cerebral cortex to the pontine nuclei, to the cerebellar cortex and deep cerebellar nuclei, to the red nucleus and then back to thalamus and cerebral cortex, including all regions of the frontal lobes. Therefore, both the cortical-striatal and cortical-cerebellar projections are anatomically defined as re-entrant systems that are obviously in a position to influence not only motor behavior, but also cognition and affect. This represents overwhelming evidence based upon neuroanatomy alone that subcortical regions play a role in cognition. The first half of this book defines the functional neuroanatomy of cortical-subcortical circuitries and establishes that since structure is related to function, what the basal ganglia and cerebellum do for movement they also do for cognition and emotion.

The second half of the book examines neuropsychological assessment. Patients with lesions restricted to the cerebellum and/or basal ganglia have been described as exhibiting a variety of cognitive deficits on neuropsychological tests. Numerous investigations have demonstrated that higher-level cognitive functions such as attention, executive functioning, language, visuospatial processing, and learning and memory are affected by subcortical pathologies. There is also considerable evidence that the basal ganglia and cerebellum play a critical role in the regulation of affect and emotion. These brain regions are an integral part of the brain s executive system. The ability to apply new methodologies clinically is essential in the evaluation of disorders with subcortical pathology, including various developmental disorders (broadly defined to include learning disorders and certain psychiatric conditions), for the purpose of gaining greater understanding of these conditions and developing appropriate methodologies for treatment.

The book is organized around three sources of evidence:

1. neuroanatomical connections;
2. patients with various disease processes;
3. experimental studies, including various imaging techniques.

These three sources of data present compelling evidence that the basal ganglia and cerebellum are involved in cognition, affect, and emotion. The question is no longer if these subcortical regions are involved in these processes, but instead, how they are involved. The book is also organized around two basic concepts: (1) the functional neuroanatomy of the basal ganglia and the cerebellum; and (2) how this relates to behavior and neuropsychological testing.

Cognitive neuroscience is entering a new era as we recognize the roles of subcortical structures in the modulation of cognition. The fields of neuropsychology, cognitive psychology, neuropsychiatry, and neurology are all developing in the direction of understanding the roles of subcortical structures in behavior. This book is informative while defining the need and direction for new paradigms and methodologies for neuropsychological assessment. "