Cas-Pauline - itsbrain

Clinical Case: Pauline, 14 years old

Context :

Pauline is referred to assess persistent learning difficulties that have been present since primary school. Pauline has previously received speech therapy and psychomotor therapy. Attention difficulties are suspected.

Neuropsychological Assessment Report

WISC: Cognitive functioning is homogeneous and within the average range.

FEA Tasks:

At the executive and attentional levels, Pauline exhibits generally weakened performances on classical neuropsychological tests. Executive control and inhibition difficulties are identified, along with flexibility issues that suggest executive overload. While auditory attention is of good quality, visual attention is weak and slowed.

Parental Questionnaires:

As expressed by the parents during the anamnesis, the parental questionnaires reflect a global and significant executive and attentional complaint, with clinical scores for attention deficit and hyperactivity disorders in Pauline, coupled with a tendency toward oppositional behavior. Pauline reports these same difficulties in her self-questionnaires.

MindPulse test:

An overview of Pauline’s performance using the MindPulse tool reveals difficulties primarily in the executive domain, both in terms of speed and accuracy. Vigilance appears fragile but of better quality, as does her response to difficulty.

Pauline presents with executive slowing as the primary issue, associated with secondary perceptual-motor slowing. Despite this slowness, Pauline makes numerous errors, which is a notable deficit, and experiences additional slowing related to difficulty, which does not allow her to balance her speed/accuracy profile.

An analysis of response times shows variability in her performance from the first section (TRS), which increases significantly with the rising executive load in the final section, indicating overload. Pauline makes numerous errors, particularly hesitation errors, primarily in the complex Go/No-Go task, which reflects executive overload. A few inhibition errors are observed in the second section. Impulsivity is evidenced by anticipation errors, along with an attentional lapse (aberrant response) in the first section.

Detailed results highlight Pauline’s primary executive impairment, manifested by an imbalance in speed, accuracy, and variability whenever executive functions are engaged. Attention is of better quality but is affected by executive slowing and displays a degree of alertness fragility, which appears scattered.

Conclusion :

The MindPulse highlights the predominance of executive impairment in Pauline, with secondary attentional fragility. Executive overload effects manifest as a global imbalance in her speed, accuracy, and variability of performance.
The slight vigilance impairment may be attributed to the MindPulse’s heightened sensitivity and appears to reflect fatigue effects due to the tool's administration at the end of the neuropsychological assessment. Overall, attention capacities remain within the normative range.