Dr. Kimberly S. Adams, Psy.D., ABPP-CN

2008-03-08T17:02:00.002-05:00

What is Neuropsychology ?
Neuropsychology is a specialty profession within the general field of Clinical Psychology that requires advanced training, experience and knowledge in how the brain affects your thoughts, feelings and behavior. Neuropsychology helps us understand how the brain works by evaluating skills related to different systems of brain function such as sensory/perceptual and motor, attention/concentration, visual/spatial, language, memory/learning executive function and emotional adjustment. Neuropsychology can help your understanding and treatment of known or suspected neurological impairment that may interfere with meeting the demands of daily living at home, school or work through assessment services.

What is a Neuropsychological Assessment?
A Neuropsychological assessment can aid in differential diagnosis of neurological versus psychological syndromes and facilitate appropriate placement decisions for a variety of disorders. This comprehensive evaluation also provides a baseline of neurobehavioral functioning following known brain injury and can be useful in identifying potential barriers for decision making in daily living.

Common Referral Questions include:
Acquired and Traumatic Brain Injury
Stroke
Aneurysm
Tumor
Encephalitis
Hypoxic Encephalopathy
Multiple Sclerosis
Parkinson's Disease
Seizure Disorder
Alzheimers
Forensic concerns

Childhood Referral Questions Include:

Attention Deficit/Hyperactivity Disorder
Learning Disability
Psycho-Educational evaluations

Older Adult Referral Questions Include:
Age-Associated Memory Impairment
Mild Cognitive Impairment
Early Dementia
Depression and Anxiety

About Dr. Kimberly S. Adams

2008-03-08T16:55:00.006-05:00

Dr. Kimberly Adams is joining Dr. Tom Milam, and Dr. Robby Adams, both psychiatrists, and the staff of Coastal Behavioral Medicine at 2301 Delaney Avenue in Wilmington. Dr. Kimberly Adams received her Doctor of Psychology degree in Clinical Psychology from Florida Tech in Melbourne, Florida. Dr. Kimberly Adams completed her internship at the University of Miami/Jackson Memorial Hospital in clinical neuropsychology and behavioral medicine. She completed a two-year fellowship in Neuropsychology at the University of Virginia School of Medicine in Charlottesville, Virginia. She has also served as an Assistant Professor in the Department of Psychiatric Medicine at the University of Virginia School of Medicine. Dr. Kimberly Adams specializes in neuropsychological testing and behavioral management of patients with disorders such as ADHD, traumatic brain injury, stroke, memory impairment, and dementia. She is also a cognitive-behavioral psychologist and treats adults and adolescents with depression and anxiety.

2008-03-08T16:41:00.003-05:00

What is Neuropsychology ?
Neuropsychology is a specialty profession within the general field of Clinical Psychology that requires advanced training, experience and knowledge in how the brain affects your thoughts, feelings and behavior. Neuropsycholcogy helps us understand how the brain works by evaluating skills related to different systems of brain function such as sensory/perceptual and motor, attention/concentration, visual/spatial, language, memory/learning executive function and emotional adjustment. Neuropsychology can help your understanding and treatment of known or suspected neurological impairment that may interfere with meeting the demands of daily living at home, school or work through assessment services.

What is a Neuropsychological Assessment?
A Neuropsychological assessment can aid in differential diagnosis of neurological versus psychological syndromes and facilitate appropriate placement decisions for a variety of disorders. This comprehensive evaluation also provides a baseline of neurobehavioral functioning following known brain injury and can be useful in identifying potential barriers for decision making in daily living.

Common Referral Questions include:

Acquired and Traumatic Brain Injury
Stroke
Aneurysm
Tumor
Encephalitis
Hypoxic Encephalopathy
Multiple Sclerosis
Parkinson's Disease
Seizure Disorder
Alzheimers
Forensic concerns

Childhood Referral Questions Include:

Attention Deficit/Hyperactivity Disorder
Learning Disability
Psycho-Educational evaluations

Older Adult Referral Questions Include:

Age-Associated Memory Impairment
Mild Cognitive Impairment
Early Dementia
Depression and Anxiety

Dear Providers,

2008-03-01T14:08:00.002-05:00

I am a board certified clinical neuropsychologist and have recently joined Coastal Behavioral Medicine with Dr. Tom Milam and Dr. Robby Adams, both psychiatrists. I look forward to working with the physicians in the Wilmington, North Carolina and surrounding areas in order to provide timely and comprehensive psychological and neuropsychological evaluations for their patients.

I have experience and training in providing testing and therapy with persons with ADHD, learning disorders, traumatic brain injury, developmental disorders, behavioral disorders, and mood disorders.

I look forward to aiding in the diagnostic process and treatment planning for patients and families with neuropsychological needs. Thank you for your time and consideration.

Sincerely,

Kimberly S. Adams, Psy.D., ABPP-CNBoard Certified Clinical Neuropsychologist

Normally, a neuropsychological examination explores in depth an individual's performance

2008-03-01T10:40:00.000-05:00

Normally, a neuropsychological examination explores in depth an individual's performance in a wide range of functional domains. There are instances, however, in the early phases of diagnostic exploration when the presence of a brain injury or disease is not compelling but when a suspicion reasonably might be considered. In such cases, along with other diagnostic procedures, a neuropsychological screening examination may be employed. A neuropsychological screening examination is a considerably abbreviated version of a full neuropsychological assessment, looking only at key sensitive areas of function.
The purpose of a neuropsychological screening examination is to determine if there is reasonable evidence, beyond initial clinical impression, for a diagnosis of brain injury or brain disease. Even though it is "screening," the examination must be definitive in this regard. To miss a neurological diagnosis on the basis of a screening examination could be quite unfortunate. Once a screening points to reasonable probability that a neurological condition exists, a full neuropsychological examination would be indicated to attain further diagnostic, prognostic, and treatment planning information. A referral for neurological examination would also be appropriate at this point.
Both screening and full neuropsychological examinations offer the opportunity for diagnosis of probability of brain dysfunction (as opposed to diagnosis of psychodynamic, personality, and/or emotional disorder not associated with neurological causes). For a screening examination, assessing probability of brain dysfunction is about as far as the diagnosis goes. A full neuropsychological examination, on the other hand, is necessary to delineate the wide variety of functional manifestations of brain damage or disease. Such detail is necessary to understand the life consequences of functional impairment (e.g., work, school, relationships, driving potentials, competency, and so forth).
Ability to understand personality, mental health, and behavioral characteristics of the individual when there is a brain injury requires a full neuropsychological examination. A broad range of functional domains must be evaluated. Also, designing a cognitive, rehabilitative, or psychological treatment program for a person with brain injury or disease requires comprehensive understanding of broad neuropsychological characteristics.
Formal neuropsychological testing is typically a relatively minimal component of a screening examination. The psychologist performing a screening examination may rely as much on history, behavioral observations, patterns of subjective complaints, and other history to establish a reasonable suspicion of an organic pathological state of the brain.
Screening neuropsychological examination is indicated when:
situational explanation for changes in emotions or cognitive functioning cannot be readily identified;
a medical or injury condition is suspected to have impacted brain health (for example, compromised circulation, chronically poor nutrition, or drug toxicity);
any relatively sudden, unexpected, and unaccounted for changes appear in mental or cognitive performance that impacts work or daily functioning;
gradual or sudden onset of unusual physical, sensory, or motor changes (an examination by a physician is always indicated in these instances, as well);
an individual fails to improve with special educational or therapeutic interventions designed to address a specific mental or cognitive problem.
Full neuropsychological examination is indicated when:
screening examination is positive for likelihood of brain disorder;
a brain injury or disease is already known and comprehensive understanding of functional impact is desired;
a brain injury or disease is highly suspect and comprehensive neurofunctional characteristics are desired to complement neurological examination and diagnostic understanding;
comprehensive diagnostic and functional nature of brain injury or disease is necessary for rehabilitation and life-long planning;
comprehensive diagnostic, functional, and causative nature of brain injury or disease is necessary for forensic application;
complex diagnostic efforts require careful, objective, and often serial measurement of neurofunctional performance across cognitive domains.
Copyright ©1999, 2000, 2001 Dennis P. Swiercinsky, Ph.D.

Clinical Neuropsychology 101

2008-03-01T10:37:00.000-05:00

Clinical Neuropsychology 101 (An Introduction)
The clinical specialty of neuropsychology bridges interest in the biological functioning of neural cells in the brain, spinal cord, and body with the study of psychological disorders. The neuropsychologist uses objective, scientific techniques to link behaviors to underlying normal and abnormal biological (i.e., brain) processes. The clinical neuropsychologist studies patterns of abnormal behavior to infer the biological abnormalities that might be producing or contributing to those behaviors.
Traditionally defined, neuropsychology is the study of (and the assessment, understanding, and modification of) brain-behavior relationships. Neuropsychology seeks to understand how the brain, through structure and neural networks, produces and controls behavior and mental processes, including emotions, personality, thinking, learning and remembering, problem solving, and consciousness. The field is also concerned with how behavior may influence the brain and related physiological processes, as in the emerging field of psychoneuroimmunology (the study that seeks to understand the complex interactions between brain and immune systems, and the implications for physical health).
Neuropsychology seeks to gain knowledge about brain and behavior relationships through the study of both healthy and damaged brain systems. It seeks to identify the underlying biological causes of behaviors, from creative genius to mental illness, that account for intellectual processes and personality. Clinical neuropsychology seeks such understanding, particularly, in the case of how damaged or diseased brain structures alter behaviors and interfere with mental and cognitive functions.
The neuropsychologist uses objective tools--neuropsychological tests--to tie the biological and behavioral aspects together. Through the use of tests, the clinical neuropsychologist is able to differentiate whether or not a behavioral abnormality is more likely caused by a biological abnormality in the brain or by an emotional or learned process.
If we presume that the brain is the starting point for why and how we process all mental information (not just cognitive, but interpersonal communications, self-concept, emotional reactivity, personality, learned responses, etc.), then in some aspect, all psychology is neuropsychology. Neurolinguistics, for example, is the study of how language shapes our self-concepts and our interpersonal communications. Neurodevelopmental psychology is the study of how behavioral and mental characteristics change with nervous system growth. Even psychological concepts of dreaming (and dream content), level of attention, and conscious experience are subserved by brain processes.
Neuropsychology is a structured, objective, and scientific discipline for peeking into individual brains by way of formally observing behaviors. Clinical neuropsychology seeks, ultimately, to understand the individual mind and brain (and its normal as well as errant behaviors). The discipline uses experimental and objective procedures to compare performance among persons with known differences in their biological brain structures (within the limited criteria currently available for defining these differences), and to search for the myriad sources of brain variance that produce individual differences in behavior. These sources include biological factors (e.g., genetic, diseases, and injuries) as well as psychological factors (e.g., learned behaviors and personality) and social factors (e.g., economics, family structure, and cultural values).
In the application of clinical neuropsychology, understanding the biological sources of individual differences, particularly, helps identify brain-based disorders in memory, personality, self-awareness (conscious experience), cognition, and emotional expression. Working backwards, then, from a look at abnormal behavior obtained using formal tests, reasonable inferences about brain disorders can be reached. Understanding these neurofunctional changes (i.e., abnormalities) as a result of brain changes (i.e., injury) defines parameters for current and future behavioral expectations in the lifestyle of the individual. Combined with additional understanding of biopsychosocial factors that coalesce into behavioral expression, the neuropsychologist can gain a comprehensive impression of what is normal or abnormal behavior. As our knowledge of recovery from brain injury improves, such understanding provides realistic expectations for remediation (restoration or adjustment) of disordered behavior.
Neuropsychological understanding is achieved through a comprehensive exploration of the neurophysiological foundation of behavior and seemingly infinite potential contributing factors. Everyone’s brain is wired differently, a product of native biological structure, past experiences, physical health, learned responses and personality, injuries and diseases, and a host of other factors. Clinically, it is the role of the neuropsychologist to sort out the factors that influence how the brain is working in order to understand disease expression, progress, and recovery.
Copyright ©1999, 2000, 2001 Dennis P. Swiercinsky, Ph.D.

2008-01-01T12:13:00.012-05:00

Important Links and Resources...

ABPP Value Statement
Board certification by the American Board of Professional Psychology (ABPP) provides peer and public recognition of demonstrated competence in an approved specialty area in professional psychology.
http://www.abpp.org/

The American Board of Clinical Neuropsychology (ABCN) is the member board of the American Board of Professional Psychology (ABPP) which is responsible for administration of the examination for competence in the specialty of Clinical Neuropsychology. ABPP is the senior parent board for the profession of psychology and was established in 1947, with ABCN being incorporated in 1981.
http://www.theabcn.org/

The International Neuropsychological Society is a multi-disciplinary non-profit organization dedicated to enhancing communication among the scientific disciplines which contribute to the understanding of brain-behavior relationships. The Society currently has more than 4500 members throughout the world.
http://www.the-ins.org/

The National Academy of Neuropsychology (NAN) seeks to advance neuropsychology as a science and health profession, to promote human welfare, and to generate and disseminate knowledge of brain-behavior relationships through:
http://www.nanonline.org/

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