Young specialist shines spotlight on neuropsychology
There are currently only two Doctors of Clinical Neuropsychology in Botswana, meaning a significant gap in the health system.
One of the two, and the youngest in the country is Clinical Neuropsychologist, Dr Tumelo Kgolo-Ramashaba.
According to the 34-year old, Neuropsychology is a highly specialised branch of psychology that studies the relationship between the brain and behaviour. It focuses on understanding how brain structures work. With advanced skills in assessment, diagnosis and treatment planning of disorders, clinical neuropsychologists assess and treat people with brain disorders that affect memory, learning, attention, language, reading, problem solving and decision-making.
A neuropsychologist can help determine brain impairments and how severe they are. Dr Kgolo Ramashaba says they evaluate conditions including, Stroke, which can affect behaviour, thinking, memory and other brain functions in obvious or subtle ways.
“A neuropsychologist can perform an evaluation to help determine the degree of stroke impairment,” she says.
Another condition that they evaluate is Parkinson’s disease, a progressive disorder that can cause several neurological problems. Others include, Alzheimer’s disease and other types of dementia that can interfere with memory,
personality and cognitive abilities, as well as Traumatic brain injuries.
“Neuropsychologist can help determine which of the many types of learning disabilities someone has and develop a treatment plan,” she explains.
The sticky part is that Neuropsychological assessments are currently not covered by medical aid system, leaving patients to pay significant amount for service. Dr Kgolo-Ramashaba however, believes that improving access to reliable and comprehensive neuropsychological and educational assessment would reduce the risk of misdiagnosis and inappropriate treatment, for example, in relation to medication for Attention Deficit Hyperactivity Disorder (ADHD), and has been shown to enhance outcomes in disorders such as learning disability.
“Neuropsychologists bridge the gap between neuroscience and psychology, we aim to contribute to the enhancement of health services and to help provide a more balanced approach to client care whereby cognition or brain function is given as much weight as psychological and physical health because we know that these three strongly interact,” she says. Further adding that in effect, they want to be better able to help ensure that more accurate diagnosis, more accurate delineation of need and capacities, and targeted treatments and interventions that more reliably reduce returns to hospitals and increase productivity.
The University of Botswana-based Clinical Neuropsychologist says her trade and profession would contribute to eearly and accurate diagnosis and intervention for neurodevelopmental disorders such as Autism Spectrum Disorder and ADHD, which is critical for reducing and better managing mental health conditions in later life.
Neuropsychologists also help develop a treatment plan as part of a multidisciplinary team including, neurology, neurosurgery and other allied health professionals, therefore treatment plans may include medication, rehabilitation therapy, and or surgery.
She worries that if left undetected and untreated, individuals with these disorders are at significantly more risk of mental health conditions and their conditions become more difficult to treat. In addition, she says to enhanced diagnostic accuracy, comprehensive neuropsychological assessment in this population provides reliable and detailed information about cognitive and educational abilities and needs that are critical for improving outcomes.
But when does one need to consult a neuropsychologist? According to Dr Kgolo-Ramashaba Neuropsychological evaluations are requested to help understand how the different areas and systems of the brain are working. Testing is usually recommended when there are symptoms or complaints involving memory and or thinking abilities.
“This may be signalled by a change in concentration, organization, reasoning, language, perception, coordination and personality,” Dr Kgolo-Ramashaba explains, further adding that the change may be due to any of a number of medical, neurological, psychological or genetic causes.
Neuropsychologists deal with disorders including Autism Spectrum Disorder, Epilepsy, Concussion, Dementia, Traumatic brain injury, Learning and attention disorders, Multiple sclerosis and Brain cancer.
According to Dr Kgolo-Ramashaba, a Neuropsychological assessment involves the evaluation of how one’s brain functions. It includes an interview and questions that would help outline history of presenting concern and current functioning.
“The neuropsychologist will also cover information on any history of brain injury or neurological problems, current symptoms, medical history, and medications. Brain scans, such as CT or MRI scans, can also help a neuropsychologist make a diagnosis,” Dr Kgolo-Ramashaba explains, adding that during a neuropsychological assessment, various mental abilities such as intelligence, attention and concentration, learning and memory, problem solving and language are systematically tested specific assessment tools.