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Übersicht

Neuropsychologische Interventionsstrategien am Beispiel der umschriebenen Entwicklungsstörungen der Sprache und der Motorik

Published Online:September 01, 2006https://doi.org/10.1026//0942-5403.10.2.97

Abstract

Zusammenfassung. Für höhere mentale Funktionen ist das unbeeinträchtigte Zusammenwirken mehrerer einzelner Prozesse erforderlich. Mittels neuropsychologischer Interventionsansätze bei Kindern wird versucht, bei Funktionsbeeinträchtigungen, die sich auf in Entwicklung befindliche Systeme auswirken, gestörte Prozesse sowie deren Zusammenwirken spezifisch zu beeinflussen. Eine neuropsychologische Interventionsstrategie bei umschriebenen Entwicklungsstörungen beinhaltet die Erfassung des Profils von Stärken und Schwächen, die Identifizierung des oder der gestörten Prozesse des betreffenden funktionellen Systems, die Anwendung spezifischer neuropsychologischer Interventionen unter Verwendung geeigneter Instruktionsstrategien und verhaltensmodifzierender Maßnahmen sowie den kompensatorischen Einsatz intakter Prozesse oder Funktionen. Bei Patienten mit umschriebenen Entwicklungsstörungen der Sprache wurde eine Beeinträchtigung der auditiven Verarbeitung kurzer bzw. in schneller Abfolge präsentierter Stimuli gezeigt. Mittels computergestützter neuropsychologischer Trainingsprogramme konnten auditive Diskrimination und Segmentierung, Phonemverarbeitung und Sprachverständnis deutlich verbessert werden (Merzenich et al., 1996; Tallal et al., 1996). Zur Behandlung von Kindern mit umschriebenen Entwicklungsstörungen der Motorik wurden sensorische Integration und Kinästhetisches Training eingesetzt. Für beide Behandlungsverfahren wird zwar postuliert, daß Funktionsverbesserungen über die Veränderung spezifischer Prozesse erreicht werden, es konnte auch eine gewisse Effektivität belegt werden, welche jedoch weitgehend unspezifisch ist und wahrscheinlich auf allgemeinen Wirkfaktoren beruht.


Neuropsychological intervention strategies exemplified by developmental language and coordination disorders

Abstract. The unimpaired interplay of several single processes is mandatory for higher-order mental functions. With the aid of neuropsychological interventional approaches it is tried to influence disturbed processes as well as their interplay in functional deficits that affect developing systems in children. The neuropsychological intervention strategies for specific developmental disorders cover the profiling of strengths and weaknesses, the identification of the disturbed process or processes within the respective functional system, the application of a specific neuropsychological training program employing suitable instructional strategies and interventions aimed at behavior modification as well as the compensatory use of intact processes and functions. In patients with specific developmental language disorders an impairment of temporal auditory processing was shown. With the aid of two adaptive computer games auditory discrimination and segmentation, phonological processing and language comprehension could be markedly improved (Merzenich et al., 1996; Tallal et al., 1996). Sensory integration training and kinesthetic training have been used in the treatment of specific developmental coordination disorders in children. Although for both methods of treatment it has been postulated that functional improvement is gained by changing specific processes, and certain effects could indeed be documented, these effects are largely unspecific and are more likely related to general strategies.

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