1. What aspects of cognitive psychology are evident in the case? 2. What can be understood about the relation between brain structures and mental processes and the development of cognition from the case?

Although SDM is a brilliant, intelligent teenager, her processing speed issues have been affecting her ability to function effectively in school. She has been trying to compensate for these challenges by spending additional time on her workload which results in reduced sleep, feelings of frustration when she is unable to meet deadlines and significant stress when she is attempting to sort through verbal information. Since she has been pulled from school, SDM has been doing significantly better. Challenges such as the short-term memory and stimulus overload that were happening previously, are no longer present. Now she is focusing on a number of different things, including taking the DELE examinations in Spanish, and starting a business with her cousin and a friend in a bid to become more independently minded and earning something for herself. SDM also wants to get back into swimming, a sport she enjoys and has done a lot of “emotional unpacking” focusing on her spirituality, her relationships and the goals she would like to accomplish in life. She and her family have realized that even though she is a brilliant child, there will have to clear focus on balancing her stress levels and workload. Her performance on Working Memory and Attention and Concentration task showed that she is able to attend to information, give attention to tasks and engage in rote recall. She was able to hold information in memory long enough to mentally manipulate the information indicating good attention and concentration. SDM processed information significantly slowly than expected based on her age and education. It is also likely that her processing speed will impact not only how quickly she learns new information (especially visual information), but also her working memory.

Executive Functioning

The background information does not suggest any significant decline in problem solving or reasoning abilities. Her WISC-V Fluid Reasoning scores showed that she had an extremely good ability to identify and detect patterns and logical rules, as well as acquire and manipulate new information. She has a good understanding of the relationship between concepts and is able to generalize and apply concepts learned. Specifically, an in-depth analysis of her scores identified that SDM’s processing speed deficit seems more prominent when she is required to mentally manipulate verbal or symbolic information. 

Learning and Memory

SDM’s overall memory functioning, based on her performance at testing is at a lower level than expected when compared to her same aged peers and is, therefore, indicative of general memory deficits. She displayed an excellent ability to manipulate information held in short-term memory. It is important to note however that she was most accurately able to do this with symbolic information as opposed to verbal information. In verbal memory she was better able to recall meaningful verbal information than rote learned information, a pattern which was consistent in her recognition scores. Although her Verbal Memory scores were in the Average range, when we compare it to her WISC-V Vocabulary scores, her performance is lower than expected

language

Of importance to note however, is significant impairment in her written expression. SDM showed no challenges with her fine motor skills (ability to hold and use writing materials), grammar, punctuation or spelling abilities. She did, however, have severe restrictions in her ability to organize her thoughts in written form. 

DIAGNOSTIC IMPRESSIONS

SDM presents as a 17-year-old girl with an Extremely High General Ability Index (GAI) and significant challenges with memory and processing speed that are impacting on her ability to function adequately in an academic setting. Based on background information and her previous assessment, there is progressive decline in her memory and her processing speed. Her previous assessment showed that her cognitive ability was in the Upper Extreme which is consistent with her WISC- V GAI score. SDM’s results on cognitive and memory tests shows impairments that span  multiple cognitive domains namely processing speed, memory and executive functioning. an assessment of her executive functioning showed that while there is no significant decline in her problem solving or reasoning abilities, she is having challenges with planning and organizing verbal information, which implies some challenges in her language domain. 

1. What aspects of cognitive psychology are evident in the case?
2. What can be understood about the relation between brain structures and mental
processes and the development of cognition from the case?