Neuropsychology Review

, Volume 24, Issue 4, pp 389–408 | Cite as

Functional Plasticity in Childhood Brain Disorders: When, What, How, and Whom to Assess

  • Maureen DennisEmail author
  • Brenda J. Spiegler
  • Nevena Simic
  • Katia J. Sinopoli
  • Amy Wilkinson
  • Keith Owen Yeates
  • H. Gerry Taylor
  • Erin D. Bigler
  • Jack M. Fletcher


At every point in the lifespan, the brain balances malleable processes representing neural plasticity that promote change with homeostatic processes that promote stability. Whether a child develops typically or with brain injury, his or her neural and behavioral outcome is constructed through transactions between plastic and homeostatic processes and the environment. In clinical research with children in whom the developing brain has been malformed or injured, behavioral outcomes provide an index of the result of plasticity, homeostasis, and environmental transactions. When should we assess outcome in relation to age at brain insult, time since brain insult, and age of the child at testing? What should we measure? Functions involving reacting to the past and predicting the future, as well as social-affective skills, are important. How should we assess outcome? Information from performance variability, direct measures and informants, overt and covert measures, and laboratory and ecological measures should be considered. In whom are we assessing outcome? Assessment should be cognizant of individual differences in gene, socio-economic status (SES), parenting, nutrition, and interpersonal supports, which are moderators that interact with other factors influencing functional outcome.


Plasticity Neuropsychological assessment Neurodevelopmental disorder Childhood acquired brain injury 



Supported in part by National Institute of Child Health and Human Development Grants P01 HD35946 & P01 HD35946-06,“Spina Bifida: Cognitive and Neurobiological Variability” and by National Institutes of Health Grant 1RO1 HD04946, “Social Outcomes in Pediatric Traumatic Brain Injury.” We thank Beverly Andres for help with manuscript preparation and Laura Janzen for assistance with the brain tumor literature.


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Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Maureen Dennis
    • 1
    • 2
    • 3
    Email author
  • Brenda J. Spiegler
    • 4
  • Nevena Simic
    • 1
  • Katia J. Sinopoli
    • 5
  • Amy Wilkinson
    • 1
  • Keith Owen Yeates
    • 6
  • H. Gerry Taylor
    • 7
  • Erin D. Bigler
    • 8
    • 9
  • Jack M. Fletcher
    • 10
  1. 1.Department of PsychologyProgram in Neurosciences and Mental Health, The Hospital for Sick ChildrenTorontoCanada
  2. 2.Department of Surgery, Faculty of MedicineUniversity of TorontoTorontoCanada
  3. 3.Music and Health Research Collaboratory, Faculty of MusicUniversity of TorontoTorontoCanada
  4. 4.Department of Pediatrics, Faculty of MedicineUniversity of TorontoTorontoCanada
  5. 5.Department of Psychology, Division of NeurologyThe Hospital for Sick ChildrenTorontoCanada
  6. 6.Department of PediatricsThe Ohio State University, and The Research Institute at Nationwide Children’s HospitalColumbusUSA
  7. 7.Department of PediatricsCase Western Reserve University, and Rainbow Babies & Children’s HospitalClevelandUSA
  8. 8.Departments of Psychology and NeuroscienceBrigham Young UniversityProvoUSA
  9. 9.Department of PsychiatryUniversity of UtahSalt Lake CityUSA
  10. 10.Department of PsychologyUniversity of HoustonHoustonUSA

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