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Medical Psychology

Medical Psychology

Neuropsychology Unit

1. Contact Person:

Alexandra Walker (Head)
Senior Clinical Neuropsychologist and Clinical Psychologist
Brain Injury Rehabilitation Service
Ph: (+61 2) 9845 6906
E-mail:  awalker@biru.wsahs.nsw.gov.au or

Fernando Cruz
Department of Medical Psychology,
Ph:  (+61 2 98456686)
E-mail:   fernando_cruz@wsahs.nsw.gov.au

2. Services:


The Neuropsychology Unit provides a comprehensive assessment service to inpatients and outpatients of Westmead Hospital. This includes the Comprehensive Epilepsy Programme, the Huntington’s Disease Service, Redbank House, neurosurgical and neurology wards, psychiatry wards and general medical wards. A clinician employed by the Brain Injury Unit sees outpatients of that unit with traumatic brain injury. The neuropsychological examination assesses the nature and degree of brain damage or dysfunction including cognitive, behavioural and emotional aspects. The results may contribute to diagnosis and medical management and lead to recommendations with respect to rehabilitation and the ability to engage in employment, education, domestic and personal care activities, driving, and competency in decision-making about financial and medical management. Recommendations for the client or family to compensate for cognitive or behavioural difficulties are also made. 

The specific services include:

Inpatients
with acquired brain impairment referred from any ward or department within the hospital. 
Clinician:   Ms Sara Lucas.

Consultation to the Huntington Disease Service
, through the Department of Neurology.  Patients are seen for neuropsychological assessment and management and counselling is provided to patients and carers. This service is provided to Westmead Hospital outpatients and inpatients of Huntington’s Lodge at Lottie Stewart Hospital, Dundas. 
Clinician:   Dr Bernadette Bibb.

Consultation to the Epilepsy Unit
– Neuropsychological assessment is an integral part of this program for which referrals must come through Dr Andrew Bleasel. Assessments are performed as part of the pre-surgery work up, and follow up assessments post-surgery may also take place. The Neuropsychologist may perform the Wada technique to aid in lateralisation of epilepsy focus pre-surgery.
Clinician:   Alex Knopman.



Psychogeriatrics

Neuropsychological Assessment is provided to older individuals (>65 years) with psychiatric disorders. Assessments are often requested in order to differentiate between psychiatric and neurodegenerative disorders, to document the extent of cognitive impairment associated with psychiatric conditions in older people, or to obtain a baseline assessment so that a patient’s cognition can be followed up over time. A neuropsychological assessment may also be sought to help determine cognitive capacity for decision-making and guardianship processes. Referrals are taken for patients of the Aged Care Psychiatry service.
Clinician:  

Westmead Cognition Clinic (Geriatric Medicine)
is a specialty clinic that takes referrals relating to differential diagnosis of dementia. This multidisciplinary clinic, consisting of Geriatricians (led by Dr. Nick Cordato), Neuropsychologists, Social workers and Nursing Staff, aims to enhance clinical and research interest in dementia syndromes, as well as improve support and outcomes for patients and their families.
Clinician: Ilana Hepner and Sara Lucas


A general outpatient service accepts referrals from doctors and psychologists for patients within the SWAHS (and out of area patients with no access to neuropsychological services) who may have an acquired brain disorder including psychiatric, neurological and neurodegenerative disorders. Referrals for assessment of developmental disorders (eg., intellectual disability, learning disability, ADHD) are not accepted unless there is an associated acquired disorder. 
Clinician: Ms Sara Lucas and Alex Knopman

Brain Injury Rehabilitation Unit
– Neuropsychological examination of people who have suffered a traumatic brain injury and are a client of the Brain Injury Unit. Assessments may be performed soon after the injury and as follow-up to chart progress and make recommendations for ongoing rehabilitation and treatment of cognitive and/or psychological problems. 
Clinician: Ms Alexandra Walker.

Redbank House
– Neuropsychological services are provided to adolescents with a range of psychiatric disorders through inpatients and day patients of the Adolescent Units (Acute and Adolescent & Family), outpatients through the Alternate Care Clinic and first episode psychosis patients, with whom there is ongoing follow up. A cognitive remediation programme is provided to inpatients recovering from first episode psychosis. 
Clinician: Ms Antoinette Redoblado.

3. Specific Programmes:

Redbank Cognitive Remediation programme
– A 20-session programme aimed at improving cognitive skills of adolescents recovering from First Episode Psychosis through the use of computerised educational software programs. Sessions occur four days a week for one hour each day and are conducted with groups of three to four adolescents. Programmes are tailored to suit each individual’s learning style and profile of neuropsychological strengths and weaknesses.
Clinician: Ms Antoinette Redoblado.

4. Research projects:

Ongoing neuropsychological assessment data is collected as part of an international study by the Huntington’s Study Group.  This study is co-ordinated at the University of Rochester, New York.  The patient sample at Westmead Hospital is one of the largest in the study.
Clinician: Dr Bernadette Bibb.

The Western Sydney First Episode Psychosis project investigates the neuropsychological profiles of young people with a first episode psychosis. 
Clinicians: Ms Antoinette Redoblado, Ms Sara Lucas

The study of memory lateralisation by Wada versus standard neuropsychological tests for people with epilepsy.
Clinician:  Alex Knopman

The Neuropsychological Educational Approach to Remediation is a project aimed at trialing a cognitive remediation approach in a population of adolescents with First Episode Psychosis and is being conducted in conjunction with Northern Area Health Service.
Clinician: Ms Antoinette Redoblado.

5. Research Publications 1997-2003

Dr Bernadette Bibb:

Bibb, B. C.,
Coltheart, M., & Nickels, L. A. (1997). Abstract word form deafness: A  case study [Abstract]. Australian Journal of Psychology, 49(Suppl.), 134.
Bibb, B. C. & McCusker, E. A. (2000). Neuropsychological impairment in older   adults with late onset Huntington’s Disease [Abstract]. Brain Impairment, 1,   81-82.
Bibb, B. C. & Nickels, L. A. (1999). Phonological dyslexia in primary progressive  aphasia [Abstract]. Australian Journal of Psychology, 51[Suppl.], 148.
Bibb, B. C., Nickels, L. A., & Coltheart, M. (2000). Impaired auditory lexical   access and the effect of speech-reading. Asia Pacific Journal of Speech,   Language and Hearing, 5(2) (Special Issue), 129-135.
Bibb, B. C., Nickels, L. A., & Coltheart, M. (2000). Speech reading and its role in  auditory processing. Brain and Language, 74, 489-491.
Bibb, B. C., Nickels, L. A., & Coltheart, M. (1998). Abstract word form deafness and the effect of lip-reading [Abstract]. Australian Journal of Psychology,   50 (Suppl.), 133.

Ms Alexandra Walker:


Walker AJ, Onus, M., Doyle, M., Clare, J., & McCarthy, K. (2005). Cognitive rehabilitation after severe traumatic brain injury: A pilot programme of goal planning and outdoor adventure course participation. Brain Injury, 19 (14), 1237-1241.
Walker AJ, Meares S, Sachdev P & Brodaty H (2005). The differentiation of mild frontotemporal dementia from Alzheimer’s disease and healthy elderly by neuropsychological tests. International Psychogeriatrics, 17:1, 57-68.
Walker AJ, Shores EA, Trollor JN, Lee T & Sachdev PS. (2000). Neuropsychological functioning of adults with Attention Deficit Hyperactivity Disorder. Journal of Clinical and Experimental Neuropsychology, Vol 22 (1), 115-124.
Sachdev P, Trollor J, Walker AJ et al. (2001). Bilateral orbitofrontal leucotomy for obsessive-compulsive disorder: a single case study using positron emision tomography. Australian and New Zealand Journal of Psychiatry, 35: 684-690.
Sachdev P, Brodaty H, Wang X, Valenzuela M, Gillies D, Looi J, Lorentz L, Monk D, Kinch J, Howard L, Walker A, Shnier R, Zagami A & Wilcken D. (2001) . Cognitive impairment in a stroke sample: Preliminary results from the Sydney stroke study. In Contemporary Psychiatry, M Gaviria & Y Morita (Eds), Springer: Tokyo.
Sachdev P, Gaur R, Brodaty H, Walker A, Meares S, Koder D & Haindl W. (1997). Longitudinal study of cerebral blood flow in Alzheimer’s disease using single photon emission tomography. Psychiatry Research: Neuroimaging, 68, (2-3), 133-141.
Lee T, MacKenzie R, Walker A, Matheson J & Sachdev P. (1997). The effects of left temporal lobectomy and amygdalohippocampectomy on memory. Journal of Clinical Neurosciences, Vol 4 (3), 314-319.

Ms Sara Lucas:

Langeluddecke, P.M. & Lucas, S.K. (2004). WMS-III findings in litigants following moderate to extremely severe brain trauma. Journal of Clinical and Experimental Neuropsychology,27, 576-590.
Langeluddecke, P.M. & Lucas, S.K. (2004). Evaluation of Two Methods for Estimating Premorbid Intelligence on the WAIS-III in a Clinical Sample. The Clinical Neuropsychologist, 18 (3), 423-432.
Langeluddecke, P.M. & Lucas, S.K. (2004). Validation of the Rarely Missed Index (RMI) from the Wechsler Memory Scale – Third Edition (WMS-III) as a method of detecting memory malingering in mild head injury litigants. Journal of Forensic Neuropsychology, 4(1), 49-64.

Lucas, S.K
., Carstairs, J. & Shores, E.A. (2003). A comparison of methods to estimate premorbid intelligence in an Australian sample: Data from the Macquarie University Neuropsychological Normative Study (MUNNS). Australian Psychologist, in press.
Langeluddecke, P.M. & Lucas, S.K. (2003). Wechsler Adult Intelligence Scale - Third Edition findings in relation to severity of brain injury in litigants. The Clinical Neuropsychologist, in press.
Langeluddecke, P.M. & Lucas, S.K. (2003). Quantitative measures of memory malingering on the Wechsler Memory Scale - Third Edition in mild head injury litigants. Archives of Clinical Neuropsychology, 18, 181-197.
Lucas, S. & Wade, T. (2001). An examination of the power of the voices in predicting the mental state of people experiencing psychosis. Behaviour Change, 18, 51-57.

Ms Sara Lucas & Ms Antoinette Redoblado:

Wegener, S., Redoblado-Hodge, M.A., Lucas, S.K., Fitzgerald, D., Harris, A. & Brennan, J. (2005). The relative contribution of psychiatric symptoms and neuropsychological functioning to quality of life in first episode psychosis. Australian and New Zealand Journal of Psychaitry, in press.

Harris, A., Brennan, J., Anderson, J., Taylor, A., Sanbrook, M., Fitzgerald, D., Lucas, S., Redoblado-Hodge, A., Gomes, L. & Gordon, E. (2005). Clinical profiles, scope and general findings of the Western Sydney First Episode Psychosis Project. Australian and New Zealand Journal of Psychiatry, 39, 36-43.


Lucas, S., Fitzgerald, D., Redoblado-Hodge, M.A., Anderson, J., Sanbrook, M., Harris, A. & Brennan, J. (2004). Neuropsychological correlates of symptom profiles in first episode schizophrenia. Schizophrenia Research, 71, 323-330.

Fitzgerald, D., Lucas, S., Redoblado, M.A., Winter, V., Brennan, J., Anderson, J. & Harris, A. (2004). Cognitive functioning in young people with first episode psychosis: relationship to diagnosis and clinical characteristics. Australian and New Zealand Journal of Psychiatry, 38, 501-510.

Lucas, S. K.,
Fitzgerald, D., Redoblado, A., Brennan, J., & Harris, A. (2000). Neuropsychological correlates of symptom profiles in first-episode psychosis [Abstract]. Australian Journal of Psychology, 52 (Suppl.), 134.
Redoblado MA, Lucas S, Fitzgerald, Winter V, Harris A, Brennan J. (2002). Cognitive profiles of first episode schizophrenia and affective disorders. Acta Psychiatrica Scandinavica, 106 (413):40
Winter V, Lucas S, Fitzgerald D, Redoblado MA, Harris A & Brennan J. (2002) Duration of untreated psychosis in first episode psychosis. Acta Psychiatrica Scandinavica, 106 (413): 72
Fitzgerald D, Lucas S, Redoblado MA, Brennan J, Anderson J, Sanbrook M, Taylor A & Harris A. (2002). WSFEPP: neuropsychological function and diagnosis in early psychosis. Acta Psychiatrica Scandinavica, 106 (413): 98

Ms Antoinette Redoblado:


Nolan MA, Redoblado MA, Lah S, Sabaz M, Lawson J, Cunningham AM, Bleasel AF, & Bye AME. (2003). Intelligence in childhood epilepsy syndromes. Epilepsy Research. 53:139-150
Redoblado MA, Grayson S & Miller LA. (2003). Lateralized Temporal-Lobe Lesion Effects on Learning and Memory: Examining the Contributions of Stimulus Novelty and Presentation Mode. Journal of Clinical and Experimental Neuropsychology, 25: 36-48.
Nolan, M., Redoblado, A., Lah, S, Sabaz, M., Lawson, JA, Bleasel AF, Bye AME. Does epilepsy syndrome predict intellectual ability in childhood? Journal of Clinical Neurosciences, 8:488.
Redoblado, A., Bleasel, A., & Bye, A. M. (2000). Neuropsychological features of   different epilepsy syndromes [Abstract]. Brain Impairment, 1, 84.
Redoblado, A. & Miller, L. A. (1998). Stimulus novelty contributes to the   lateralisation of lesion effects of temporal lobectomy on learning [Abstract].   Australian Journal of Psychology, 50(Suppl.), 144.

Honorary Members

Dr Arthur Shores
Dr Jenny Batchelor
Susanne Meares

Updated:   20th April 2006   fsc

 

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