Abstract

Objective: Anoxic brain injury has been implicated in severe intellectual, attention, memory, and behavioral impairments. The presented case delineates circumscribed areas of strength within the cognitive profile of an individual presenting with severe global deficits resulting from anoxia/ hypoxia in early childhood. Method: The client was a 9-year-11 month-old English dominant Latino male affected by developmental delays and a significant history of multiple episodes of tonic-clonic status epilepticus (40−75 minutes). Presenting problems included receptive and expressive language deficits, failure to develop reading or writing skills, attentional difficulties across domains, limited self-care abilities, tantrums, memory impairment, and frequent violation of social boundaries. Comprehensive and culturally sensitive neuropsychological instruments were used to obtain information regarding the client's current functioning. Data from neuroimaging studies conducted at 3 and 9 years of age is discussed. Although an MRI at 3 years of age revealed no structural abnormalities, an EEG conducted several months prior to the presented assessment revealed epileptiform discharges at the left temporal head region. Results: Neuropsychological test results revealed severely impaired performance across intellectual, verbal, memory, academic, visuomotor, and socio-emotional domains. Circumscribed strengths in associative learning were used as the basis for behavioral interventions with this child's impaired adaptive functioning. Additional areas of strength emphasized in intervention design included low level receptive language abilities, visual perception and recognition skill, and basic motor functioning. Conclusion(s): The described case illustrates the value of defining and subsequently capitalizing on specific strength areas in an otherwise depressed cognitive profile.