What Is Pediatric Neuropsychology And What Are Neuropsychological Assessments? With Leanne Al-Mrayat

Joining me today on the Psychology World Podcast is Leanne Al-Mrayat, a brilliant postgraduate research assistant and we have a great discussion today about neuropsychology. By the end of this clinical psychology podcast episode, you’ll understand what is pediatric neuropsychology, what are neuropsychological assessments, how to choose the right assessment tool for your project, and most importantly, Leanne shares ideas about how to get clinical experience with neuropsychological assessments. If you’re interested in psychological research, clinical psychology or neuroscience, then this will be a great episode for you.

Today’s psychology podcast episode has been sponsored by Cognitive Psychology: A Guide To Neuropsychology, Neuroscience and Cognitive Psychology. Available from all major eBook retailers and you can order the paperback and hardback copies from Amazon, your local bookstore and local library, if you request it. Also available as an AI-narrated audiobook from selected audiobook platforms and library systems. For example, Kobo, Spotify, Barnes and Noble, Google Play, Overdrive, Baker and Taylor and Bibliotheca.

Who is Leanne Al-Mrayat?

Leanne Al-Mrayat is a research assistant at the University of Cambridge researching brain and behaviour in rare genetic conditions. Prior to starting her role at Cambridge, she completed her Masters in Applied Pediatric Neuropsychology at University College London and her Bachelor’s in Psychology at the University of Kent.  Her research interests are in neurogenetics, neurodevelopment and mental health within different clinical groups, as well as understanding the link between behavioural and neuroimaging findings. In her free time she enjoys reading, exploring new coffee shops, and journaling.

What Is Pediatric Psychology And What Are Neuropsychological Assessments?

Connor: Hi, everyone. Today, I've got a brilliant, very special guest called Leanne. So, welcome to the podcast. Do you want introduce yourself?

Leanne: Hi, everyone, and hi, Connor. First of all, thank you so much for having me on the podcast. I'm very, very happy to be here. My name is Leanne, and I'm currently a research assistant looking at genetics and neurodevelopment. I was with Connor at university. We were working on similar final year projects, and we had a similar supervisor. We had the same supervisor. And, yeah, that's a bit about me.

Connor: Okay, brilliant. And Leanne is brilliant, really kind, and she's one of the most hardest working people that you will ever meet.

Leanne: You're kind.

Connor: I've also been meaning to say, it'd been my pleasure though to work with her.

Leanne: Likewise.

How Did You Get into Psychology and Why Did You Want to Do It?

Leanne: Such a good question. I always felt like, from a very young age, I had this very kind of interest in people and individuals and how we interact, and more importantly, how we differ. This is from a personal and, like, just from a kind of social aspect, where I just always was very curious about people. I love being around people, and I just love knowing more about people.

And then I had received a GCSE booklet. Like, you know how you get the brochure before you choose your board's GCSE subjects to do it at school? I was very fortunate that my school offered psychology as a GCSE. Now, at the time, I did not even know what psychology meant. So I did a quick Google search, and it says, like, "The study of people's mind and behavior, and how they interact." And I was like, "Absolutely, yes. This is going to be my top option." Just because I think I had that innate interest in people and humans, and I think being able to study that scientifically was definitely something I wanted to do.

And then fast forward, what? Eight, nine years later, I think every time, I think, we're progressing from GCSE psychology to A-level psychology to an undergrad in psychology. I feel like the only thing that happened, I just kind of enjoyed the topic more, and I'd realized just how much there is and how much the world revolves around psychology. And that's how I got into it.

Connor: Wow, brilliant. And I definitely get what you mean, because when I did IB Psychology, I fell in love with the topic, especially neuroplasticity, which is such a niche topic that I had to fall in love with. But then as you learn more and more, especially when you get to university, that's something that I really like about clinical psychology is that there's always more to learn, whether it's about a specific mental health condition, a new therapy...

Leanne: Precisely.

Connor: ...or something that's brand new like pediatric psychology, which is actually a very good segue. I'm very proud of myself.

Leanne: I'm proud of you too for that. That was really, really impressive.

What Made You Want to Do Pediatric Psychology? And What Is It?

Leanne: So just a bit of background. After I finished my undergrad in psychology, I went to UCL to do my master's in applied pediatric neuropsychology. Pediatric neuropsychology...or neuropsychology is, basically, the study of links between brain and behavior, and trying to look at how differences or how brain structures and function facilitates different aspects of our behavior and cognition, and how different environmental aspects in our life actually sometimes impact our neural development and our neural functioning.

I chose pediatric neuropsychology specifically because when I was at uni...so when we were at Kent, we were very fortunate because the university just offered us so many different fields. We kind of got to explore so many different fields within psychology, such as cognitive, social, business, forensics. But I think the lectures and the subjects that stood out to me the most were developmental psychology, child psychology, and a lot of aspects of neuroscience and cognition modules that we had.

I specifically remember one lecture by Laura Smith, I think it was. She was a lecturer at Kent at the time, and it was about neuropsychological assessment and how we basically measure cognitive abilities in individuals. And I think I just remember being in that lecture and being like, "I want to learn more about this. I want to be doing this in my future." I just did my own research, and I was very fortunate to find a course that merged my interest in development and my passion towards development and improving children's developmental trajectories, but also merging that kind of link between brain and behavior. And then I went ahead and I applied, and I did the course there.

Connor: Wow, brilliant. And I definitely get what you mean there, because I think that module...wasn't it called Advanced Topics in Developmental Psychology, or something like that?

Leanne: It would have been. I can't remember. I remember vividly the lecturer name and what the lecture was about, but I can't, for the life of me, remember the module name. But it could be, yes.

Connor: Yeah. And at the time, though, it sounded like such an interesting module. Back then, though, I sort of hated developmental psychology...

Leanne: Oh, no.

Connor: ...which I'm so surprised by now, just because I really love child development.

Leanne: Absolutely.

Connor: Because I know what happens in your childhood really does have a massive impact.

Leanne: I think I have the same thing where I wasn't very keen on doing child development or particularly working with pediatric groups. But, genuinely, I think doing these modules made me realize just the importance of basically childhood experiences, of neural development that happens in early years. That just made me realize this is such an important field to be in. I think, obviously, there's the passion of it, but there's an enjoyment of it, but there's also the fact that this is crucial, essential work that could really change someone's life outcomes and their cognitive abilities. And I think it's such an important field to be in, for sure.

Connor: Yeah, definitely. And that's something that I think that our listeners can take away, though, about you've got to find out something that you're passionate about. And even if you don't enjoy something at that particular point in that time, in your psychology journey, you might later on.

Leanne: I see. Never close any door, I think, early on. I think definitely allow yourself that time during your undergrad, especially during school, just explore all avenues before just... But then one will stand out at some point or the other, and they will find... I think, the right field within psychology will find itself to you, will find its way to you, the right career will do as well. For short.

Connor: I agree and more. But there is one aspect of psychology which I will never enjoy, and that is language acquisition.

Leanne: Language acquisition, really?

Connor: Yeah, it's interesting in theory, because after doing it for like a full six hours in my undergrad, and it's so complex, I just cannot get my head around it, especially with different theories.

Leanne: I get that. I get that. It can definitely, sometimes, get a bit repetitive in some of the lectures. I completely get that. I think, for me, one of the modules I just never kind of...or one of the fields within psychology I just never really resonated with was social psychology, funny enough. I know I said don't close the doors too early, and I truly mean it, but it's just, like, I had a very gut feeling of, like, "Social psychology, I don't really see myself moving forward or progressing in that career or that area of psychology." But, hey, you never know.

Connor: No, true. And, like, I think that the thing about social psychology is that it's interesting. Because of the sort of things you're wanting to research, you can't do it as empirically as other aspects of psychology.

Leanne: Precisely.

Connor: I think that's where some people. get a bit stuck. Go on.

Leanne: I agree. It's very theoretically heavy sometimes.

Connor: And sometimes the theories are just so complicated. You're like, "Right, please go very, very slowly," especially when they start bringing, like, well, the stats, though. Because in my masters, I had to do this sort of complex one. I had to do adult group proving teenage group relation, and there was like five slides filled with these different effect sizes.

Leanne: Oh my goodness.

Connor: And back then, like, the class wasn't as good. She wasn't explaining it. She's just going through the slides.

And there were some people in the cohort who were, yes, like, backing the slide, "Look at it and go, right. I know exactly what it means." The rest of us were just like, "You're just giving us numbers and no context." I was failing.

Leanne: Oh my goodness. I think stats is just... I think it was never I go to the lecture and I know exactly what's going on. It's like you need to go back to it three, four times. And then I'm like, "Okay, I now know what this all means." I completely agree. Stat is just a very interesting aspect of psychology, but I think it's necessary, nonetheless.

Connor: Yes, it's painfully necessary. This is why if you need help, everyone, please just ask, contact people, contact your university.

Leanne: Please do.

Connor: Your lectures will be more than happy to support you.

Leanne: Absolutely. I think the earlier you kind of seek that support in stats, the better outcomes you'll have with it. I think it's one of those things that you just kind of have to keep up with rather than leave it all to last minute because it will really add up. And then that's when you get overwhelmed. But if you're tackling it bit by bit, and if you're asking all the questions and you're just really, really trying to get to the bottom of it, it will definitely be clearer with time, and it will not be a jumble of numbers. You'll understand why it's also important. Yeah.

What Was Your Favourite Pediatric Psychology Topic And Your Least Favourite?

Connor: So looking back at your masters. What was your favorite topic, and what was your least favorite?

Leanne: Good question. Oh my God, I have to remember what modules I did. I really don't have the best memories sometimes. Right, my favorite module would be, I think the first one I did, and it was, basically, a neuroanatomy module. So all we did for...I think it was maybe 40 hours a month. Like, during the month was just learn about different zone parts, how they're connected, what different brain networks we have, and what their functions are. And I remember vividly, we had...the lecturer was amazing. I think the lecturer made a big difference on how much I enjoyed that aspect of my course. That actually is very daunting for some that don't come back, don't come from a background of neuroscience or biology, and they don't really know how the brain is structured.

But I think the best part was that at the end of the module, we did this, like, recap of where the different parts of the brain were from different sections, so if it was a caudal, a sagittal, or coronal section. and just seeing where the, for example, the hippocampus is relative to other brain structures or from one side of the brain or from one aspect. I think it was really nice to tie everything together. And I feel like it definitely improved my knowledge of brain anatomy and different neural networks in the brain. And I will never forget that module. It was such a well presented and well delivered module. And I loved it a lot.

And then the other part was about my least favorite module. I think I can pinpoint one that I did not really enjoy because they were all really, really good in different ways. I think I definitely did struggle a bit with my final pieces that I had to submit. I think that was the least enjoyable bit of the course just because it was just a lot of independent work. And it was just a lot of, like, structuring your own time and having to...

Basically, we were working on two different projects simultaneously. So one was a systematic review and then the other was an original project. So, yeah, I found a bit of a hard time trying to balance between working on my systematic review and then stopping and not thinking about it and then working on my original part of the project and doing all the tasks for that. I think that was the least enjoyable bit, but I can't really fault the modules. They were all fantastic.

Connor: Again, brilliant. And I'd like to thank you for sharing. And I definitely get what you would mean about the whole idea that if you've got a good lecturer, then that can really make all the difference.

Leanne: It is life changing.

Connor: Because I had a neuropsychology of ageing module. And at first, that sounded really dull to me or not the sort of area of clinical psychology where I wanted to go in there too. But then because quite a lot of clinical people were taking it, the lecturer decided, "Right, I'm going to adapt my content, and I'm going to make it more clinical focused." And that was so much more engaging. And I loved it because of him, because of what he had done. And it was one of my best modules, even though it wasn't directly clinical related. So if you've got a good lecturer, keep it.

Leanne: But it really brings back to that point of passionate and being passionate about what you do. Because I'm sure these lecturers, it comes from a place of passion that they want to deliver this content and they want you to understand this content as well as possible. And I'm so glad. That seems like a very interesting module to take as well.

Connor: Definitely. But I do struggle with different areas of the brain. I remember that Amir, like, our former supervisor, so he used to say, I feel like, "Dorsolateral prefrontal cortex." And for some reason, that is the only bit of the brain I actually remember. Because I think it sounded so complicated to me. I still don't know where that part of the brain is, even though I know it's like up here. Yeah.

Leanne: I'm pretty sure it's forehead. Yeah, I'm just gonna... Yeah, near the forehead area. Dorsolateral prefrontal cortex. Yeah, pretty much. Wasn't that the area that you were researching in the EEG project? Correct me if I'm wrong.

Connor: You know what that very much could have been. It's a few  years ago. But, yeah, it definitely...

Leanne: It was a long time ago. Yeah.

What are Neuropsychological Assessments?

Connor: Yeah. It was. So neuropsychological assessments.

Leanne: Yeah.

Connor: Please tell us more about that. Because psychological assessments are one of my favorite topics in clinical study I grant you. So please tell me more. I'm all ears.

Leanne: Okay. So in terms of neuropsychological assessments, those are assessments that we provide or we give to individuals to, basically, assess their abilities, whether it's language, memory, working memory...well, memory, such as working memory, long term memory, their social and communication abilities, their adaptive functioning, this is a very...like the Vineland, for example, which is a very big neuropsychological...yeah, it is a neuropsychological assessment. And I think the difference here is that it doesn't really focus on mood and maybe internal well-being or mental well-being as much as just more so focuses on how well is this individual functioning from a social domain, from a communication domain, from all different sorts of domains.

And I think there's just a plethora of neuropsychological assessments that cover all sorts of different domains. Some could be very focused on...for example, some assessments will only look at one cognitive ability, such as executive functioning. Whilst with the Vineland, it does social communication, maladaptive behaviors. So really, it varies with the different assessments. And I think it's all about choosing the right assessment, but making sure that you're not just relying on that neuropsychological assessment to dictate what this individual is capable of or not. Because truthfully, these assessments, they give us a snippet of what these individuals are capable of doing, but actually meeting them and interacting with them gives us a different picture, and a more nuanced picture of what this individual can and cannot do. So I think that's definitely something worth mentioning as well.

Connor: Okay, brilliant. Thank you. So you've mentioned that it's really important to actually pick the right psychological assessment. How would you do that?

How Do You Pick the Right Neuropsychological Assessment?

Leanne: I think it depends on what... Well, in a research aspect, it depends on what questions you want to ask or...sorry, what questions you want to answer. So if you are looking to investigate certain clinical populations communication abilities, it would make more sense to choose a communication checklist and to run through that. Because you also want to think and consider the participants' time and energy. And you don't want to give them this extensive neuropsychological assessment that looks at social, executive functioning, their memory abilities, but you actually just want to focus on this, their communication abilities.

And then you also want to really sit down and study this assessment, see why it was developed, what is it measuring, and whether this measure would really work well with the other measurements that you are including in your research. I think from a clinical aspect, I think I'm not really the most qualified to talk about that, but I think it would be more so of looking at just getting a bit of a snapshot of what this individual is capable of doing in preparation to maybe meeting them, or when you're meeting them, you just want to just get a better idea of where they're at right now and what we could do to better improve or help them in the future.

So I think it really just depends on the questions that you're asking and what you want to get out and what you want to understand better. Obviously, there's also intelligence assessments that we do, IQ, like the WASI. I completely forgot to mention those as well. Those are quite big in neuropsychological assessments, and those just give you a much more generalized idea of the individual's abilities. They're not very focused on a specific domain, as communication checklists would be, for example.

Connor: Thank you for that.

Leanne: Does that make sense?

Connor: Yes, it does. And I think that's really helpful because I know that the issue that I have, and this is coming in, like, actually, as someone who doesn't have the most, like, extensive neuropsychological background, is that I know there were just so many. There were tons, and I think that can be quite overwhelming.

Leanne: Of course.

Connor: But I think that your advice about just taking, like, step back and think about what it is it that you actually want to answer, I think that can actually make it a lot more focused and a lot more easier to understand for us. So thank you for that.

Leanne: Yeah, of course. And I think this is definitely what I see happening from a research element. Obviously, there's more logistical elements about which assessments you can...actually are available in the UK or which assessments are available at a certain center or unit. So that's also another thing to kind of keep in mind. But I think with us in research, it's just a matter of what questions are we wanting to get out of this research and what tools. So because these assessments are essentially tools that help us learn more and know more and aid our understanding.

Connor: Do you have a favorite?

Do You Have a Favourite Neuropsychological Measurement?

Leanne: No, I can't be biased like that. I don't necessarily. I don't think so. I think each one of them, they have pros and cons. I think it's difficult. I do like the Vineland, which we use quite often here, because it just covers a big range of cognitive domains. And I think pros and cons with all of them, I think, it's difficult to just pinpoint and be like, "This is the one," because there's no such thing as that.

Connor: Okay, then I could then, like, thank you for that, though. Because I remember when I was doing, like, my mental health studies, I definitely had like a ton of favorite, but that's because they did look at some different things. And I did tend not to use like three or four different ones because they were short. They looked at different things. And they did help to fulfil with some of the negative gaps over the other ones. So that's actually a really good point.

Leanne: Precisely. And I think you kind of already answered the question of which one to use. I think it's similar to a mental health questionnaire, you want to use something that is answering the question, is not really taking up a lot of the time of the participant. It's important to be considerate to the people that are coming in and doing this research, but at the same time, you're getting good data out of it.

Connor: True. So the last neuropsychological question I've got for you is that when it comes to assistant psychology jobs, I constantly see one of the most annoying things. So they want you to have experience in neuropsychological assessment. Can you please help us? How would you get that?

How Do You Get Experience In Neuropsychological Assessments?

Leanne: I'm not an assistant psychologist. I know that these positions are quite competitive. I think it's difficult because you want experience in a setting where you're actually administering this neuropsychological assessment. I think looking at research assistant positions where there is that kind of interaction with clinical groups is always a very good kind of experience to have. And maybe during your undergrad or your master's thesis and projects, it's always good to look for projects where you might have this interaction or ability to administer these assessments.

Although I don't know which projects would offer that, but I think it's one of those things where you could develop your knowledge, but how you develop administering these assessments really would differ from based on what projects you can be involved in during undergrad and if you find a research assistant job. So that's more academia, like the one I have, which works with clinical groups. And you might have that ability or chance to oversee or administer some of these assessments. Although I don't think it's a guarantee, but it's worth it.

Connor: No, but true. And as you were saying, that these are really common and competitive. And considering that I didn't actually prompt you that question to allow you to prepare beforehand. That was a really good answer.

Leanne: Of course.

Connor: Wonderfully said. So thank you for joining us today, Leanne, and if people wanted to connect with you and follow your work, then where could they come, find you online?

Leanne: I will be on LinkedIn. I think that's the best place. I'm quite active on there. So, yeah, feel free to just tag me on LinkedIn, and if you have any questions or anything, I'm always up to chat. And, yeah, that's where you'll find me.

Connor: Thank you, Leanne, and best of luck with your psychology journey for the future.

Leanne: Thank you so much. You too.

I really hope you enjoyed today’s clinical psychology podcast episode.

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Clinical Psychology Further Reading

Roberts, M. C., & Steele, R. G. (Eds.). (2010). Handbook of pediatric psychology. Guilford Press.

Delozier, A. M., Kamody, R. C., Rodgers, S., & Chen, D. (2020). Health disparities in transgender and gender expansive adolescents: A topical review from a minority stress framework. Journal of Pediatric Psychology, 45(8), 842-847.

Roberts, M. C., Aylward, B. S., & Wu, Y. P. (Eds.). (2014). Clinical practice of pediatric psychology. Guilford Publications.

Ernst, M. M., Barhight, L. R., Bierenbaum, M. L., Piazza-Waggoner, C., & Carter, B. D. (2013). Case studies in clinical practice in pediatric psychology: The “why” and “how to”. Clinical Practice in Pediatric Psychology, 1(2), 108-120.

Duncan, C. L. (2023). Clinical Practice in Pediatric Psychology: The Future Continues to Expand. Clinical Practice in Pediatric Psychology, 11(1), 1-5.

Simon, S. L., Clay, D., Chandrasekhar, J., & Duncan, C. L. (2021). Gender bias in pediatric psychology. Clinical Practice in Pediatric Psychology, 9(1), 82-95.

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