12

Educational Neuropsychology
Rebecca Ashton

Rationale for this Approach

Most children are in education for a large proportion of their waking life,
whether in school, nursery, college or some other educational setting.
Schools can make a difference to children’s academic outcomes, as well as
their well-being (Sellstrom and Bremberg, 2006), and what happens at school
can therefore influence the child’s development following a brain injury.
However, educators can only help with a child’s rehabilitation if they
know about the brain injury and if they know how to help. Too often,
teachers are unaware that the child has had a brain injury, especially if
the child has changed school or changed class since returning to school
(Hawley et al., 2004). Understanding of brain injury among educators is
also a concern (e.g. Linden et al., 2013), so school staff may need a range of
support if they are to be an effective part of the child’s rehabilitation plan.
Clinical neuropsychologists are well placed to help children with
brain injuries in many ways, but may find it difficult to provide the
support that schools need. Even if the systems in which they work
enable clinical neuropsychologists to be in contact with schools, the
gap between clinical and educational worlds can present a barrier to
effective partnership working.
Ernst et al. (2008) published an article on what clinical neuro-
psychologists in the USA need to know when working with educa-
tion colleagues. They made an informal analysis of the problems that
educational colleagues raised when trying to work with clinical neuro-
psychologists, summarised as follows (p. 965):

1. Difficulty understanding reports due to too much medical and neuro-

psychological jargon

237
238 Neuropsychological Rehabilitation of Childhood Brain Injury

2. Failure to document the impact of the neurological condition on

academic functioning
3. Failure to provide the documentation necessary to determine eligibility
for special education
4. Recommendations that have already been attempted by school
personnel
5. Recommendations that are too vague, not applicable to the school
setting or not specific to instruction.

Parents, too, identify the gap between clinical neuropsychology involve-

ment and positive impact on their child’s education. In a postal survey
in the USA (Bodin et al., 2007), 43% of parents said that they were not
sure or did not think that the clinical neuropsychologist’s input had
helped improve services at school. The bridge between health and edu-
cation for children with brain injury is very important, but often not
systematically in place (Tomlin et al., 2002).
Ernst et al. (2008) suggest that the clinical neuropsychologist should
collaborate closely with the educational psychologist, which would be
helpful in overcoming some of these issues. (In this chapter, practitioner
psychologists working to enhance learning and development are referred
to as educational psychologists. In some countries these professionals
would be known as school psychologists, but educational psychology
is used here in order to be more inclusive of those working in a range
of settings such as nurseries, colleges and local authorities.) However, a
more efficient solution would be to work with a neuropsychologist from
an educational psychology background, a combination which in this
chapter is referred to as educational neuropsychology. Such professionals
have the knowledge, language, skills and experience to address educa-
tional issues while also having the neuropsychological understanding to
translate clinical information into the educational setting.

Application
Clinical and educational psychology usually form separate training
routes. Clinical psychology is invariably accepted as a basis from which
to move into specialist training in neuropsychology, but educational
psychology only in some countries (such as the UK). In some places,
including Australia and some US states, it is possible to train directly in
neuropsychology, although the curriculum is often clinical rather than
educational in nature. For example, the Australian Psychological Society
(2013) describes neuropsychology professional training using language
including, ‘patients’, ‘diagnosis’ and ‘treatment’.
 Educational Neuropsychology 239

Crespi and Cooke (2003), writing in a US context, outline the

benefits of school psychologists becoming trained in neuropsychology,
even though they may not be able to become accredited as a clinical
psychologist could. In response, Pelletier et al. (2004) caution against
the possibility of falsely overstating the expertise of such individuals,
who may have had much less specialist training than an accredited
clinical neuropsychologist. They rightly point out that the value
of specialising in neuropsychology is in a thorough understand-
ing of the developmental acquisition of neuropsychological func-
tions, not simply learning how to administer tests that are deemed
neuropsychological.
Educational neuropsychologists should be trained in their neuropsy-
chology specialism to the same level as clinical neuropsychologists, and
national accrediting bodies should consider what opportunities they
offer for such training. Equally, where neuropsychology is offered as an
initial training route, institutions should consider how they equip their
trainees to understand educational, as well as clinical, issues.
Tharinger et al. (2008) write from an American perspective; however,
their description of what distinguishes an educational psychologist
from other practitioner psychologists seems to have universal relevance.
It includes:

• a focus on the application of psychological knowledge and methods to

solve problems or improve processes and outcomes within educational
institutions or with individuals involved in the learning process.
• an understanding of schools as organisations in and of themselves,
in reciprocal interaction with their local communities
• knowledge of the law and regulation relevant to schools, education
and children with disabilities
• knowledge of effective instructional processes
• understanding of classroom, school and other educational environments
• applying principles of learning to the development of student
competence
• skills in consulting effectively with educators and other professionals
regarding cognitive, affective, social and behavioural performance of
children
• striving to improve the organisation of schools
• developing effective partnerships between parents/carers and educators.

Adding layers of knowledge about how brain injury can impact upon
child development, learning, behaviour and relationships enables the
240 Neuropsychological Rehabilitation of Childhood Brain Injury

educational neuropsychologist to help schools plan and implement

interventions for this group of children, and to act as an ‘interpreter’
between the languages of medicine and education.
Figure 12.1 was presented by the author at the British Psychological
Society’s Division of Neuropsychology conference in 2011. It summarises
the commonalities between clinical and educational neuropsychology, as
well as the areas of unique expertise.
With a particular young person, support may be best provided from
a clinical neuropsychologist, an educational neuropsychologist or both,
depending on the issues to be addressed at the time. Key activities that the
educational neuropsychologist may be best placed to undertake include:

• ensuring that educational staff understand the impact of a student’s

brain injury on his/her learning and behaviour
• assessing the best fit between an educational setting and a student
• supporting teachers to plan appropriate teaching strategies and tar-
geted interventions, prioritising which skills to work on first
• ensuring that the right educational resources are in place (this
may include reassurance that provision can be made from existing
resources, as well as re-presenting assessment evidence to meet crite-
ria for additional resources)
• developing joint intervention plans with schools and families.

These areas are illustrated in the case study within this chapter.

Educational: Clinical:
Common ground:
Therapeutic
Knowledge and Knowledge of neuropsychology skills and
experience of Quickly establishing helpful knowledge
educational systems relationships
Understanding of Reflection and analysis Experience
pedagogical working acorss
approaches Formulation/hypothesising the age range
Linking assessment, theory,
Community research evidence and Individual/family
orientation intervention orientation

Often more Report writing for specific Often more direct

consultative role purposes and audiences intervention role

Figure 12.1 Overlaps between educational and clinical neuropsychology

 Educational Neuropsychology 241

Assessment
An educational neuropsychology assessment may include psychometric
testing of cognitive functions (see Table 12.1). The focus, however, is
likely to be more functional, including academic progress and response
to interventions. Data from the educational setting are likely to be
integrated into the assessment, as well as information from the child
and family.
The purpose of the educational neuropsychology assessment is
to inform educational practice, which may include advice on the
most appropriate type of institution, groupings, curriculum, teaching

Table 12.1 Educational neuropsychology assessment prompts

Background
• Injury and brief history
• Presenting concerns (may be different concerns from different people involved)
Educational history
• Did the child attend nursery/preschool?
• Which schools have they attended?
• Attendance record—before and since the injury?
• Any identified special educational needs before and since the injury?
• History of additional educational support provided
Educational assessments
• Academic assessments, ideally over time so that a trajectory can be
described pre- and postinjury
• Assessments of social, emotional and behavioural skills may already be
available, or the school can be asked to complete questionnaires such as the
strengths and difficulties questionnaire (Goodman, 1997)
• Other professionals’ assessments, e.g. psychologist attached to the school,
advisory teacher
Current provision
Look at the individual education plan:
• Do the targets address what the child needs to learn next?
• Are the targets clear and specific enough?
• Do the strategies/provision give the child a fighting chance of achieving
the targets?
• Are the staff monitoring and evaluating effectively (how will they know if the
target has been achieved)?
• Does the plan take into account advice from other professionals and from
parents?
• Provision map, showing what additional support is scheduled for the child
across the week
• Responses to interventions so far

(continued)
242 Neuropsychological Rehabilitation of Childhood Brain Injury

Table 12.1 Continued

Neuropsychological assessment
Observations—in lessons and at break times. It is often worth trying to schedule
a visit when you can see a range of situations, e.g. different types of lesson,
smaller group work or one-to-one, directed and free-choice time. Can provide
lots of information about:

• how well the environments suit the child

• how well the child is included and is accessing opportunities
• what the adults are (or are not) doing to help the child
• social relationships and social skills
• motor skills
• sensory skills (even as basic as whether the child is wearing their glasses)
• language understanding and use
• personal organisation
• attention
• motivation and engagement
• behaviour

Self- and adult reports of physical health, including sleep, nutrition and
exercise
Cognitive and academic attainment tests—depending on what has already been
tested and what hypotheses have been generated
Self-assessment of abilities and relationships
Sociometry if appropriate—to gauge the child’s social standing within the class
or group

approaches and support. Ideally, the written report of such an assess-

ment will be presented in such a way that it can be used directly for
local resource allocation processes, should that be needed. In these
respects, the educational neuropsychology assessment differs from
other neuropsychological assessments, which may instead focus upon
family functioning, therapeutic requirements or adjustment to trauma.
During the course of an educational neuropsychology assessment,
staff at the child’s school or setting are likely to be key contributors.
This engagement enables the educational neuropsychologist to begin
processes of intervention, including raising awareness of brain injury
generally and the child’s needs in particular.

Intervention
Few approaches to intervention are supported by evidence from
research directly with children who have brain injuries, and those few
are denoted by asterisks in Table 12.2 and discussed in the next section.
In most cases, educational neuropsychology interventions are likely to
 243

Table 12.2 Examples of educational neuropsychology intervention

Academic skills

• Direct instruction and precision teaching*

• Task analysis to set specific achievable goals
• Specific programmes, e.g. Reading Recovery
• Paired reading
• Computer-based programmes, e.g. ARROW
• Home reinforcement (e.g. send home on flash cards)
Cognitive skills

• Use of external aids, e.g. music through headphones, pager, timer*

• Training weaker systems, e.g. Cogmed, Pay Attention!*
• Teaching meta-skills, e.g. strategies for remembering information,
self-monitoring*
• Environmental adaptations to reduce load on weaker systems
• Identifying and making use of cognitive strengths
• Providing organisational systems, e.g. colour coding for revision of different
subjects
• Vygotskian approaches to support in the classroom, e.g. mediated learning
experiences
Motor skills

• Gross motor programmes, e.g. Write Dance

• Fine motor programmes, e.g. Clever Fingers
• Handwriting programmes, e.g. Teodorescu Write From the Start
• Backward chaining of everyday tasks, e.g. putting coat on
Social, emotional and behavioural skills

• Positive behaviour supports*

• Emotional literacy, e.g. recognising and managing own feelings, such as
frustration, fatigue
• Functional behaviour analysis
• Circle of friends
• Social stories
• Motivational interviewing
• Nurture groups
• Restorative justice approaches
• Small group programmes, e.g. PATHS (Promoting Alternative THinking
Skills), Friends for Life
• Teaching relaxation skills

* Approach validated with at least one study including children with brain injuries.
244 Neuropsychological Rehabilitation of Childhood Brain Injury

borrow from the wider field of educational psychology, although some

practitioners may also be able to provide more clinically oriented inter-
ventions such as cognitive behavioural therapy.
Interventions may be delivered directly by the educational neuro-
psychologist, but in the interests of developing capacity within the
organisation they are usually delivered wholly or jointly by staff within
the setting. The role of the educational neuropsychologist is often to
create sustainable subsystems that work to promote the child’s learn-
ing and development within their day-to-day settings, rather than to
intervene directly with the child him or herself (see, e.g., Beaver, 2011).
Clearly, the intervention plan must be linked to the assessment find-
ings. The plan may include compensatory strategies, as well as direct reme-
diation of weaker areas. As for any child, it is important that a key teacher
takes responsibility for planning, delivering and monitoring the educa-
tional programme. While the child may need input from a range of adults,
including support assistants or aides, the plan must be coordinated and
quality assured by a teacher who can make adjustments to the provision.
Often, the work of the educational neuropsychologist will include
education and support for the school staff implementing interventions.
Enhancing teachers’ knowledge, skills, confidence and objectivity is
part of most educational psychologists’ core training (Fagan and Wise,
2007; Kennedy et al., 2009). These skills, together with specialist exper-
tise in neuropsychology, mean that the educational neuropsychologist
is ideally placed to support staff through training, consultation, coach-
ing and resource suggestions.
An important point is that intervention must be tailored to the indi-
vidual, in their context. In some studies, ‘special education,’ is assumed
to be an intervention (Taylor et al., 2003). In practice, many clinical
colleagues make assumptions that special school will provide a more
appropriate educational environment for children with brain injuries or
neurological conditions, without being able to assess whether that par-
ticular school is any more able than a mainstream setting to meet that
individual child’s needs. In fact, whichever school the child attends is the
setting in which the intervention needs to be personalised and embed-
ded. It is just as important to support special schools and classes as it is
to support mainstream settings in helping children with brain injuries.

Working with the wider system

Beyond individual casework, the educational neuropsychologist may be
able to work at a systemic level to support children who have had brain
injuries (see Ball and Howe, 2013).
 Educational Neuropsychology 245

Depending on their position within the local systems, an educational

neuropsychologist may be able to act as a link between hospital and
school services. With good relationships, colleagues may be able to
agree on a process that enables information about children with brain
injuries to be passed systematically from the hospital to the educational
neuropsychologist, who can then offer support to the school and family
as the child returns to their community.
Educational neuropsychologists may also be able to provide a lon-
gitudinal service, keeping information on children in their school or
area who have had a brain injury and prompting staff periodically to
consider whether any new needs are emerging. This sort of support can
be particularly useful as children move through the education system,
as information about their brain injury may not be passed between
teachers.
In addition, training may be one way in which awareness of brain
injury can be raised proactively in groups of colleagues. For example, an
educational neuropsychologist may work with a youth offending team
to educate them about the prevalence of brain injury in young people
within the justice system (see Williams et al., 2010). Such training is
likely to lead to discussions about how best to assess and intervene in
the participants’ own professional context.

Evidence Base

Much of the evidence base for educational neuropsychology is drawn

from work with wider populations and applied to children with brain
injuries. Very little research has been published about the effective-
ness of cognitive or behavioural interventions for children with brain
injuries (Limond and Leeke, 2005; Laatsch et al., 2007). However, there
are some areas in which educational approaches have been directly
validated with this specific group (denoted in Table 12.2 by asterisks).
Direct instruction is an approach based on mastery learning, in which
skills to be learned are broken down into very small steps and taught
systematically. The learning steps are small and systematic so that the
risk of making errors is small, and when the student does make an error
it is corrected quickly and without fuss. Direct instruction was originally
devised as a way of teaching economically disadvantaged students, and
has been shown to help children with brain injuries to automatise basic
academic and procedural skills (Glang et al., 1992).
Linked with direct instruction is precision teaching, a method of
monitoring learning in very small steps. The underpinning psychology
246 Neuropsychological Rehabilitation of Childhood Brain Injury

is mastery learning: the concept that some factual learning needs to

be taught and practised to fluency in order for that knowledge to be
retained and applied. Daily probes are used in order to chart perfor-
mance, and analysis of this data guides the teaching programme which
is often based on direct instruction principles. Precision teaching has
been shown to enhance academic, language and motor skills in children
with brain injuries (Chapman et al., 2005).
With cognitive difficulties, there is some evidence that direct reme-
dial approaches can be helpful for children with brain injuries. Cogmed
(computerised training) has been shown to improve working memory
in children and adults. Studies directly investigating the effects of this
programme on children with brain injuries are ongoing in the UK and
Australia. See www.cogmed.com for a summary of published and forth-
coming articles. Face-to-face training of specific cognitive skills such as
self-monitoring have also been shown to work for children with brain
injury (Selznick and Savage, 2000).
Cognitive problems can also be ameliorated using environmental
supports such as smartphones (DePompei et al., 2008). Functions such
as reminders, prompts to stay on task and task lists can all be helpful in
compensating for weak organisation and memory skills.
In terms of behavioural management, both antecedent and conse-
quence-based approaches have some evidence of efficacy for children
with brain injuries (Ylvisaker et al., 2007). The possible disinhibition
that can follow brain injury can be difficult to manage in educational
settings, and structured systems that increase the chances of positive
behaviours can be helpful.
Although much research tells us that social relationships following
brain injury can be very difficult for children (Muscara et al., 2009),
very little research has focused on what might help in this area. Glang
et al. (1997) attempted to apply a peer group intervention in the school
setting with children who had brain injuries, but the improvements
in their friendships did not last over time. Ylvisaker et al. (2001) sug-
gest Circles of Friends, an approach that has been used with a range of
children, although not specifically evaluated for children with brain
injuries. Social difficulties following brain injury may be linked to a
range of factors such as language problems, behavioural disinhibition,
slower processing and emotional dysregulation (Beauchamp and
Anderson, 2010), so interventions may need to be tailored to address
these underlying issues.
On a more general level, Ylvisaker et al. (2001) give a useful sum-
mary of teaching approaches that have evidence of efficacy in a range
 Educational Neuropsychology 247

of populations and could therefore be applied to children with brain

injuries. These pedagogical methods include pacing, cumulative practice
and facilitation of generalisation by applying the same concept in mul-
tiple contexts. Although many teachers will feel that they lack the spe-
cialist knowledge to work with children following brain injury (Clark,
1996), teachers are likely to be familiar with these techniques and can
therefore implement them with some confidence (Ylvisaker et al., 2005).

Case Study: Michael

Names have been changed to provide anonymity.

Background
Michael’s brain injury occurred perinatally, with hypoxic ischaemic
insult leading to neonatal encephalopathy. Michael experienced epilep-
tic seizures soon after birth, and longer-term cerebral atrophy. His injury
was generalised but more marked in left frontal areas of the brain.
This brain injury left Michael with quadriplegic cerebral palsy.
Consistent with the injury, motor skills on the right side of his body
were weaker than on the left side. In addition, Michael showed sig-
nificant general learning difficulties and language delay. Emotionally,
Michael was described by his parents as frequently anxious, and he
would become particularly distressed by changes to his usual rou-
tine. Shortly before the educational neuropsychologist’s involvement,
Michael had been given a diagnosis of autistic spectrum disorder.
At home, Michael’s family received support from the social services
disability children’s team. This support included direct funding for the
family to employ personal care assistance, as well as a social worker to
coordinate and review the care plan. The family also participated in the
ongoing medico-legal assessment process towards bringing a medical
negligence case against the hospital trust.
Michael accessed conductive education from the age of 1 year (Hari
and Akos, 1989), and continued to attend blocks of therapy at a regional
centre. From the beginning of his school career, Michael attended an
additionally resourced setting where a wide range of children were
educated together. Physiotherapy, speech and language therapy, psycho-
therapy, nursing and enhanced adult : student ratios were available as
part of the usual school provision.
From the start of Michael’s schooling, his parents challenged the local
authority and the school to ensure that Michael got as much support as
possible. They had used the legal recourse available in the UK to ensure
248 Neuropsychological Rehabilitation of Childhood Brain Injury

that Michael had a Statement of Special Educational Needs, which set

out one-to-one full-time support over and above the usual school provi-
sion. This process took years, and at the beginning of the educational
neuropsychologist’s involvement, when Michael was 8 years old, the
relationship between home and school was very weak. Michael’s par-
ents did not trust the school to put in place everything that Michael
needed, and the school felt that the parents were overly critical of the
education Michael was receiving.

Summary of Rehabilitation Plan

Michael already had a range of professionals involved with his reha-
bilitation and education. His individual education plans from school
were detailed and relevant to helping him achieve the next small step
of academic progress. The key aim for educational neuropsychology
involvement was to help rebuild the trust between the family and the
school. The focus for some years had been on resolving disagreements
about assessments of need and details of resources required; the role at
that point was to help them work on shared targets and shared strate-
gies to achieve them.
From the outset, it was important to ensure that all adults involved
saw the educational neuropsychologist as an advocate for Michael, and
not to take sides. Strategies included bringing together aims from dif-
ferent parties to be worked on across settings, and also introducing a
technique new to both the school and the family so that they could
engage in learning together.

Summary of Intervention
The educational neuropsychologist visited the three main settings where
Michael spent time: school, home and conductive education centre. In
each setting he was observed doing his usual activities, and discussions
were had with Michael and the adults who knew him well. This enabled
the educational neuropsychologist to develop a broad picture of the
common issues, as well as differences in views, about Michael. The role
was then to act as a mediator, sharing targets and strategies between set-
tings. In most cases, all involved agreed on what should be done next
with Michael, for example helping him to develop a routine for brush-
ing his teeth supported by a strip of pictures and an agreed reward. The
only area where this approach did not result in shared aims was around
motor skills. The physiotherapy provided in school was not compatible
with the conductive education methods, and it was a step too far for
either side to accept strategies from the other.
 Educational Neuropsychology 249

The new technique, introduced to the family and the school together,
was precision teaching. Although the school had a long and successful
history of special needs education, the staff were not familiar with preci-
sion teaching, which is one of the few techniques to be directly validated
for children with brain injuries (Chapman et al., 2005). The educational
neuropsychologist led a training session in school for five school staff
and Michael’s mother. They tried out the techniques using role play, with
Michael’s mother pairing up with the school’s special educational needs
coordinator. The school suggested some adaptations to make the charts
more visually accessible for Michael, which were agreed by everyone.
After a further home visit and conversation with school, it was agreed
that the situation was much improved and the educational neuro-
psychologist’s involvement was no longer needed.

Outcomes
At school, Michael’s academic progress was slow but steady. Precision
teaching was being used at home and at school, with success. One
example given by Michael’s mother was that he could name colours
consistently, which he could not do before precision teaching of this
skill. Both school and home reported that they were using precision
teaching with other children too (Michael’s brother was learning his
multiplication tables using the timed probes and charting the results).
From a position of very low trust between home and school, by
the end of the educational neuropsychologist’s involvement the two
reported that they were communicating more openly and agreeing the
plan for Michael rather than having separate home and school plans. At
the beginning of involvement, Michael’s mother was considering mov-
ing him to a different school but he stayed in the same primary school
until the end of the age range there.

Reflection

Overall, the initial aims of involvement were met over the course of
12 months, with school and home no longer requiring the educational
neuropsychologist to mediate a shared plan for Michael. This case illus-
trates many of the areas where an educational neuropsychologist can
provide specialist intervention, as summarised in Table 12.3.
The case is now closed to the educational neuropsychologist,
although the rehabilitation programme continues and the family may
request further support in future, perhaps in planning transition to a
secondary school setting.
250 Neuropsychological Rehabilitation of Childhood Brain Injury

Table 12.3 Key functions of the educational neuropsychologist

Activity Application to this case

Assessing the best fit between
an educational setting and a
student
Ensuring that educational staff
understand the impact of a
student’s brain injury on his/her
learning and behaviour
Supporting teachers to plan
appropriate teaching strategies
and targeted interventions
Ensuring that the right
educational resources are in place
(this may include reassurance
that provision can be made from
existing resources, as well as
re-presenting assessment evidence
to meet criteria for additional
resources)
Developing joint intervention
plans with schools and families
Reassuring both school and parents that
the placement was appropriate for Michael:
he was happy and progressing there
Reminding staff that Michael’s complex
difficulties were the consequences of a
brain injury, which helped to frame his
needs and his family’s anxiety to get the
provision right for him
Validating the existing individual
educational plan and adding a new
evidence-based strategy to help towards
the targets in the plan
Michael already had access to excellent
resources within his school, including
additional one-to-one support, so staff and
parents could be reassured that they no
longer needed to spend their energy on
fighting for resources
Michael’s plans are now jointly agreed
rather than separate home and school
plans, although conductive education
plans are still separate

In a wider sense, this case raises some issues for professional neuro-
psychology. If Michael was living in a country where educational psycho-
logists cannot train to become neuropsychologists, would the outcomes
have been different? He already had access to an educational psychologist
linked with his school, but this had not resolved the presenting problems.
In this case, the outcomes were improved by the psychologist’s expertise
in both education and brain injury.
A further issue raised by this case is equality of access to educational
neuropsychology services. Michael had private funding, which enabled
his case manager to bring in an educational neuropsychologist for this
work. However, in the public sector, there is no structure in most coun-
tries for ensuring that children can access educational neuropsychology,
and it depends whether there is a local educational psychologist who
happens to specialise in neuropsychology. Localities and regions may
need to work together to coordinate access (see, e.g., Glang et al., 2004).
 Educational Neuropsychology 251

The distinct lack of educational approaches validated for use with

children after brain injury is also a key issue. In this case, it was possible
to find an evidence-based strategy to offer, but in many cases inter-
ventions have to be suggested without any specific research into their
application to children with brain injuries.

Future Directions

Educational neuropsychologists have much to offer children after brain

injury. The next steps will be to move from a small number of scattered
individuals towards finding an organisational place for educational
neuropsychology, within national accreditation routes and within
delivery organisations that can match professionals with the children
who would benefit from our involvement. In the research arena, edu-
cational neuropsychologists would be well advised to engage in studies
that can establish the efficacy (or otherwise) of educational interven-
tions for children with brain injuries.

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