Neurocognitive Disorders

Mixing up Letters and Numbers- Dyscalculia vs. Dyslexia

Most people have heard of dyslexia, a disorder that causes individuals to have an unexpected difficulty with reading. 5-15% of Americans are dyslexic, meaning it’s highly likely you know someone who has this disorder. Dyslexia can be recognized as early as a child’s preschool years but can have lifelong implications. It can impact an individual’s ability to read fluently, spell, or learn another language. Though the challenges are language based, the implications span beyond just reading and into every subject. However, there is another similar disorder that might be confused for dyslexia, especially when someone struggles with math.

Dyscalculia is another learning disability that causes difficulties specifically with math. While it has a nickname of “math dyslexia”, don’t let this fool you: the two disorders are distinct from one another. Individuals with dyscalculia can have difficulties with manipulating numbers in their head, understanding mathematical concepts like bigger and smaller, or might not be able to apply concepts, even if they understand them. It is currently thought that three- six percent of the population has dyscalculia, but being that this disorder is not well studied, it is likely closer to that of dyslexia.

While there is some overlap in the signs, of these two disorders, it is possible to tell them apart. One of the most obvious ways to figure out whether an individual has dyscalculia or dyslexia is by seeing where an individual’s struggles arise. If they only occur while doing math problems, or if they are an issue in many different areas, can be the first sign of which disorder an individual is dealing with. If someone avoids reading out loud and has issues with spelling and grammar, this would most likely be due to dyslexia, while issues with counting and computation would likely point to dyscalculia. These differences may be due to the way that the disorders impact cognitive functioning. In the case of dyslexia, it has been seen that the underlying issues are actually phonologically based. This is in contrast to dyscalculia, which is has been linked to specific issues with the manipulation of numbers.

In both cases, there is no “cure” for either dyslexia or dyscalculia, but there are ways to help an individual overcome the challenges that come along with the disorders. While there are some accommodations that both types of students can benefit from, such as additional time on tests; however, there are different ways that can help with each individual’s issues more head-on. With a child with dyslexia, using shorter written assignments or testing them in other ways, such as oral reports will help them succeed. For s child with dyscalculia, giving and breaking down math assignments, using games to implement math concepts, and giving them additional help like access to a calculator or math facts, may be more helpful. Overall, both disorders can be manageable, but it is important to treat the correct disorder. By giving a child the proper tools to handle their specific challenges, they will be better equipped to handle the challenges that come with each of these unique disorders.


Work Cited:

Dyslexia: What Brain Research Reveals About Reading. (n.d.). Retrieved from

Landerl, K., Fussenegger, B., Moll, K., & Willburger, E. (2009). Dyslexia and dyscalculia: Two learning disorders with different cognitive profiles. Journal of Experimental Child Psychology,103(3), 309-324. doi:10.1016/j.jecp.2009.03.006

Rosen, P. (n.d.). The Difference Between Dyslexia and Dyscalculia. Retrieved from

Team, U. (n.d.). Understanding Dyscalculia. Retrieved from

What is Dyscalculia? (n.d.). Retrieved from

What is Dyslexia? (n.d.). Retrieved from


Trauma and Stressor Related Disorders Uncategorized

Living in a Sea of Faces- Life with Prosopagnosia

Everyone has had that awkward encounter where someone comes up to you and says hello, and you have no idea who that person is. Maybe there is some sense of familiarity as you look into their eyes and try to place where you know them from. Or maybe you have absolutely no recollection of meeting them at all. Either way, you now have to either fake your way through a conversation, acting like you know this person, or ask awkwardly where you might know them from. For most people, this only happens every once in a while. For the most part, when you see someone who you have met or know on a personal level, you are able to recognize who they are. For one percent of the population, however, this feeling is much common. These individuals a condition known as prosopagnosia.

Agnosia is a disorder where individuals are unable to recognize objects or people, due to some sort of trauma to the brain. Prosopagnosia, or facial agnosia, is a specific branch in this type of disorder where individuals are not able to recognize faces. The causes for prosopagnosia can vary but typically are based in some sort of abnormality in the parts of the brain that relate to facial recognition, like the fusiform gyrus and the visual cortex. There are varying levels of severity to the disorder. In some cases, the individual could have a hard time recognizing faces and putting a name to the person. In more severe cases, an individual might not be able to tell the difference between a face and any other object. These abnormalities can be congenital, with an individual having this disorder their entire life, or it can be caused due to some sort of neurological damage, like a stroke or traumatic brain injury.

People with prosopagnosia have to use compensatory strategies to help them recognize others. They might rely on clues such as hairstyle, clothing, or voice to help identify who a person is, but this method is not perfect. As one woman who live with prosopagnosia said, if her curly hair mother straightened her hair, she wouldn’t be able to tell who it was. She couldn’t recognize an ex-boyfriend at a bar when after he got a haircut and she was wearing heels, so the height difference was off.

As you could probably imagine, this can be extremely isolating. Not being able to know who is around you and recognize your loved ones would be terrifying. It can also be extremely dangerous, especially if you don’t know that you have this condition. Individuals have accidentally cheated on their spouses, thinking that they are with their partner and not a stranger.  Children with the condition could be easily kidnapped, as they would think that they are with someone they know. If you aren’t aware that you have this condition, you wouldn’t know to look out for these situations.

What is alarming is that it is not that uncommon of a condition, but not many people may know that they actually have this disorder. If you would like to compare how well you can recognize faces compared to others, there are online tests that can be done such as this one, . While the results of these tests should be taken with a grain of salt, it is informative to see how well you can recognize faces, as well as get a better insight into what it might feel like to have face blindness.

Work Cited:

(n.d.). Retrieved from

Agnosia. (n.d.). Retrieved from

Information About Prosopagnosia. (n.d.). Retrieved from

Information About Prosopagnosia. (n.d.). Retrieved from

Prosopagnosia Information Page. (n.d.). Retrieved from

Prosopagnosia: How face blindness means I can’t recognize my mum. (2016, July 01). Retrieved from

Thomas, C., Avidan, G., Humphreys, K., Jung, K., Gao, F., & Behrmann, M. (2008). Reduced structural connectivity in ventral visual cortex in congenital prosopagnosia. Nature Neuroscience,12(1), 29-31. doi:10.1038/nn.2224


Neurodegenerative Disorders

An Impossible Choice -A Look at Huntington Disease

You notice your mother has been having harder time controlling her movements than usual. She has been more irritable and forgetful than usual, and has had jerky, uncontrolled movements on her arms and face. When you speak to her doctor, he diagnoses her with a specific disorder, one that is known for being highly heritable. He asks whether you would like to be tested to see if you too have the gene for this disorder. Not only do you have to grapple with the fact that your mother has this disease, but now you also need to consider the fact that you might also be carrying the mutation for this disease. Seems like a stressful situation? For family member’s with Huntington Disease, this is the situation that they find themselves in.

Huntington disease is a neurological disorder that causes motor difficulty, specifically involuntary jerking and twitching, as well as emotional and cognitive difficulties.  The disease is progressive, meaning that once the initial symptoms set in, they tend to become considerably worse over time. Typically, individuals with adult-onset Huntington disease live for 15 to 20 years after they begin to show symptoms.

What makes Huntington disease very unique is the fact that it is known to be highly heritable, with a well documented genetic mutation that has been known about since 1993. This mutation is an autosomal dominant trait, meaning that if a parent has this disease and passes the gene down to you, you would almost certainly develop the disease at some point during your lifetime.

Though a lot is known about the genetic causes of Huntington’s disease, unfortunately, the reasoning for why this mutation causes can be so devastating not as clear. This means that there is not a current cure for the disease, nor is there a way to slow down the progression of the disease. There are drugs that are available to help with symptom management, specifically mood stabilizers and muscle relaxers, but these can not minimize all of an individual’s suffering. There is a lot of research that is being done about Huntington’s disease. Hopefully, this research that will lead to a solution to cure or slow down the progression of the disease,  but as of right now, while there has been promising studies in other organisms, there are no drugs that are currently available for human subjects.

What would you do if you were in this position? Would you want to know if it is likely for you to develop the disorder and try to get treatment to manage your symptoms early? Doing this would allow you to make plans about your future, and plan for what you like to happen when you start developing this disease. Or, would you rather live in a state of ignorant bliss, and handle the disease whenever you begin to notice the symptoms? A positive test result can mean a lot of things emotionally, and also can impact your insurance and employment. Whether you would decide to take the test or not, the decision is not an easy one, and one that an individual should not take lightly. Since this is such a recent field, there is still a lot of confusion as to what the results of a genetic test like this could mean. Any type of genetic testing involves many ethical considerations, especially in regards to who can be allowed to view the results of the test.


Works Cited:

Huntington disease – Genetics Home Reference – NIH. (n.d.). Retrieved from

Huntington’s Disease. (n.d.). Retrieved from

Huntington’s disease. (2018, May 16). Retrieved from

Learning About Huntington’s Disease. (n.d.). Retrieved from


Vonsattel, J. P., MD, & DiFiglia, M., PhD. (1998). Huntington Disease. Journal of Neuropathology and Experimental Neurology, 57(5), 369-384.

Neurocognitive Disorders

HAND-y Information about HIV Associated Neurocognitive Disorder

HIV. This is a disease that 1.1 million people in the United States are currently living with and is also known for many devastating outcomes. In the early stages, HIV, or human immunodeficiency virus, is commonly associated with fevers, chills, rashes, fatigue and muscle ache. As the disease progresses, the symptoms only worsen, especially after the progression to AIDS (acquired immunodeficiency syndrome). These symptoms include rapid weight loss, night sweats, sores, pneumonia, extreme tiredness, and depression. What many people do not realize is that these are not the only challenges that come along with a diagnosis of HIV. One of the major issues that these individuals face is a complex neurological problem, also known as HIV associated neurological disease.

HIV associated neurological disease, or HAND, describes cognitive impairments that individuals with HIV face, and while it is not one of the more commonly discussed issues, the consequences can be dire. Some of these difficulties include slowed processing, deficits in memory and attention, issues with fine motor control and behavioral changes. The most commonly reported issues and the ones with the most significant impacts are with executive and motor skills, as well as information processing. There are two different classifications of HAND: HIV associated mild neurocognitive disorder (MND), and the more severe HIV associated dementia (HAD). To be diagnosed with MND, an individual must have symptoms that impair their daily functioning, and either they or someone they are close to must have observed reduced mental acuity, and challenges in work, at home, or in social functioning. For a diagnosis of HAD, there must be impairment in at least two different cognitive domains, and these impairments must significantly impact their daily functioning.

One question that you might be having is why do cognitive impairments even occur if HIV infects immune cells? Does it also infect neurons themselves? The reason why HIV is commonly associated with neurological issues is due to the fact that infected immune cells are able to travel across the blood-brain barrier as early as a hours after infection. These infected immune cells release different chemicals that are able to induce neural apoptosis or cell death. This is linked to reduced volume of the hippocampus and frontal lobe, which has been connected to neurocognitive impairment. On top of this, HIV is linked with spinal cord and peripheral nerve pathology that could be linked to these impairments as well.

While this may seem like a very bleak diagnosis, all hope is not lost. There are medicines that can be used to help treat HAND. Most of these treatments are aiming to achieve viral suppression, minimizing the impacts of HIV on the body as a whole, and not specifically the cognitive issues. The benefits that these medicines are expected to have include increased concentration, alertness and memory. In addition to these medicines, there are also non-pharmacological treatments that can be used, the most important method of which is living an all-around healthy lifestyle. This includes a healthy diet, physical activity, and mental and social engagement. It is also very important to make sure that the individual gets a good amount of sleep, as disruptive sleep is known to impact memory and thinking.


Anand, P., Springer, S. A., Copenhaver, M. M., & Altice, F. L. (2010). Neurocognitive Impairment and HIV Risk Factors: A Reciprocal Relationship. AIDS and Behavior, 14(6), 1213-1226.

Content Source: HIV.govDate last updated: May 15, 2017. (2018, September 25). Symptoms of HIV. Retrieved from

Weill Institute For Neurosciences. (n.d.). A Healthcare Provider’s Guide to HIV-Associated Neurocognitive Disorder (HAND): Diagnosis, pharmacologic management, non-pharmacologic management, and other considerations. Retrieved from Dementia_Providers_11-6-17.pdf


Neurocognitive Disorders Neurodegenerative Disorders

Going Back to School: Adult Day Care

When someone says “daycare”, what is the image that pops into your head? Primary colors abound the alphabet on the walls, and the smell of crayons heavy in the air. And obviously, children running around playing, possibly with paint from arts and crafts on their shirt or remnants of snack time on their face, with a teacher or two trying to wrangle them all in. This is what a daycare center entails… or is it? While the term daycare might be commonly associated with young children who are being cared for while their parents are in work, there is another population that has been using daycare: elderly individuals with dementia.

Adult day care centers for individuals with dementia have become increasingly popular to help engage the growing number of individuals suffering from dementia and help alleviate the stress off of their caregivers. Currently, there are 50 million people with dementia around the world, and approximately 10 million new cases are being diagnosed every single year. With this massive population that is just growing, there need to be effective ways to help minimize the suffering that the individuals and their families face.  This is where adult day care center can come into play.

One particular center in Chula Vista, California that opened up earlier this year was designed to look like a town square from the 1950’s, a time when most of these patients were young. The town has 14 activity centers that appear to be storefronts, with anything you can think of it a town: vintage clothing stores, a gas station with a Thunderbird, dinner, movie theater and more. This specific center is trying to engage the participants by using what they call reminiscence therapy, trying to promote socialization by creating an environment where their memories are more easily recalled.

Though not every center uses such elaborate techniques, simpler applications of these principles are used in other centers. They try to engage these people by allowing them to socialize and participate in a variety of activities. Some of these activities could include outings, pet therapy, counseling and therapy, health services, behavior management, along with recreational activities like music and art.

Using the Montessori method, which is commonly used to teach social, cognitive and functional skills to children, has been found to be beneficial in this setting to engage individuals socially and with their environment. This can be extremely helpful in minimizing behavioral issues that are common among dementia patients, especially apathy and agitation.  Along with potentially helping behavioral and cognitive symptoms, these patients may also foster physical improvements. This population often is associated with degrees of frailty and fall risks. By being a part of a program like this, there may be improvements in gait, especially after longer participation.

With so many people suffering from dementia, be it a specific form such as Alzheimer’s or any other form, there will also inherently be an increase in the number of people that care for them. Currently, according to the Alzheimer’s Association,  16.1 million Americans provide unpaid care for people with Alzheimer’s or other dementias. Caring for someone with dementia can take an incredible toll on caregivers, one-third of who are 65 years old and older. The sandwich generation, as they are called, are responsible for not only caring for an aging family member but also a child under 18. These individuals make up approximately one-fourth of all caregivers. Could using an adult daycare service be beneficial to the caregivers, on top of being helpful for those with dementia?

The short answer: yes! Studies have shown that after only a three month period, caregivers who used an adult daycare service had significantly fewer feelings of overload and strain, as well as lower levels of depression and anger. The reasoning for this may be that having the adult daycare gives the caregiver more time to do other necessary tasks, allowing them to feel less stressed. It was also found that for caregivers with a family member that had their memory symptoms improve when using the adult daycare, there was a correlation with a reduction of overload, or feeling mental and emotionally drained.

By away giving a break to the caregiver and an avenue for socialization for someone with dementia, adult day care seems to be an amazing opportunity. Hopefully, this will become more accessible to a greater number of people, with increasing the number of locations worldwide and decreasing the cost or having this service be covered by more insurances. To find out more information about how to find an adult day care center near you, check out the Alzheimer’s Association’s resources!  


Adult Day Centers. (n.d.). Retrieved from

Dementia. (n.d.). Retrieved from

Facts and Figures. (n.d.). Retrieved from

Hageman, P. A., & Thomas, V. S. (2002). Gait performance in dementia: The effects of a 6-week resistance training program in an adult day-care setting. International Journal of Geriatric Psychiatry, 17(4), 329-334. doi:10.1002/gps.597

Judge, K. S., Camp, C. J., & Orsulic-Jeras, S. (2000). Use of Montessori-based activities for clients with dementia in adult day care: Effects on engagement. American Journal of Alzheimers Disease, 15(1), 42-46. doi:10.1177/153331750001500105

Powell, R., & Pawlowski, A. (2018, April 10). Dementia day care looks like 1950s town to stimulate patients’ memories. Retrieved from

Steven H. Zarit, Mary Ann Parris Stephens, Aloen Townsend, Rickey Greene; Stress Reduction for Family Caregivers: Effects of Adult Day Care Use, The Journals of Gerontology: Series B, Volume 53B, Issue 5, 1 September 1998, Pages S267–S277,

Zarit, S. H., Stephens, M. A., Townsend, A., & Greene, R. (1998). Stress Reduction for Family Caregivers: Effects of Adult Day Care Use. The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 53B(5). doi:10.1093/geronb/53b.5.s26

Neurocognitive Disorders

Searching for the Right Words: Living with Aphasia

Imagine waking up one morning and forgetting how to speak your native language, the one you have spoken for most of your life. Your loved ones try speaking to you, and while you know how you’d like to respond, you just can’t seem to find the words to say. You become tongue-tied, embarrassed, and increasingly frustrated when no one can seem to understand the words that you do get out of your mouth. Trying to write what you are thinking is to no avail as well. You feel isolated in your inability to communicate, stranded on an island with no way to get off. Now, imagine living like this every day.  For close to two million Americans, this, or something similar to this, is their everyday existence. This is known as aphasia.

Aphasia is a cognitive disorder that involves the loss of language function, particularly in regards to speaking, reading, and writing. Though commonly considered to be a speech disorder and treated by speech-language pathologists, aphasia has origins in the brain. Aphasia is most often the results of a stroke, but can also come from other traumatic brain injuries, brain tumors, or other neurological issues. There are several different treatment options available, but recovery is often very slow and laborious, and a full recovery is not often seen.

As language is something that many people take for granted, it may be hard to conceptualize the cognitive difficulties that these individuals are facing.  Wheeler E. Hubbard, a man who has been suffering from aphasia, describes what his personal experience with aphasia:

“Imagine that you are playing bingo. My brain is like the drum that they turn to pick a number.  I have about 2,000 words in my brain. To speak, I have got to go into the “drum” and find the word that I want, concentrate on it, bring it to my mouth and figure out how to say it, what tense to make it, then get it in the right order in the sentence.  Something you take for granted takes all my effort, energy, and concentration to do.”

While this is one individual’s experience with living with aphasia, aphasia can actually mean different things depending on what area of the brain is impacted. There are three major categories of aphasia: Wernicke’s, Broca’s and Global aphasia. Wernicke’s aphasia is the most common type of fluent aphasia, meaning that a person ’s sentences may sound completely fluent, but the word choice can have no meaning, contain extra words, or even use made-up words. Individuals with Wernicke’s aphasia do not often recognize that they have made any mistakes in their sentences, and often have difficulty understanding what others say. Broca’s aphasia, on the other hand, is nonfluent aphasia. This means that they may understand speech and know what they want to say, but have a hard time producing sentences. They may omit smaller words and speak in shorter phrases. They are more likely to recognize their mistakes and become frustrated. Global aphasia is a more severe type of aphasia. These individuals may only be able to say a few words, repeat the same phrase over and over again, and have severe difficulties understanding others.

Now that you are well armed with the knowledge of aphasia, a question you might be having is “How can I communicate with someone with aphasia?” Though it depends on every individual, here are a few suggestions!

  1. Allow the individual time to speak. Trying to offer up words and finishing the individual’s sentences, may make them feel like you are rushing them or do not care about what they have to say.
  2. Try to find non-verbal ways to communicate, such as gestures, facial expressions, or even drawings. This will allow for the conversion to rely not so heavily on language.
  3. Give them praise when they are able to say or pronounce something clearly, and downplay any mistakes that they might make. This does not mean pretending that every single word is perfect if it isn’t; lying to them will not make the situation any better, especially if they can tell that you are lying.
  4. Make sure that you do not come across as speaking down to them. Though it may seem like you are trying to be nice and use simple words to communicate, as if talking to a child, it’s important to remember that this individual is still an adult, and should be treated as one.

Ultimately, the most important thing that you can do is to be empathetic. Understand that however frustrated you are with your inability to communicate with an individual with aphasia, that they are most likely frustrated with themselves. Showing the individual that you care by including them in conversations and allowing them the space to talk reminds them that they do have people who care about them and want to communicate with them.


Aphasia. (2018, June 15). Retrieved September 30, 2018, from

Aphasia FAQs. (n.d.). Retrieved September 30, 2018, from

Communication Tips. (n.d.). Retrieved from

My Story of Aphasia. (2015, February 25). Retrieved from

Neurocognitive Disorders

Neurocognitive Disorders: What Are They?

When people think about different types of disorders that can affect the brain, many different things might come to mind. Depression, anxiety, epilepsy, autism spectrum disorder and other types of psychological and neurological disorders, probably top the list; however, there are plenty of other disorders that can have a significant impact on daily living and impact a huge number of people. One of these, in particular, is neurocognitive disorders.

Now, you might be asking yourself “what is a neurocognitive disorder?” If you are, don’t fret, there’s a reason you might not be as familiar with the diagnosis. The diagnosis of neurocognitive disorders was only added to the DSM-V, the most recent iteration of the manual. Prior to that, the closest diagnosis that existed was Delirium, Dementia, Amnestic, and Other Cognitive Disorders. The current diagnosis of neurocognitive disorders covers individuals with cognitive decline across many domains. While this might sound complex, this means that individuals who have issues with attention, executive functioning, like planning and organization, memory and/or language, that causes some significant level of impairment in their daily functioning would meet the qualifications to be diagnosed with a neurocognitive disorder.

There are two different methods that are used to classify neurocognitive disorders. The first way is by establishing the severity of symptoms with one of two diagnoses: major and minor neurocognitive disorders. For individuals that feel there are severe decline and significant impact on daily functioning, a diagnosis of major NCD would be more appropriate, whereas those with a mild decline and modest impairment would most likely be diagnosed with minor NCD. While some health care providers feel that the division between the two disorders are unnecessary and even artificial, most find this division to be helpful in terms of establishing a diagnosis much earlier than it has been previously.

The other classification within these diagnoses are based on the etiology, or the underlying issue, causing the neurocognitive issues. Some examples of these categories include Alzheimer’s NCD, vascular NCD, and frontotemporal NCD. This can be extremely helpful to specify what type of treatment an individual should be receiving. For example, the term dementia is frequently used synonymously with neurocognitive disorders. Using this term, however, might cause some to think that the associated disorders are exclusively Alzheimer’s disease, Lewy body disease or other types of neurodegeneration. These, however, are not the only types of diseases or disorders that can cause neurocognitive disorder to be diagnosed. Parkinson’s disease, vascular disease, HIV, substance abuse, traumatic brain injury and Huntington’s disease are all highly related with the cognitive decline that can be classified as a  neurocognitive disorder. Each of these specific diseases and disorders may all have a different underlying reason for how the cognitive issues came about, and therefore most likely would need different types of treatments to help resolve the symptoms that the individual is facing.

Though this is a new diagnosis, the symptoms that the individuals diagnosed with these disorders are faced with are not new. The prior confusing diagnoses did not fully explain why individuals were having cognitive problems and what these cognitive challenges are. This makes it much more complicated for both those with the diagnosis as well as those who are trying to understand or treat the individual. Hopefully, having a clear diagnosis will allow more people to get treated effectively for these cognitive complaints that come along with so many different diseases and disorders.


Blazer, D. (2013). Neurocognitive Disorders in DSM-5. American Journal of Psychiatry, 170(6), 585-587. doi:10.1176/appi.ajp.2013.13020179

Ganguli, M., Blacker, D., Blazer, D. G., Grant, I., Jeste, D. V., Paulsen, J. S., . . . Sachdev, P. S. (2011). Classification of Neurocognitive Disorders in DSM-5: A Work in Progress. The American Journal of Geriatric Psychiatry, 19(3), 205-210. doi:10.1097/jgp.0b013e3182051ab4

Symptoms of Major Neurocognitive Disorder. (2017, August 24). Retrieved from

Symptoms of Minor Neurocognitive Disorder. (2018, February 04). Retrieved from