Plenary A: Presidential Address: Anesthesia: A Wake-Up Call. Part 2. Developmental Risk or Resilience?

Course Date: Wednesday, February 01, 2023

Course Time: 16:30 - 17:25 (04:30 PM - 05:25 PM)

Timezone: America/Los_Angeles

Credit Hours: 1
Instructor(s) Ida Sue Baron

Level of Instruction: Advanced

Ida Sue Baron, Ph.D., ABPP

Clinical Professor Emerita

The George Washington University School of Medicine, Washington, DC

Credit Hours: 1.0

Level of Instruction: Advanced

Plenary A: Presidential Address: Anesthesia: A Wake-Up Call.  Part 2. Developmental Risk or Resilience?

Abstract & Learning Objectives:

This presentation is a clarion call to neuropsychologists to contribute their specialized knowledge to help answer a critical question: Is there a Fetal Anesthesia Syndrome that results in subtle and persistent adverse effects over an individual’s lifespan? Neuropsychologists are uniquely positioned to make substantial contributions to conceptualization, methodology, and interpretation in studies of human exposure to general anesthesia (GA). Part 1, presented at the 2022 INS Barcelona meeting, reviewed preclinical data that documented effects on the central nervous system and long-term behavioral adversities of GA exposure during an animal’s critical growth spurt developmental period. Studies of human adult exposure were also summarized, and attention directed to the absence of prospective studies from childhood to adulthood. Part 2 extends the conversation to GA exposure during the highly vulnerable in utero and early childhood developmental periods. Human retrospective study results began to be published in the early 2000s, and prospective studies only within the last decade. Reports of associations between GA and attentional problems, learning disorder, neuropsychological deficit, and neuropsychiatric disorder are emerging. Yet, due to methodological weaknesses and multiple confounders, clear evidence of causality remains lacking in this nascent literature. A ‘developmentalistic’ way forward for neuropsychologists will be suggested, one using neuropsychological expertise along with the application of innovative technologies that is informed by the extensive preclinical data showing cellular, synaptic, and neural circuitry disruption during critical growth periods and short- and long-term neuropsychological effects.  

Upon conclusion of this course, learners will be able to:

1. Describe types of central nervous system disruption that result in animals following exposure to general anesthesia

2. Identify neuropsychological domains at high potential risk following exposure to general anesthesia during the human critical growth spurt period

3. Explain what is meant by ‘vertical transfer’

Speaker Biography:

Ida Sue Baron, Ph.D., ABPP is President of the International Neuropsychological Society (INS) and Clinical Professor Emerita in Pediatrics at The George Washington University School of Medicine, Washington, DC.  She founded and was Director of Neuropsychology at Children’s National Medical Center (1971-1985) and Georgetown University School of Medicine (1985-1989) in Washington, DC. She evaluated children and adults for the Departments of Neurology, Neurosurgery, and Pediatrics before opening an independent private practice for the next 30 years.  Her honors include the 2007 American Academy of Clinical Neuropsychology Distinguished Neuropsychologist Award, 2014 INS Distinguished Career Award, 2014 American Board of Professional Psychology Award for Service to the Specialty of Clinical Neuropsychology, President of the American Board of Clinical Neuropsychology (2001-2005), Chair of the ABCN Committee on Subspecialization in Neuropsychology and then the Pediatric Subspecialty Committee (2007-2022), and Fellow of the American Psychological Association.  Dr. Baron has authored or edited seven books including Neuropsychological Evaluation of the Child, Second Edition (2018). Her editorial board service included terms as Associate Editor for The Clinical Neuropsychologist and Neuropsychology Review.  Dr. Baron’s research and clinical interests include application of neuropsychological methods to infants, toddlers, and preschoolers, especially the neuropsychological outcomes of children born extremely preterm or late preterm.