Neuropsychologist aims to grow diversity in her field, help cancer survivors ‘live better’
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Natalie Kelly, PhD, ABPP, is one of few Black women board-certified in both neuropsychology and pediatric neuropsychology in the oncology field.
Her path began while studying child development with an initial goal of treating children with epilepsy, but after a 1-year rotation of working with young patients with brain tumors, she refocused her career path and combined neuropsychology and child development.
“Neuropsychology is an area that is not promoted or shown as much attention to in some regards for cancer survivors, regardless of age, but it is a crucial aspect of assessing function,” Kelly, assistant clinical professor of psychology and clinical neuropsychologist in the department of supportive care medicine at City of Hope, said during an interview with Healio. “Our brains direct our behavior and our functioning as humans. Being able to assess that and contribute in that way as a neuropsychologist is crucial, particularly as we have more survivors in oncology, which of course is wonderful. As individuals are living longer, we need to consider how we are going to help them live better, and neuropsychology can play a role in supporting that.”
Kelly spoke with Healio about what led her to practice in this area of medicine, why it is so important to train the next generation of experts in this area, and the importance of diversity in this field and in medicine overall.
Healio: How did this area of medicine become your focus?
Kelly: I first became interested in neuropsychology when I was an undergraduate at Vanderbilt University and Oliver Sacks, MD, a very famous behavioral neurologist, came to speak. I found him and what he spoke about fascinating, and so that became an entry point that sparked my interest.
I had also heard about neuropsychology in my child development coursework, and that resulted in child development becoming my major. Also, my mother was a physical therapist and I remember she received a newsletter about rehabilitation and the feature story was about neuropsychology. As I read more about the specialty, I thought it was fascinating. I knew I wanted to work with children and so I put the brain and pediatrics together and that is how I ended up on the pediatric neuropsychology route.
Healio: Why is it important to train the next generation of experts in this area?
Kelly: It is definitely important, particularly when it comes to oncology. Neuropsychology is a large discipline that is widely applied in a number of different settings in medicine. Neuropsychology is crucial in oncology because across the lifespan, neurological complications can occur across many cancer types and it is important to evaluate neurocognitive function, particularly for cancer survivors. Neuropsychology provides a window into how a person’s cognition can impact their function. There can be an interruption in cognitive function related to different aspects of treatment or lifestyle factors, such as sleep or exercise, that are affected during cancer treatment. When a neuropsychologist can work with a patient with cancer, this provides helpful information about validating their cognitive experiences and changes and also provides education around what may be going on with the etiology of those changes. We can also support and inform recommendations or next steps to help patients with their goals of being functional adults or even adolescents or children in school or educational settings.
Healio: Why is it important to you to have more diversity in the field?
Kelly: Diversity, equity and inclusion are very important in many aspects of our culture and lives in America. Reflecting on this as a professional and as a Black woman, diversity provides really important value to the neuropsychology field in trying to understand human behavior and particularly cognitive aspects related to brain behavior. Culture and ethnicity are a large part of who we are. From a clinical perspective, it is really important to be able to provide patient assessments that are culturally appropriate. Neuropsychology as a discipline is growing in this area in terms of trying to provide assessments of the patient in their native language and thinking beyond the English language, and also thinking about how we develop tests that can be more broadly applied across linguistic groups. This is just one example; there are so many ways that the neuropsychology field is working toward diversity.
Another aspect is with training. I’m involved in training other neuropsychologists; mentoring younger neuropsychologists; and being able to be intentional about how we develop graduate training programs, internships and fellowships for neuropsychology where these individuals are learning cultural competence from the beginning stages of their training and career. I have the opportunity to be involved in these novel efforts that are coming down the pipeline.
Healio: Is there anything else that you would like to mention?
Kelly: Speaking to my oncology colleagues who may not be as familiar with neuropsychology, it is important to consider a patient’s cognitive function as a vital part of their overall functioning. We often think about the physical outcomes, which is natural and important but underlying that is our cognition. For example, how does treatment affect decision-making abilities or learning for children and goal setting or memory? All these things that are integral to who we are and our ability to make our way through this world at any age across the lifespan is an important aspect for clinicians to consider.
For more information:
Natalie Kelly, PhD, can be reached at City of Hope Comprehensive Center, 1500 East Duarte Road, Duarte, CA 91010.
References:
- ASCO Answers: Chemobrain. Available at: https://www.cancer.net/sites/cancer.net/files/asco_answers_chemobrain.pdf. Accessed May 16, 2022.
- American Cancer Society. Chemo Brain. Available at: https://www.cancer.org/content/dam/CRC/PDF/Public/7288.pdf. Accessed May 16, 2022.
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