Neuropsychologist

Hans-Jürg Casal is a neuropsychologist at the psychiatric unit for children and young people in the Grisons. As well as working in the practice, he also develops diagnostic software.

Hans-Jürg Casal’s interest actually lay in technology and IT when he had to choose his path of study. He was fascinated by artificial intelligence in particular. The native of Chur went to Zurich with a friend with whom he shared an apartment. Everything was unfamiliar and life was quite challenging. When his friend began studying psychology, Hans-Jürg Casal also took an interest in the subject as artificial intelligence was also relevant here. He decided to take a degree in neuropsychology under professor Etienne Perret at the University of Zurich’s Institute of Neuropsychology. He took psychotherapy and curative education as minor subjects.

The computer as a problem-solver

He initially focused on machines rather than people. This nevertheless changed when he had to work with people in a clinical practice. Another area of interest was awakened. However, he returned to the subject of artificial intelligence for his thesis. He aimed to program a computer to simulate human thought processes, or at least in part. More specifically, this involved the strategic management of a virtual city taking account of various factors, such as the number of inhabitants, health, prosperity, happiness and education. The probands could make investments and had to deal with non-variable factors that suddenly arose. He then tried to teach the computer this problem-solving behaviour. “The thesis was great fun and extremely instructive.

It not only enabled him to enhance his programming skills but also to improve his own cognitive abilities. He learned how to systematically approach problems and produce solutions. These skills are also beneficial in everyday life.

Digital neuropsychological tests

On top of his degree course, he also developed diagnostic software, involving computer-based, neuropsychological tests and their automatic evaluation, as part of a research internship at the institute. “We produced a test battery based on norms for people of the same age.” Attention, memory, perception and executive functions are tested. The participants, including professor Etienne Perret, founded a company called Candit.com, which still exists today, as an upshot of the project. Hans-Jürg Casal lectured and held a scientific post at the neuropsychological institute for 13 years after graduating. Perret then had to close down the institute due to his age.

Cognition and emotion in tandem

Having now qualified as a neuropsychologist, he and his wife decided to move back to Chur in 2003 as a baby was on the way. Hans-Jürg Casal was now dealing with children both at home and professionally as a neuropsychologist at the psychiatric unit for children and young people in the Grisons. The move into psychotherapy was also new to him and made him aware of an important finding: “Cognition is not independent of emotion and vice-versa. Neuropsychology as a science has also only increasingly recognised this recently.” This had a major impact on his work in terms of interdisciplinary contact but also the development of the test battery which now also extended to emotions.

Expert opinions for invalidity insurance

His main task in psychiatry is drawing up expert opinions for invalidity insurance. For example, a young man suffers a traumatic brain injury. He visits the practice where Hans-Jürg Casal spends a half to a full day assessing him, mainly via computer. This produces a performance profile of the brain functions indicating capabilities and deficiencies compared with peers with healthy brains. A detailed report now has to be drawn up which answers various questions: What impact will the injury have on academic and professional performance? What support can be provided for the youngster? Which factors must be taken into account? What resources and forms of professional support exist? The report usually covers a single discipline. It can nevertheless sometimes be interdisciplinary: “The psychiatrist from the institution and I then sit down together and draw up an expert opinion from a psychiatric perspective, on one hand, and a neuropsychological one on the other.” This means that both emotional and relational aspects are adequately taken into account as contextual factors.

Consultation for those concerned

Hans-Jürg Casal’s job is then usually done – even though the process is not actually complete. What does the teacher or employer now do with this information? How should relatives deal with the situation? How can appropriate support be provided for those concerned? In addition to meetings with the invalidity insurance representatives, Hans-Jürg Casal therefore also provides consultations for the other persons affected and is involved in the actual integration process in an advisory capacity if required. However, it has long been the case that such support services are not always taken up which Hans-Jürg Casal very much regrets. In contrast to adults, in the case of children and young people it is not generally a matter of providing a basis to assess the level of invalidity insurance benefits but instead enabling optimal integration and a high degree of independence. “That’s what makes this job so exciting. I can help ensure that the person concerned does not even need to rely on benefits in the best-case scenario.”

Finding motivation in learning new things

Hans-Jürg Casal continually undertakes further training to keep up to speed with the latest developments which is no mean feat in neuropsychology at the moment. Regularly reading specialist journals, taking part in conferences and discussing matters with colleagues are all part of his routine. He also finds contact with interns who bring the latest knowledge directly from the universities incredibly helpful. In future, Hans-Jürg Casal hopes to focus more on research again. While he is providing the test system for several research projects, he would also like to tackle his own research issues. However, this desire certainly does not come from any sort of discontentment – quite the opposite as he very much enjoys his job.