Neuropsychological Assessment

A neuropsychological evaluation typically begins with a comprehensive clinical interview. The information collected during the interview is used to develop a contextual understanding of an adult or child, their history, and their current cognitive, emotional, and functional strengths and weaknesses.

 

The clinical interview may incorporate the collateral report of parents, family, friends, and/or educators, as well as a review of available medical, academic, and/or legal records as needed. The clinical interview is followed by a comprehensive assessment of brain function using standardized tests.

 

Tests may include paper and pencil, manual/visual/auditory stimuli, as well as computer-based measures of various domains of cognitive functioning as deemed clinically appropriate to the referral question. Test results are then interpreted in the context of a person's clinical history and current functioning to inform clinically indicated diagnoses and treatment recommendations. 

Various domains of functioning that may be assessed include: Intelligence, Academic skills, Attention and Executive Functioning, Memory and Learning, Problem Solving, Language, Perceptual and Motor Abilities, as well as Emotional/Behavioral Functioning and Personality.

 

Adult

Neuropsychological Evaluations

How can a neuropsychological evaluation help?

Depending on the referral question, a neuropsychological evaluation may:
 

  • Confirm or clarify a diagnosis.

  • Generate a profile of strengths and weaknesses to guide educational, rehabilitation, or vocational interventions, or other treatments.

  • Help patients and their families to understand the difficulties that brought them to seek the evaluation. Treatment options and compensatory strategies are targeted to improve functioning and help patients and families achieve the best possible outcomes.

  • A neuropsychological evaluation can be very effective in the documentation of the effects of treatment on specific deficits over time. Comparisons made between evaluations can also help to clarify the progression and course of changes in cognitive functioning (i.e., improvement or decline), which can be of interest for certain disorders.

  • A neuropsychological evaluation can also be a critical element in the process of disability determination, or for forensic (legal) purposes.

  • Additionally, neuropsychological evaluations may result in a referral to other specialists such as educational/learning intervention specialists, neurologists, psychiatrists, psychologists, as well as various Federal, State and Local social services/programs. 

Happy Couple

When is a neuropsychological evaluation needed? 

A neuropsychological evaluation is indicated when impairment in cognitive, behavioral, and/or emotional functioning is suspected. Referrals are usually made to rule out a particular condition(s) and/or to describe their impact on a person’s functioning:
 

  • Traumatic Brain Injury (TBI)

  • Stroke

  • Alzheimer's Disease and Other Dementias

  • Seizure Disorders

  • Medical Illnesses or Treatments

  • Effects of Toxic Chemicals or Chronic Substance Abuse 

  • Attention-Deficit/Hyperactivity Disorder (ADHD)

  • Psychiatric or Neuropsychiatric Disorders

Who is qualified to conduct a neuropsychological evaluation?

Neuropsychological evaluations should only be conducted by Clinical Neuropsychologists. Clinical Neuropsychologists are psychologists with expertise in the assessment of cognitive, emotional, and adaptive functioning, as well as the clinical interpretation of test findings, the generation of appropriate diagnoses, and the provision of treatment recommendations. Clinical Neuropsychologists specialize in the application of assessment and intervention principles based on the scientific study of human behavior across the lifespan as it relates to normal and abnormal functioning of the central nervous system.

Clinical Neuropsychologists should have a Doctoral-level education in Clinical or Educational Psychology from an accredited institution, followed by two years of specialized postdoctoral training in brain-behavior relationships and neuropsychological assessment. 

 

Pediatric

Neuropsychological Evaluations

How can a pediatric neuropsychological evaluation help?

A pediatric neuropsychological evaluation assists in better understanding your child’s functioning in areas such as memory, attention, perception, coordination, language, and personality. This information will help you and your child’s teacher, therapists, and physician provide treatments and interventions for your child that will meet his or her unique needs. Pediatric neuropsychological evaluations are appropriate for children and adolescents ages 6 to 18.  

Why are children referred for neuropsychological evaluation and what is assessed?

Children are referred by a doctor, teacher, school psychologist, or other professional because of one or more problems, such as:

  • Difficulty in learning, attention, behavior, socialization, cognitive/developmental delays, or emotional issues

  • A disease or inborn developmental concern

  • A brain injury from an accident, birth trauma, or other physical stress


A typical neuropsychological evaluation of a school-age child may assess these areas: 

  • General intellect abilities

  • Academic Achievement skills, such as reading and math

  • Executive skills, such as organization, planning, inhibition, and mental flexibility

  • Attention

  • Learning and memory

  • Language

  • Visual–spatial skills

  • Motor coordination

  • Behavioral and emotional functioning

  • Social skills


Some abilities may be measured in more detail than others, depending on the child’s needs. A detailed developmental history and data from the child’s teacher may also be obtained. Observing your child to understand his or her motivation, cooperation, and behavior is a very important part of the evaluation. Emerging skills can be assessed in very young children. However, the evaluation of young children is usually shorter in duration, because the child may not yet have developed many skills. 

What should I expect and how should I prepare for my child's evaluation?

A neuropsychological evaluation usually includes an interview with parents about the child’s history, observation of and interview with the child, and testing. Testing involves paper and pencil and hands-on activities, answering questions, and sometimes using a computer. Parents may be asked to fill out questionnaires about their child’s development and behavior. 

A trained examiner, or technician, may assist with the administration and scoring of tests, so your child may see more than one person during the evaluation. Parents are usually not in the room during testing, although they may be present with very young children. The time required depends on the child’s age and the referral question.

Please be sure to:

  • Make sure your child has a good night’s sleep before the testing. 

  • If your child wears glasses or a hearing aid or any other device, make sure to bring it. 

  • If your child has special language needs, please alert us to these. 

  • If your child is on stimulant medication, such as Ritalin, or other medication, check with the us beforehand about coordinating dosage time with testing. 

  • If your child has had previous school testing, an individual educational plan, or has related medical records, please bring or send this information and records to the neuropsychologist for review. 


What you tell your child about this evaluation depends on how much he or she can understand. Be simple and brief and relate your explanation to a problem that your child knows about such as “trouble with spelling,” “problems following directions,” or “feeling upset.” Reassure a worried child that testing does not involve “shots.” Tell your child that you are trying to understand his or her problem to make things better. You may also tell the child that “nobody gets every question right,” and that the important thing is to “try your best.” Your child will probably find the neuropsychological evaluation interesting, and the detailed information that is gathered will contribute to your child’s care.

What will the results tell me about my child?

By comparing your child’s test scores to scores of children of similar ages, the neuropsychologist can create a profile of your child’s strengths and weaknesses. The results help those involved in your child’s care in a number of ways.
 

  • Testing can explain why your child is having school problems. For example, a child may have difficulty reading because of an attention problem, a language disorder, an auditory processing problem, or a reading disability

  • Testing also guides the pediatric neuropsychologist’s design of interventions to draw upon your child’s strengths. The results identify what skills to work on, as well as which strategies to use to help your child.

  • Testing can help detect the effects of developmental, neurological, and medical problems, such as epilepsy, autism, attention deficit hyperactivity disorder (ADHD), dyslexia, or a genetic disorder. Testing may be done to obtain a baseline against which to measure the outcome of treatment or the child’s development over time.

  • Different childhood disorders result in specific patterns of strengths and weaknesses. These profiles of abilities can help identify a child’s disorder and the brain areas that are involved. For example, testing can help differentiate between an attention deficit and depression or determine whether a language delay is due to a problem in producing speech, understanding or expressing language, social shyness, autism, or cognitive delay. 

  • Most importantly, testing provides a better understanding of the child’s behavior and learning in school, at home, and in the community. The evaluation can guide teachers, therapists, and you to better help your child achieve his or her potential. Additionally, we can also work with your physician to combine results from medical tests, such as brain imaging or blood tests, to help diagnose your child’s problem.

Who is qualified to conduct a neuropsychological evaluation?

Neuropsychological evaluations should only be conducted by Clinical Neuropsychologists. Clinical Neuropsychologists are psychologists with expertise in the assessment of cognitive, emotional, and adaptive functioning, as well as the clinical interpretation of test findings, the generation of appropriate diagnoses, and the provision of treatment recommendations. Clinical neuropsychologists specialize in the application of assessment and intervention principles based on the scientific study of human behavior across the lifespan as it relates to normal and abnormal functioning of the central nervous system.

Clinical Neuropsychologists should have a Doctoral-level education in Clinical or Educational Psychology from an accredited institution, followed by two years of specialized postdoctoral training in brain-behavior relationships and neuropsychological assessment. 



[Adapted from: Public Interest Advisory Committee, Division 40 (Clinical Neuropsychology), American Psychological Association,© 2001 Division 40, APA]

Kids Playing