The Adult Neuropsychological Assessment
Why this assessment?
A neuropsychological assessment provides a “road map” for diagnosis and intervention by systematically probing abilities and behaviors that correspond to specific aspects of brain function and social-emotional processes. Processing information, working quickly, remembering information, and juggling work/home related tasks can be very frustrating for the adult with selective medical, developmental, and educational disorders. Compromises in these areas can directly impact work and daily life functions.
A neuropsychological assessment provides an accurate and thorough evaluation of cognitive and social-emotional processes that are important to consider in the diagnostic and intervention planning phases. The type of neuropsychological assessment will vary depending on its purpose. An assessment may be required by the referral source to determine the etiology underlying the suspected difficulties that the individual is experiencing on a daily basis. Specifically, an assessment may be required to identify and describe a life-long learning disability, to determine whether an individual's presenting complaints are related to brain and/or emotional involvement, or in determining an individual's ability to benefit from a particular medical treatment or rehabilitation program.
In summary, a neuropsychological assessment is an integral and necessary component of the diagnostic process. It is crucial for providing direction for medical/educational team management and remediation planning purposes.
How does it differ from a neurological evaluation?
The neurological evaluation generally involves examination of the basic motor and sensory functions (strength, reflexes, sensitivity to touch, and coordination) and of basic thinking skills including functional communication (speech and language), orientation to person, place, time, and circumstances, simple memory functions, and an ability to follow basic commands.
The most sensitive indicators of head injury, learning disabilities, etc., are often weaknesses in subtle and complex cognitive and behavioral functions. It is these functions among others that are assessed in the neuropsychological evaluation. The neuropsychological evaluation will assess an individual's intellectual, language functions, attentional and concentrational skills, motor skills, sensory perceptual skills, auditory perception skills, verbal learning and memory skills, visual learning and memory skills, visual perceptual skills, executive functions, achievement, as well as social-emotional levels. Unlike the neurological evaluation, the neuropsychological assessment measures these areas in depth using standardized objective systematic tests. The performance of the individual is then analyzed using both normative and individual comparison standards for measuring the relative strengths and weaknesses of neuropsychological systems
How does it differ from psychological testing?
The psychological assessment focuses on the intellectual and social-emotional areas whereas the neuropsychological evaluation targets these areas and also measures the domains of cognitive, achievement, behavioral, regulatory, and adaptive functioning levels in the context of an individual's current and previous functioning.
What is appropriate training for a neuropsychologist?
The neuropsychologist will have a doctoral degree in psychology and a certificate of completion from an American Psychological Association (APA) accredited post-doctoral residency program in neuropsychology. A strong background in neuropathology (including familiarity with neuroanatomy and neurophysiological principles), cognitive psychology (including understanding of the complex, multifaceted, and interactive nature of cognitive functions), and in clinical psychology (including knowledge of psychiatric syndromes and of test theory and practice) is necessary per standard guidelines (Division 40 Clinical Neuropsychology of APA).
How long will the assessment take?
Each assessment is tailored to the individual since the reasons for the assessment will vary. A specific “core” of tests will be administered with additional tests being performed depending on the compromises seen. The tests will identify the areas of strengths and weaknesses and will allow for specific treatment planning.
Generally, the testing session will last between six and seven hours, with time given for breaks as needed. If necessary, testing can be accomplished over the course of two testing sessions. A clinical interview prior to the testing is necessary in order to gather information about the individual's presenting complaints and discuss relevant background information. In addition, interviews with significant others, i.e., parents, spouses, grandparents, may be obtained given the individual's approval.
What do I need to bring to the first testing session?
Please bring any copies of previous assessments, educational records, and neurological/psychiatric records for background information review purposes. Remember to bring glasses and hearing aids if these are applicable. Also, we suggest that you eat breakfast prior to the time of the assessment and wear comfortable clothes. Breaks are provided during the testing session(s) and approximately an hour for lunch is taken.
What happens before the assessment?
An intake with the the patient or someone who knows the patient well is done by the office manager, Scott Mellor. He will obtain a "thumbnail sketch" of what is of concern with the patient. He will then explain the testing process. Any questions concerning insurance, etc., can be answered by Mr. Mellor. At that point, an appointment can be scheduled for the assessment. He will then send you a packet by email, fax or letter confirming the appointment. This confirmation package will have directions to the office, the consent form, the Health Insurance Portability and Accountability Act (HIPAA) form, and the office policies form for you to read, sign, and return to us.
The process of the neuropsychological assessment:
The neuropsychologist will interview the patient and any significant others that the patient would like concerning the presenting situation and for relevant background information purposes. Records can be mailed, faxed, or emailed to the office before the final analysis is completed. The patients and significant others will also be given packages and rating scales at the time of the patient interview. As mentioned previously, sometimes a second session will be scheduled after the completion of the first session.
After the assessment is complete, and all of the required documentation has arrived, the neuropsychologist will review the records, score, interpret the data, dictate the report, and provide feedback to professionals for whom the patient has given us a release. A feedback session will be scheduled with the patient within approximately 14 working days in order to discuss the test results. Patients are encouraged to call the neuropsychologist if there are any questions after their feedback session and after they review the report. The neuropsychological report will be given to the patients and any professional that they request. No report will be sent out from the office without the consent from the patient.
What should I do if I have more questions?
Our office provides specialized, up-to-date services in the following areas:
- Accommodations for elementary, middle, high school, and college
- Accommodation requests such as the ACT, GMAT, GRE, LSAT, MCAT, SAT, SSAT
- Attentional disorders
- Autism spectrum disorder
- Carbon monoxide poisoning
- Cerebrovascular disease
- Chronic fatigue
- Cognitive behavioral therapy (CBT)
- Cognitive changes following rehabilitation or educational remediation
- Concussion education
- Decompression illness
- Disability assessment
- Emotional disorders associated with neurological diseases, developmental delays
- Executive disorders (e.g., initiation, working memory, planning, organization, time management, emotional dysregulation, monitoring, shifting, impulsivity)
- Expert review of reports (clinical and forensic)
- Fetal alcohol spectrum disorders
- Forensic evaluations
- Genetic disorders such as Fragile X
- Geriatric assessment
- Independent medical examination (IME)
- Language disorders
- Learning disability and weakness (reading, written expression, mathematics)
- Low birth weight
- Memory disorders, including dementia
- Neuropsychiatric disorders (anxiety, depression, mood instability, psychosis)
- Neurotoxin exposure
- Other neurological and neuropsychiatric conditions
- Post-chemotherapy disorders
- Posttraumatic stress disorder
- Pragmatic and social communication disorders
- Seizure disorder
- Substance use disorders
- Tourette’s syndrome
- Traumatic brain injury, including post-concussion syndrome