The Developmental Neuropsychological Assessment

 

Why this assessment?

Early childhood is a critical period in development. Many different abilities and behaviors are rapidly developing, including a child's cognitive, language, motor, social, emotional, behavioral, play, adaptive, and emerging academic skills. If concerns arise that your child is not making age-appropriate progress in one or more of these domains, they may benefit from a developmental neuropsychological evaluation.

A developmental neuropsychological evaluation can be performed on a child as young as 24 months through the preschool years. Common referral questions include concern for global developmental delay, autism spectrum disorder, language and communication delay, behavioral problems, intellectual disability, emerging attentional or learning difficulties, and effects of pre/perinatal insults, medical, and genetic conditions.

The developmental neuropsychological evaluation will assess a child's cognitive, language, motor, social, emotional, behavioral, play, adaptive, and emerging academic skills in depth using systematic, objective tests. The performance of the child is then analyzed using both normative and individual comparison standards for measuring the relative strengths and weaknesses of these domains.

The neurodevelopmental evaluation will provide: 1) systematic and integrative information about a child's current cognitive, language, motor, social, emotional, behavioral, play, adaptive, and emerging academic skills; 2) diagnostic impressions (if appropriate); and 3) evidence-based recommendations for intervention, tailored to the child's needs. Early identification and intervention is key in promoting a child's overall development.
 

Who refers for an assessment?

Referrals are accepted from parents and professionals involved in the child's care such as school personnel, physicians, attorneys, educational advocates, behavioral, speech-language, occupational, and physical therapists, etc.
 

How does it differ from a neurological evaluation?

A neurologist will typically examine basic motor and sensory functions (strength, reflexes, sensitivity to touch, and coordination) and fundamental 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. A detailed review of a child's medical history is obtained with additional testing ordered as needed given the initial consultation.
 

How does it differ from an evaluation conducted by a developmental pediatrician?

A developmental pediatrician oversees and monitors the medical status of individuals with developmental issues. They often conduct a physical exam, prescribe medication, and perform screenings of neurodevelopmental disorders (e.g., autism spectrum disorder, learning disabilities, etc). A detailed review of a child's medical history is obtained with additional testing ordered as needed given the initial consultation.
 

What is the standard of training for the 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 developmental neuropsychological evaluation take?

Each evaluation is tailored to the child's individual needs and to answer the referral questions. In general, the evaluation will be conducted over several sessions and will include a parent interview and direct testing with the child. A preschool/daycare observation may be performed on a case-by-case basis. The neuropsychologist will administer a set of “core” tests to the child, with additional measures as needed to test hypotheses and answer the referral questions. Interview and direct testing times will vary depending on the needs of the child. Additionally, parent and teacher questionnaire measures will be given to obtain information about the child's functioning at home and school.
 

What do I need to bring to the testing session?

Bring your child's glasses/hearing aids if needed. Make sure that your child gets a good night's sleep before the assessment. Remember to have your child eat breakfast prior to the time of the assessment and wear comfortable clothes. Keep your child on their medication regimen (when applicable) unless their physician requests otherwise. Your child will be provided with breaks and snacks. Please bring your own snacks if your child has individual dietary needs. Please bring any relevant records such as reports by a school psychologist, speech-language therapist, occupational therapist, physical therapist, developmental pediatrician, psychiatrist, neurologist, medical genetics physician, imaging results, etc. These materials are important for background information purposes and are necessary per standard neuropsychological testing guidelines.
 

What should I tell my child about the assessment?

Tell your child that the neuropsychologist or “doctor” is trying to understand how they learn and that all children learn differently. The evaluation will help them understand how to make things better. Children often find the evaluation process interesting as many of the measures are colorful, fun, and interactive! You can also tell them that there will be snacks, breaks, and even a dog at the office (if the child likes dogs). Please reassure the child that there are no “shots.” You are welcome to visit this office with your child before the date of the assessment so that they feel comfortable.
 

What happens before the assessment?

An intake with the parents is done by the practice manager, Scott Mellor. He will obtain a "thumbnail sketch" of what is concerning you about your child. He will then explain the testing process to you. Any questions concerning insurance, etc., can be answered by Mr. Mellor. At that point, an appointment can be scheduled for the assessment. He will 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 neurodevelopmental evaluation:

The neuropsychologist will first interview the parents and any relevant individuals in the child's life (with parental consent) in order to gather information about the child's development and presenting concerns. The parents will also be given a packet of questionnaire measures to be completed by themselves and the child's teacher/day care provider. Any relevant records should be mailed, faxed, or emailed to the office as soon as possible and must be received before the report is completed. The remaining sessions will include direct testing with the child. Parents are required to stay at the office for the duration of the child testing to provide behavioral support as needed. A school observation may be conducted on a case-by-case basis. A primary goal of the evaluation is to complete the interview and direct testing close together. Once the interview and direct testing are complete and all relevant documents are received, the information is scored, interpreted, and summarized in a report. A feedback session will be scheduled with the family no later than 14 days after all information has been received. The neuropsychologist will also provide feedback to relevant professionals involved in the child's care (with parental consent).

Parents are encouraged to call us if there are any questions after their feedback session and after they review the report. The report will be given to the parents and any professional that they request. No report will be sent out from the office without the consent from the parents.

Services

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

  • Anoxia

  • Attentional disorders

  • Autism spectrum disorder

  • Cancer

  • Carbon monoxide poisoning

  • Cerebrovascular disease

  • Chronic fatigue

  • Cognitive behavioral therapy (CBT)

  • Cognitive changes following rehabilitation or educational remediation

  • Concussion education

  • Decompression illness

  • Disability assessment

  • Embolism

  • Emotional disorders associated with neurological diseases, developmental delays

  • Epilepsy

  • 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

  • Strokes

  • Substance use disorders

  • Tourette’s syndrome

  • Traumatic brain injury, including post-concussion syndrome