What Is a Neuropsychological Evaluation?

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Neuropsychological evaluation is a specialized psychological assessment that includes systematic, comprehensive assessment of cognitive functions, including:

• Intelligence & problem solving
• Attention & executive function
• Language & auditory processing
• Memory, & learning
• Visual-perceptual & sensorimotor abilities
• Academic achievement
• Emotional, & behavioral functioning

Neuropsychological evaluation has been classically used to assess the cognitive consequences of brain injury and neurological problems.  It is, however, also an excellent tool for ascertaining the underpinnings of learning difficulties and other childhood disorders because it identifies specific intellectual strengths and weaknesses. For example, knowing that your child struggles with reading does not tell you what neuropsychological processing problems (or other, coexisting disorders) may be at the root of the difficulty. Therefore, remediation becomes a “shot in the dark.” Subsequently, neuropsychological assessment is perhaps the most useful means available for guiding educational remediation and other recommendations.

Neuropsychological evaluation is the most thorough (and therefore the most time-consuming) means of evaluating cognitive functioning. A comprehensive neuropsychological work-up includes testing time, scoring of protocols and evaluation of results, report writing, and final consultation.

Here is the typical course of events for my neuropsychological evaluations with children and adolescents:

• Initial visit with parents, review of previous assessment results (if any), clinical interview
• Testing. This can take 4 or more hours, depending on the age of the child, the amount and quality of      previous assessment results, etc. It usually requires 2-3 appointments.  The first testing session is more general in order to obtain broad-based results so that I may begin to form hypotheses about areas of strength and weakness.  Subsequent testing sessions include more fine-tuned assessment, based on the results of previous sessions.
• I score the protocols, interpret the results (this is the part of the process that requires      extensive training — without it, the results are mere “testing”), and write the report.
• Feedback session is held with parents. Results are explained, recommendations are made, written report is given, questions are answered.

There are really no shortcuts to a good neuropsychological evaluation. Those with minimal or no training in neuropsychology often jump to conclusions about a specific area of functioning (e.g. attention) without proper investigation of all cognitive domains.  This leads to errors because what may appear to be a “malfunction” of one system is really a consequence of a problem in another system. Sometimes there is an interaction between more than one area of difficulty. Therefore, systematic evaluation of more than one area of cognitive functioning is often necessary in order to “put all of the pieces of the puzzle together.” 

Besides deficit areas, a neuropsychological evaluation also indicates areas of strength that may be useful in remediating learning difficulties.

Neuropsychological evaluation provides comparison between areas of functioning, as well as comparison of the individual cognitive domains with general intellectual functioning.  Additionally, it provides rich and detailed information about strengths and weaknesses within a particular area of functioning. This information can be extremely helpful for educational planning.