msneuropsych

What is a neuropsychological assessment?

A neuropsychological assessment does two things:
(1) it determines an individual's strengths and weaknesses over a wide range of abilities, and
(2) uses that information to develop individualized treatment strategies to best help an individual function better at home, school and/or work.

Moreover, it is particularly helpful in determining the pattern of abilities and deficits in individuals with special issues relating to learning disabilities, poor self-regulation, traumatic brain injury, and brain dysfunction as well as emotional and/or behavioral issues that may impact adaptive functioning.

What information does a neuropsychological assessment provide?

There are many abilities that are necessary for functioning successfully in everyday life, like for school, play, work, and socializing. Some examples of these are how coordinated you are, how well you can remember things - both what you hear and what you see, how well you can focus your attention on something, how well you can figure things out, how well you can see things from others' perspectives, as well as school-related material like reading, spelling, and arithmetic. Since everyone is different and nobody is perfect, most individuals have some things that they can do well and some things that may be a little more difficult for them to complete or accomplish. Knowledge of an individual's specific pattern of strengths and weaknesses is critical to the development of more effective treatment and/or remedial plans (e.g., for home, school, work).

How does it differ from a typical academic or IQ testing?

A typical school or psychological assessment provides information on IQ and/or how well a child performs in various "content" or "skill areas like reading, spelling, arithmetic, etc. More often than not, the purpose of such assessments is only to classify someone as having a normal IQ or not, being learning disabled or not, or qualifying for special services or not. Specific information about one's functional abilities are not the focus. That is, the major problem with these types of assessment is that when an individual recieves a "low score" on a test or subscale you still don't know why or what it really represents. While it does indicate that something may be wrong, there is no information regarding why the individual had a problem nor does it provide any leads about how best to address the issue.

Take for example someone who receives a poor score on test of "arithmetic". Two persons may recieve the same poor score but for very different reasons. To begin with, the poor performance may be due to personality or emotional issues like anxiety, poor self confidence, poor motivation, or even oppositional behavior (e.g., they just didn't want to do it). Maybe the poor performance was due to a lack of sufficient prior training and/or exposure to the material. On the other hand, if there is an actual cognitive deficiency, it could be due to any number of "component behaviors" that are a part of that "arithmetic process". These could include problems with attention, memory coding and/or retrieval, visual allignment of their written work, sequencing or efficiency with multi-step tasks, cognitive shifting or transitioning from one sub-process to the next, comprehension of abstract concepts, or any combination of the latter. Each of these aforementioned issues would require different remedial strategies.

Most academic and many life tasks typically involve complex behaviors requiring multiple steps and processes. A neuropsychological assesment can help pinpoint where the weak link in that chain occurs. This information, as well as knowing what a person can do well are critical to developing an individualized remedial plan. The latter may involve "attacking the deficiencies directly" and/or teaching "compensatory strategies" to help circumvent problems.

What is a "comprehensive" evaluation?

Beyond the information provided by a typical neuropsychological assessment (e.g., tactile-perceptual, motor and psychomotor, attention, memory, auditory-verbal and psycholinguistic, visual-spatial and visuo-motor, intellectual, and academic skills), this comprehensive focus provides a more extensive evaluation of executive/frontal lobe functions (e.g., planning, fexibility in thinking, working memory, problem solving and reasoning, response inhibition, and decision making skills) as well as personality and emotional factors (e.g., using among other things, the Millon clinical inventories). Such an approach is often quite helpful in identifying residual cognitive and emotional problems resulting from early neglect and/or decreased enrichment (e.g., inadequate models for skill development), attachment and bonding issues, other emotional trauma, and brain injury.

What skills and abilities are assessed?

Tactile-Perceptual: the ability to perceive, appreciate and differentiate through the sense of touch; “hand’s on” learning skills
Motor/Psychomotor: gross motor strength, speed, steadiness, and fine-motor coordination
Attention & Memory: the ability to pay attention to what one hears and sees; the capacity to keep more than one thing in mind at the same time; the capacity to remember information you see and hear both immediately and some time later, both verbal and visual
Auditory-Verbal & Psycholinguistic: ability to perceive and comprehend language; the capacity to organize and express one’s thoughts; rote-verbal skills and information
Visual-Spatial & Visual-Motor: the ability to perceive and differentiate what one sees; the ability to make sense of what one sees and to construct objects in space; writing and drawing skills; perception of facial emotions
Executive Function & Reasoning: the ability to form concepts and ideas; problem-solving and strategy generation; the capacity to be flexible in one’s thinking; working memory; response inhibition; deductive reasoning; planning and decision making skills
Intellectual/Academic: intellectual functioning; reading, spelling, arithmetic
Personality/Behavioral: personality, socio-emotional, behavioral and adaptive functioning

What does the actual assessment appointment entail?

The assessment lasts the length of a typical school or work day, approximately six hours. For children and adolescents, the mother will be asked to complete several personality and behavioral questionnaires pertaining to their child as well as a clinical interview/history. The assessments begin promptly at 9:30 AM and are usually completed before 5:00 PM; there is a one-hour lunch break at 12 noon. A parent feedback session will be scheduled about two to four weeks following the assessment. A written report of the findings and recommendations of the assessment will be made available at that time.

Who can be assessed?

Children (ages 6 years and older), adolescents and adults.