Clinical neuropsychologists specialize in assessing and treating the cognitive and emotional needs of patients suffering from neurological disorders or conditions, such as Alzheimer's disease, brain injury, or brain tumors.
A neuropsychological evaluation is recommended for any case in which brain-based impairment in cognitive function or behavior is suspected. Typical referrals are made to diagnose or rule out the following neurological conditions, and to describe their impact on a person's functioning:
- Traumatic brain injury
- Stroke or other neuro-vascular problems
- Brain Tumors (neuro-oncology)
- Dementing conditions (e.g., Alzheimer's Disease)
- Parkinson's Disease and other Movement Disorders
- Attention deficit disorders or other developmental learning disabilities
- Seizure disorders (e.g., Epilepsy)
- Multiple Sclerosis
- Central Nervous System infection
- Effects of toxic chemicals or chronic substance abuse
- Psychiatric or neuropsychiatric disorders
When Should Someone Seek Neuropsychological Care?
When an individual displays difficulties or changes in thinking, memory, speech, personality, or other behaviors, which are significant enough to interfere with normal daily routines, a neuropsychological evaluation may be indicated. An individual's impairment or symptoms may be mild to severe.
In some conditions where patients are expected to decline over time (e.g., Alzheimer's disease, brain tumors) a baseline evaluation may be needed to help with interpreting possible changes shown in future evaluations. A neuropsychological evaluation is useful for tracking progress in rehabilitation. Neuropsychological evaluations can assist greatly in planning educational and vocational programs. They can also be invaluable for disability determination or for forensic (legal) purposes.
The types of behaviors that might indicate the need for evaluation or treatment include:
- Memory loss (e.g., forgetting conversations, or forgetting names of people you should know, losing articles around the house)
- Attention and concentration problems (e.g., difficulty focusing on a task, being easily distractible)
- Difficulty organizing and planning (e.g., knowing how to do the parts of a task but not being able to accomplish it, having difficulty with flexibility of thinking or changing plans)
- Difficulty with multitasking (e.g., no longer being able to do several things at once, such as listening to someone speaking to you in person while talking on the phone)
- Difficulty communicating (e.g., having trouble coming up with the name of a common object, decreased fluency in speech, using the wrong word)
- Changes in spatial skills or vision (e.g., not being able to make sense of maps or drawings, having trouble picture an object as you put it together, difficulty making sense of what you see as you drive)
- Difficulty writing or reading (e.g., not being able to read as well as you could in the past, not being able to read what you have written)
- Disturbed thinking or confusion (e.g., thinking illogical thoughts, forgetting or not recognizing where you are, not remembering what day or time it is)
- Increased impulsivity (e.g., saying things you wouldn't normally say, noticeable changes in patience)
What Can Be Learned From A Neuropsychological Assessment?
Neuropsychologists assess patients in a systematic way to determine the extent and nature of any behavioral changes due to disease or injury. These assessments help to determine the root causes and possible treatments for problems with memory, intellectual and cognitive functioning, daily activities, or behavior and emotions.
Neuropsychological assessment is helpful in determining the differential contribution of neurologic and psychiatric factors in a patient's presenting problems, and in the specification of the patient's psychological and behavioral strengths and weaknesses related to neurological dysfunction. Information is provided that can contribute to decisions about the patient's:
- Differential diagnosis--distinguishing between different conditions that have similar symptoms
- Prognosis--how much will the patient improve or decline over time?
- Rehabilitation potential--will the patient benefit from a referral to rehabilitation services?
- Ability to return to work or school or playing field--what changes need to be made to get the patient back to work or school or playing sports?
- Ability to function independently--how can we maximize patients' independence?
- Need for specialized school services--does the student need referrals to special education, or adaptations such as unlimited time on tests?
- Ability to drive
- Forensic issues--is the patient legally competent?
- Other questions about patient functioning
What is a Neuropsychological Evaluation?
A neuropsychological evaluation is a comprehensive assessment of cognitive and behavioral functions using a set of standardized tests and procedures. Various mental functions are systematically tested, including, but not limited to:
Problem solving and conceptualization
Planning and organization
Attention, memory, and learning
Perceptual and motor abilities
Emotions, behavior, and personality
Who is Qualified to Conduct a Neuropsychological Evaluation?
A neuropsychological evaluation can only be done by a psychologist who has had specialized training and experience in the field, which can include:
- Predoctoral training in psychology and neuropsychology.
- Ph.D. in Psychology with clinical training
- Formal postdoctoral training focusing on brain-behavior relationships and neuropsychological assessment.
- Professional board (ABCN, ABPN) recognition in the specialized
techniques of neuropsychological assessment and interpretation.
Are All Neuropsychological Evaluations the Same?
No. A neuropsychological evaluation is not a fixed series of tests that anyone can give. Specialized training allows the neuropsychologist to select, administer, and interpret the particular tests and procedures that will yield the most comprehensive understanding of an individual's strengths and weaknesses. Each neuropsychological examination is tailored to the needs and history of the individual client.
What is a Neuropsychological Evaluation Like?
Generally, a neuropsychological evaluation involves a wide variety of tasks, most of which are done sitting at a table or at bedside in a hospital. A neuropsychological evaluation is a way of looking at many different kinds of abilities such as problem solving, attention, memory, language and motor skills. This involves several different pencil and paper tests and may include some computer-administered tests. Many people find these tests interesting. There are no invasive procedures, no pain, no needles, or electrodes. The evaluation often takes 2 to 4 hours of face-to-face contact, including an interview and the testing, but can vary widely depending on what information is being sought. The testing is broken up into several shorter tasks, so there are plenty of opportunities to stop or take a break if you wish. The evaluation can be scheduled in a single appointment or in a series of appointments.
What Should I do to Prepare for the Evaluation?
You do not need to study for the evaluation, as there are no right or wrong answers, it is just important to do your best. It is helpful to get a good night's sleep and to eat a good meal beforehand, so that factors such as fatigue and hunger do not complicate the testing. Make sure to bring your eyeglasses, as you may be asked to read and write in some tasks. We ask that people discuss the use of any medicines or other substances which might alter patients' functioning (such as sleeping pills, anti-anxiety drugs, etc.) with us and their physician to make sure that patients are tested under the best conditions possible.
How are the Test Results Used?
That depends on the reason for the evaluation. Neuropsychological evaluations may:
- Confirm or clarify a diagnosis.
- Provide a profile of strengths and weaknesses to guide rehabilitation, educational, vocational, or other services.
- Document changes in functioning since prior examinations, including effects of treatment.
- Clarify what compensatory strategies ("work-around solutions") would help.
- Result in referrals to other specialists, such as educational therapists, cognitive rehabilitation professionals, neurologists, psychiatrists, psychologists, social workers, nurses, special education teachers, or vocational counselors.
How Can I Determine Whether I Would Benefit From Neuropsychological Assessment?
Talk with your doctor. Discuss your concerns. Your doctor will be able to help you know whether a neuropsychological referral is appropriate to help you. Your doctor's office can contact ours to set up the appointment, or you can call directly.
How Do I Find A Neuropsychologist?
Click here to see our neuropsychologists.
Clinical neuropsychologists in the Neurosciences Service Center are found in:
Neurosurgery: click here to learn more about neuropsychology patients recovering from traumatic head injury and those with brain tumors.
Click here to learn how to make an appointment .
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