Neuropsychological Assessment—What Is It? Who Needs It? And Why?

 

Neuropsychology is the study of behavior as it relates to the brain. Neuropsychological assessment (NA) is a complex investigative procedure geared toward gaining a detailed and comprehensive understanding of a person’s neurocognitive functioning.  Neuropsychologists are licensed psychologists with specialized additional training and supervision in administering and interpreting neuropsychological tests. Pediatric neuropsychologists have further additional training in the use of these tests in relation to children and adolescents, whose brains are still developing (please see www.abpdn.org for more information about pediatric neuropsychology). 

 

NA involves administering a series of tests that measure the performance of different brain areas or functions in addition to gathering extensive information about a person’s history and symptoms. It is not uncommon for someone to spend eight hours or more with a clinician who is performing the assessment. By looking at patterns of test results (and how a person struggles, succeeds or fails) in the context of the other information gathered, it is possible to understand the deficits that contribute to or create that person’s problems. This process allows a very detailed understanding of a person’s strengths and weaknesses and makes it possible to craft a treatment plan that is personalized and specific.

 

A thorough assessment will examine someone’s overall intellectual ability, visual-perceptual skills, ability to coordinate vision with movement, motor coordination and symmetry of motor movements, receptive and expressive language skills, learning and memory, planning, organizational skills, and the various elements of attention. NA often also includes an assessment of academic skills in order to clarify the underlying nature of any academic difficulties that might be present. A thorough assessment will also examine emotional and personality functioning, and will assist with determining their relative contribution to a person’s overall difficulties.

 

In what circumstances is NA indicated? When a child is having difficulty in one or more subjects in school or is said to be, “not working up to potential,” NA can explain why this is occurring and what needs to be done to help. If someone appears restless, inattentive or distractible and the question is raised as to the presence of some type of attentional disorder, NA can determine whether this disorder is present, and which areas of the attentional system are most affected. It can determine the areas in which the individual’s functioning is strongest versus those areas in which it is weakest so as to inform a comprehensive strategy for treatment.  NA can be useful when someone is failing to progress in development in any area—social, emotional, intellectual; or when someone appears to be losing his or her abilities in any area, such as memory or speech. NA can be useful in discriminating between emotional and neurological problems for people of any age.

 

NA can also be employed to provide a map of someone’s abilities after the brain has been damaged due to any cause, such as stroke, birth trauma, multiple sclerosis, head injury, brain infection, or seizure. Repeated testing can allow the progression of the person’s abilities to be charted over time. 

 

Parents often seek NA for their children who are having difficulty in school. Some families are new to the assessment process, while others have previously been identified with a problem through more general special-education assessments by the school district. While psycho-educational assessments provide a useful overview and can broadly determine whether a child appears to have a learning disability such as “dyslexia (reading problem),” NA provides an in-depth understanding of the factors that underlie the apparent problem, thus allowing a more comprehensive and specific plan for treatment to be designed. A comprehensive NA can aid parents and school staff in determining the best possible interventions for the child in question.