Clinical Neuropsychology

What is clinical neuropsychology?

Clinical neuropsychology is a specialty profession that focuses on brain functioning. A clinical neuropsychologist is a licensed psychologist with expertise in how behavior and skills are related to brain systems. In clinical neuropsychology, brain function is evaluated by the objective testing of memory and thinking skills. A very detailed assessment of abilities is performed, and the pattern of strengths and weaknesses is used in important health care areas, such as diagnosis and treatment planning. The clinical neuropsychologist conducts the evaluation and makes recommendations. He or she may also provide treatment, such as cognitive rehabilitation, behavior management, or psychotherapy.

What is a clinical neuropsychologist?

A clinical neuropsychologist is a professional psychologist trained in the science of brain-behavior relationships. The clinical neuropsychologist specializes in the application of assessment and intervention principles based on the scientific study of human behavior across the lifespan as it relates to normal and abnormal functioning of the central nervous system.

What is Assessed?

A typical clinical neuropsychological evaluation will involve assessment of the following:

General intellect
Higher level executive skills (e.g., sequencing, reasoning, problem solving)
Attention and concentration
Learning and memory

Language
Visual-spatial skills (e.g., perception)
Motor and sensory skills
Mood and personality

Some abilities may be measured in more detail than others, depending on the needs of each individual patient.

How are test scores used to understand my specific situation?

Your test score will be compared to scores from people who are like you in important ways. By using database scores from large groups of healthy people for comparison, the neuropsychologist can judge whether or not your scores are normal for your age and educational background. The pattern of your own test scores will also be reviewed to estimate whether or not there has been a change in certain abilities. How you approach the various problems and answer questions during the examination will also be noted. Using these methods, your strengths and weaknesses will be identified.

What will the results tell me?

Test results can be used to understand your situation in a number of ways.

Testing can identify weaknesses in specific areas. It is very sensitive to mild memory and thinking problems that might not be obvious in other ways. When problems are very mild, testing might also be used to identify problems related to medical conditions that can affect memory and thinking, such as diabetes, metabolic or infectious diseases, or alcoholism.

Test results can also be used to help differentiate among illnesses because appropriate treatment depends on accurate diagnosis. The results can also be helpful in determining which areas of the brain might be involved. Your physician will use this information along with the results of other tests, such as brain imaging and blood test, to come to the most informed diagnosis possible.

Sometimes testing is used to establish a “baseline,” or document a person’s skills before there is any problem. In this way, later changes can be measured very objectively.

Test results can be used to plan treatments and accommodations that use strengths to compensate for weaknesses. The results help to identify what target problems to work on and which strategies to use.

Studies have shown that scores on specific neuropsychological tests relate to everyday functional skills, such as managing money, driving, or effectiveness in work or study. Your results will help your doctors understand what problems you may have in everyday life, and help to formulate a plan that will help you to optimize your performance in target areas.

What to Expect

A neuropsychological evaluation usually consists of an interview and testing. Ideally a close family member will be present for the interview, but if that is not possible, the doctor may ask to speak on the telephone with someone close to you. If the patient is a child, the doctor will ask to meet with parents separately, before meeting the child. During the interview, information that is important for the doctor to consider will be reviewed. You will be asked about your symptoms, medical history, medications, and other important factors. Testing involves taking paper-and-pencil or computerized tests and answering questions. The time required depends on the problem being assessed, but can be anywhere from three to six hours; this time is needed for a thorough evaluation. Some tests will be easy while other will be more complex; most people find the examination challenging and interesting. Try to get a good night’s sleep and eat a nourishing meal before your evaluation. You may want to bring a snack and a beverage with you.

More information about clinical neuropsychology

Pediatric Neuropsychology

What is Pediatric Neuropsychology?

Pediatric neuropsychology is a professional specialty concerned with learning and behavior. A pediatric neuropsychologist is a licensed psychologist with expertise in how learning and behavior are associated with brain development. Some pediatric neuropsychologists work closely with schools to help them provide appropriate educational programs.

Why are children referred for neuropsychological assessment?

Children are referred by a doctor, teacher, or at the parent’s initiative because of concerns about:

Difficulty in learning, attention, behavior, socialization, or emotional issues;
A disease or inborn developmental; or
A brain injury from an accident, birth trauma, or other physical stress.

What will the results tell me about my child?

By comparing you child’s test scores to scores of children of the same age, the neuropsychologist can create a profile of your child’s strengths and weaknesses. The results help those involved in your child’s care in a number of ways.

Testing can explain why your child is struggling in school. For example, a child may have difficulty reading because of an attention problem, a language disorder, an auditory processing problem, or a reading disability. Testing also guides the pediatric neuropsychologist’s design of interventions to draw upon your child’s strengths. The results identify what skills need improvement, as well as which strategies to use to help your child.

Testing can be used to determine what accommodations, if any, are appropriate at school, or on standardized testing, to help the child perform as well as he or she should in light of any disabilities that are diagnosed.

Testing can measure the impact of developmental, neurological, and medical problems, such as epilepsy, autism, attention deficit hyperactivity disorder (ADHD), dyslexia, injury or a genetic disorder. Testing may be done to obtain a baseline against which to measure the outcome of treatment or to track a child’s development over time.

Different childhood disorders result in specific patterns of strengths and weaknesses. These profiles of abilities can help identify a child’s disorder. For example, testing can help differentiate between attention deficit, subtle learning disabilities, and depression. Your neuropsychologist may work with your physician to combine results from medical tests, such as brain imaging or blood tests, to diagnose your child’s problem.

More information about Pediatric Neuropsychology