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Neuropsychological Testing
What Is Clinical Neuropsychology and Pediatric
Neuropsychology?
Clinical neuropsychology is a specialty
profession that focuses on brain functioning. In clinical neuropsychology, brain
function is evaluated by objectively testing motor, sensory, memory and thinking skills. A very
detailed assessment of abilities is done and the pattern of strengths and
weaknesses is used to assist with diagnosis and treatment planning. Pediatric
neuropsychology also addresses how learning and behavior are associated with the
development of brain structures and systems.
Why Are Children and Adults Referred for Neuropsychological Assessment?
Children are typically referred because
of difficulty in learning, attention, behavior, socialization or emotional
control. They also may be referred for neuropsychological assessment because of
a disease or developmental problem that affects the brain in some way.
Both adults and children may be referred when there is a brain injury from an
accident, illness, or other trauma, or there is some unexplained change in the
persons concentration, organization, reasoning, memory, language, perception,
coordination, or personality.
What Is Assessed?
A typical neuropsychological evaluation will involve
assessment of the following:
 | General intellect |
| Executive skills such as organization, planning,
reasoning and problem-solving |
| Attention and concentration |
| Learning and memory |
| Language |
| Visual-spatial skills (e.g., perception) |
| Motor and sensory skills |
| Behavioral and emotional functioning |
| Achievement skills such as reading and math |
Some abilities may be measured in more
detail than others, depending on the individual’s needs. Emerging skills can be
assessed in very young children. However, the evaluation of infants and
preschool children is usually shorter in duration, because the child has not yet
developed many skills.
What Will the Results Tell Me?
Test results can be used to understand the patient’s
situation in a number of ways.
For adults:
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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 may
be the only way to detect them. For example, testing can help determine
whether memory changes are normal age-related changes or if they reflecting
neurological disorder. 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. |
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Test results can also be used to help
differentiate among illnesses, which is important because appropriate
treatment depends on accurate diagnosis. Different illnesses result in
different patterns of strengths and weaknesses on testing. Therefore, the
results can be helpful in determining which areas of the brain might be
involved and what illness might be operating. For instance, testing can help
to differentiate among Alzheimer’s disease, stroke, and depression. Your
physician will use this information along with the results of other tests,
such as brain imaging and blood tests, to come to the most informed diagnosis
possible. |
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Sometimes testing is used to
establish a "baseline," for documenting a persons skills before there is any
problem. In this way, later changes can be measured very objectively. |
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Test results can be used to plan
treatments that use strengths to compensate for weaknesses. The results help
to identify what cognitive problems to work on and which strategies to use. For
example, the results can help to plan and monitor a cognitive rehabilitation
therapies following a stroke or traumatic brain injury. |
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Studies have shown how scores on
specific tests relate to everyday functional skills, such as managing money,
driving, or readiness to return to work. Your results will help your doctors
understand what problems you may have in everyday life. This will help guide
planning for assistance and treatment. |
For children:
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Testing can explain why your child is
having school problems. For example, the child may have difficulty reading
because of an attention problem, a language disorder, and auditory processing
problem, or a reading disability. Testing also guides the pediatric neuropsychologist
to design interventions that draw upon your child’s strengths.
The results identify what skills to work on as well as which strategies to
use to help your child. |
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Testing can help detect the effects
of developmental, neurological, and medical problems, such as epilepsy,
autism, attention deficit hyperactivity disorder (ADHD), dyslexia, or a
genetic disorder. Testing may be done to obtain a baseline against which to
measure the outcome of treatment or the child’s development over time. |
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Different childhood disorders result
in specific patterns of strengths and weaknesses. The profiles of abilities
can help identify child’s disorder and the brain areas that are involved. For
example, testing can help differentiate between an attention deficit and
depression, or determine whether a language delay is due to a problem in producing
speech, understanding or processing language, social shyness, autism, or
cognitive delay. |
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Most importantly, testing provides a
better understanding of the child’s behavior in learning and school, at home,
and in the community. The evaluation can guide teachers, therapists, and you to
better help your child achieve his or her potential. |
What Should I Expect?
A neuropsychological evaluation usually
includes an interview and testing. A detailed intake history form and symptom
checklist is filled out by adult patients or parents of children prior to the
initial visit. During the interview, information that is important for the
neuropsychologist to consider will be reviewed. The testing involves taking
paper-and-pencil or computerized tests and answering questions. The time
required to complete the testing depends on the problems being assessed. In
general, several hours are needed to assess the many skills involved in processing
information. Some tests will be easy while others will be more complex. It is
important that the person being tested gets a good night’s sleep before the
testing. Also, it is important that glasses or hearing aids be used during the
evaluation. Any medications that are being taken at the time of testing should
be reported to the examiner.
Key Benefits
| More sensitive that CT, MRI or EEG in detecting
brain impairment/dysfunction. |
| Provides objective information regarding functional
limitations. |
| This information can be used to develop helpful
treatment interventions. |
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