The Neuropsychological Assessment

The neuropsychological assessment includes several steps. Before determining how to help a patient, I obtain a complete history from the patient and parents if the patient is a child or dependent. In the case of children I also obtain school and medical records and consult with school personnel and others in the medical community who know the patient. In some cases, when working with children, I observe the child in school as well as during play in my office.  Observations during the assessment are also an important part of the evaluation. The information I seek to obtain includes school performance, behavior at home and school, social skills, previous treatment, and a thorough developmental, family, and medical history.  Because the ability of children to sustain attention is less than that of an adult, assessment of children often require two or three sessions. 


I will utilize all of the tools at my disposal in order to answer the referral question. The assessment includes a variety of neuropsychological and educational tests as well as rating scales specific to the referral question, which are filled out by those who know the patient as well as by the patient.  For some cases standardized personality tests are also administered.


The results will be used to answer the referral question as well as to investigate other issues that might be contributing to the presenting problem. Results will also result in an understanding of the strengths and weaknesses of the patient across domains as well as recommendations in order to aid the patient in compensate for areas of weakness and utilize his/her strengths in order to function more effectively.  Some of these recommendations are for the patient and some, especially in the case of a child, are for those in the home and school environment. 


I prepare a written report and review all of the results and recommendations with the patient  and with the family if the patient is a minor. Sometimes during the feedback session the parents will present a  problem not previously discussed that can be addressed in light of the findings.  If this is the case, I will amend the report to address the new problem in my recommendations. If the referral is from an attorney or a community agency, the report is sent to the referral source rather than given to the patient.


A neuropsychological evaluation assesses the following areas:


  • attention
  • learning
  • memory
  • executive functioning (Inhibition, initiation, emotional control,     organization, self monitoring, planning, and problem solving}
  • general intelligence
  • sensory and tactual skills
  • reasoning 
  • spatial planning and organization
  • motor skills
  • processing speed
  • language and social communication
  • emotion and behavior
  • personality


When performing an evaluation I use what is called the Process Approach, which means that I try to find out how the patient performs tasks rather than looking only at scores.  For example when a patient performs a task slowly it is important to examine why.  Is it because he is distracted, because he is just slow, or because he has difficulty with the task for another reason.  When examining memory it is important to find out under which conditions the patient can remember and retain information and under which conditions he has the most difficulty.  This approach generates more helpful information than simply examining scores and can be used more effectively when planning interventions.

 

The neuropsychological assessment includes several steps. Before determining how to help a patient, I obtain a complete history from the patient and parents if the patient is a child or dependent. In the case of children I also obtain school and medical records and consult with school personnel and others in the medical community who know the patient. In some cases, when working with children, I observe the child in school as well as during play in my office.  Observations during the assessment are also an important part of the evaluation. The information I seek to obtain includes school performance, behavior at home and school, social skills, previous treatment, and a thorough developmental, family, and medical history.  Because the ability of children to sustain attention is less than that of an adult, assessment of children often require two or three sessions.


I will utilize all of the tools at my disposal in order to answer the referral question. The assessment includes a variety of neuropsychological and educational tests as well as rating scales specific to the referral question, which are filled out by those who know the patient as well as by the patient.  For some cases standardized personality tests are also administered.


The results will be used to answer the referral question as well as to investigate other issues that might be contributing to the presenting problem. Results will also result in an understanding of the strengths and weaknesses of the patient across domains as well as recommendations in order to aid the patient in compensate for areas of weakness and utilize his/her strengths in order to function more effectively.  Some of these recommendations are for the patient and some, especially in the case of a child, are for those in the home and school environment. 


I prepare a written report and review all of the results and recommendations with the patient  and with the family if the patient is a minor. Sometimes during the feedback session the parents will present a  problem not previously discussed that can be addressed in light of the findings.  If this is the case, I will amend the report to address the new problem in my recommendations. If the referral is from an attorney or a community agency, the report is sent to the referral source rather than given to the patient.


When performing an evaluation I use what is called the Process Approach, which means that I try to find out how the patient performs tasks rather than looking only at scores.  For example when a patient performs a task slowly it is important to examine why.  Is it because he is distracted, because he is just slow, or because he has difficulty with the task for another reason.  When examining memory it is important to find out under which conditions the patient can remember and retain information and under which conditions he has the most difficulty.  This approach generates more helpful information than simply examining scores and can be used more effectively when planning interventions.