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What is Neuropsychological Testing?

Neuropsychological testing (sometimes called neuropsychological exam, assessment, or evaluation) is an in-depth assessment of brain function that can help localize brain regions impacted by injuries, medical conditions, or disorders. Neuropsychological evaluation reveals a person’s cognitive strengths and weaknesses and explains how an individual’s unique profile relates to performance in everyday life. The tests measure specific thinking skills, as well as academic ability, motor skills, social skills, behavior, and emotional functioning. Neuropsychological testing is often recommended by a neurologist, primary care physician, psychiatrist, or therapist.  Data from the evaluation are used to establish diagnoses and develop a medical treatment plan.

Neuropsychologists use research-based, standardized measures to evaluate function by comparing an individual’s performance to that of demographically matched peer groups. Evaluations cover many domains, including:

  • General intellect or IQ
  • Motor speed/ dexterity
  • Executive functions (fundamental cognitive skills used to organize and plan, manage your time, problem solve, multi-task, make judgments, and maintain self-control)
  • Information processing speed
  • Attention/ working memory
  • Speech and language
  • Visuospatial skills/ visual construction
  • Learning and memory
  • Mood and personality
  • Academic skills (such as reading, writing, or math)
  • Social cognition

Who Can Administer Neuropsychological Testing?

If you, your child, or a family member are referred for neuropsychological testing, you will need a clinical neuropsychologist who is a licensed doctoral-level psychologist with specialty training to understand brain-behavior relationships. All neuropsychologists have advanced post-doctoral training to conduct and interpret neuropsychological tests, integrate multiple sources of data, and diagnose a variety of conditions. Some neuropsychologists have also obtained board certification within their clinical specialty through the American Board of Professional Psychology/American Board of Clinical Neuropsychology and/or the American Board of Professional Neuropsychology.

Who Can Benefit from Neuropsychological Testing?

A neuropsychological evaluation provides two primary benefits: clarifying diagnosis and informing treatment. Testing is helpful for individuals with established or suspected medical diagnoses known to affect thinking skills, for those with longstanding unexplained cognitive, social and/or functional challenges, and for patients experiencing cognitive and/or behavioral change. For those struggling to obtain a clear diagnosis, or those who have not benefited as expected from previous treatments, neuropsychological testing can provide a road map to symptom improvement.

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Neuropsychological Testing for Individuals with Neurological or Other Medical Conditions

Neuropsychological testing aids in early detection (like in dementia). It can also be used to clarify the etiology (or underlying reason) for the changes a patient is experiencing and distinguish between medical and psychiatric bases for symptoms.  It is often used to help those with existing medical, neurological, and physical conditions track the progression of their disease over time. Neuropsychological testing can clarify the functional consequences of accidents and injuries to the brain. Further, testing yields recommendations for treatment plan adjustments to match a patient’s needs.  Neuropsychological testing routinely benefits patients with the following diagnosed or suspected conditions:

  • Dementia and mild cognitive impairment (MCI)
  • Alzheimer’s disease
  • Frontotemporal dementia (FTD)
  • Dementia with Lewy bodies
  • Vascular dementia
  • Seizure disorders or epilepsy
  • Parkinson’s disease and other movement disorders
  • Multiple sclerosis
  • Genetic conditions
  • Fetal alcohol syndrome (FAS)
  • Traumatic brain injury (TBI)
  • Concussion (mTBI) and post-concussion syndrome (PCS)
  • Stroke, aneurysm, and other vascular conditions
  • Cognitive impact of addiction or substance abuse
  • HIV
  • Brain tumors
  • Cancer, paraneoplastic conditions, and post-chemotherapy
  • Lyme disease
  • Long COVID
  • Encephalitis/ encephalopathy

Neuropsychological Testing for Those with Unexplained Symptoms

Neuropsychological evaluation can clarify diagnosis and direct treatment in individuals with unexplained cognitive, emotional, social, and/or functional challenges. Oftentimes, patients have been bothered by these symptoms since childhood or adolescence. Neuropsychological testing is especially helpful when standard means of diagnosis and treatment, such as meeting with a person’s primary care physician or psychiatrist, engaging in therapy, and/or trialing medication, have not resulted in symptom improvement. A neuropsychological evaluation can determine whether reported symptoms are due to a physical condition, substance or medication effect, developmental condition, or occur secondary to a mental health disorder, such as anxiety, depression, or bipolar disorder. At the request of the patient or family, neuropsychological testing can also involve making recommendations for accommodations or support at work or school.  Conditions often assessed in neuropsychological evaluations for this purpose include, but are not limited to:

  • Attention deficit/ hyperactivity disorder (ADHD)
  • Autism spectrum disorder (ASD)
  • Intellectual disability
  • Social pragmatic communication disorder
  • Other developmental delays and disorders
  • Learning disorders (dyslexia, dyscalculia, dysgraphia)
  • Giftedness or twice exceptionality
  • Developmental coordination disorder
  • Anxiety, depression, or other mental health conditions
  • Bipolar disorder
  • Functional neurologic disorder

Neuropsychological Assessment of Cognitive and Behavioral Change

Neuropsychological evaluation is an important facet of care for individuals experiencing a change in cognitive abilities, personality, or behavior as compared with their previous baseline. Testing can clarify diagnosis, determine the etiology for observed changes, and yield recommendations to optimize treatment. The following are examples of symptoms that may warrant a neuropsychological exam:

  • Repeating the same questions or information multiple times
  • Frequently misplacing items
  • Getting lost in familiar locations
  • Forgetfulness or memory problems
  • Decline in a person’s ability to express him or herself or understand others
  • Trouble finding the right words
  • Difficulty following commands
  • Atypical patterns of speech
  • Attentional changes, such as distractibility and inability to follow a conversation
  • Poor focus
  • Social isolation or difficulty making/sustaining friendships
  • Inability to recognize and/or use everyday items
  • Exhibiting poor judgment, making bad decisions
  • Sudden personality changes
  • Disinhibition, doing or saying inappropriate things
  • Increased anxiety or depression
  • Significant changes in sleeping or eating habits
  • Having delusions or hallucinations
  • Difficulty doing everyday tasks or chores and/or managing bills or money
  • Not recognizing or forgetting names of familiar people