Neuropsychological Testing and Evaluation
Neuropsychology focuses on two things: the physical structure of someone’s brain and their psychological behaviors. People seek out the help of a neuropsychologist when they need to determine how well their brain is working after they have experienced a brain injury or psychological disorder.
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Table of Contents
What is Neuropsychological Testing?
If you, your child or a loved one has been told that you need a neuropsychological test you will need to find a neuropsychologist. A neuropsychological test (sometimes called a neuropsychological exam or evaluation) is an in-depth assessment of skills and abilities linked to brain function. The test measures such areas as attention, problem solving, memory, language, I.Q., visual-spatial skills, academic skills, and social-emotional functioning. After the neuropsychologist runs their tests they render a diagnosis and develop a treatment plan.
Anyone seeking care from a neuropsychologist should look for a credentialed mental health professional. The American Board of Clinical Neuropsychology and the American Academy of Clinical Neuropsychology are the organizations that certify these professionals.
Behaviors That May Signal the Need for a Neuropsychological Test
- Asking the same questions
- Repeating the same things
- Not appearing to listen
- Difficulty finding the right words
- Inability to follow a conversation
- Unable to recognize everyday things
- Exhibiting poor judgment
- Making bad decisions
- Frequently losing things
- Sudden personality changes
- Increased anxiety or depression
- Having delusions or hallucinations
- Getting lost in familiar places
- Difficulty managing bills or money
- Can’t recognize familiar people
Neuropsychology can address several mental health issues including:
Assessing Disorders and Conditions With a Neuropsychological Test
A neuropsychological test can be used to assess an existing condition, gauge its stage of development, or provide a new diagnosis. It is often used to help those with physical disorders, including TBI or stroke. A neuropsychological test can also identify mental health disorders, such as bipolar disorder.
Assessing An Existing Disorder
A neuropsychological test can be used to assess the effects of a physical event on the brain. For example, a doctor might use one to determine what areas of the brain were affected in a patient in the aftermath of a Traumatic Brain Injury.
Other issues neuropsychological tests can address include:
- Memory Loss
LifeStance Health specializes in Neuropsychological Testing and Evaluation with multiple locations in 33 states. Services vary by location.
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Learning and Developmental Disorders
Neuropsychological testing is also useful in identifying and diagnosing developmental and learning disorders in children. These can include:
- Autism Spectrum Disorder (ASD)
- Sensory Processing Disorder
- Language Disorders
- Seizure Disorders
Patients with mood disorders can also benefit from neuropsychological testing. Oftentimes, mood disorders are hard to identify, and a neuropsychological test can dial in on the problem at hand. Patients with bipolar disorder, severe depression, or psychosis are just some of the individuals that can benefit from a neuropsychological test.
Running a Differential Diagnosis
Oftentimes, practitioners need to rule out other disorders in order to give a diagnosis. For this reason, a neuropsychological test may include a differential diagnosis. As an example, an elderly person presenting with memory loss may have Alzheimer’s, but TBI needs to be ruled out before that diagnosis can be confirmed. Running a differential diagnosis may also involve a physical examination.
Neuropsychological practitioners can test for many mental functions including:
- Executive Functions, which are higher-level skills you use to organize and plan, manage your time, problem solve, multi-task, make judgments and maintain self-control.
- Visuospatial Skills
- Mood & Personality
- General Intelligence
- Reading Comprehension
- Language Usage & Understanding
- Mental Reasoning
- Dementia-Specific Challenges
- Multiple Functions
- Motor Speed & Dexterity
Memory works in five different ways: procedural, semantic, episodic, short-term, and priming. A neuropsychological test may assess one or more of these areas of memory.
Intelligence can be affected quite easily after physical trauma. A neuropsychological test is a reliable way to test areas of one’s intelligence that might be less affected by trauma; thereby providing a differential diagnosis. When testing for any form of intelligence, doctors use scales to compare a patient’s results with those of other individuals with similar backgrounds.
Language testing in a neuropsychological test can assess what aspects of language a patient has retained after a trauma such as a stroke or seizure. It can also be used in assessing developmental delays.
Testing for executive function involves assessing a patient’s ability to solve problems, organize, and plan. Testing can vary depending on the patient’s medical history.
In some neuropsychological tests, the doctor may test visuospatial functioning. This determines how well a patient can perceive, integrate or construct a visual space.
Dementia-specific testing is run on individuals who may have dementia. A doctor typically uses the Clinical Dementia Rating and the Dementia Rating Scale to assess whether or not a patient has the disorder and what stage of development that patient is in.
Some neuropsychological tests may involve testing multiple functions across different areas, including:
Neuropsychological Testing and Evaluation FAQ
Neuropsychology is a specialty field that combines neurology, psychology and psychiatry. Neuropsychology involves determining how well the brain is working when it is disrupted by a brain injury or psychological disorder.
A neuropsychological test is a comprehensive examination of a wide range of mental functions including behavior.
The neuropsychologist will talk to you to understand any concerns you and your family members might have about your cognitive functions. They will review your medical and psychological history and then administer a series of tests over a set timeframe.
The testing can include questions, puzzles, game-like activities, computer tasks, and drawing or writing. While the child completes their testing, the parents or caregivers will complete an interview with the neuropsychology team. If a child has received a neuropsychological test in the past, an updated evaluation can be used to document changes and developments in their skills over time and suggest any needed changes in treatment.
An observation is sometimes used to view a child’s behavior in a classroom setting. The neuropsychologist will be looking for a child’s behavioral response to teachers and students, social interactions, ability to work independently, compliance with directions, ability to pay attention, and any withdrawal or anxiety exhibited in class.
- Diagnose problems with thinking and understanding.
- Determine cognitive strengths and weaknesses after a neurological event or injury.
- Establish a baseline for measuring recovery and determining if you’re ready to return to normal activities.
- Plan a treatment or other intervention, and to make decisions about the skills that need to be worked on.
Referrals for neuropsychological tests are usually requested by physicians or other health care professionals.
You can ask your primary physician for a recommendation or go to your health insurance company’s website to see who is in your network. There are also many online resources, such as LifeStance, that can help you find a doctor to perform neuropsychological testing.
There is no physical strain or stress involved in a neuropsychological test, but it can be a long and taxing process. Neuropsychological tests can serve as stress tests in many ways, pushing patients in terms of cognition and emotion. Patients should discuss the process in detail with their doctor so that they understand what is involved and are prepared. No neuropsychological test will push a patient farther than they want to go, and it’s important to remember that the ultimate goal is to get that patient on the road to healing, and the test is the first part of that process.
Depending on the situation, testing can take anywhere between one and eight hours, although two to four hours is more typical. The testing time depends on which tests need to be administered and how quickly you are able to complete the tasks.
Insurance coverage varies greatly, so what is covered will depend on your individual insurance plan. Some portion of the assessment is usually covered, but to make sure please check with your insurance company before undergoing neuropsychological testing.
A neurologist treats the physical component of a nervous system disorder or an injury to the nervous system, and a neuropsychiatrist treats the mental symptoms associated with a nervous system injury or disorder.
A neurological exam can include a brain scan, tumor biopsy, molecular testing, and other diagnostic tests.