Neuropsychological Evaluation

Neuropsychological [NOO-row-sahy-kuh-loj-i-kuh l] evaluations are tests that focus on the relationship between our central nervous system (brain and spinal cord) and how we think (cognitive), move (motor), behave (behavioral), use language (linguistic), and do more advanced planning and organizing (executive functioning) . These tests can be used to diagnose conditions in the nervous system. Learn more about neuropsychological evaluation.

Neuropsychological [NOO-row-sahy-kuh-loj-i-kuh l] evaluations are tests done by a trained neuropsychologist [NOO-row-sahy-kuh-loj-i-jist] to assess how the brain and nervous system are functioning. These tests are used to identify potential sources of emotional, behavioral, or developmental problems in children, adolescents, or adults. These tests focus on the relationship of the nervous system to the brain and how it influences these  functions within the body:

• Cognitive [KOG-ni-tiv]. These are the mental processes that help us understand our thoughts, experiences, and our senses. Cognitive functions include things like memory, attention, comprehension, and problem-solving.
• Motor. Motor functions are the impulses that control movement. This function starts in your brain but also involves the central nervous system’s ability to relay those messages to the body.
• Behavioral. These are responses that are tied to emotional reactions or reinforcement. It can involve repetitive behaviors that are interfering with normal development, especially in children.
• Linguistic [ling-GWIS-tik]. This is the general use of language to interact with the world around you and to process information or communication needs.
• Executive. Executive functions are higher level functions that allow you to organize, plan, and act.

A neuropsychological evaluation can involve spending most of a day being interviewed and performing some pencil-and-paper or computer-based tasks. Afterwards, the activities are scored and compared to others of the same age and with a similar education level. The therapist will then send you and your doctor a detailed report assessing you cognitive, motor, behavioral, linguistic, and executive functioning strengths and weaknesses. The report will include recommendations for self-care, therapy, or referral to other healthcare providers.

A different type of evaluation is a psychological [sahy-kuh-LOJ-i-kuh l] evaluation, which is similar but focuses on psychological sources for problems, like depression and bipolar disorder.  By contrast, neuropsychological testing is used to look for problems in the central nervous system itself, such as Parkinson’s disease or ADHD (Attention Deficit Hyperactivity Disorder).

There are no particular risks or side effects with neuropsychological evaluations. However, because these evaluations involve a series of pen-and-paper tests, they may not be useful for children, adolescents, or adults with severe conditions. Those with symptoms of stroke, seizure, or severe dementia [dih-MEN-shuh] may not find neuropsychological evaluations useful, since the tests could be too hard to complete.

You should talk to your doctor if you or your child are experiencing severe symptoms of fatigue, inability to speak, or attention problems that would make the tests too hard. Depending on the results of the neuropsychological evaluation, additional testing such as blood tests, MRI or CT scans, or psychiatric [si-KAHY-uh-trik] testing may be needed to rule out other conditions or disorders.

Neuropsychological evaluations can be helpful for children, adolescents, and adults who have persistent cognitive or behavioral issues that are affecting their ability to sleep, eat, learn, and have relationships. Your doctor or your child’s doctor may recommend a neuropsychological evaluation if you or your child have one of the following conditions or triggering events:

• Head injury
• Failure to achieve a developmental milestone
• Psychiatric disorder
• Symptoms of dementia
• Problems with learning or paying attention
• Exposure to drugs or alcohol while in the womb
• Exposure to toxins
• Symptoms of stroke
• Neurogenerative [NOO-ro-jen-er-uh-tiv] disease (such as Parkinson’s disease)
• Cerebral palsy [ser-REE-bruhl PAWL-see]
• Genetic disorder (an inherited condition)
• Seizure disorder (such as epilepsy)

Your doctor will recommend a neuropsychological evaluation based on your age, how severe your symptoms are, your personal and family medical history, and your preferences.

Neuropsychological evaluations can take anywhere from 2 to 5 hours. If these types of activities leave you easily fatigued, you may want to ask a friend or family member to come with you to the appointment to offer support and drive you home. Your doctor will recommend that you bring a list of medications (including prescriptions, over-the-counter medicines, supplements, inhalers, liquid medicines, and patches) to your appointment. You will also need to bring information about your family and medical history and results of any imaging tests (such as MRIs or CT scans).

Neuropsychological exams should always be conducted by a trained, licensed neuropsychologist. Check with your insurance company before you schedule the appointment to ensure the evaluation will be covered by your insurance plan.

A neuropsychologist will likely ask you some questions and then administer a series of tests that make up a neuropsychological evaluation. These paper-and-pencil tests usually involve assessing:

• Brian function
• Attention and concentration
• Verbal and visual memory
• Hearing and visual processing
• Language and reading skills
• Spatial [SPEY-shuh l] skills
• Sensory development
• Social skills
• Executive function
• Emotional development

These tests are standardized and can take up anywhere from 2 to 5 hours, depending on your level of function and fatigue. If you have concerns about completing the tests in one sitting, talk with your neuropsychologist or doctor about dividing the tests into 2 sessions instead of 1.

Your neuropsychologist will talk with you about when to expect results from your exam. You may get some indication of the results directly following the exam, or your neuropsychologist may need more time to consult with your doctor or treatment team before providing any results.

Depending on the results of your neuropsychological exam, follow-up treatment may be needed for conditions or disorders identified within the nervous system. It may also be the case that additional testing is recommended if the neuropsychological exam did not identify the source of the functional problems you or your child are experiencing. Talk with your doctor or neuropsychologist about next steps in your treatment plan.