Our referrals come from a wide variety of sources:
Most of the referred children/adolescents have learning, attention or behavior difficulties that need further clarification in order to provide a more comprehensive treatment plan. Neuropsychological evaluations are diagnostic so that there is a better understanding of the causes of the learning, attention and behavior difficulties. School evaluations, in contrast, are not diagnostic (they are designed to determine if there is a need for special education services).
We also evaluate children/adolescents who have suffered some form of personal or physical trauma. For example, neuropsychological assessment might be useful if a child suffers a serious head injury or has witnessed a traumatic event.
Many adults initiate neuropsychological evaluation on their own or in consultation with a mental health professional or a physician. Many adults have concerns about relationship patterns or their work performance due to attention difficulties so they want clarification regarding the severity of the problem and its origin. When an adult has suffered a head injury or a stroke, it can be important to document changes in memory, attention and reasoning. Neuropsychological testing can also assist in identifying patterns of strengths and weaknesses that help to differentiate Alzheimer’s disease, stroke and depression (and assist with treatment recommendations).
Many school systems contract for our services in order to assist them with the identification of disabilities that qualify for an Individualized Educational Program (IEP). Usually, Special Education Directors fax a contract to our office, outlining the evaluations that are needed. Ms. Neulist can assist school systems that are unfamiliar with this process.
How Neuropsychological Evaluations Can Be Helpful
Neuropsychological evaluation can be helpful in understanding learning problems. Reading comprehension problems, for example, can stem from single-word decoding problems, language problems, and/or attention difficulties. Some attention and behavior difficulties require a clearer perspective. For example, although ADHD is the most common cause of attention difficulties, one can have attention problems due to anxiety, depression and learning problems also. Other common diagnostic puzzles include:
(1) social anxiety versus an autism-spectrum disorder
(3) general cognitive delay versus a learning disorder
(2) normal moodiness versus Bipolar Disorder
It can be important to identify the child/adolescent’s strengths. Particularly in older adolescents (and young adults), this can be useful in college and vocational decisions. Neuropsychological testing can be useful in identifying forms of mental health treatment that can be most effective in dealing with a specific set of behavioral difficulties. Child psychiatrists, pediatric neurologists and pediatricians use test findings to help guide medication choice and management. Testing can help to establish a “baseline” so that the effects of education, mental health and medication interventions can be assessed.
The Steps of The Evaluation
A comprehensive evaluation at our offices always begins with a parent or adult interview. At this interview, we discuss the presenting difficulties, the past history and what interventions have been attempted so far. We generally ask parents to complete behavioral questionnaires.
The testing schedule can depend on the complexity of the clinical questions that need to be answered (and the amount of testing required). A typical evaluation would consist of one 3 to 4 hour session.
There is a feedback session to go over the report and this usually takes place about two weeks after the final testing appointment.
What We Assess
Our evaluations are flexible so the assessment focus can be determined by the referral questions. There are ten possible areas:
- general intellectual ability
- language skills
- visual/constructive skills
- motor skills/processing speed
- organization/planning skills
- academic achievement
- emotional regulation
- social skills
What to Tell Your Child/Adolescent
It is usually best to keep the focus on how this will help the adults who are involved. For example, the evaluation will help teachers to understand his/her learning difficulty better, or the evaluation can guide the therapist to work more effectively.
Our evaluations typically cost $950 to $3500. Most of our evaluations are under contract with school systems. We accept health insurance on a limited basis (contact the office).