Neuropsychology

Neuropsychological Evaluations

Neuropsychological evaluations are typically requested specifically to help doctors and other professionals understand how the different areas and systems of the brain are working. Neuropsychological assessments are broader than traditional psychological or psychoeducational evaluations, and are often used to answer questions or resolve contradictions that remain after a more basic evaluation.

A neuropsychological evaluation typically assesses the following: general intellect; higher-level executive skills (e.g., sequencing, reasoning, problem solving); attention and concentration; learning and memory; language; visual-spatial skills (e.g., perception); motor and sensory skills; and mood and personality. Some abilities may be measured in more detail than others, depending on the specific situation.

The evaluation produces not only qualitative data about a person's neurological functioning, but it also provides objective benchmarks that allow comparisons to scores from people who are demographically similar. By using a database of scores from large groups of healthy people for comparison, a neuropsychologist can judge whether or not the scores are normal for the subject's age and educational background. The pattern of test scores can be reviewed to estimate whether or not there have been changes in certain abilities. How the subject goes about solving the various problems and answering questions during the examination will also be noted. These methods reveal a person's unique profile of strengths and weaknesses.

Neuropsychological assessment results can be used to understand an individual's situation in a number of ways:

• Testing can identify weaknesses in specific areas. It is very sensitive to mild memory and thinking problems that might not be obvious in other ways. When problems are very mild, testing may be the only way to detect them and formally identify them. Gifted individuals often perform at levels that require elevated skills, and subtle deficits and strengths can have a disproportionate effect when tasks are challenging.
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• Testing can also help determine whether memory changes are normal age-related changes or if they reflect a neurological disorder. Testing might also be used to identify problems related to medical conditions that can affect memory and thinking, such as medication side effects, diabetes, metabolic or infectious diseases, or alcoholism.
• Test results can also be used to help differentiate among illnesses, which is important because appropriate treatment depends on accurate diagnosis. Different illnesses result in different patterns of strengths and weaknesses on testing. Therefore, the results can be helpful in determining which areas of the brain might be involved and what illness might be operating. For instance, testing can help to differentiate between Alzheimer's disease, stroke, or depression. Depression can profoundly undermine cognitive performance and a gifted, depressed child may be excluded from gifted programs in error.
• Sometimes testing is used to establish a baseline, or document a person's skills before there is any problem, such as before a medication trial. In this way, later changes can be measured very objectively. For example, a perfectionistic, inattentive child may respond well to a stimulant medication or it may heighten anxiety and worsen performance.
• Test results can be used to plan treatments that utilize strengths to compensate for weaknesses. The results help to identify what target problems to work on and which strategies to use. For example, the results can help to monitor and rehabilitate the recovery of skills after a neurological injury or to help an individual who is twice exceptional develop strategies for working around an attention deficit or tendency to become overloaded by sensory stimuli.
• Studies have shown how scores on specific tests relate to everyday functional skills, such as managing money, driving, or readiness to return to work. This applies to individuals with injury, but it can also be used to document competence of exceptional ability that exceeds that of a person's age peers.

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